Suicide

If you or someone you know is struggling or in crisis, help is available. Call or text 988, or text MHA to 741741.

No suicide attempt should be dismissed or treated lightly!

Why do people attempt suicide?

A suicide attempt is a clear indication that someone is struggling and needs immediate help. The majority of suicides worldwide are related to mental health disorders; depression, substance use, and psychosis are the biggest risk factors.

• Suicide is the 10th leading cause of death in the U.S., accounting for more than 1% of all deaths. It is the second leading cause of death among people ages 15-24.
• More years of life are lost to suicide than to any other single cause except heart disease and cancer.
• In 2020, 46,000 Americans died by suicide. There were 13.48 deaths by suicide per 100,000.
• In 2020, 12.2 million adults had serious thoughts of suicide, 3.2 million made a suicide plan, and 1.2 million attempted suicide in the last year.
• 40% of persons who complete suicide made a previous attempt. Nine of out 10 people who attempt suicide and survive do not go on to complete suicide at a later date.
• Previous suicide attempts serve as a risk factor for completed suicide. Suicide risk is 37% higher in the first year after deliberate self-harm than in the general population. Older white adults have triple the suicide risk than younger adults of another race.
• Suicide rates are highest among adults ages 45-64 at 19.6 per 100,000. The second highest rate is 19.4 per 100,000 among those 85 years or older. Compared with middle-aged older adults, younger populations have consistently lower suicide rates. While males are four times more likely to do die by suicide, females are three times more likely to attempt suicide.
• Those with substance abuse disorders are six times more likely to complete suicide than those without. The rate of completed suicide among men who abuse alcohol/drugs is two-three times higher than among those who don’t abuse substances. Women who abuse substances are at six-nine times higher risk of suicide compared to women who do not abuse substances.

Any one of these signs does not necessarily mean a person is considering suicide, but several of these symptoms together may signal a need for help:

• Verbal statements such as, “you’d be better off without me” or “maybe I won’t be around.”
• Expressions of hopelessness and helplessness
• Previous suicide attempts
• Daring or risk-taking behavior
• Personality changes
• Depression
• Giving away valued and important possessions
• Lack of interest in future plans

Remember: 8 out of 10 people who are considering suicide give some sign of their intentions. Talking about suicide is not a typical response to stress. All talk of suicide should be taken seriously and be addressed immediately.

If you think someone is considering suicide

• Trust your instincts that the person may be in trouble.
• Talk with the person about your concerns. Communication needs to include listening to the person.
• Ask direct questions without being judgmental. Determine if the person has a specific plan to carry out the suicide. The more detailed the plan, the greater the risk.
• Get professional help, even if the person resists.
• Do not leave the person alone.
• Do not swear to secrecy.
• Do not act shocked or judgmental.
• Do not counsel the person yourself.

• No single therapeutic approach is suitable for all people considering suicide or who have suicidal tendencies. The most common ways to treat underlying illnesses associated with suicide are with medication, talk therapy, or a combination of the two.
• Cognitive (talk therapy) and behavioral (changing behavior) therapies aim to relieve the despair of suicidal patients by showing them other solutions to their problems and new ways to think about themselves and their world. Behavioral methods, such as training in assertiveness, problem-solving, social skills, and muscle relaxation, may reduce depression, anxiety, and social ineptitude.
• Cognitive and behavioral homework assignments are planned in collaboration with the patient and explained as experiments that will be educational even if they fail. The therapist emphasizes that the patient is doing most of the work, because it is especially important for a person thinking about suicide not to see the therapist as necessary for their survival.
• Recent research strongly supports the use of medication to treat the underlying depression associated with suicide. Antidepressant medication acts on chemical pathways of the brain related to mood. There are many very effective antidepressants. The two most common types are selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants (TCAs). Doctors may also prescribe other new types of antidepressants (e.g., alpha-2 antagonist, selective norepinephrine reuptake inhibitors (SNRIs), and aminoketones), and an older class, monoamine oxidase inhibitors (MAOIs).
• Antidepressant medications are not physically addictive. Although some symptoms such as insomnia, often improve within a week or two, it may take three or four weeks before you feel better; the full benefit of medication may require six to eight weeks of treatment. Sometimes changes need to be made in dosage or medication type before improvements are noticed. It is usually recommended that medications be taken for at least four to nine months after the depressive symptoms have improved. People with chronic depression may need to stay on medication to prevent or lessen further episodes.
• People taking antidepressants should be monitored by a doctor who knows about treating clinical depression to ensure the best treatment with the fewest side effects. It is also very important that your doctor be informed about all other medicines that are taken, including vitamins and herbal supplements, in order to help avoid dangerous interactions. Alcohol or other drugs can interact negatively with antidepressant medication.
• Do not discontinue medication without discussing the decision with your doctor.

If you or someone you know is struggling or in crisis, help is available. Call or text 988 or chat 988lifeline.org. You can also reach Crisis Text Line by texting HOME to 741741.

• 988 Suicide and Crisis Lifeline: 988
• The TrevorLifeline for LGBTQIA+ Youth : 1-866-488-7386⠀
• Crisis Text Line : Text ‘HOME’ to 741741
• Disaster Distress Helpline: Call 1-800-985-5990 or text TalkWithUs to 66746 to connect with a trained crisis counselor.
• Veterans Crisis Line: Dial 988 and Press 1
• Warmlines (For those who aren’t in crisis, but still want to talk to someone): http://www.warmline.org
• Dial 211 : 211 provides callers with information about and referrals to social services for every day needs and in times of crisis. Learn more: https://www.helplinecenter.org/
• Find MHA in your area
• SAMHSA Treatment Locator: https://findtreatment.samhsa.gov

Not sure if what you’re feeling might be related to a mental health condition? You can take a free, anonymous, and confidential mental health screen at MHAscreening.org and use the results to talk to a trusted person or your provider.

• We Can All Prevent Suicide
• #BeThe1To
• Mental Health First Aid
• The Jason Foundation
• The Jed Foundation
• Lifeline Chat
• The National Action Alliance for Suicide Prevention
• Now Matters Now

Suicide and youth

It can be hard to know how to deal with all the things life throws at us. For some, sometimes death seems like the only option. More young people survive suicide attempts than die, but even one death is too many. It’s important to know that there is help and there is hope.

• Suicide is the number two cause of death among young people ages 10-24.
• Boys are more likely to die from suicide, while girls are more likely to report attempting suicide.
• 17% of students seriously considered attempting suicide in the last year.

What can you do?

A is for Ask: Ask your friend if they are considering suicide or if they have a plan to end their life. It’s okay to be direct, just try to be non-judgmental and show you care.

C is for Care: If you think someone is in immediate danger, stay with them and offer to go with them to find help, even if it doesn’t make sense to you, try your best to sympathize and offer support. Try not to leave someone with suicidal thoughts alone.

T is for Tell: Tell a trusted adult what’s going on. Your friend might ask you not to tell anyone, but you should never keep talk of suicide a secret. It is worth breaking trust to save a life. You should never try to handle the situation by yourself. The most helpful thing you can do is guide your friend to someone with training.

What should parents and other adults do if they think a child is suicidal?

• Ask the child or teen if he or she feels depressed or thinks about suicide or death. Speaking openly and honestly allows the child to confide in you and gives you a chance to express your concern. Listen to his or her thoughts and feelings in a caring and respectful manner.
• Let the child or teen know that you care and want to help.
• Supply the child or teen with local resources, such as a crisis hotline or the location of a mental health clinic. If the child or teen is a student, find out if there are any available mental health professionals at the school and let the child know about them.
• Seek professional help. It is essential to seek expert advice from a mental health professional that has experience helping depressed children and teens.
• Alert key adults in the child’s life—family, friends, teachers. Inform the child’s parents or primary caregiver, and recommend that they seek professional assistance for their child or teen.
• Trust your instincts. If you think the situation may be serious, seek immediate help. If necessary, break a confidence in order to save a life.

Suicide and older adults

In 2013, the highest suicide rate (19.1%) was among people 45 to 64 years old. The second-highest rate (18.6%) occurred in those 85 years and older. According to the CDC, an estimated 10,189 older Americans (ages 60 and up) died from suicide in 2013. Notably, the suicides are particularly high among older, white males (32.74 suicides per 100,000 people). In fact, the rate of suicide in the oldest group of white males (ages 85+) is over four times higher than the nation’s overall rate of suicide.

Suicidal thoughts in older adults may be linked to several important risk factors and warning signs. These include, among others:

• Depression
• Prior suicide attempts
• Marked feelings of hopelessness; lack of interest in future plans
• Feelings of loss of independence or sense of purpose
• Medical conditions that significantly limit functioning or life expectancy
• Impulsivity due to cognitive impairment
• Social isolation
• Family discord or losses (i.e. recent death of a loved one)
• Inflexible personality or marked difficulty adapting to change
• Access to lethal means (i.e. firearms, other weapons, etc)
• Daring or risk-taking behavior
• Sudden personality changes
• Alcohol or medication misuse or abuse
• Verbal suicide threats such as, “You’d be better off without me” or “Maybe I won’t be around”
• Giving away prized possessions

Medicare helps cover mental health services

Worrying about health insurance costs should never be a barrier to treatment. Visit the Medicare QuickCheck® on MyMedicareMatters.org to learn more about all of the mental health services available to you through Medicare.

Medicare Part A

Medicare Part A (hospital insurance) helps cover mental health care if you’re a hospital inpatient. Part A covers your room, meals, nursing care, and other related services and supplies.

Medicare Part B

Medicare Part B (medical insurance) helps cover mental health services that you would get from a doctor as well as services that you generally would get outside of a hospital, like visits with a psychiatrist, clinical psychologist or clinical social worker, and lab tests ordered by your doctor. Part B may also pay for partial hospitalization services if you need intensive coordinated outpatient care.

Medicare Part D

Medicare Part D (prescription drug coverage) helps cover drugs you may need to treat a mental health condition.

Need help figuring out mental health coverage through Medicare? Use the Medicare QuickCheck® to get a personalized report on the best options for your situation.

988 Suicide & Crisis Line
Phone: 988
Website URL: 988lifeline.org

American Academy of Child and Adolescent Psychiatry
3615 Wisconsin Ave., N.W.
Washington, D.C. 20016-3007
Phone Number: (202) 966-7300
Fax: (202) 966-2891
Email Address: clinical@aacap.org
Website URL: www.aacap.org

American Association of Suicidology
Phone Number: (202) 237-2280
Website URL: www.suicidology.org

American Foundation for Suicide Prevention
Phone Number: 888-333-AFSP (2377)
Website URL: www.afsp.org