Suicide Prevention: Risk factors, warning signs and treatment options
9/14/2023 by Rachel Wasson, Ph.D.; Annie Roche, Ph.D.; Jocelyn Lebow, Ph.D., L.P.; Craig Sawchuk, Ph.D., L.P.
In 2021, approximately 47,500 people died by suicide, which placed suicide as the 11th leading cause of death. Below are recent statistics regarding suicide from the National Center for Health Statistics and National Institute of Mental Health.
- Rate of suicides in the United States increased 4% from 2020 to 2021.
- Among females, suicide rate was highest for those aged 45-64 in 2021. Among males, suicide rate was highest for those aged 75 and older in 2021.
- In 2020, suicide was the second leading cause of death for individuals between 10-14 and 25-34.
- American Indian or Alaska Native people had the highest rates of suicide in 2021 compared with other groups.
- In 2021, 12.3 million adults reported having serious thoughts of suicide and 1.7 million adults attempted suicide.
- In 2020, 42% of LGBTQ youth seriously considered suicide, with more than half being transgender and nonbinary (The Trevor Project).
The effect of suicide is staggering — not only because of the thousands of lost lives each year, but the impact on grieving family and friends who will live with the loss for the rest of their lives. Suicide prevention can and should be a priority for all of us.
Be aware of risk factors
The first step toward reducing these numbers is being aware of the risk factors for suicide. The American Foundation for Suicide Prevention identifies important risk factors falling into three broad categories:
- Health (e.g., depression, anxiety, substance use problems, serious medical conditions, chronic pain, traumatic brain injury).
- Social/environmental (e.g., access to firearms and drugs, chronic stress, significant loss or major life transition, unemployment, financial crisis, relationship problems, exposure to someone else's suicide).
- Historical (e.g., previous suicide attempts, family history of suicide, childhood abuse and neglect).
For individuals from diverse identities, experiencing prejudice, discrimination and/or trauma has been associated with an increased risk of suicidal thoughts and behaviors. Data indicates that American Indian/Alaska Native, LGBTQ+ and older adult populations are particularly vulnerable.
For adolescents and children, bullying — both face-to-face and cyberbullying — has been strongly correlated with suicidal thoughts and behavior. Data suggests that being the perpetrator, as well as the victim, of bullying might be linked to an increased risk of suicide in youth.
Watch for warning signs
Pay attention to certain warning signs from individuals who may be at risk for harming themselves:
- Changes in mood, such as severe depression, anger, anxiety, hopelessness, apathy or relief/sudden improvement.
- Changes in behavior, including isolation, acting impulsively, excessive substance use, deliberately searching for ways to harm themselves, saying goodbye or giving away cherished possessions or fatigue and changes in sleep patterns.
- Talking about not wanting to live, hopeless that things will get better, having no reason to live or feeling they are a burden to others.
Be aware of protective factors
Protective factors, those that help to promote safety and reduce the risk of suicide, include:
- Social connections (family, friends, community).
- Cultural and spiritual beliefs.
- Access to physical and mental healthcare services.
- Problem-solving and coping skills.
- Limited access to lethal means such as firearms.
- A sense of purpose or reasons for living.
Help is always available
Reach out to others, including friends, family and healthcare professionals, to increase social support and feelings of connectedness.
For those in immediate crisis, help is always available. Call 911, go to the nearest emergency room or dial 988 to reach the National Suicide Prevention Lifeline — available 24 hours a day, seven days a week.
Talk with your child
For caregivers concerned that their child might be considering suicide, it can be hard to know how to behave. Bringing up your concerns with your child, including asking directly about suicide, is important. Caregivers sometimes worry that talking about suicide can "plant ideas" in their child's head, but in reality, talking openly about your concerns and making a family-wide plan to get help is the best way to ensure your child's safety. Visit the Society for the Prevention of Teen Suicide website for more information.
Effective treatments are available to further reduce the risk of suicide, including psychotherapy and medications. Your healthcare team can refer you to local resources. Increasing family and social support can help strengthen connections to your community, promote safety and increase a sense of meaning or purpose in life.
Educating yourself about risk factors, warning signs, protective factors and available treatments can begin a new trend toward reducing the risk of suicide.
Rachel Wasson, Ph.D., and Annie Roche, Ph.D., are clinical health psychology fellows in Primary Care in Rochester and Kasson's Division of Integrated Behavioral Health at Mayo Clinic.
Jocelyn Lebow. Ph.D., L.P., is a child and adolescent psychologist in Primary Care in Rochester and Kasson's Division of Integrated Behavioral Health.
Craig Sawchuk. Ph.D., L.P., is a clinical psychologist in Primary Care in Rochester and Kasson's Division of Integrated Behavioral Health. He is the co-chair of the Division of Integrated Behavioral Health and co-chair of Clinical Practice with the Department of Psychiatry and Psychology at Mayo Clinic.