While the stigma surrounding mental health issues has improved with time, suicide continues to be a topic filled with shame, fear, and unspoken thoughts. The potential for suicide can strike any person, family or situation, though there are specific risk factors that may increase the risk of suicide. The efforts to prevent suicide include conversations, screenings, and collaboration across professionals, caregivers, and family members.
The Center for Disease Control lists both the risk and protective factors for suicide. Suicide risk factors include previous attempts, family history of suicide, recent losses, substance and alcohol use, impulsive tendencies, and feelings of hopelessness, among other variables. The protective factors include access to mental health care, family and friend supports, and strategies for conflict resolution and problem solving. Frankly understanding those that are at risk include coming up with risk management plans, which may include inquiring about means and lethality, preventing access to medications, firearms, or other means, and strategizing to come up with supports that can keep the person at risk safe. This often includes hospitalization, where monitoring safety is included with stabilizing a persons mood and situation.
Because understanding risk factors is so important, an increasing push to include suicide risk screening assessment in primary health care settings has been a welcome change. Young adults and adolescents are particularly vulnerable to suicide, as their frontal lobe, the part of the brain responsible for foreseeing consequences and problem solving, is not yet fully developed. That is not to say that suicide is not a problem for all ages – in fact, it is one of the leading causes of death in the elderly population as well. Yet early detection and screening policies can set the stage for ongoing conversations, risk management, and suicide prevention. Additionally, this type of screening works. The policy began in behavioral healthcare settings, and suicide risk factors were more readily identified, and prevented. The movement towards a more mainstream suicide risk assessment will continue to save lives, but also will decrease the stigma of talking about suicide.
Many people avoid talking about suicide because the topic is so scary. Adults may worry that asking questions about a child or adolescent’s suicidal ideation may put ideas into their head. However, for truly suicidal children, they already had the idea, and being seen and heard comes as a relief, as they genuinely want help. For a child who isn’t suicidal, asking about these types of thoughts would be considered ridiculous, and they easily move on. These children also go to school with other children, and it is often peers who will alert their teachers and other familiar adults when a friend starts talking about death, or not wanting to live anymore. Helping a child or teen recognize these warning signs empowers them, and continues to work on globally preventing suicide.
It helps also to know exactly what to do if someone mentions not wanting to live anymore. In a true emergency, calling 911 or visiting the nearest emergency room is the fastest, most effective way to save a life. Stay connected, and have open conversations. Meet them with empathy and compassion, and avoid minimizing, or reassuring that “It will all be just fine.” This can feel quite invalidating to a person feeling suicidal. Encourage mental health care, and offer to drive, or go with them to an initial appointment which may feel overwhelming in this current distress. Suicide is scary, but with early intervention, care, and ongoing conversation, more suicides can be prevented, and more lives can be saved.