Suicide in the United States

Understanding the warning signs and steps to intervene can save a life.

Photo Credit: @Bourdain

Anthony Bourdain. Kate Spade. Robin Williams. Chester Bennington. Chris Cornell. In the last year, a number of very public deaths have brought the topic of suicide to the forefront of public health.

And rightfully so, because research suggests that suicide rates are on the rise. A report published by the Center for Disease Control on June, 2018, suggests that, in 2016, almost 45,000 people died due to suicide in the US alone. Moreover, suicide rates went up more than 30% from 1999 to 2016 in more than half of US states. In youth and teens, suicide rates have almost tripled since the 1940’s.

Although most of us associate suicide with depression and mood disorders, emerging data suggests that only about half of people who die by suicide have a known mental health diagnosis. As such, effective suicide prevention efforts focus on identifying risk factors for people who die by suicide.

The truth is that a number of factors contribute to suicidal behavior. According to 2015 data from the CDC’s National Violent Death Reporting System, the most common factor that contributed to suicide among those with or without mental illness was relationship problems (42%), followed by a crisis situation in the past or upcoming two weeks (29%) and problematic substance use (28%).

Additionally, the CDC highlights 12 key warning signs of suicidal behavior. They are:

1) feeling like a burden,

2) being isolated,

3) increased anxiety,

4) feeling trapped or in unbearable pain,

5) increased substance use,

6) looking for a way to access lethal means to hurt oneself or others,

7) increased anger or rage,

8) extreme mood swings,

9) expressing hopelessness,

10) sleeping too little or two much,

11) talking or posting on social media the desire to die,

12) making plans for suicidal behavior.

So, what can we do if we believe someone in our life may be at risk of attempting suicide? #BeThe1To outlines five simple action steps that we can use to talk to loved ones about suicide.

1) ASK the person directly how they are and if they are thinking about suicide in a non-judgmental and supportive way. This can open the door to discussion if the person is open to talking. Even if they don’t answer immediately, they may be more comfortable talking to you in the future. Then LISTEN.

2) KEEP THEM SAFE. If you believe that suicidal behavior is an issue, you want to understand how you can help keep them safe. Try to find out whether they have tried to kill themselves before; if they have a plan; and their timeline. If you believe they are at immediate risk, you may need to call 911. If you believe that they are thinking about it but don’t have a clear plan in place, you want to encourage them to get rid of any lethal means (e.g., firearms, medication) and get help to address their suicidal ideation (e.g., a good therapist).

3) BE THERE. This is simply about being available and connected to the person. Calling or texting each day. Listening to the persons’ struggle. Do not commit to anything that you are not willing to do, but research suggests that feeling connected to a social group acts as a buffer against psychological pain and hopelessness.

4) HELP THEM CONNECT. You cannot be the only source of support in the person’s life. But social support is key to suicide prevention. Consequently, helping the person connect with others who can support their process is critical. Lifeline (1-800-273-8255) is an excellent resource that can assist in creating a safety plan and developing skills for dealing with the hardest emotional moments (e.g., distress tolerance).

5) FOLLOW UP. Continue checking in on the person. Offering ongoing support and care can reduce the risk that they will attempt suicide.

The Naked Truth is This: Suicide is an increasingly common cause of death in the United States today. Being aware of the 12 key warning signs of suicidal behavior may save the life of someone you know. If you are concerned, directly ask them about suicidality, try to keep them safe, be there, help them connect, and follow-up over time. Be the one to ask and try to make a difference.

Copyright Cortney S. Warren, Ph.D.

Dr. Cortney S. Warren, PhD, ABPP

Exposed to a diversity of cultures and lifestyles from an early age, Dr. Cortney was intrigued by the ways cultural and environmental conditions affected the psychological well-being of individuals, groups, and even whole societies.


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cortney warren