The prevalence of suicide is increasing at an alarming rate. The Suicide Prevention Resource Center reports that in 2016, among Americans ages 18 and older:

• 9.8 million adults had serious thoughts of suicide
• 2.8 million made suicide plans
• 1.3 million attempted suicide

Suicidal thoughts most often occur when stressors and mental health issues merge to create feelings of hopelessness and despair and the inability to cope. In most cases, suicidal thoughts are about wanting the pain to stop or for the feelings of hopelessness to go away. It is important to keep in mind that suicidal thinking is usually associated with problems that can be treated, or situations that are temporary.

Contributors to Suicidal Thinking

There is no single cause that can provoke suicidal thoughts, and not everyone responds the same way to stressors and mental health challenges. However, research indicates the following factors, individually or in combination, are common contributors to suicidal ideation:

• mental health issues
• substance use
• family history of suicide
• chronic stressors with no relief in sight
• losing hope
• significant loss
• low self-esteem
• loss of employment or underemployment
• relationship issues
• death of a loved one
• unbearable emotional or physical pain

NOTE: This list is not exhaustive. Seek guidance and help if you believe someone is suicidal even when you aren’t aware of any of these contributors.

Common Signs of Suicidal Risk

How do you know if someone is suicidal? There are behaviors and signs that may indicate that someone is experiencing a suicidal crisis.

• Talking about suicide – Any talk about suicide, dying, or self-harm, such as “I’d be better off dead.”
• Looking for ways to kill oneself – Seeking access to guns, pills, knives, or other objects that could be used in a suicide attempt.
• Preoccupation with death – Unusual focus on death, dying, or violence; writing poems or stories about death.
• No hope for the future – Feelings of helplessness, hopelessness, and being trapped (“There’s no way out”); a belief that things will never get better or change.
• Self-loathing, self-hatred – Feelings of worthlessness, guilt, shame, and self-hatred; feeling like a burden (“Everyone would be better off without me”).
• Saying goodbye – Unusual or unexpected visits or calls to family and friends; saying goodbye to people as if they won’t be seen again.
• Withdrawing from others – Withdrawing from friends and family, increasing social isolation, desire to be left alone.
• Self-destructive behavior – Taking unnecessary risks as if they have a “death wish”, for example: increased alcohol or drug use, reckless driving, unsafe sex.

Preventing Suicide

The good news is that, in most cases, suicide is preventable. Effective suicide prevention includes education, treatment, and research.

Suicide prevention is much more than a training that you attend, or an article that you read. Suicide prevention requires action – intentional and purposeful action. Some of the most effective resources for those contemplating suicide or others who are concerned for someone who is exhibiting behaviors associated with suicidal ideation are suicide prevention hotlines. The Los Angeles Times reports that when the group Logic’s song “1-800-273-8255” was released in April 2017, the National Suicide Prevention Lifeline received 4,573 hotline calls that day, their second highest call volume in history. According to John Draper, director of the National Suicide Prevention Lifeline, calls have increased by 30% to 50% thanks to the increased awareness spread by the video, which prominently features the lifeline’s number and emphasizes the concept, “You are not alone.” Education makes a difference.

When you observe a loved one, friend or co-worker struggling, it’s okay to express your concern by saying: “I have been concerned about you lately.” Or, “Recently, I have noticed some differences in you and wondered how you are doing.” Or, “I wanted to check in with you because you haven’t seemed yourself lately.”

If you think someone you know is considering suicide, then ask them. It is a myth that asking someone about having suicidal thoughts will result in that person attempting suicide. In fact, just the opposite is true. People who are in distress and experiencing suicidal thoughts are often relieved to talk to somebody about it. If they express that they are having thoughts of wanting to hurt themselves, here are some helpful responses:

• I’m happy that you are talking to me
• I’m sorry you are struggling
• I want to stay with you until we can get you someone to talk to
• Help is available
• How can I help you?
• What is going on that makes you think about dying?

Be Prepared to Take Action

• Ask direct questions.
• Find out if the person has worked out a suicide plan. A person who has developed or considered a plan is at much greater risk of committing suicide.
• If the danger for self-harm is imminent, call 911 right away.
• Urge the person to call the EAP, the suicide hotline or medical doctor right away.
• If he or she is unable to seek help, offer to make the arrangements.
• Stay with the person until arrangements for care have been made.

Seeking help for a suicidal person is the best way to demonstrate that there is hope. Your concern can make a difference.