If you or someone you know is in crisis call or text the 988 Suicide & Crisis Lifeline at 988 (para ayuda en español, llame al 988). The Lifeline provides 24-hour, confidential support to anyone in suicidal crisis or emotional distress. Call 911 in life-threatening situations. If you are worried about a friend’s social media updates, you can contact safety teams at the social media company . They will reach out to connect the person with the help they need.
What is suicide?
Suicide is a major public health concern. In 2020, suicide was the 12th leading cause of death overall in the United States, claiming the lives of over 45,900 people. Suicide is complicated and tragic, but it is often preventable. Knowing the warning signs for suicide and how to get help can help save lives.
Suicide is when people harm themselves with the intent of ending their life, and they die as a result.
A suicide attempt is when people harm themselves with the intent of ending their life, but they do not die.
Avoid using terms such as “committing suicide,” “successful suicide,” or “failed suicide” when referring to suicide and suicide attempts, as these terms often carry negative meanings.
What are the warning signs of suicide?
Warning signs that someone may be at immediate risk for attempting suicide include:
Talking about wanting to die or wanting to kill themselves.
Talking about feeling empty or hopeless or having no reason to live.
Talking about feeling trapped or feeling that there are no solutions.
Feeling unbearable emotional or physical pain.
Talking about being a burden to others.
Withdrawing from family and friends.
Giving away important possessions.
Saying goodbye to friends and family.
Putting affairs in order, such as making a will.
Taking great risks that could lead to death, such as driving extremely fast.
Talking or thinking about death often.
Other serious warning signs that someone may be at risk for attempting suicide include:
Displaying extreme mood swings, suddenly changing from very sad to very calm or happy.
Planning or looking for ways to kill themselves, such as searching for lethal methods online, stockpiling pills, or buying a gun.
Talking about feeling great guilt or shame.
Using alcohol or drugs more often.
Acting anxious or agitated.
Changing eating or sleeping habits.
Showing rage or talking about seeking revenge.
Suicide is not a normal response to stress. Suicidal thoughts or actions are a sign of extreme distress and should not be ignored... If these warning signs apply to you or someone you know, get help as soon as possible, particularly if the behavior is new or has increased recently.
Here are five steps you can take to #BeThe1To help someone in emotional pain:
ASK: “Are you thinking about killing yourself?” It’s not an easy question, but studies show that asking at-risk individuals if they are suicidal does not increase suicides or suicidal thoughts.
KEEP THEM SAFE: Reducing a suicidal person’s access to highly lethal items or places is an important part of suicide prevention. While this is not always easy, asking if the at-risk person has a plan and removing or disabling the lethal means can make a difference.
BE THERE: Listen carefully and learn what the individual is thinking and feeling. Research suggests acknowledging and talking about suicide may reduce rather than increase suicidal thoughts.
HELP THEM CONNECT: Save the 988 Suicide & Crisis Lifeline number (call or text 988) in your phone so they’re there if you need them. You can also help make a connection with a trusted individual like a family member, friend, spiritual advisor, or mental health professional.
STAY CONNECTED: Staying in touch after a crisis or after being discharged from care can make a difference. Studies have shown the number of suicide deaths goes down when someone follows up with the at-risk person.
What are the risk factors for suicide?
People of all genders, ages, and ethnicities can be at risk. Suicidal behavior is complex, and there is no single cause. The main risk factors for suicide are:
Depression, other mental disorders, or substance use disorder
Chronic pain
Personal history of suicide attempts
Family history of a mental disorder or substance use
Family history of suicide
Exposure to family violence, including physical or sexual abuse.
Presence of guns or other firearms in the home
Having recently been released from prison or jail.
For people with suicidal thoughts, exposure, either directly or indirectly, to others' suicidal behavior, such as that of family members, peers, or celebrities can also be a risk factor.
Most people who have risk factors will not attempt suicide, and it is difficult to tell who will act on suicidal thoughts. Although risk factors for suicide are important to keep in mind, someone who is actively showing warning signs of suicide may be at higher risk for danger and in need immediate attention.
Stressful life events (such as the loss of a loved one, legal troubles, or financial difficulties) and interpersonal stressors (such as shame, harassment, bullying, discrimination, or relationship troubles) may contribute to suicide risk, especially when they occur along with suicide risk factors.
Family and friends are often the first to recognize the warning signs of suicide, and they can take the first step toward helping a loved one find mental health treatment. See NIMH’s page with resources for finding help for mental illnesses if you're not sure where to start.
Identifying people at risk for suicide
Universal screening: Research has shown that a three-question screening tool helps emergency room personnel identify adults 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.
Predicting suicide risk using 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 also beginning to use data from electronic health records to help identify people with suicide risk.
What treatments and therapies are available for people at risk for suicide?
Effective, evidence-based interventions are available to help people who are at risk for suicide.
Brief interventions
Safety planning: Personalized safety planning has been shown to help reduce suicidal thoughts and actions. Patients work with a health care provider to develop a plan that describes ways to limit access to lethal means such as firearms, pills, or poisons. The plan also lists coping strategies and people and resources that can help in a crisis.
Follow-up phone calls: Research has shown that when at-risk patients receive supportive phone calls for further risk monitoring and are encouraged to engage in safe behaviors and seek help, their suicide risk goes down .
Psychotherapies
Multiple types of psychosocial interventions have been found to help individuals who have attempted suicide (see below). These types of interventions may prevent someone from making another attempt.
Cognitive behavioral therapy (CBT) can help people learn new ways of dealing with stressful experiences. CBT helps individuals recognize their thought patterns and consider alternative actions when thoughts of suicide arise .
Dialectical behavior therapy (DBT) has been shown to reduce suicidal behavior in adolescents. DBT has also been shown to reduce the risk of suicide attempts in adults with borderline personality disorder , a mental illness characterized by an ongoing pattern of varying moods, self-image, and behavior that often results in impulsive actions and problems in relationships. A therapist trained in DBT can help a person recognize when their feelings or actions become overwhelming and teach the person skills that can help them cope more effectively with upsetting situations.
Medication
Some individuals at risk for suicide might benefit from medication. People can work with their health care providers to find the best medication or medication combination, as well as the right dose. Many people at risk for suicide often have a mental illness or substance use problems and may benefit from medication along with psychosocial intervention.
Clozapine is an antipsychotic medication used primarily to treat individuals with schizophrenia. To date, it is the only medication with a specific U.S. Food and Drug Administration (FDA) indication for reducing the risk of recurrent suicidal behavior in patients with schizophrenia or schizoaffective disorder.
If you are prescribed a medication, be sure you:
Talk with a health care provider to make sure you understand the risks and benefits of the medications you're taking.
Do not stop taking medication without talking to your health care provider first. Suddenly stopping medication may lead to worsening of symptoms. Other uncomfortable or potentially dangerous withdrawal effects also are possible.
Report any concerns about side effects to a health care provider right away. They can help determine whether you need a change in the dose or a different medication.
Report serious side effects to the FDA MedWatch Adverse Event Reporting program online or by phone at 1-800-332-1088. You or your health care provider may send a report.
To find the latest information about medications, talk to a health care provider and visit the FDA website .
Collaborative care
Collaborative care is a team-based approach to mental health care. A behavioral health care manager will work with the person, their primary health care provider, and mental health specialists to develop a treatment plan. Collaborative care has been shown to be an effective way to treat depression and reduce suicidal thoughts.
Youth Suicide Rates Increased During the COVID-19 Pandemic
May 22, 2023 • Research Highlight
Suicide is a leading cause of death among young people in the United States. Rates of youth suicide deaths were rising before the coronavirus (COVID-19) pandemic began, so it is critical to understand how the pandemic impacted this public health crisis. In a new study supported by the National Institute of Mental Health, researchers examined national youth suicide trends and characteristics in the United States before and during the COVID-19 pandemic.
A research team led by Jeffrey Bridge, Ph.D. , Donna Ruch, Ph.D. , and Lisa Horowitz, Ph.D., MPH, analyzed national suicide data from the Centers for Disease Control and Prevention. The researchers first identified all U.S. youth aged 5 to 24 years with suicide listed as the cause of death over the first 10 months of the pandemic (March 1, 2020–December 31, 2020). They calculated the total and monthly suicide deaths overall and by sex, age, race and ethnicity, and suicide method. Then, they examined how many young people died by suicide during the first 10 months of the pandemic and compared it to an estimated number of suicide deaths during that same period had the pandemic not occurred (calculated using data from the previous 5 years).
The researchers identified 5,568 youth who died by suicide during the first 10 months of the pandemic, which was higher than the expected number of deaths had the pandemic not occurred. Higher than expected suicide rates were found a few months into the pandemic, starting in July 2020.
The increase in suicide deaths varied significantly by sex, age, race and ethnicity, and suicide method. During the pandemic, there were higher than expected suicide deaths among males, preteens aged 5–12 years, young adults aged 18–24 years, non-Hispanic American Indian or Alaskan Native youth, and non-Hispanic Black youth as compared to before the pandemic. Suicide deaths involving firearms were also higher than expected.
The significantly higher number of suicide deaths reported for certain racial and ethnic groups, specifically non-Hispanic American Indian or Alaskan Native and non-Hispanic Black youth, highlights ongoing disparities in rates of suicide that the pandemic may have exacerbated. The increase in suicide deaths among preteens also suggests that more attention may need to be paid to this age group, who tend to be understudied in suicide prevention research and have different developmental needs than older adolescents and young adults.
This research is only a first step in examining the pandemic’s impact on youth mental health and points to several areas for further investigation. First, it is possible that other events or factors unrelated to the pandemic that occurred during the study’s time frame contributed to the rise in youth suicide deaths but were unmeasured. Second, research is still needed to identify the underlying causes of the increase in youth suicide deaths, both overall and for specific groups. Third, the COVID-19 pandemic period analyzed in this study was limited to 10 months in 2020 and does not reflect longer-term trends in youth suicide that may have changed as the pandemic wore on. Last, suicide deaths for some groups may have been underreported due to inaccurate or misclassified data; ongoing monitoring of suicide rates will help clarify the suicide risk faced by young people in the United States.
This study shows that the pandemic impacted youth suicide rates, but the impact was not the same for everyone and varied based on sex, age, and race and ethnicity. As such, the authors suggest that it may be helpful to broadly implement suicide prevention efforts in settings that serve young people, while also tailoring those efforts to address the disparities faced by specific groups. Moreover, given the extended duration of the pandemic and its ongoing impact on young people in the United States, it will be important to monitor long-term trends in suicide rates associated with COVID-19 and identify factors driving the increased risk for suicide among some people.
Reference
Bridge, J. A., Ruch, D. A., Sheftall, A. H., Hahm, H. C., O’Keefe, V. M., Fontanella, C. A., Brock, G., Campo, J. V., & Horowitz, L. M. (2023). Youth suicide during the first year of the COVID-19 pandemic. Pediatrics, 151(3), Article e2022058375. https://doi.org/10.1542/peds.2022-058375
Comments
Post a Comment