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How to help someone who might be at risk of suicide

Suicide is rare but it’s also increasing in America.

“As humans we try to look for pretty simple explanations, and neat narratives and stories, and it turns out that suicide is just incredibly complicated,” said Joseph Franklin, a psychologist who studies suicide risk factors at Florida State University.
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The deaths of Anthony Bourdain and Kate Spade last week woke many Americans up to the growing problem of suicide across the country. According to recent data from the Centers for Disease Control and Prevention, the suicide rate has increased in almost every state in the nation — and by more than 30 percent in 25 states — in the past two decades.

More than half of the people who died by suicide had no known mental health problems. The CDC noted that “relationship, substance use, health, and job or financial problems are among the other circumstances contributing to suicide.”

It’s important to note: Suicide is a rare event. Even though it is on the rise in this country, it’s just 16 out of every 100,000 people who die from it each year. This is important to stress. Humans are very sensitive to information about what’s normal. Sometimes when we hear a trend is “on the rise,” our brains translate that to “everyone is doing it.” Suicide is the tenth leading cause of death; but it’s still rare, and it ought to be rarer.

But suicide is absolutely preventable, and we’re learning more about the best ways to intervene. There are clear things we can do to reduce the risk that our friends and family take their own lives. Here’s what to look out for, and how to help.

How to spot a friend or family member at risk of suicide

Sussing out suicide risk can be difficult, even for the most practiced mental health clinicians. It’s not always linked to obvious declines in mental health or even sadness.

“As humans we try to look for pretty simple explanations, and neat narratives and stories, and it turns out that suicide is just incredibly complicated,” Joseph Franklin, a psychologist who studies suicide risk factors at Florida State University, told us in an interview last year. “That doesn’t mean we can’t make sense of it.”

The CDC has a list of the most common individual risk factors associated with suicide. They include:

  • A family history of suicide and/or childhood maltreatment
  • Previous suicide attempts
  • A history of mental health disorders, including depression
  • Recent losses and personal challenges, including deaths and financial troubles

According to the American Foundation for Suicide Prevention, people at risk of suicide will often talk about killing themselves, or feeling hopeless or trapped and a burden to others. They may also turn to drugs and alcohol more often, and withdraw from social activities.

One of the theories of how people can become comfortable with the idea of suicide is called acquired capacity. That is, most of us, by default, recoil at the notion of self-harm. But slowly, some people can grow more comfortable with the idea. And you can look out for friends and family going down this path.

Some of the reasons people become comfortable with the idea of self-harm have to do with personality. Some people have higher pain thresholds or are less squeamish about violence or blood. Some of these risk factors are acquired, meaning experiences can push people to get more used to the idea of self-harm. These experiences include cutting and other self-injury. People can become habituated to not fear the tools of death. And to be clear: Any form of self-harm is a serious matter.

When in doubt, don’t hesitate to offer help

If you think a friend of family member may be at risk of suicide, you should reach out. And when you do, there are many resources you can point them to. Here are a few:

In the US:

Crisis Text Line: Text START to 741741 from anywhere in the USA, at any time, about any type of crisis

The National Suicide Prevention Lifeline: 1-800-273-8255

The Trevor Project: 1-866-488-7386

Outside the US:

The International Association for Suicide Prevention lists a number of suicide hotlines by country. Click here to find them.

Befrienders Worldwide

You can also find a trained mental health clinician to help someone before a crisis begins. Psychology Today has a wonderful tool to find a counselor nearby. Just put in your zip code and you can sort therapists by insurances accepted and specialty. And Wirecutter has some great recommendations to find a web-based counseling service, if that route makes more sense for your situation.

Anecdotally, we know that just being a good listener to a friend in need can be reassuring. As the New York Times reported, simply showing up to keep someone company if they’re alone, asking questions, and offering to make an appointment with a health professional can have an outsize impact. That’s what made the difference for our colleague Zack Beauchamp, who struggled with his own suicidal depression.

As a society, we need better suicide prevention policies — and we could start with gun control

We can’t always control the individual factors that put people at risk of suicide, but we can work to ensure that our environments are less conducive to suicide. And in America, access to guns remains a chief risk factor for suicide that we could address with stricter regulations.

According to the new CDC data, 48 percent of deaths by suicide involved firearms — another reminder that while the homicides in America’s gun crisis get a lot of public attention, suicides by gun are far more common.

When there are fewer weapons around to inflict damage, there are fewer suicides. Countries that have enacted tougher gun regulations have also seen their suicide rates decline. But change can start in your own home. We know that having a gun at home can increase the risk of death by suicide for all family members.

Suicide, and its recent increase in the United States, is a frustrating, stubborn tragedy. But remember: We’re not powerless. We can help.

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