Preventing suicide requires the work of psychiatrists, emergency room physicians, social workers, teachers, pediatricians and many other professionals. Psychotherapy, such as cognitive behavioral therapy and dialectical behavior therapy, can help people understand their feelings and improve coping skills.
Reducing access to highly lethal items and places is an important part of preventing suicide. Even simple follow-up contact interventions, such as sending a caring postcard, have been shown to reduce suicide attempts and suicide ideation.
Identifying People at Risk
Suicide is often complicated and tragic, but it can be preventable. It is important to learn the warning signs and how to respond when someone is at risk.
A person is at risk for suicide if they talk about killing or harming themselves, have a history of depression or bipolar disorder, are drug dependent, have a family history of suicide or attempted suicide, or feel hopeless. They may also be at higher risk if they are bullied or have a close friend who committed suicide.
Identifying people who are at risk and connecting them to care is critical for suicide prevention. This includes suicide screening, gatekeeper training, and teaching warning signs. It also includes providing access to crisis services that provide evaluation, treatment and support for people in emotional distress. This can include mobile crisis teams, walk-in crisis clinics and hospital-based psychiatric emergency services. It can also include peer support programs and outreach initiatives that promote help-seeking.
Helping People Build Life Skills
Suicide is a complex and widespread issue that affects all parts of society. The best way to help is by identifying people who are at risk, connecting them with care and supporting them to get better. This includes reducing stigma and raising awareness of mental disorders and suicide.
People who are at increased risk of suicide include those with depression or other mental health conditions, those who have attempted suicide before and those who use alcohol or drugs. Some groups are at higher risk than others, including young people who identify as lesbian, gay or bisexual, and those living in rural areas.
It is important to recognise when someone is at risk and talk about it in a non-threatening, nonjudgmental way. Encourage them to call a crisis line or their GP, and to remove any potential means of self-harm (for example, pills, knives and razors). Support them in making a safety plan, and keep in contact with them. Studies show that ongoing, supportive follow up reduces suicide rates.
Helping People Build Resilience
Resilience can’t make stress or traumatic experiences go away, but it can help people better manage them. People who are resilient have more healthy coping strategies and a greater sense of life satisfaction.
One thing that helps build resilience is feeling connected to a community and having a sense of purpose. This can be accomplished by volunteering, being a mentor, or participating in school activities such as the musical. This can give young people the message that their efforts and accomplishments matter to others and that there is hope for a bright future even in the darkest of times.
Reading books or watching movies that tell stories of how other people cope with trauma or setbacks can help. So can meditating and spiritual practices, like prayer. Getting enough sleep and exercising are also important. And, if needed, the suicide prevention hotline can provide immediate support and connect people to care. This number is available 24/7 in the United States and connects people with trained crisis workers who are specially trained to assist with suicidal thoughts.
Connecting People to Care
Increasing a person’s connectedness to others and limiting isolation have been identified as protective factors against suicide. Connectivity can be promoted through community-based education, skill-building classes and encouraging attendance at social events or volunteerism.
Continuity of care is a critical component in reducing suicide risk. Tools and practices that support continuity of care include formal referral protocols, interagency agreements, cross-training and follow-up contacts.
Reducing access to lethal means is another important strategy for preventing suicide. NIMH-supported research shows that when people at high risk limit their access to highly lethal methods (e.g., firearms), suicide attempts often decline. In addition, studies show that method substitution frequently occurs when lethal means are restricted and can be a signal of increased suicide risk.
Hospital and health system trustees can help raise awareness about the importance of promoting connection by advocating for a gatekeeper training program, such as ASIST, and providing resources for a board-led discussion on suicide prevention. AHA Trustee Services and the Behavioral Health team have developed a useful resource to initiate this discussion.