While suicide can’t be prevented entirely (a person who chooses to commit it decides on their own), there are ways we can reduce its prevalence.
Teaching people about risk factors and warning signs, reducing access to lethal means and expanding options for temporary assistance are among the best strategies.
Identifying People at Risk
Identifying people at risk of suicide is the first step in prevention. Gatekeeper training helps community members recognize those at risk and refer them for care. It also encourages safe storage of weapons and a home inventory of over-the-counter drugs that could be used to commit suicide.
Symptoms and other factors that predispose someone to consider or attempt suicide include depression, impulsive responses to stress, a history of abuse, and access to lethal means. Protective factors, such as a supportive community, healthy relationships, and internal coping skills help people avoid or recover from suicidal thoughts and behaviors.
Health care workers are at increased risk for suicide, based on the combination of difficult work conditions (long hours, rotating and irregular shifts), emotional difficulty with patients and their families, frequent exposure to death and suffering, and easy access to lethal means. The AMA’s comprehensive guide to suicide prevention for the health care workforce provides hospital and system leaders with ideas, tools, interventions, and metrics they can use to support their teams’ mental well-being and prevent suicide among them.
Teaching Warning Signs
Like teaching the public about CPR, teaching people to recognize warning signs and get help quickly is vital. Just as the prompt recognition of a scream from someone having a heart attack can prevent the need for emergency room visits and even psychiatric hospitalization, the early detection of suicidal thoughts, the opening of supportive dialogue, and the consultation of a mental health professional can often prevent suicide attempts altogether.
People who are thinking about suicide are often desperate, hopeless and feel powerless to change their circumstances. They may be suffering from an underlying mental illness or addiction, a serious chronic or painful medical condition; a major loss or painful life change; or experiencing extreme stress or trauma, such as violence, abuse or discrimination.
Warning signs include talking about or making plans for suicide, focusing on getting lethal means (guns, pills, etc.), withdrawing from friends and family, or displaying extreme mood swings (from rage to deep sadness). Suicide risk is higher when the behavior is new or has increased.
Supporting Those in Need
While some people may think it’s insensitive to ask someone who is considering suicide if they are, studies show that asking doesn’t increase suicidal thoughts or attempts. It’s important to talk openly and listen attentively. Anyone who is threatening to kill themselves should be taken seriously. It’s also important to remove lethal items such as guns, ropes and chemicals from access, especially in the home.
Gatekeeper training has been shown to be effective at reducing suicide rates. These individuals are those who can influence a person’s behavior on a regular basis and include family members, friends, teachers, military commanders and social workers.
Psychological resilience programs that teach coping and problem-solving skills, reduce stigma related to mental illness and increase access to help are other preventive measures. These are in addition to prevention strategies that focus on screening, means restriction and responsible media coverage. All of these strategies work together to help reduce suicide rates. They can be implemented individually, but a multimodal approach is essential to success.
Be Proactive
Many suicides occur in a context of high personal distress and hopelessness. The stigma surrounding mental illness and suicide means that people often fail to seek help.
Suicide can be prevented by educating people about the warning signs and where to get help. However, it is equally important to be proactive and support those who are at risk.
Those who are thinking about suicide often believe that they can’t be helped, so it is important to be more proactive in offering assistance. Rather than saying, “Call me if you need anything,” try to actively reach out, visiting or calling regularly.
Those who are thinking about suicide need to know that they can and do recover from these thoughts. It takes time, effort, and support from others, but most people who have thoughts of suicide move beyond them with treatment and resiliency. Emphasize hope and emphasize that there are other ways to cope with distressing thoughts, including resiliency-building activities, healthy lifestyle choices, and positive social connections.