Using a public health approach to suicide prevention, organizations and communities can prevent death by suicide. These strategies can include gatekeeper training, suicide screening, and identifying warning signs.
Listening without judgment is one way to help someone who is struggling with suicidal thoughts. It also helps to remove access to lethal objects and places, such as firearms or poisons.
Risk factors
Many risk factors at the personal, family, community, and societal level can increase a person’s chances of suicide. Similarly, a range of protective factors can reduce a person’s chance of suicide.
There is no single cause of suicide, but rather an interplay between background personal and family factors, current emotional state and recent significant life events, which lead to intolerable mental anguish that cannot be overcome. This often results in a fatal act of self-harm.
One widely used method to identify suicide risks is the psychological autopsy, an examination of a deceased person’s circumstances using standardised interviews with proxy informants and medical and coronial records. A review of 37 studies found that a number of risk factors were associated with suicide, including any mental disorder, previous suicide attempt, legal problems, relationship conflict, poor coping skills, and psychiatric illnesses. Among these, depression was the most common factor, and was present in 80% of suicides. Risk factors also included alcohol and drug abuse, social isolation, and low socioeconomic status.
Prevention strategies
There are a variety of prevention strategies to reduce suicide rates. These range from reducing access to lethal means to promoting life skills and resilience. However, there are limitations to these efforts. Small sample sizes, lack of replication studies and differences in study populations make it difficult to draw firm conclusions about the effectiveness of these methods.
There is some evidence that a combination of strategies is most effective. These include training gatekeepers such as primary care physicians in depression recognition; restricting means of suicide; and providing psychiatric hospital discharge and outreach services to vulnerable individuals, including those with a history of mental health conditions.
Another important step is to raise awareness about suicide prevention. This can be done by educating the public and establishing crisis hotlines. Additionally, a number of talking therapies have been shown to reduce suicidal thoughts and behaviors. These can be administered over the phone, in a group therapy setting or through one of many apps.
Interventions
Suicide is a complex problem that affects people from all walks of life, cultures and socioeconomic statuses. It can be prevented by understanding the risk factors and warning signs and providing support for those in crisis. It is also important to provide training for health care workers on how to recognize and respond to suicide risk.
Health care workers are at high risk for suicide because of long working hours, rotating and irregular shifts, emotionally difficult situations with patients and their families and routine exposure to death and suffering. In addition, they often have limited access to behavioral health services and may experience workplace stigma.
To help prevent suicide in the health care workforce, the AHA has developed a curated list of 12 evidence-informed interventions and associated metrics. These tools are designed to help hospitals and systems establish or expand suicide prevention programming. These efforts should include strategies to address the three resonant drivers of suicide among health care workers: stigma, limited access to treatment and job-related stressors.
Postvention
Schools need to be prepared to respond to a suicide attempt or death in a way that maximises protective factors and supports the community’s recovery. Schools should also be aware of the risk of a “copycat” suicide in their community.
Postvention is an intervention conducted after a suicide and focuses on the support for survivors of the suicide. The main objective is to alleviate the stress of survivors whose lives have been permanently altered by the event and help them cope with their loss.
Support for grieving individuals and communities includes providing emotional support, collective healing practices, and resource information. The support should address the complex grief reactions that may be experienced by survivors and should include cultural considerations. It should also avoid glamorising, sensationalising, or stigmatising suicide. Moreover, it should prevent suicide contagion by minimising exposure and promoting responsible media reporting. Moreover, it should reduce the likelihood of copycat suicides by performing biohazardous cleaning of the scenes of suicide attempts and deaths.