Suicide Risks, Crises, and Prevention

September 9-15 is National Suicide Prevention Week, and organizations throughout the country are working to help people understand long-term risk factors and how to deal with a suicidal crisis.

Most of us can name the leading causes of death in the US. In fact, if you want to know more about how people are dying in your state, the Centers for Disease Control and Prevention (CDC) can provide you with national and regional "top ten" lists.

What most people don't know is that suicide is number 11.

In the United States, twice as many people die by suicide than by homicide. More than 31,000 Americans kill themselves each year. That's 89 suicides every day; one every 16 minutes.

Suicide Risk Factors
Some factors might make people more likely to commit suicide. Mental illness, access to lethal means, recent loss of loved ones, hopelessness, and unemployment are just a few examples of risk factors. Others include:

• Previous suicide attempt(s)
• History of depression or other mental illness
• Alcohol or drug abuse (The National Violent Death Reporting System examined toxicology tests of those who committed suicide in 13 states: 33.3% tested positive for alcohol; 16.4% for opiates; 9.4% for cocaine; 7.7% for marijuana; and 3.9% for amphetamines).
• Family history of suicide or violence
• Physical illness
• Feeling alone

Protective factors - those that buffer against suicidal behaviors - include high self-esteem, social connectedness, problem-solving skills, and supportive family and friends.

Suicide Warning Signs
If you know someone who you think could be suicidal, do not leave him or her alone. Stay with them or stay in touch.

Listen to them with sincere concern for their feelings. Do not offer advice, but let them know that they are not alone.

Tell them how you feel. If you think that they might make a reckless decision, tell them that you are concerned. They need to know that they are important to you and that you care.

In a straightforward and caring manner, ask if they have had suicidal thoughts or if they have made a suicide plan. If you feel you cannot ask the question, find someone who can.

Try to get the person to seek immediate help from his or her doctor or the nearest hospital emergency room, or call 911 contacting a mental health professional, or call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255).

If you or someone you know exhibits any of the following suicide warning signs, seek help as soon as possible:

• Threatening to hurt or kill oneself or talking about wanting to hurt or kill oneself
• Looking for ways to kill oneself by seeking access to firearms, available pills, or other means
• Talking or writing about death, dying, or suicide when these actions are out of the ordinary for the person
• Feeling hopeless
• Feeling rage or uncontrolled anger or seeking revenge
• Acting reckless or engaging in risky activities-seemingly without thinking
• Feeling trapped-like there's no way out
• Increasing alcohol or drug use
• Withdrawing from friends, family, and society
• Feeling anxious or agitated, being unable to sleep, or sleeping all the time
• Experiencing dramatic mood changes
• Seeing no reason for living or having no sense of purpose in life

If it is safe for you, eliminate access to firearms or other potential tools for suicide, including unsupervised access to medications.

Warning signs can include changes in a person's mood, diet, or sleeping pattern. The American Association of Suicidology has detailed information on what to look for and how to respond.

Left Behind
The CDC estimates that more than 5 million people in the United States have been directly affected by a suicide. Family and friends of people who commit suicide are left devastated. They may feel shock, anger, guilt, and depression. It's very important that people understand that no one is responsible for the suicide of another.

More people survive suicide attempts than actually die. For each completed act of suicide, there are 25 attempted suicides. More than 425,000 people with self-inflicted injuries are treated in emergency rooms each year; people who attempt suicide and survive may have serious traumas like broken bones, or lifelong injuries such as brain damage or organ failure.

Prevention
Many people feel uncomfortable talking about suicide, but being aware of risk factors and warning signs might give us time to get help for someone who is considering taking the final step.

The National Suicide Prevention Lifeline is a 24-hour, toll-free suicide prevention service for people who feel like they have nowhere to turn.
Call to speak with someone who cares.
Call if you feel you might be in danger of hurting yourself.
Call to find referrals to mental health services in your area.
Call to speak to a crisis worker about someone you're concerned about.

If you need help, please dial 1-800-273-TALK (8255) the National Suicide Prevention Lifeline. Its mission is to provide immediate assistance to anyone seeking mental health services. The service is free and confidential, and someone will be available to talk to you 24 hours a day, 7 days a week. Call for yourself, or someone you care about.

Suicidal crises are often brief. Experts believe that most suicidal individuals do not want to die; they just want to end the pain they are experiencing.

When suicidal behaviors are detected and managed, lives can be saved.

A series of thoughtful articles called "Griefwords" on the Froedtert Hospital website, found under "Health Resources," provide guidance and direction for anyone touched by grief.

This article includes information from the US Department of Health and Human Services/Substance Abuse and Mental Health Services Administration and the National Institute for Mental Health.

Each year, Medical College of Wisconsin physicians care for more than 180,000 patients, representing nearly 500,000 patient visits. Medical College physicians practice at Children's Hospital of Wisconsin, Froedtert Memorial Lutheran Hospital, the Milwaukee VA Medical Center, and many other hospitals and clinics in Milwaukee and southeastern Wisconsin.