Suicide Prevention, Support, and Healing Strategies

Suicide is a tragic form of death that affects hundreds of thousands of families yearly around the globe. Families facing loss by suicide are often left with grief, trauma, and unanswered questions. While the reasons behind suicide are complex and frequently misunderstood, it is often preventable. Lives can be saved with the right interventions, support, and education.

In this article, we will explore suicide risk factors, warning signs, and prevention strategies and discuss mental health treatment, coping strategies, and support for those affected by suicide.

Understanding Suicide

Suicide is defined as death caused by self-injury with intent to die as a result of the injury.^[1]

Each year, 726,000 people take their own lives, and a further 1,6 million attempt to take their own lives worldwide, which placed suicide in the top 20 causes of death in 2021^[3][2][4]. Each person who takes their life is a tragedy that affects families and communities for generations to come. Suicide is common throughout all age groups but was the third leading cause of death among 15–29-year-olds globally in 202.^[2]

While suicide is prevalent worldwide, over 77% of suicides have occurred in lower-income countries^[5]. Because of these alarming statistics, suicide has been classified as a serious public health concern that requires an urgent public health response. Suicides can be prevented through fast and often affordable interventions. For national efforts to be successful, an extensive, multisectoral strategy must be implemented for suicide prevention.^[2]

Suicide Risk Factors

A range of individual, relationship or family, community, and societal risk factors can increase an individual’s risk for suicide.^[6] Here are some of the main risk factors associated with suicide and suicide attempts:

Individual Risk Factors

• Being between the ages of 10-14 years old or older than 75.
• Military veterans.
• Previous suicide attempt.
• History of depression, bipolar disorder, Schizophrenia, or other mental health disorders.
• Violence victimization and/or perpetration.
• Aggressive tendencies.
• Substance use, such as drugs or alcohol.
• An illness like chronic pain.
• A stigmatized disease like HIV/AIDS.
• Job/financial problems or loss.
• Current or history of abuse.

Relationship or Family Risk Factors

• Suicide in the family or previous relationship.
• Relationship stress/ending, such as a divorce.
• High-conflict relationships.
• Abuse in a relationship.
• Isolation.
• Identifying as part of the LGBTQIA+ community.

Community Risk Factors

• Lack of access to healthcare.
• A history of multiple suicides in a community.
• Community violence.
• Discrimination within a community.

Societal Risk Factors

• Criminal/legal issues.
• Stigma towards those seeking help.
• Easy access to means of suicide.
• Unsafe media portrayals of suicide.
• Bullying or prolonged stress.

Suicide Warning Signs

Knowing the signs of suicidal ideation in friends, partners, and family members (especially those who are at-risk) is important in avoiding a preventable suicide and helping identify when someone may be contemplating suicide.^[7] It is important to note that not all people display warning signs before attempting to take their own life, so if you have lost someone you love due to suicide, don‘t spend time thinking about the possibility of missed signs. Some of the warning signs of a suicide attempt may include:

Talking About:

• A fascination with death.
• Researching death and ways to die.
• Making specific plans to commit suicide.
• Other’s lives being better without them.

Feelings Of:

• Unbearable pain.
• Hopeless, worthless, or being trapped.
• Guilt, shame, agitation, or anger.
• Burdening others.

Changes in Behavior or Mood:

• Increased alcohol or drug use.
• Losing interest in hygiene.
• Changes to personal appearance.
• Withdrawing from loved ones.
• Saying goodbye to loved ones.
• Giving away important or meaningful possessions.
• A recent episode of emotional distress.
• Changes in sleeping patterns.
• Eating more or less.
• Extreme mood swings.
• Increased anxiety.
• Becoming violent.
• Recklessness.

Suicide Prevention

Suicide is a preventable form of death, and much can be done to prevent suicide and suicide attempts at individual, community, and a national level.

Individual Response To Suicide Prevention

Almost anyone can be supported through a suicidal crisis with the right help, such as a listening ear, someone who takes them seriously, and someone who helps them express their feelings. While many people contemplating suicide may feel hopeless, they often do not want to die. Instead, they are searching for a way to cope with the pain they are experiencing and someone to lean on during moments of fear and despair.^[8]

An individual can assist someone who is considering suicide by:

• Recognizing warning signs and seeking urgent help.
• Treating suicidal statements with seriousness.
• Encouraging the person to seek professional help.
• Ask the person directly if they are suicidal.
• Not leaving a suicidal person alone.

Community Response To Suicide Prevention

Each community member can play a role in preventing suicide. Members of the broader community can learn to identify suicide warning signs and provide at-risk individuals with resources.

In rural communities, community members should engage in suicide prevention training. Certain groups play an important role in suicide prevention and should receive appropriate training. These groups include members of law enforcement, first responders, gun shop owners, motel staff, religious leaders, and personnel from community-based programs.^[9]

National Response To Suicide Prevention

The World Health Organization suggests four effective, evidence-based interventions that should be included in every national response to suicide:

1. Limit access to methods of suicide.
2. Engage with the media to promote responsible suicide reporting.
3. Develop socio-emotional life skills in adolescents.
4. Promptly identify, assess, manage, and provide follow-up care for individuals affected by suicidal behaviors.^[10]

The Role of Mental Health Treatment in Preventing Suicide

Suicide prevention is defined as a collection of interventions used to reduce an individual’s risk of suicide.^[11] Suicide can be prevented by knowing how to identify the risk factors and recognizing the warning signs. Suicide is known to be linked to mental disorders such as depression and substance or alcohol use disorders. The most at-risk person for suicide is someone who has had a previous suicide attempt.^[12]

The following interventions can help in the fight to prevent suicide:

Psychological Counseling:

Several types of psychotherapies are successful in preventing suicide. One such therapy is dialectical behavior therapy (DBT), which has been shown to reduce suicide attempts and hospital admissions for suicidal thoughts. Another is cognitive behavioral therapy for suicide prevention (CBT-SP), which is a form of cognitive therapy that’s been adapted for at-risk adolescents and has been found to help improve problem-solving and coping.^[13]

Crisis Hotlines and Associations

Crisis hotlines can connect a person in distress to immediate help. One study of the effectiveness of crisis hotlines found that those who used them reported a decrease in psychological pain, hopelessness, and suicidal thoughts. However, suicidal thoughts did not decrease long-term.^[14]

Improving Physical Health

One study on major depression found that it is caused by several lifestyle factors, amongst others. Diet, exercise, and sleep are examples of lifestyle influences that play an important role in the development, progression, and treatment of depression and, by extension, suicide prevention.^[15]

Medication

Antidepressant medication has been associated with a decreased risk of suicide. Antipsychotic drugs are another type of medication that can be used to prevent suicide. One study found that treatment with antipsychotics is effective in preventing suicide attempts in patients with schizophrenia and schizoaffective disorder at high risk of suicide. Providing at-risk individuals who also misuse substances with specific treatments for chemical dependence may reduce their risk of suicide in a person with substance use disorder.^[16]

How to Support

The National Institute for Mental Health suggests the following five steps to support a person who may be considering suicide:^[18]

1. Ask: “Are You Suicidal?”
   While this question is not easy, it can help start a conversation. Studies have found that asking people if they are suicidal does not increase suicidal behavior or thoughts.^[19]
2. Be There:
   Listening without judging is important for learning what the person thinks and feels. Research has shown that talking about suicide may reduce suicidal thoughts.^[20]
3. Keep The Person Safe:
   Removing any items that may be lethal and avoiding dangerous places can help prevent suicide. Talking to a suicidal individual about their plan can help the person stay safe when they are experiencing suicidal thoughts.
4. Help Them Find Help:
   Connecting the person with a suicide hotline or other resources can provide a safety net and prevent suicide.
5. Follow Up:
   Make sure to stay in touch with the suicidal individual to prevent a future suicide attempt. Studies have found that supportive contact is important in suicide prevention.^[21]

How to Cope After a Suicide Attempt

Individuals who have attempted suicide may feel raw, numb, and emotionally drained in the wake of this crisis. Although it may seem difficult, it is possible to find hope after attempting suicide. Here are some things one can do to cope after a suicide attempt:

Practice Self-Care

People can and do heal from a suicide attempt, and while people who have attempted suicide have factors in common, each person’s journey is unique. Healing both physically and emotionally takes time. After a suicide attempt, the person should take time to care for themselves, ensuring that they engage in activities that provide an outlet for stress and promote well-being, such as getting enough rest, eating well, doing exercise, and doing enjoyable activities.^[22]

Reach Out

Although it may feel that way, silence is not a strength. Those who have attempted suicide and are recovering should find a safe and trusted space to share their experience and help to move forward. This type of support can be found in a family member or friend, a therapist, or a support group.^[23]

Create a Crisis Plan

An at-risk person should have a plan in place for when they feel suicidal or in crisis. This plan is typically a step-by-step process until the individual feels safe. It can include a list of things to distract them from negative thoughts, details of getting themselves to a secure environment, and safe people who can provide support.^[24]

Supporting Those Affected by Suicide Loss

Supporting those affected by suicide loss can be difficult, and it is often hard to know what to say or do.

It is important to talk to a person who has experienced a loss due to suicide(when they are ready to talk about it) and offer condolences for their loss. Support them without judgment and consider that they may be experiencing intense and conflicting emotions. Listen actively and have some grief support resources available to them.^[25]

Supporting friends and family after a suicide can be challenging, especially if the supporter is also grieving. It’s important for them to focus on their mental health during this time.^[26]

Crisis Resources and Hotlines

If you or someone you know is suicidal, please seek immediate help. The following resources can be used for someone who is experiencing a crisis:

Australia

• National emergency number: 000
• Lifeline Australia – Dial 13 11 14 for 24/7 crisis support, Text 0477 13 11 14 for 24/7 text support

Canada

• National emergency number: 911
• Talk Suicide Canada – Dial 1-833-456-4566 for 24/7 crisis support, Text 45645 for text support; available 4 pm to midnight ET
• In Quebec – Dial 1-866-APPELLE (277-3553) for 24/7 crisis support, and Text 535353 for 24/7 text support. For 24/7 chat support, visit suicide.ca
• Kids Help Phone – 24/7 text support: Text CONNECT to 686868

France

• National emergency number: 112
• National suicide prevention number: 3114
• 24/7 crisis support; visit 3114.fr to learn more
• Suicide Écoute – Dial 01 45 39 40 00 for 24/7 crisis support
• SOS Suicide Phénix – Dial 01 40 44 46 45 for phone support between 1 pm and 11 pm Central European Time

Germany

• National emergency number: 112 (EU emergency number), 110 for police
• TelefonSeelsorge – Dial 0800 111 0 111 or 0800 111 0 222 for 24/7 crisis support. For chat or email support, visit TelefonSeelsorge’s website

Ireland

• National emergency number: 112 or 999
• The Samaritans – Dial 116 123 for 24/7 mental health support
• Mental Health Ireland – Text About It. For 24/7 text support, text 50808. On smaller phone networks (such as An Post or 48), text HELLO to 0861800280

New Zealand

• National emergency number: 111
• National mental health and addiction hotline: 1737
• Can be reached by phone or text; learn more at 1737.org.nz
• Lifeline Aotearoa – Dial 0800 543 354 for 24/7 crisis support, Dial 0508 828 865 for the suicide crisis helpline, Text HELP to 4357 for 24/7 text support

South Africa

• National emergency numbers: 10111 (police) or 10177 (ambulance)
• South African Depression and Anxiety Group – Dial 0800 567 567 for 24/7 crisis support

United Kingdom

• National emergency number: 999 or 112
• The Samaritans – Dial 116 123 for 24/7 mental health support
• Campaign Against Living Miserably (CALM) – Dial 0800 58 58 58 for crisis support; available between 5 pm and midnight, BST or
• GMT – Visit thecalmzone.net to access chat support. Text SHOUT to 85258 for 24/7 text support

United States

• National emergency number: 911
• Suicide and Crisis Lifeline: 988 – Accessible by phone or text, 24/7 support in English or Spanish, 24/7 support for deaf or hard-of-hearing individuals; learn more at 988lifeline.org. For TTY Users: Use your preferred relay service or dial 711 then 988. Online chat: Visit 988lifeline.org
• Crisis Text Line – 24/7 text support: Text HOME to 741741

Conclusion

Suicide is a common and preventable form of death. Many factors can place a person at risk, but with the proper support and planning, individuals can work through this time of crisis and heal. Finding help via a trusted person, professional, or support group can significantly increase your chances of survival.

If you or someone you know has been affected by loss due to suicide or an attempted suicide. Please seek urgent help. Practice self-care, create a suicide safety plan, and find a trusted supporter.