As someone with bipolar disorder, I have contemplated suicide at several points in my life. I’ve also experienced the loss of a friend to suicide, and I’m a mental health professional — so it’s easy to see why I have a significant interest in suicide prevention. However, the National Strategy for Suicide Prevention’s latest report concludes that “suicide prevention is everyone’s business.” Suicide impacts us all, directly or indirectly, and we all can play a role in its prevention.
In about 90% of cases, suicide is related to a mental disorder, most commonly major depression or another mood disorder, a substance use disorder, schizophrenia or a personality disorder—though in many cases the issue was not diagnosed or treated. Because mental disorders are treatable, suicide is largely preventable. However, there are a number of barriers to prevention that need to be overcome:
- Underdiagnosis of mental disorders
- Lack of access to or lack of insurance coverage for treatment
- Lack of awareness in the general public regarding the signs of mental illness and the warning signs of suicide
- Stigma, prejudice and discrimination regarding mental disorders; a taboo around talking about suicide
- Inadequate training for health care professionals, including mental health professionals, in suicide assessment
While there are complex, systemic problems that need to be addressed, each of us has at least some power to prevent suicide. Below are 10 groups that play a key role in suicide prevention, and what each can do:
Suicide impacts everyone. It’s the 10th-leading cause of death in the United States. The economic cost of suicide in the U.S. is estimated to be more than $44 billion annually, mainly due to lost wages and productivity. For every reported suicide, an estimated 12 people either attempt suicide or engage in some type of self-harm. Non-fatal injuries due to attempted suicide or self-harm cost an estimated $6.3 billion annually in medical care, lost wages and productivity.
What everyone can do:
- Learn the signs of mental illness. Visit the Campaign to Change Direction and learn the five signs that someone might need help.
- Learn the warning signs of suicide. Visit the American Association of Suicidology and learn the “IS PATH WARM?”
- Educate yourself about suicide. Visit the American Foundation for Suicide Prevention for answers to frequently-asked questions.
- Change your attitude. If you believe suicide is a sign of weakness or selfishness, recognize that people with mental illness who attempt suicide are incapable of seeing other options, incapable of making rational decisions or are acting out of impulse; weakness and selfishness don’t enter the equation.
- Change your language. Learn and use non-stigmatizing terms regarding suicide. Most important, use “died by suicide” instead of “committed suicide,” and “attempted suicide” instead of “unsuccessful suicide.”
- Answer phones at a local crisis center or become a suicide prevention advocate.
- Choose a non-profit related to suicide prevention or a local mental health program.
- Get involved in mental health treatment reform. The Treatment Advocacy Center, a national nonprofit organization, hassuggestions for advocating to remove barriers to treatment.
2. Those diagnosed with a mental disorder
Again, 90% of people who die by suicide have a mental disorder (this is determined by “psychological autopsy,” which includes reviewing records and interviewing people who knew the decedent). As someone with a mental disorder, I’ve come to understand that we have to be proactive about our own suicide prevention — and that we have a lot of power to help prevent it in others.
What you can do if you are diagnosed with a mental disorder:
- If you are thinking about suicide, call the National Suicide Prevention Lifeline, use their Lifeline Crisis Chat or call 911.
- If you are not currently thinking about suicide, make a safety plan.
- See a mental health provider regularly.
- Join a support group, such as those offered through your local chapter of the National Alliance on Mental Illness or theDepression and Bipolar Support Alliance.
- Become a mental health advocate, educator or peer supporter.
- Tell your story. Consider joining a speaking program such as “In Our Own Voice.”
3. Those who think they might have a mental disorder
Mental disorders are very common. In 2013, an estimated 18.5% of U.S. adults had some type of mental illness in the past year. Overall, only about half of those affected by mental illness receive treatment.
What you can do if you think you might have a mental disorder:
- Talk to your primary care provider about your mental health concerns and ask them for a referral to a mental health provider.
- Call the Substance Abuse and Mental Health Services Administration (SAMHSA’s) National Helpline for a treatment referral.
- Take the 3-Minute Test for Depression, Anxiety, Bipolar Disorder and PTSD.
- Take an alcohol abuse self-test or drug abuse self-test.
- Recognize that mental disorders are brain disorders and there is no shame in asking for help.
4. Family members or loved ones of someone who may be at risk for suicide
About one-third of people who die by suicide do not communicate their intent to anyone. However, most exhibit warning signs. People close to those with mental illness can play a powerful role by being on the lookout for warning signs and helping their loved one find treatment.
What you can do if you are a family member or loved one of somebody who may be at risk for suicide:
- Call the National Suicide Prevention Lifeline for advice and resources in your area.
- Be familiar with the warning signs of suicide. Get a free wallet card from SAMHSA.
- Find a support group or education program for family through organizations such as your local chapter of the National Alliance on Mental Illness.
- Talk openly with your loved one about suicide. You’re not going to plant an idea in their head that wasn’t already there.
- Offer hope (“Things will get better”), but avoid platitudes (“Suicide is a permanent solution to a temporary problem”).
5. Those affected by the suicide of another person (also called a “survivor” or “one bereaved by suicide”)
The loss of someone to suicide is said to leave a “special scar.” People who have lost a loved one to suicide are more likely to die by suicide themselves. Many people bereaved by suicide feel alone and have trouble getting support. People can be significantly affected even if they weren’t close to the decedent.
What you can do if you are affected by the suicide of another person:
- Recognize that you will likely need support.
- Get help through organizations such as the Alliance of Hope for Suicide Survivors.
- Find a support group for survivors through the American Foundation for Suicide Prevention.
- Start a survivors’ group if no groups are available in your area.
- Consider seeking counseling.
6. Those who know someone affected by the suicide of another person
If you know someone bereaved by suicide, it can be difficult to know what to do or say. Survivors are at risk for suicide, and they are at even greater risk if they are socially isolated.
What you can do if you know someone affected by the suicide of another person:
- Offer your sympathy, condolences and support.
- Don’t avoid the topic of suicide.
- Be on the lookout for signs of mental disorders and warning signs of suicide.
- Suggest the possibility of seeking counseling or joining a support group.
- Take care of yourself so you can be there for the bereaved person.
7. Primary care physicians (PCPs)
Primary care physicians play an important role in screening for suicide risk. At any given time, 2% to 4% of patients visiting their PCP are having thoughts of suicide. Over 75% of those who die by suicide have seen a PCP in the year before their death; but only about 30% have received mental health services. Studies have shown that educating doctors in assessing and treating depression leads to reductions in suicide.
What you can do if you are a PCP:
- Get training in suicide risk assessment.
- Know where and how to refer people for mental health treatment.
- Get the Suicide Prevention Resource Center’s Primary Care Toolkit for suicide prevention.
- Read “Practical Suicide-Risk Management for the Busy Primary Care Physician,” a 2011 publication from Mayo Clinic Proceedings.
- Learn to recognize and treat depression.
8. Mental health professionals
Many mental health professionals haven’t received adequate training in suicide prevention. According to a 2013 study, only about 50% of psychologists, 25% of social workers, and 6% of counselors have training in suicide risk assessment.
What you can do if you are a mental health professional:
- Get training in suicide risk assessment and renew your knowledge regularly.
- Get a free Suicide Assessment Pocket Card for clinicians, available from SAMHSA.
- Find trainings, webinars and other resources through the Suicide Prevention Resource Center.
- Consult with colleagues as needed.
- Communicate hope to clients and their families, and let them know that recovery is possible.
9. Employers and managers
Because mental disorders are so common, it’s highly likely that some of your employees have one — and it’s also likely that some aren’t getting treatment.
What you can do if you are an employer or manager:
- Include mental health benefits in employee health plans and encourage people to use them when needed.
- Promote the mental health of employees through organizational changes and wellness programs.
- Check out the resources at Working Minds on suicide prevention in the workplace.
- Arrange for the National Alliance on Mental Illness to do an “In Our Own Voice” presentation for your organization to increase employees’ understanding of mental illness.
10. Journalists, bloggers and others who report and write about suicide
Journalists play an important role in the public’s perception of suicide. By reporting news stories about suicides properly, they can help prevent the documented phenomenon of “suicide contagion” or “copycat suicides”. Suicide contagion is more likely when media sources describe the suicide method, sensationalize the story using dramatic or graphic content or give the story extensive and repeated coverage.
What you can do if you are a journalist, blogger or otherwise write or report on suicide:
- Use the Recommendations for Reporting on Suicide, developed by leading journalistic organizations.
- Don’t sensationalize suicide; report factual data from reliable sources.
- Learn and use proper language about suicide.
- Consult suicidology experts as needed.
- Take the free “Reporting on Mental Health Conditions and Suicide” online course.
If we all do our part to reach out and save lives on World Suicide Prevention Day and beyond, we can get people at risk the help they need, reduce suicides and alleviate a lot of pain and suffering.