People at risk for suicide often exhibit warning signs. Identifying them and making referrals to a mental health professional can prevent suicidal behavior.
Restricting access to lethal means of suicide reduces attempts, and a number of prevention strategies have shown promising results. These include gatekeeper training, active screening for depression, CBT and DBT, individual psychodynamic therapy, and medication with antidepressants or ketamine.
1. Know the Signs
Adolescence can bring about major physical, social and emotional changes that may lead to feelings of overwhelming stress, hopelessness and inadequacy. It is important to know the warning signs and how to respond.
Talking about or thinking about suicide, expressing rage or anger, sleeping too little or too much and major changes in appetite are all serious issues that should not be ignored. Watching for self-isolation and an increased use of drugs or alcohol can also signal trouble.
Anyone who demonstrates these symptoms needs to be taken seriously. If they live in your home, reduce opportunities to act by removing pills (both over-the-counter and prescription) and firearms and locking them up. Seek help for them, even if it makes you feel uncomfortable or afraid.
2. Be Proactive
A variety of prevention strategies have been proven to reduce suicide risk, including creating safety plans, encouraging people in a suicidal crisis to talk about their feelings and reducing access to lethal means. This may include distributing gun safety locks, changing medication packaging, and removing potential weapons such as knives or razors.
Encourage people to get the expert help they need. This includes calling a crisis line and helping them find a mental health professional in their area. It also means supporting them in making positive lifestyle changes like getting plenty of sleep, eating a nutritious diet and staying physically active. Encourage them to avoid alcohol and drugs, which can exacerbate their symptoms. And if they are taking a prescription drug that can cause a dangerous side effect of suicidal ideation, make sure to monitor their behavior.
3. Encourage Positive Lifestyle Changes
Providing encouragement and support to help people in need can make a difference. Recommendations include saving the 988 Suicide & Crisis Lifeline number in their phone and encouraging them to get treatment (if they don’t already). Helping them build life skills, including problem-solving, coping, and stress management skills and increasing resilience, can reduce risk factors.
Removing potential means of suicide, such as firearms and large quantities of medication, also can be a life-saving measure. Encourage them to stay with their treatment plan and not skip therapy sessions or medication.
Research shows that being connected to a network of friends, family members, spiritual advisors or mental health professionals can be protective against suicide. Often, those who commit suicide feel alone and isolated. Help them stay connected to their community, by reducing isolation and offering social programs.
4. Make a Safety Plan
Creating a safety plan helps people recognize warning signs that may be indicators of an impending suicide crisis and provides a list of personal resources they can use to prevent or manage a crisis. Typically, a mental health professional will help create the plan with the person at risk, but it can also be created by friends or family members.
The plan will include contact information for a trusted friend or family member, the person’s doctor or therapist and local and national resources like the 988 Suicide & Crisis Lifeline. It will also include coping or distraction activities that the person can use to divert their attention away from thoughts of self-harm, such as journaling, exercising, listening to music, distracting themselves with hobbies or taking a hot bath.
5. Remove Potential Means
Suicide has a devastating impact on individuals, their families and friends, schools, communities and the economy. The financial toll, including lost productivity and value of life costs in 2020, is estimated at over $500 billion.
Personalized safety planning has been shown to reduce suicide risk, and removing or locking up pills, razors, knives and firearms is an important part of that plan. It’s a myth that someone who wants to kill themselves will find another way if they can’t get their hands on lethal means, and research has shown that method substitution often does not happen.
If you know or suspect that a person is at high risk for suicide, do everything possible to help them get the expert care they need. This can mean calling a crisis line or urging them to go to an emergency room.