According to the Centers for Disease Control and Prevention (CDC), 45,979 people died by suicide in the U.S. in 2020. Mayo Clinic psychiatrist J. Michael Bostwick, M.D., MFA, helps us better understand suicide and what can be done to prevent these deaths.
Can suicide be prevented?
According to an interview with Dr. Bostwick on the “Mayo Clinic Talks” podcast, this is a difficult question to answer directly. Someone who is suicidal may not provide any clues or insights into their mental state. That makes it hard or even impossible for family, friends and health care providers to recognize their distress, let alone step in to intervene.
That being said, many factors contribute to suicidal thoughts and actions. Identifying and treating these could reduce the likelihood of feeling suicidal:
- Anxiety and depression. If someone you know has a mental health condition or concern, encourage them to seek help. They can start with providers recommended by their medical plan, an employee assistance program through their employer or any number of community organizations that provide mental health services.
- Addiction. Addiction touches many lives, including substance users and those who care about them. Connect your loved one to mental health services or community groups that focus on their addiction type. If your loved one won’t participate in a group — or even if they will — find a group like Al-Anon for family members of addicts.
- Social stress. Relationship issues and financial stresses, including food and housing insecurity, can become overwhelming. Connect your loved one to mental health or financial planning services if you see this happening.
See the signs
Anybody from any background could become suicidal, but some characteristics elevate suicide risk. These include being white, male, widowed, older and dependent on alcohol. Other factors that significantly increase risk are access to firearms, particularly when not secured, and history of one or more prior suicide attempts.
Maybe you have a neighbor you haven’t seen lately. He’s older, and his wife recently passed away. Consider sending a message or stopping by to check in. Simply connecting with people has immense benefits — many we never fully realize. And even if someone is not in a higher risk demographic, that does not mean they are immune from suicidal thinking or behavior. No one is.
Where to start
Engaging people will help them feel supported. Dr. Bostwick says, “It doesn’t take a medical school and psychiatry residency to recognize distress and ask, ‘How can I help?'”
There are specific ways to address someone who is potentially suicidal in medical practice. Some of these strategies can be used by anyone — even without medical training.
If you notice or suspect something, inquire further.
When someone you know seems to be in despair, ask them about it. Say something like:
- Are you OK?
- Do you want to talk about what’s going on?
- You look upset. Can I call someone to connect with you?
If someone is struggling, asking them about being suicidal will not make them suicidal.
It’s OK to ask something like:
- Are you thinking about hurting yourself?
- Have you thought about killing yourself?
If the person is in immediate danger of harming themselves, make sure someone is with them at all times and call or text a suicide hotline such as the 988 Suicide & Crisis Lifeline, call 911 or — if it’s safe to do so — escort the individual to an emergency department or other social agency right away. You also can use the 988 hotline if the person isn’t in immediate danger — or you’re not sure. If they’re willing, the person can call the hotline themselves.
A medical or mental health professional can assess the situation to see if the person is likely to harm themself. Some strategies such professionals employ are to ask whether the person has an active plan to kill themself and whether they have access to the substances or weapons needed for that plan. If someone convincingly expresses a desire to harm themself and has a plan and the means to do so, seek help immediately.
We cannot prevent what we don’t know. It can be enormously challenging for the suicidal person to open up to others or to recognize that others care. Sometimes the simple steps indicating you care can make a big difference.
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