Suicide can be prevented by addressing risk factors at the individual, community and system levels. Warning signs can help to identify individuals at risk, and reducing access to lethal means reduces the incidence of suicide.
How we talk about, write about and report on suicide matters. It’s important not to sensationalize or glamorize the issue.
Identifying Risk Factors
Suicide prevention efforts must take into account the complex set of risk factors and protective factors that play a role. Risk factors include a range of health conditions, such as mental illness (especially depression), substance use and abuse, and physical illness; environmental stresses, such as prolonged financial pressures or major life changes or losses, like the death of a loved one; and social circumstances, including stigma and a taboo against seeking help and access to care.
Warning signs that someone is at risk for suicide include explicit talk about wanting to die, a loss of interest in activities and friendships, and isolation. Extreme mood swings and a perception of unendurable pain or feeling trapped are also signs to watch for. A history of suicide in the family or in their own personal life and easy access to lethal means are also important risk factors. Protective factors include a sense of hope, strong connections with friends and others, good problem-solving skills, and cultural and religious beliefs that discourage suicide and support self-preservation.
Educating the Public
Suicide is a complex and tragic event that affects people of all ages. Educating the public about warning signs and risk factors may help to prevent suicide.
Education and outreach are especially important in communities that are exposed to high levels of suicides. Reducing the stigma associated with mental illness and encouraging people to seek treatment may encourage individuals at risk of suicide to reach out for help. Changing the way that mental health issues are portrayed in popular culture is another long-term strategy for suicide prevention.
School health educators and pupil services professionals are often the only individuals in schools who are trained to educate students about suicide prevention. A well-developed suicide prevention curriculum that is coordinated with classroom educational programming may be particularly effective. Talking openly about suicide and teaching students to identify the warning signs may help reduce student stress. Giving trigger warnings when the topic is discussed can be beneficial as well.
Providing Support to Individuals at Risk
A suicide attempt or death is often the result of a “tipping point” in which an individual feels overwhelmed and can’t see a way out. Stressful events, the loss of a job or relationship, substance abuse and mental illness can all contribute to suicidal feelings.
Providing people at risk with appropriate treatment and support can help to prevent suicide. Psychotherapy such as cognitive behavioral therapy and dialectical behavior therapy can teach individuals to recognize ineffective patterns of thinking, improve their coping skills and increase resilience. Pharmacotherapy for psychiatric disorders such as depression and bipolar disorder can also reduce suicidal symptoms.
Crisis services are another key element of a comprehensive approach to suicide prevention. These include hotlines, walk-in crisis clinics and hospital-based psychiatric emergency services. These services can evaluate and stabilize people at risk and provide referrals for ongoing care. They can also help to educate the community about risk factors and warning signs. Training gatekeepers such as family members, friends and authority figures (like school staff and military commanders) on how to recognize warning signs and make timely referrals is important.
Developing a Comprehensive Public Health Approach
In addition to addressing individual risk factors, suicide prevention efforts should focus on the underlying social and environmental conditions that produce them. Efforts that address these factors, such as fostering connectedness and providing economic support to vulnerable populations, can help prevent suicide.
Efforts that expand access to mental health services, especially among those who have difficulty seeking it due to stigma or logistical barriers, are important to decreasing suicide rates. Screening, Brief Intervention and Referral to Treatment (SBIRT) programs in primary care settings, and outreach campaigns that target a variety of audiences, are examples of such strategies.
Communities and government agencies should also work to reduce the barriers that often prevent individuals from seeking assistance or finding help, such as a lack of awareness about services, difficulties obtaining healthcare coverage and concerns relating to confidentiality. Such programs should include teaching coping skills and reducing the availability of lethal means. They should also consider supporting military service members and veterans by addressing their unique risks, including concerns about maintaining security clearances and the impact on careers.