Things You Should Know About Suicide

According to the World Health Organization, approximately 700,000 people die by suicide each year and it is the fourth leading cause of death among 15–29-year-olds worldwide.

It's a huge and complex global public health issue, and most experts agree that suicide deaths occur for many different reasons and are the result of a complex interplay between many different risk and protective factors (which change over time).

Still, there are a lot of myths about it.

Our goal today is to debunk some of these myths, and provide an evidence-based approach to helping people (perhaps including yourself) dealing with thoughts about suicide.

This content should not be used as a substitute for professional mental health treatment. This content is designed for educational purposes. If you feel you may be suicidal, we strongly advise you to see a counselor, therapist, psychiatrist, or other appropriate professional right away.

The resources listed at the end of this email can assist you in finding help.

Myths and facts about suicide

Myth #1: Asking about suicide makes somebody suicidal.

There are now many studies showing the opposite. People who are exposed to suicide-related content (e.g., questions about whether they have ever experienced suicidal thoughts) experienced reduced suicidal ideation and lowered the likelihood that the individual would later engage in suicidal behaviors (e.g., suicide attempt, non-suicidal self-injury). Similarly, asking persons with depression if they are having thoughts of suicide can reduce depressive symptoms in some cases. Lastly, some individuals at risk for suicide tend to experience less suicidal thoughts when they were assessed for risk.

Myth #2: If somebody really wants to kill themselves, nothing will stop them.

There have been several large, population-level studies that have found a similar pattern – most people (about 90%) who attempt suicide and live do not go on to die of suicide. Further, these studies also indicate that most people who attempt suicide and live, do not make another attempt (about 75%).

Myth #3: There is nothing we can do to help a person at risk for suicide.

Research supports several interventions and treatments that help reduce suicide risk. Limiting access to lethal methods for suicidal individuals (especially firearms) shows a strong association with reducing suicide deaths. There are also many well-researched psychotherapeutic treatments that may reduce the risk of suicide, such as Brief Cognitive Behavioral Therapy (B-CBT) and Dialectical Behavioral Therapy (DBT). Further, there are also quick interventions, such as Safety Plans (more on this later) that have been found to reduce suicide risk.

What do we actually know about suicide prevention?

There are well-researched, modern theories of suicide that agree on a general model for understanding why many people die of suicide. These theories include (but are not limited to) the Three-Step Theory (3ST) and the Interpersonal Theory of Suicide (ITS); often referred collectively as ideation-to-action frameworks.

This picture shows the general overlapping principles of ideation-to-action frameworks (i.e., both 3ST and ITS models) that help describe why many people die by suicide.

No single risk factor can accurately predict who will die of suicide. This is because suicide risk is the result of a complex, dynamic interaction between a multitude of fluctuating risk and protective factors, so it is important to treat suicide risk with the utmost seriousness.

Although no single risk factor can accurately predict who will die of suicide, there are some risk factors that have been identified that appear to put people at higher risk than others:

Alienation/withdrawal
Disconnectedness
Loneliness
Believing they are a burden to others
Hopelessness
Some mental disorders (e.g., depression, ADHD, panic disorder, PTSD, bipolar disorder)

These are risk factors that, in combination with the risk factors noted above, create high-risk conditions.

For example, having access to lethal means by itself does not make someone want to die, but someone with suicidal thoughts who also has access to lethal means is at higher risk than someone with suicidal thoughts without access to lethal means.

How do you help someone with suicidal thoughts?

Suicidal crises (when people are actively deciding whether to go through with suicide) appear to usually be very brief. Thus, getting people through the day (or even the hour) can save lives.

One simple intervention that has been found to reduce suicide risk is called a Safety Plan.

Safety plans are often used by clinicians, doctors, and other health professionals to help people get through a suicidal crisis - a highly stressful, emotional period when someone may consider attempting suicide. You can use a safety plan to help someone else or to help yourself.

A safety plan involves the following steps in advance of being acutely suicidal, so that you have a concrete plan of what to do if you're feeling suicidal:

1. Recognize Warning Signs. What are some warning signs (e.g., thoughts, images, behaviors) that a suicidal crisis may be developing? List two or three warning signs. If you can't imagine warning signs for a crisis, try imagining warning signs for a strong, negative emotional reaction. Example: When I start to think that my family would be better off without me.

2. Consider Independent Coping Strategies. What can you do to take your mind off your problems without contacting another person? Examples: Deep breathing, or playing video games.

3. Find Social Settings That Provide Distraction. If these coping strategies haven't worked after a few minutes, that's okay - let's move on to something else. Who are some people you would feel comfortable talking to/calling that could distract you? What social settings could you move to (e.g., a coffee shop, library) to help distract yourself? Generate two or more people or locations (write down telephone numbers if available). Example: Bryan Bower (111) 111-1111, or Vasa Park (the busy park by my house).

4. Consider Contacts to Ask For Help. Who are some people you can call to ask for help? These are people you feel comfortable talking to about what is going on, the difficulties you are having, etc. Provide two or three people you could call (e.g., close friends, family members, spouse/partner) and their phone numbers if available. Example: Sister (Jane) (111) 111-1111.

5. Contact Mental Health Professionals and Organizations. If you are seeing a clinician (e.g., psychologist, psychiatrist, counselor/therapist), write their name(s) and phone number(s). Also, list an urgent care center (e.g., hospital emergency room) address and phone number. If you live in the U.S., write down the National Suicide Prevention Lifeline phone number (1-800-273-8255) if these are not currently available. Example: Dr. Cromarty, (111) 111-1111.

6. Make the environment safer. List one or two ways you could make your environment safer (e.g., have someone temporarily hold onto your firearms/lock up firearms and store ammunition separately, remove sharp objects from being easily accessible, or remove medicines that could be lethal if taken in large doses). Example: Temporarily give my firearms to my best friend.

If you would like to build a safety plan and receive a copy of it by email, plus explore more resources and some coping skills to deal with thoughts about suicide, we encourage you to try our free, 30-minute mini-course:

Mini-Course: What You Need To Know About Suicide

This mini-course was written by Brian W. Bauer as part of our 2020 Micro Grants, and it was checked by mental health experts. Please keep in mind that it's not intended to be used as a substitute for professional treatment.

More resources

Here are some other reliable resources and information about suicide that you or someone you know may find helpful.

The National Suicide Prevention Lifeline (1-800-273-8255). A US-based service that provides 24/7, free and confidential support for people in distress. This also provides prevention and crisis resources for the caller, their loved ones, as well as information on best practices for professionals.
ReThink.Org A UK-based service that provides information and education about mental health symptoms, provides crisis and recovery services, as well as information and local resources.
SuicideCallBackService An AUS-based, nationwide service that provides professional 24/7 telephone and online counseling to people who are affected by suicide. This site is designed to help those feeling suicidal, those who are worried about someone who is suicidal, and those who have lost someone to suicide.

We hope you find this information useful. Talking about suicide can be uncomfortable, but it's also a way to bring awareness to this major public health issue. As the World Health Organization puts it:

"Stigma, particularly surrounding mental disorders and suicide, means many people thinking of taking their own life or who have attempted suicide are not seeking help and are therefore not getting the help they need. The prevention of suicide has not been adequately addressed due to a lack of awareness of suicide as a major public health problem and the taboo in many societies to openly discuss it. To date, only a few countries have included suicide prevention among their health priorities and only 38 countries report having a national suicide prevention strategy."

World Health Organization Overview on Suicide

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