Every individual and community is touched by suicide. Here’s how to help.

Despite significant advancements in mental health care over the past 16 years, suicide rates in the U.S. have increased by more than 30%. Though celebrity suicides get a lot of attention in the media, most people are unaware that more than 47,000 Americans die by their own hand each year — more than double the number who are victims of homicide. Studies indicate that about 1.4 million people attempt to take their own lives each year, while an estimated 9 million people contemplate it. The impact of this tragic loss of life on families and communities is devastating, but there are things we can all do to help. Suicide Prevention Month brings the opportunity to learn and act to reduce the rising trend, which touches almost everyone.

Know the risk factors

Understanding why a person commits suicide is complicated because each individual experiences a unique collection of stresses, circumstances, genetic and environmental influences, and other factors that converge to trigger suicidal thoughts or acts of self-harm. Though, the major risk factors for suicide include:

• A prior suicide attempt
• Depression and other mental health disorders
• Impulsivity or conditions such as substance abuse that lead to impulsive behavior
• Family history of mental health or substance abuse disorder; suicide; violence including sexual or physical abuse
• Access to lethal means
• Legal or relationship problems, or financial or housing insecurity
• Exposure to suicidal behavior by others, such as a family member, peer or media figure
• Medical illness, chronic pain, or insomnia

Though females attempt suicide more often, males are nearly four times more likely than women to die by suicide, due to the use of more lethal means. White males accounted for nearly 70% of suicides in 2017, and more than 50% of all suicide deaths involved firearms. The highest suicide rate is among adults age 45-54, with the second highest in those over 85. Suicide rates have also risen dramatically among those 15-24 years old.

Recognize behaviors that may be signs, know what to do 

Millions of people have one or more risk factors but never attempt suicide, and it is difficult to predict who will act on suicidal thoughts. There are some noticeable behaviors that are warning signs that an individual may be in danger:

• Changes in behavior, especially if related to a loss, change, or painful event
• Increased social isolation, dropping out of usual communication channels
• Unusual restlessness, agitation or aggression
• Increased use of alcohol or drugs
• Talking about suicide, feeling hopeless, being a burden to others, feeling trapped, unbearable pain
• Mood changes including depression, or relief and sudden improvement of mood
• Visiting people to say “goodbye” or giving away treasured possessions; making a will

If you see these behaviors, the most important thing you can do is ask directly if they are thinking of harming themselves. Contrary to myth, this will not "put the idea in their head" to take their own life. A compassionate, non-judgmental conversation about the things you’ve noticed, your concern for their safety, and an offer to help them access care can begin to defuse a crisis. Anyone contemplating suicide is not safe, and needs professional evaluation. If it doesn’t appear that someone has an immediate plan or urge to hurt themselves, calling a Suicide hotline or a mental health professional is an important next step. However, no matter their age or gender, if it appears that they are imminently suicidal, call 911 or bring them to the emergency department of a hospital. Suicide is a behavior of impulsivity, and even professionals find it challenging to predict individual risk. You can find more information and guidance 24/7 at any of these resources:

• National Suicide Prevention Lifeline, 1-800-273-TALK, or 1-800-273-8255
• National Suicide Prevention Lifeline Chat
• Lifeline Nacional de Prevención del Suicidio, En Español, 1-888-628-9454
• National Suicide Prevention Lifeline, for Deaf & Hard of Hearing, 1-800-273-8255
• The Trevor Project for LGBTQ Youth, 1-866-488-7386
• Veterans Crisis Line, 1-800-273-8255 (Press 1)

Understanding social roots and remedies

Research suggests a number of theories to account for the rising number of suicides. One involves social disconnection in the face of increasing reliance on social media. Despite the appearance of greater connection with others, we may be lacking important face-to-face interactions and human connection vital to emotional wellness. At the same time, many social media platforms create opportunities for potentially deleterious comparisons with others as well as hurtful posts. For teenagers, increased competitiveness in school admissions, sports and activities can increase stress and anxiety, potentially contributing to a greater likelihood of suicidal thoughts. In adults, economic issues in the past decade have taken a psychological toll on middle-aged workers, as well as those newly entering the job market. And our vulnerable elderly population is coping with physical limitations and pain, loss of autonomy and social isolation, coupled with access to multiple medications that can be lethal.

Communities can begin to reverse the upward trend in suicide by expanding access to quality mental health services, addiction treatment and battling stigma against mental health treatment. Education about warning signs, how to talk with loved ones about suicide, dissemination of information about suicide hotlines and sharing practical steps for immediate safety if a person appears to be actively suicidal are more ways communities can have an impact. Reducing access to lethal means, including firearms and medications, is another crucial effort with the potential to save lives.

Montefiore integrates the latest advancements in research and science

Our Department of Psychiatry & Behavioral Sciences is recognized as one of the most robust in the United States, offering a full range of in-patient and out-patient services and treatments. 

Montefiore has also made mental health care an integral part of our primary care services systemwide, through our Behavioral Health Integration Program (BHIP), where we offer a full medical evaluation including a mental health component. At every primary care location, physicians and specialists, including social workers, psychologists and psychiatrists, work hand-in-hand to provide a full range of mental health services.

Robust school-based programs are one way to protect children now and help them develop lifelong coping, problem-solving, and stress reduction skills early in life. Through its nationally acclaimed School Health Program, Montefiore partners with schools to support access to mental health services for children and young adults, offering screening and treatment for conditions such as depression and anxiety.

Montefiore Health System, with our Albert Einstein College of Medicine, are training the next generation of physicians and psychologists, and our students and post-graduate trainees from all disciplines bring a clearer understanding of mental health challenges than ever before. Every individual can take action by promoting a sense of community and connection, encouraging face-to-face interaction with friends and loved ones, and engaging with others to bring awareness and action on suicide prevention into their workplaces, schools, and communities as a whole. Organizations that offer excellent guidance and resources include: 

• American Foundation for Suicide Prevention
• National Action Alliance for Suicidal Prevention
• Suicide Awareness Voices for Education
• #BeThe1To
• JED Foundation

While suicide statistics are not heading in the right direction today, continued support for mental health awareness is one of our best chances of reversing this unfortunate trend.

Montefiore’s Department of Psychiatry and Behavioral Sciences provides the highest quality care and comprehensive support to patients of all ages. The department’s ongoing research continues to break new ground with innovative treatments for disorders such as anxiety and depression. The department’s education programs continue to ensure a pipeline of devoted expert professionals for the future. For more information, visit https://www.montefiore.org/psychiatry.