Suicide.
It’s a word many use with polite and mindful tones in public. Some whisper it, deeming it the other s-word. Others refer to a person “unaliving” themself.
Suicide is often not publication discussed in the media until a celebrity dies by suicide. Media has a rule not to report on suicide in fear of “contagion,” or people copycatting the behavior. Only due to a person’s prominence is it discussed on large platforms. The topic of suicide then returns to the quiet conversations of peer groups, mental health professionals, and family and friends affected by the tragic and painful aftermath when a loved one dies by suicide.
Suicide while quietly discussed is a loud, brash, and in-your-face, worldwide public health crisis that negatively affects families, communities, and individuals from every race, gender, age, and socioeconomic background.
According to a Lancet journal study, “The Forever Decision: A Qualitative Study Among Survivors of a Suicide Attempt,” worldwide, more than 700,000 people die by suicide every year, while the prevalence of suicide attempts is estimated to be 20 times higher.
One of the biggest misconceptions is that talking about suicide will give someone the idea to end their life. There is no evidence supporting that idea. Instead, talking about suicide can open paths of communication that a vulnerable person is looking for, according to the article, 10 Things to Know from Those Who Have Attempted Suicide.
Suicide is one of the leading causes of death in the United States, and in 2022, there were approximately 49,449 deaths by suicide in the United States, according to the CDC.
That is one death every 11 minutes.
The suicide rate among males in 2022 was approximately four times higher than the rate among females. Males make up 50% of the population but nearly 80% of suicides. People ages 85 and older had the highest rates of suicide in 2022.
Is suicide preventable? The answer is yes. September is Suicide Prevention Month, and I want to be intentionally vocal about suicide and give actionable and educational support to help those who may be considering ending their life and help everyone do their part to prevent suicide, suicide attempts and the impact it has on everyone affected by this traumatic cause of death.
Suicidal Thoughts Can Start Early
“I didn’t want to die. I just wanted the pain to stop..”
These are words that people who have survived suicide attempts often say as they reflect. Survivors have said suicide attempts weren’t as much about a desire to die as they were about making a particular kind of pain stop.
I’ve said these words myself.
I was 10 years old when I attempted suicide. I ingested a bottle of pills and slipped into darkness. I’m blessed my mother discovered me before it was too late.
At a young age, I was wrought with mental health disorders that as a child I didn’t understand and didn’t know how to cope with. Not existing felt like it’d make life easier for everyone and it felt like my only option at that time.
Sadly, my experience isn’t uncommon for many youths. Suicidal thoughts predominately emerge during adolescence, according to the LANCET journal study. Participants in the study all reported they had experienced suicidal ideations previously in their life despite attempts as an adult and the onset of suicidal ideation was early in life, mostly in adolescence.
Over the past five years, suicide has been the second-leading cause of death for people ages 15-19 in the United States—second only to accidents.
It might seem convenient or tempting to blame youth suicides on social media, the COVID-19 pandemic, bullying, or substance abuse, but the reality is much more complicated. It involves location, race, and socioeconomic status, among other compounding factors, the report said.
The reasons why children or teens may commit suicide can involve a combination of individual, familial, and environmental factors, such as:
- Mental Health Issues: Mental health conditions such as depression, anxiety, bipolar disorder, or other mood disorders are significant risk factors. Children experiencing severe emotional distress or mental illness may see suicide as a way to escape their pain.
- Bullying and Peer Pressure: Experiences of bullying, harassment, or exclusion at school or in social settings can lead to feelings of hopelessness and worthlessness. Peer pressure and issues with fitting in can also contribute.
- Family Issues: Problems within the family, such as parental divorce, abuse, neglect, or domestic violence, can create a sense of instability and despair. Additionally, family history of mental illness or suicide can be a risk factor.
- Trauma and Abuse: Experiencing trauma, including physical, emotional, or sexual abuse, can have profound effects on a child’s mental health and lead to suicidal thoughts.
- Academic and Social Pressures: High levels of stress related to school performance, expectations, and social relationships can overwhelm children, especially if they feel they are failing to meet expectations.
- Substance Abuse: Substance abuse can impair judgment and exacerbate feelings of hopelessness and despair. It can also be both a cause and effect of underlying mental health issues.
- Lack of Support: A lack of emotional support from parents, teachers, or peers can contribute to feelings of isolation. Children who feel they have no one to turn to may be at higher risk.
- Chronic Illness or Disability: Chronic physical illness or disability can contribute to emotional distress and feelings of being a burden, which may increase the risk of suicidal thoughts.
- Developmental Issues: Children dealing with developmental disorders or difficulties in communication and social interactions may struggle with feelings of inadequacy and loneliness.
- Exposure to Suicide: Exposure to suicide through family, friends, or media can sometimes contribute to a child’s perception of suicide as a solution to their own problems.
- Identity Issues: Struggles with identity, including issues related to gender identity or sexual orientation, especially in environments where they face discrimination or lack acceptance, can contribute to suicidal thoughts.
It’s important to recognize that children or teens who express suicidal thoughts or engage in self-harming behavior need immediate support and intervention.
The spotlight fell on youth mental health and the suicide rate at the peak of the COVID-19 pandemic. Rates of youth suicide deaths were rising before the coronavirus (COVID-19) pandemic began, and the pandemic impacted this public health crisis. In a study supported by the National Institute of Mental Health, 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.
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.
In 2022, nearly 500 suicides among children ages 10-14 and more than 6,000 among young adults ages 15-24— were reported, according to the CDC.
Know the Signs
Knowing the warning signs is a critical tool for prevention of youth suicide. According to www.youth.gov, the warning signs for those at risk of suicide include:
- Talking about wanting to die
- Feeling hopeless, having no reason to live,
- Feeling trapped or in unbearable pain,
- Seeking revenge
- Being a burden on others
- Looking for methods and making plans such as searching online or buying a gun;
- Increasing use of alcohol or drugs
- Acting anxious or agitated;
- Behaving recklessly;
- Sleeping too little or too much;
- Withdrawal or isolation;
- Displaying rage and extreme mood swings.
The risk of suicide is greater if a behavior is new or has increased and if it seems related to a painful event, loss, or change.
In the Lancet journal study, “The Forever Decision: A Qualitative Study Among Survivors of a Suicide Attempt,” the most frequent sequence from suicidal ideation to attempt observed among participants was thinking about suicide, mulling over, making a decision to attempt suicide, preparing, and finally attempting suicide.
Another pattern noted was that participants took preparatory actions before reaching the decision phase, including writing down passwords for relatives to find, being reluctant to plan vacations with friends, and writing goodbye letters.
Take Action
Parents, teachers, mentors, family, and peers can take action if they see warning signs or have concerns about a shift in behavior.
Keeping communication open, creating a safe environment to talk without judgment, and having empathy is essential to reaching youth who may have suicidal ideation and need mental health support. Being approachable and letting it be known you’re there as support is also a way to take action when warning signs are present.
Preventive methods include limiting access to the means and methods of suicide, such as firearms, medication, and pesticides. It is estimated that around 20% of global suicides are due to pesticide self-poisoning, most of which occur in rural agricultural areas in low- and middle-income countries. In the United States, the most common method of suicide is firearms.
Modeling healthy mental health behavior, promoting a healthy balanced lifestyle, and creating a safety and emergency plan are all ways to reduce the risk of suicide among teens
A safety plan should be in place if a teen has expressed suicidal thoughts in the past or made attempts. This should include triggers, coping strategies, and immediate contacts for support.
An emergency plan should be developed to address the immediate danger to a teen’s life. This should include emergency services and local crisis hotline numbers.
Most importantly, seeking professional mental health treatment is the best way to address concerns about a teen’s mental health.
Suicide: Why?
Individuals who have survived suicide attempts said that they planned and prepared for suicide long before they made an attempt. Many said they at least 6 years before the attempt, choosing a method and creating a plan, according to a study by the World Health Organization.
Suicidal behaviors are not easy to explain. They are usually not because of a single factor, but several factors may lead a person to have ideations or make attempts to take their own life The reason why can be very complex. Health, mental health, stressful life events, and social and cultural factors need to be considered when trying to understand suicidal behavior. It is often not as simple as a person having a mental health disorder such as depression or alcoholism.
Those who have previously attempted suicide are at a higher risk, but studies show many suicides happen impulsively in moments of crisis with a breakdown in the ability to deal with life stresses, such as financial problems, relationship break-ups or chronic pain and illness.
In addition, experiencing conflict, disaster, violence, abuse, or loss and a sense of isolation are strongly associated with suicidal behavior. Suicide rates are also high amongst vulnerable groups who experience discrimination, such as refugees and migrants; indigenous peoples; lesbian, gay, bisexual, transgender, intersex (LGBTI) persons; and prisoners, according to WHO.
People may have suicidal behavior, attempts, or completion, because of:
- Mental Health Issues: Depression, anxiety, bipolar disorder, and schizophrenia can significantly impact a person’s mood and outlook, sometimes leading them to consider suicide.
- Traumatic Experiences: Experiences such as abuse, severe loss, or trauma can create feelings of hopelessness and despair.
- Chronic Pain or Illness: Physical suffering from chronic pain or a terminal illness can sometimes lead people to feel that suicide is the only way to escape their pain.
- Social Isolation: Feeling disconnected from others or lacking a support network can increase feelings of loneliness and hopelessness.
- Financial or Occupational Stress: Significant financial problems, job loss, or career dissatisfaction can contribute to overwhelming stress and feelings of helplessness.
Suicide survivors were asked in a study what could have helped them prevent the attempt and most said they felt their suicidality was not taken seriously.
Image courtesy of the CDC.
Prevention and Control
Suicides are preventable. There are several measures that can be taken at population, sub-population and individual levels to prevent suicide and suicide attempts. LIVE LIFE, WHO’s approach to suicide prevention, recommends the following key effective evidence-based interventions:
- limit access to the means of suicide (e.g. pesticides, firearms, certain medications);
- interact with the media for responsible reporting of suicide;
- foster socio-emotional life skills in adolescents; and
- early identify, assess, manage and follow up anyone who is affected by suicidal behaviors.
Suicide prevention efforts require coordination and collaboration among multiple sectors of society, including the health sector and other sectors such as education, labor, agriculture, business, justice, law, defense, politics, and the media. These efforts must be comprehensive and integrated as no single approach alone can make an impact on an issue as complex as suicide, according to the World Health Organization.
But at an individual level everyone can do something.
Stigma around mental health conditions and suicide means many people thinking about suicide do not seek help. Suicides and suicide attempts have a ripple effect that impacts on families, friends, colleagues, communities and societies.
Transforming the stigma around mental health by discussing it openly is a great first step. Communicating with a person who may be exhibiting suicidal risk behaviors, asking them questions, listening and supporting them, and encouraging them to seek help, are ways each person can make a difference.
Talking openly about suicide can give a person other options or the time to rethink his/her decision, thereby preventing suicide, according to WHO.
CDC Facts
- The suicide rate for males was 3–4 times the rate for females during the 2000–2020 period.
- The racial/ethnic groups with the highest rates in 2022 were non-Hispanic American Indian and Alaska Native people and non-Hispanic White people.
- Males make up 50% of the population but nearly 80% of suicides.
- People ages 85 and older had the highest rates of suicide in 2022.
- Firearms are the most common method used in suicides. Firearms were used in more than 50% of suicides in 2022.
- The provisional 2022 suicide number (49,449) was 3% higher than the 2021 final number (48,183), and the highest number ever recorded in the United States (1). The 2022 final number of suicides is likely to be higher as additional death certificates with pending causes of death may be determined to be suicides
