Suicide prevention: What to look for and what to do

Suicide accounts for over 800,000 deaths globally each year. Furthermore, over 41,000 of these are in the U.S. alone. Also, suicide is the second leading cause of death worldwide for 15-29 year olds. Suicide is preventable in many cases, although it is tragic and often complex. Learning how to spot warning signs and what to do when you do spot them can help save lives.

Warning signs of suicidal behavior

If the below warning signs apply to you or someone you know, you should get help as soon as possible. This is particularly true if the behavior is new or has recently increased.

• Talking about wanting to die or wanting to kill themselves
• Talking about feeling empty, hopeless, or having no reason to live
• Making a plan or looking for a way to kill themselves, such as searching for lethal methods online, stockpiling pills, or buying a gun
• Talking about great guilt or shame
• Talking about feeling trapped or feeling that there are no solutions
• Feeling unbearable pain (emotional pain or physical pain)
• Talking about being a burden to others
• Using alcohol or drugs more often
• Acting anxious or agitated
• Withdrawing from family and friends
• Changing eating and/or sleeping habits
• Showing rage or talking about seeking revenge
• Taking great risks that could lead to death, such as driving extremely fast
• Talking or thinking about death often
• Displaying extreme mood swings, suddenly changing from very sad to very calm or happy
• Giving away important possessions
• Saying goodbye to friends and family
• Putting affairs in order, making a will

Risk factors

Suicide affects all races, genders, and age ranges. There is no single cause for suicidal behavior. Those that are most at risk to experience this behavior tend to have some characteristics in common. The main risk factors are:

• Depression, other mental disorders, or substance abuse disorder
• Certain medical conditions
• Chronic pain
• A prior suicide attempt
• Family history of a mental disorder or substance abuse
• History of suicide in the family
• Family violence, including physical or sexual abuse
• Having guns or other firearms in the home
• Recently released from prison or jail
• Being exposed to others' suicidal behavior, such as that of family members, peers, or celebrities

Identifying those at risk of suicide

Research has shown that a three-question screening tool can help emergency room personnel identify those at risk for suicide. Researchers found that screening all patients – regardless of the reason for their emergency room visit – doubled the number of patients identified as being at risk for suicide. The researchers estimated that suicide-risk screening tools could identify more than three million additional adults at risk for suicide each year.

Another method to identify those that may be at risk for suicide is to examine their electronic health records. Researchers from NIMH partnered with the VA and others to develop computer programs that could help predict suicide risk among veterans receiving VA health care. Other healthcare systems are beginning to use data from electronic health records to help identify people with suicide risk as well.

How to help someone in a crisis

There are various ways professionals can help an individual experiencing a mental health crisis but it is also important for individuals to know what to do before connecting someone with professional help. We previously discussed Mental Health First Aid but there are also some additional steps that you can take specifically for suicidal individuals. The 5 steps are:

1. ASK: "Are you thinking about killing yourself?" Although this can be a very difficult question to ask, studies have shown that asking at-risk people does no increase suicides or suicidal thoughts.
2. KEEP THEM SAFE: It is important in suicidal prevention to limit the persons access to lethal items or places during this period. This can be difficult to do but if the suicidal person has a plan, removing a key piece of it can make a difference.
3. BE THERE: Listen carefully to what the individual is feeling and thinking.
4. HELP THEM CONNECT: You can help the individual get in contact with a family member, friend, or mental health professional. If you don't know who to call you can always dial the National Suicide Prevention Lifeline at 1-800-273-TALK(8255). You can also text 741741 and contact the Crisis Text Line.
5. STAY CONNECTED: Following-up with an at-risk person after they are discharged from care can make a difference.

Therapies and treatments

Various types of psycho-social  methods have been shown to help individuals who exhibit suicidal behavior.

Cognitive behavioral therapy is something we have spoken about in the past here. This method of therapy helps individuals find new ways of dealing with stressful experiences through training. CBT allows people to identify their thought patterns and try to consider alternative actions.

Dialectical behavior therapy as also been shown to reduce suicidal behavior in adolescents. This form of therapy teaches an individual to recognize when their feelings or actions are disruptive or unhealthy, and teaches skills needed to deal with upsetting situations better.

Some individuals at risk for suicide might benefit from medication. Doctors and patients can work together to find the best medication or medication combination, as well as the right dose. Because many individuals at risk for suicide often have a mental illness and substance use problems, individuals might benefit from medication along with psycho-social intervention.

Collaborative care is also an important aspect of treating a patient with suicidal behavior. Collaborative care stresses the importance of an individuals primary care physician, mental health physician and a care manager to work together to create an appropriate treatment plan. The collaborative care group will stay in contact to follow-up on the treatment plan to make sure it is working for you.

About Talkiatry

Talkiatry is a local, accessible and complete mental healthcare solution that accepts insurance. We close the gap for individuals who want to get better, but feel that mental health care has been challenging to navigate up until this point and want a more convenient way to take the first step. Talkiatry takes the traditional local mental health visit and combines it with technology, scale, efficiency, and design to provide the best possible environment for healing.

‍

Talkiatry is a mental health practice, and our clinicians review everything we write. However, articles are never a substitute for professional medical advice, diagnosis, or treatment. If you think you may need mental health help, talk to a psychiatrist. If you or someone you know may be in danger, call 911 or the National Suicide and Crisis Lifeline at 988 right away.