Suicide Prevention: How You Can Make a Difference

If you or someone you know is in immediate danger, do not hesitate to contact one of the available suicide and crisis lines that exist both locally and nationally. Click here for the Cleveland County Resource Guide.

September is Suicide Prevention Month. The goal of this awareness month is to educate, reduce the stigma, and share resources around suicide. Let’s start with the facts:

Facts About & the Impact of Suicide

Suicide is something that impacts many people. It is estimated that about 42% of adults in the U.S. personally knew someone who died by suicide (source). It is also considered a leading cause of death in the U.S. with over 49,000 deaths by suicide in 2023 (source). Furthermore, for individuals between the ages of 10 and 34, suicide is the second leading cause of death (source). 

Even in cases where individuals don’t personally know someone who died by suicide, occurrences of suicide can have an impact across a community. This is part of something called “The Ripple Effect of Suicide” (source). When a pebble is dropped in a pond, it creates a ripple. The first waves of the ripple, closest to where the pebble was dropped, are big and become smaller as they move outward. The reach of the pebble ends up being much larger than the pebble itself. When someone dies by suicide, the people who are affected the most significantly are those closest to the individual. These can include family members, friends, and close peers. However, the impact (or ripple) does not stop there. Even people who do not personally know the individual who died by suicide can also be affected. In the same way an entire pond is impacted by the pebble, so is a whole community impacted by suicide. 

According to this 2016 study, approximately 115 people are affected in a single instance of suicide. 1 in 5 people also shared that their exposure to suicide “had a devastating impact or caused a major-life disruption” (source). If we take the number of 115 people impacted by a single instance of suicide and compare it to the number of 49,000 deaths caused by suicide in 2023, that means approximately 5.6 million people were impacted by suicide in 2023.

Suicide Stigma 

Despite its prevalence, suicide is often misunderstood. Stigma, as defined by the American Psychological Association, is “the negative social attitude attached to a characteristic of an individual that may be regarded as a mental, physical, or social deficiency. A stigma implies social disapproval and can lead unfairly to discrimination against and exclusion of the individual“ (source). When it comes to suicide, stigma looks like negative attitudes and stereotypes about suicide and the people who are impacted by it. Examples of this are saying things like “Suicide is selfish” or “Suicidal people can’t be helped.” Stigma is dangerous because it can cause widespread misinformation about suicide and mental health, which can discourage people from seeking support or being open to hearing about or discussing mental health. As a result institutions can also carry stigma and create policies and changes that are also harmful.

The history of suicide has also contributed to current stigma. In the past, suicide was considered immoral and considered a sin by many religions and is currently illegal in many countries (source). Myths around suicide have been influenced by media and social media, causing these myths to become accepted as truth by society.

Stigma actively harms anyone who is impacted by suicide. The American Association of Suicidology lists the following ways in which stigma harms people:

• It interrupts the healing and recovery process many people go through after an attempted suicide. For example, help received by healthcare professionals may be inadequate because they are addressing physical needs but not emotional or psychological needs that caused the attempt in the first place. Among suicide advocacy work, there has been a push for healthcare professionals, whether they are working with someone with a history of suicide attempts, to begin integrating mental health questions in their practice.

• A person who is considering suicide may not reach out for help because they’re afraid to be perceived as weak or a failure.

• Families and loved ones of people who died by suicide may have feelings of guilt, blame, or feel judged by others. This can affect the mourning process and make it harder for them to find support for their grief.

So how do we address stigma and raise awareness rooted in facts? It starts with how we show up in our daily lives. Normalizing mental health and treatment, combating myths around suicide and mental health, and educating ourselves is a great way to help with destigmatizing suicide. Agencies and community members should participate in and offer widespread educational opportunities that cover the causes of suicide and prevention techniques. We must also improve access to resources and support to those who are struggling with their mental health or thoughts of suicide and their families. We must review the resources we currently have available and recognize when those resources are failing people. We must acknowledge when the resources we have are not good enough at addressing the root causes of our issues and work together to find solutions. We must be supportive and compassionate toward one another and be willing to be curious about how our friends and community are doing, be willing to actively listen, and be willing to do more to learn about what we can do as both individuals and as a community.

Myths About Suicide

Here’s just a few of the common myths around suicide:

MYTH: Asking someone about suicide plants the idea in their head.

• If someone is showing warning signs for suicide, asking them if they’re suicidal won’t put the idea in their head. In fact, asking someone if they’re suicidal can actual provide them a sense of relief and has been shown to “reduce rather than increase suicidal ideation” (source). It demonstrates that you care and creates an opportunity for conversation. The worst someone can say is “no.”

MYTH: Every suicide attempt has warning signs.

• This myth can be a difficult one to discuss because of the nuance around it and the pain felt by people who know someone who has died from suicide. While warning signs (which we will list in the next section) can be an indicator, having warning signs does not always mean someone is actively suicidal. Ultimately, if you are concerned about someone, the best advice is to talk to them and ask directly if they are considering suicide (source).

MYTH: Suicide attempts are just attention-seeking.

• This way of thinking is harmful and is also applied to other people displaying mental health concerns (such as the case with non-suicidal self-injury). Ultimately, if someone is “crying for help” should we not listen to them? We should not dismiss people who are seeking help. In the event of a suicide attempt that the person survives, it is something to take seriously.

MYTH: Once a suicide attempt has been made, that person will eventually die by suicide.

• While a previous suicide attempt may be a risk factor for suicide, it is not a guarantee that someone will have another attempt in the future. Long term studies (here and here) have shown that a small percentage of those who have attempted will go on to die by suicide.

MYTH: People are either suicidal or not.

• Suicidal ideation, which is when a person thinks about, considers, or is preoccupied by the idea of dying/suicide, can ebb and flow across years, months, days, and even hours. It can change very quickly and may be affected by changes in thought (source). Suicidal behavior typically occurs when multiple stressors overwhelm someone’s ability to cope and can occur in a moment of crisis.

MYTH: People will always share their suicidal ideation/intent.

• People are often reluctant to share that they are considering suicide because they are afraid of what others will say, think, or do (source). This is why asking someone directly is so important. Warning signs and risk factors are not enough to know if someone is considering suicide.

MYTH: Suicide is never a sudden decision.

• Research suggests that some suicide attempts are planned while others are not. There are some studies that even suggest that sometimes suicide is not considered until about an hour or less before the attempt was made. Ultimately, human behavior is more complex than a simple “suicide is never planned” or “suicide is always planned.” This article breaks down these complexities.

MYTH: You Have to Be a Clinician to Help Prevent Suicide.

• Basic acts of showing you care can help prevent suicide. Additionally, there are clinicians who are not trained to provide suicide support and are not able to offer it. Studies from 2007 and 2018 show that there is a percentage of mental health professionals who were unable or unwilling to provide support services to people with suicidal ideation. Thus, it is important for everyone (both clinicians and non-clinicians) to support people considering suicide.

To read more myths and learn the facts, click here.

Risk Factors and Warning Signs: Who is at Risk for Suicide?

Anyone, regardless of age, gender, ethnicity, wealth, religion, and other demographics, can be at risk of suicide. Major risk factors include (source):

• A history of suicide attempts

• Depression, other mental health disorders, or substance use disorder

• Chronic pain

• Family history of depression, other mental health disorders, or substance use disorder

• Family history of suicide

• Exposure to family violence, including physical, or sexual abuse

• Presence of guns/firearms in the home

• Having been recently released from prison or jail

• Exposure to (directly or indirectly) to someone else’s suicidal behavior including family, peers, celebrities, etc.

However, it is important to note that even though these things can increase someone’s risk of suicidality, “most people who have risk factors for suicide will not attempt suicide” (source). Ultimately, It is difficult to tell who is actually having suicidal thoughts, even if they have one of the above risk factors.

Warning Signs 

Warning signs are tricky to discuss when it comes to suicide. This is because not everyone displaying warning signs is actively suicidal and someone who is considering suicide may not show any warning signs at all. Warning signs for suicide also overlap with other signs and symptoms of mental health concerns (that do not necessarily involve suicidal ideation). Further, a focus on warning signs can put undue burden on loved ones of someone who died by suicide.

There are many different warning signs presented in suicide prevention advocacy that can be an indicator of suicidal ideation or intent, however the ones that consistently come up are (source):

• Stating that they want to die or are considering suicide (these statements can be vague or clear).

• Giving away prized and valuable (to the individual) possessions.

• Indicating that they will not be around.

Suicide prevention advocacy should continue to discuss factors that contribute to a person’s mental health, especially when those factors may contribute to suicidal ideation. However, it is important to remember that (1) not ever suicidal person shows warning signs and (2) the best prevention is to just ask someone directly if you are worried about them. If they express intent to die by suicide do not leave them alone, do not promise to keep their suicidal thoughts a secret, and tell a trusted friend, family, or adult.

What to Do if Someone Needs Help

First of all, if you believe someone is in an immediate crisis, do not leave them alone. If you are approaching someone you are worried about, but do not believe is in immediate danger, make sure you have time to talk with them. Remember that this is a conversation that can take a long time and needs your full attention. Keep that in mind when preparing to talk to the individual at risk. 

If you are ever in doubt about someone, don’t wait to ask the question. If the person is reluctant, be persistent. Talk to them in a private setting, allow them to talk freely, and have resources handy such as crisis numbers, a school counselor, or mental health professional’s information. 

It can be challenging to know how to ask someone if they are considering suicide. What is important is that you remain non-judgemental in your questions. For example, avoid framing your questions like:

• “You’re not considering killing yourself, are you?”

• “You won’t do anything stupid will you?”

• “Suicide is selfish, surely you’re not thinking about it?”

Ultimately, if you are not able to ask the question, find someone who can.

If the person you are worried about confirms that they are considering suicide, keep these things in mind:

• Listen to the problem and give it your full attention. Active listening is a skill that can be built - look for trainings and free resources that offer tips on how to be a better active listener.

• Remember that suicide is not the problem, but rather the solution to a perceived unsolvable problem.

Your willingness to listen can make a difference to someone in need of help. Ask them if they can come with you to get help or what you can do to keep them safe.Suicidal people often do not believe they can be helped, so it is important to help them find support. Here are some things to do:

• Refer them directly to someone who can help. It may not always be possible to get immediate access to a mental health professional, so it is helpful to have multiple sources of support in mind (crisis phone numbers, trusted community members or adults, etc.).

• Know that if the person refuses help, you might have to get others involved.

• While arranging help, stay with the person.

• Remember that the best referral involves taking the person directly to someone who can help, the second best is getting a commitment from them that they will accept help and then making arrangements together, the third best is to give them referral information and try to get a commitment from them not to complete or attempt suicide.

Any willingness to accept help, even if it is in the future, is a good outcome.

There are many resources available in Cleveland County where you can learn more detailed information on topics such as suicide and mental health. Here are a few free community trainings:

• Partners Behavioral Health - free trainings each month on a wide range of topics.

• Mental Health Association of Cleveland County - yearly trainings in QPR Suicide Prevention; available to offer trianings in suicide prevention, CRM, and mental wellness.

Crisis Resources to know:

Local (Cleveland County, NC)

• Mobile Crisis Unit (24 hours) - 855-527-4747

• Cleveland Crisis and Recovery - 704-751-3693

• Partners Behavioral Health Crisis Line - 1-833-353-2093

• Atrium Behavioral Health (24 hours) - 704-444-2400

• Hopeline NC (call or text) - 1-877-235-4525

National

• Call or text 988 (24/7)

• Text HOME to 741741 for support through the Crisis Text Line (24/7)

• Call or text The Samaritans (24/7) - 1-877-870-4673

• Teen Line - Call 800-852-8336 6 pm - 10 pm PST every night or text TEEN to 839863 6 pm - 9 pm PST

• YouthLine - Call 8779688491 or text teen2teen to 839863

• Call 4 - 10 pm PST to talk to with a trained youth for peer-to-peer support

• Adults are available by phone all other times

• The Trevor Project Hotline for LGBTQ+  Youth - Call 1-866-488-7386 (available 24/7/365)