September is National Suicide Prevention Month in the US, and since 2003, September 10 has been recognized as World Suicide Prevention Day [1]. In light of the statistics on the prevalence of suicide and its devastating impact on individuals, families, and communities, this month serves as a vital reminder of the importance of mental health, the power of compassion, and the critical role of education and advocacy in suicide prevention. 

Statistics

According to the World Health Organization, approximately 700,000 people die by suicide each year [2]. In the U.S. alone, 49,449 people died by suicide in 2022, an increase of 2.6% over the previous year [3]. As staggering as that number might seem, it represents only 3% of attempted suicides [4]. 

While suicide ranks as the 11th leading cause of death in the US overall, it impacts certain groups more heavily than others [5]. To provide just a few examples, in 2021, suicide was the second leading cause of death for people aged 10–14 and 20–34 [4]. The rate of suicide among US military veterans is 57% higher than for non-veterans, and suicide attempts by high school students identifying as lesbian, gay, or bisexual (LGB) occur five times more frequently than for non-LGB students [6]. (Author’s note: Use of “LGB” in this instance, rather than a more up-to-date acronym, follows the CDC’s terminology in the source material.)

Given our own backgrounds in public safety, this problem hits close to home. Nationwide, first responders account for 1% of all suicides. A pair of 2021 studies found that compared to the general public, firefighters were 72% more likely to die by suicide, EMTs were 24% more likely, and law enforcement officers were 54% more likely than “all decedants with a reported occupation” [7]. Another study found that in 2017, more first responders died by suicide than in the line of duty [8].

Risk factors for suicide are numerous and include mental health problems; alcohol and/or substance abuse; history of abuse or trauma; major illness; loss of employment, financial stability, or personal relationships; lack of access to behavioral healthcare; and reluctance to ask for help due to the stigma associated with it [9].

Warning Signs

The 988 Suicide & Crisis Lifeline lists several behaviors that indicate a person may be in crisis and at risk of attempting suicide:

• Suicidal ideation (contemplating killing oneself), especially when the person communicates a plan to harm themselves and/or seeks out methods by which to do it. (Access to firearms is of particular concern, as firearms are involved in more than half of all suicides [4].)

• Voicing feelings of hopelessness and/or despair, feeling trapped, being a burden to others, or having no reason to live.

• Withdrawing and isolating oneself from other people.

• Increased alcohol consumption and/or drug use.

• Mood swings and erratic behavior, including anxiousness, agitation, excessive anger, or expressing a desire to seek revenge.

• Sleep disturbances (sleeping too much or too little) [9].

How to Help Someone in Crisis

Recognize the warning signs, especially when concerning behaviors are new or follow a major life change or traumatic event.

Reach out. Ask the person if they’re okay. People in crisis often self-isolate and avoid interactions with others.

Assess the risk. Be direct, and ask specifically whether the person is contemplating suicide or has a plan to harm themselves. While this may feel uncomfortable, simply encouraging someone to open up about suicidal thoughts can be preventive in its own right [10]. 

A few resources that can help in starting the conversation include the following:

• The 988 Suicide & Crisis Lifeline offers a list of “Do’s and Don’ts” for talking with and offering help to someone in crisis [11], and its #BeThe1To campaign provides a detailed list of action steps to follow. [12]

• “Talk Away the Dark” developed by the American Foundation for Suicide Prevention (AFSP) explores how to start a conversation with someone who is at risk [13].

• The Columbia Protocol developed by the Columbia Lighthouse Project is a simple, plain-language questionnaire that assesses a person’s suicide risk level and offers suggestions on action steps to follow [14].

Know your options. If someone is in immediate danger of harming themselves, calling 911 is the right move. Public safety agencies often have crisis management teams that can bring in specialized knowledge and resources. In other situations, staying with the person, listening to them, and assisting them in seeking behavioral health evaluation and treatment can be a critical first step toward recovery.

Resources

The following resources can be accessed at no charge, 24/7, from anywhere in the country:

• 988 Suicide & Crisis Lifeline: https://988lifeline.org/

• SAMHSA National Helpline: https://www.samhsa.gov/find-help/national-helpline

• Crisis Text Line: https://www.crisistextline.org/

(Updated: These and other links can also be found on the Resources page of our website.)

Moving Forward

Suicide is a global crisis that demands our attention and collective action. It is an issue that transcends borders, affecting individuals from all walks of life. However, there are steps we can take to prevent it. By having open conversations about mental health, offering support and empathy to those in need, and seeking information about advocacy, education, and treatment, anyone can make a difference. 

Citations

[1] International Association for Suicide Prevention. (n.d.) About WSPD. Retrieved September 8, 2023, from https://www.iasp.info/wspd/about/

[2] World Health Organization. (2023). World Suicide Prevention Day 2023. Retrieved September 7, 2023, from https://www.who.int/campaigns/world-suicide-prevention-day/2023

[3] Centers for Disease Control. (2023). Suicide data and statistics. Retrieved September 7, 2023, from https://www.cdc.gov/suicide/suicide-data-statistics.html

[4] American Foundation for Suicide Prevention. (2023). Suicide statistics. Retrieved September 7, 2023, from https://afsp.org/suicide-statistics

[5] Centers for Disease Control. (2023). Facts about suicide. Retrieved September 7, 2023, from https://www.cdc.gov/suicide/facts/index.html

[6] Centers for Disease Control. (2023). Disparities in suicide. Retrieved September 8, 2023, from https://www.cdc.gov/suicide/facts/disparities-in-suicide.html

[7] Carson, L. M., Marsh, S. M., Brown, M. M., Elkins, K. L., & Tiesman, H. M. (2023). An analysis of suicides among first responders – Findings from the National Violent Death Reporting System. Journal of Safety Research (85), 361–370. https://www.sciencedirect.com/science/article/abs/pii/S0022437523000415

[8] Heyman, M., Dill, J., & Douglas, R. (2018). The Ruderman white paper on mental health and suicide of first responders [White paper]. Ruderman Family Foundation. https://rudermanfoundation.org/white_papers/police-officers-and-firefighters-are-more-likely-to-die-by-suicide-than-in-line-of-duty/

[9] 988 Suicide & Crisis Lifeline. (n.d.). We can all prevent suicide. Retrieved September 7, 2023, from https://988lifeline.org/how-we-can-all-prevent-suicide/

[10] Chatterjee, R. (2022, December 22). Reach out and listen: How to help someone at risk of suicide. National Public Radio. https://www.npr.org/sections/health-shots/2019/04/20/707686101/how-to-help-someone-at-risk-of-suicide

[11] 988 Suicide & Crisis Lifeline. (n.d.) Help someone else. Retrieved September 7, 2023, from https://988lifeline.org/help-someone-else/

[12] 988 Suicide & Crisis Lifeline (n.d.) #BeThe1To: How and why the 5 steps can help. Retrieved September 9, 2023, from https://www.bethe1to.com/bethe1to-steps-evidence/

[13] American Foundation for Suicide Prevention. (n.d.) Talk away the dark. Retrieved September 8, 2023, from https://talkawaythedark.afsp.org/

[14] Columbia Lighthouse Project. (n.d.) The Columbia Protocol (C-SSRS): About the protocol. Retrieved September 9, 2023, from https://cssrs.columbia.edu/the-columbia-scale-c-ssrs/about-the-scale/