Suicide

• 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 MHA to 741741.

• 988 Suicide and Crisis Lifeline: 988
• The TrevorLifeline for LGBTQIA+ Youth : 1-866-488-7386⠀
• Crisis Text Line : Text 'MHA' 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: https://arc.mentalhealthamerica.net/find-an-affiliate
• 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

988 Suicide & Crisis Line
Phone: 988
Website URL: https://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