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Suicide is Preventable

What each of us can do to prevent it

September, 2018

“Suicide deaths are preventable, says Family & Children Services Behavioral Health Program Manager Susan Davis, LPC, LBSW. “With awareness and education we can envision a time when there are zero deaths by suicide.”

Yet for now, family members, friends, teachers, co-workers, and others in a position to help someone who may be contemplating suicide are still afraid to talk about it, she says.

“Don’t be afraid. People who are thinking about committing suicide have options. Help is available. There is hope.”

Here are some straightforward actions that Susan and other experts say each of us can take.

Look for Warning Signs

Mental health experts agree no one single factor leads to suicide. Look for warning signs that may indicate that someone is at risk of suicide. These include:

  • Being isolated, withdrawing from friends and family
  • Expressing feelings of hopelessness or being a burden to others
  • A change in sleep habits: sleeping too much or too little
  • Extreme mood swings, such as increased anger, anxiety, or sadness
  • Decline in quality or interest in schoolwork, hobbies, daily activities
  • Giving away important personal possessions
  • Increased substance use
  • Talking about suicide and people who have committed suicide
  • Taking an interest in guns, pills, or other lethal means of suicide

Know the Risk Factors for Young People

Be especially aware of suicide risk factors for youth and young adults. Because, according to the Michigan Youth Risk Behavior Survey (2015):

  • Youth who were bullied online were FIVE TIMES more likely to consider suicide.
  • LGBTQ youth were FIVE TIMES more likely to consider suicide than heterosexual youth.
  • Youth that experienced physical or sexual dating violence were FIVE TIMES more likely to attempt suicide.
  • Youth that were injured in a physical fight and had to be treated by a doctor or nurse were FIVE TIMES more likely to attempt suicide.

Know the Risk Factors for Adults

Be concerned about adults, too. According to the U.S. Centers for Disease Control (CDC), in nearly every state in the U.S. since 1999, adults ages 45 to 64 had the largest increase in rates of suicide. Studies suggest that falling economic fortunes and rising rates of opioid addiction are contributing to increased suicides among middle-aged Americans.

The CDC also reports that about 46 percent of Americans who committed suicide have a known mental illness. That also means that 54 percent did not. And not everyone with a mental illness commits suicide, either. So, what else was going on in peoples’ lives that may have led them to commit suicide? According to the CDC, people who committed suicide:

  • 42% had relationship problems
  • 29% had faced a crisis in the two weeks before their suicide or would have faced in the next two weeks
  • 22% had physical (not mental) health issues
  • 20% were facing financial troubles, job loss, or homelessness
  • 9% had criminal legal problems

Many people had more than one of these issues.

Care and Connect

“Listening to someone who may be contemplating suicide and then connecting them to professional resources is the best possible thing you can do,” said Susan Davis. “Don’t make it your responsibility to diagnose and treat. Your job should be to care and connect.”

Susan says directly asking someone “Are you thinking about suicide?” is critical. And you may have to ask it more than once.

“People in the throes of suicide ideation are often in so much pain that they don’t see another option. They have lost hope,” she says. “We want them to know that they have options. There is always hope.”

It starts by asking for help, which is not a sign of weakness, says Susan. “It’s a sign of strength.”

Encourage the person to reach out to a therapist, whether at Family & Children Services or elsewhere in the community, she says. “There are many compassionate and experienced therapists standing by to help.”

And be prepared to encourage them more than once, she says. “Sometimes you have to be their ‘best pest’ as well as their best friend. “I know people who called their suicidal friend or family member every day asking ‘Did you pick a therapist yet? Did you call? Because I won’t stop bugging you until you do. And then I’m driving you to the appointment.’”

Teach Your Children Well

Results from the 2015 Michigan Youth Risk Behavior Survey show that suicidal thoughts in high school students have decreased by 30 percent since 1997. Yet, suicides in Michigan youth and young adults have increased by more than 50 percent in the past ten years.

In order to help the next generation of youth and young adults, Susan borrows a quote from child psychologists Jim and Charles Fay, authors of Love and Logic and other books about parenting. “They say ‘Teach your kids lessons when the price tag is small.’ That means, allow them to fail at little things and experience small losses when they are young. This will help them overcome bigger losses later in life – lost jobs, lost love, lost loved ones.”

She also encourages parents to step out of their comfort zone and not shield children from death and dying. For example, let children go to the funeral of a family member or friend.

“Death is an inevitable part of life. Let kids see how people handle grief. Let them observe, encourage them to ask questions, and then talk with them about it. This will help them build resilience to adversity, learn to handle the loss of loved ones that they will inevitably have.”

Watch for Suicide Contagion

In the months following actress Marilyn Monroe’s suicide in 1962, health authorities reported an increase in suicides, especially among women. A 10-percent spike in suicides was measured in the months following the 2014 suicide of comedian Robin Williams. While it’s too early to measure any such spikes following the recent suicides of TV chef Anthony Bourdain and fashion designer Kate Spade, if such spikes occur, they will be in keeping with a phenomenon called “suicide contagion.”

Such contagion or clusters of suicides sometimes follow the suicide of a celebrity or someone in our peer groups, such as a family or school. Adolescents and young adults can be especially vulnerable to this. The good news is that calls to local and national suicide help lines also see a surge in call volume following suicides that garner widespread attention.

Susan encourages parents and others to talk to children and young adults about the famous person or the kid at their school who committed suicide. “Avoid glamorizing these suicides,” she says. “Don’t make it seem like their suicides were the inevitable solution for these people. Like they had no other choice.” Kids and adults who are already thinking about suicide may look at the suicide of a famous person or popular kid at school as license to follow suit, she says.

“It doesn’t matter how rich, famous, and outwardly successful you appear to be. None of these changes the chemistry in your brain that cause depression. Getting and following through with treatment is vital. Suicide is never the answer.”

In the wake of singer Kurt Cobain’s 1994 suicide at his Seattle home, health professionals there and beyond braced for a wave of suicide contagion, especially among his young fans. Yet, even as the calls to suicide prevention lines in the Seattle area and elsewhere surged, suicides actually went down. Health professionals and Cobain’s widow, Courtney Love, were credited with using his suicide as a teachable moment and speaking openly about the pain that Cobain’s suicide caused his family, friends, and fans. They also spoke openly about the drug use and clinical depression that he had fought for years. By deglamorizing his death and demystifying some of the underlying causes that led to it, they reduced the suicide contagion that might have followed.

Remove Lethal Means

“Teenagers are impulsive,” says Susan. “They often think that every awful thing that happens to them is the end of the world. The breakup of a romance or death of a family member or idol can make them feel devastated. Add in impulsiveness, lack of experience dealing with loss, perhaps drugs and alcohol, and you have a recipe for tragedy. Especially if they have an underlying mental health issue, whether diagnosed or not.”

Another toxic ingredient in this recipe is access to lethal means, such as guns, pills, and other ways to commit suicide.

“If someone in your household is struggling with depression and showing warning signs of suicide, please lock away your guns, ammunition, and medications. Even acetaminophen [the active ingredient in Tylenol] can be lethal if taken in large quantity. Remove it from your loved one’s access.”

Suicide by hanging is increasing. It may be impractical to throw away or lock up rope but you can be aware of someone showing an unhealthy interest in hanging methods or purchasing rope for no obvious reason.

It might not even be a member of your household that you need to worry about, says Susan. It could be a neighbor, family friend, or coworker who is thinking about suicide and knows where you keep unsecured weapons or dangerous medications.

“And it’s not about limiting anyone’s right to own guns. It’s about safely securing them from someone who might want to use your gun to commit suicide.”

Choose Your Words

Talking about suicide with someone who may be considering suicide is a tough conversation to have. “But you must have that conversation,” says Susan. “It matters.”

How you talk about suicide matters, too she says. For starters, use the word “suicide.” Terms such as “killing yourself, ending your life, or taking your life” are okay, but using the word suicide leaves no doubt that you and the person you think may be at-risk are talking about the same thing.

Stay away from terms such as ‘successful, unsuccessful, and failed’ suicide, however. “There is nothing ‘successful or unsuccessful’ about suicide,” Susan says. “And the word ‘failed’ or ‘failure’ only stigmatizes the person in need of help.

Before talking with someone you are concerned about, have suicide crisis materials and 24-hour crisis phone numbers on hand. These are available from trusted sources, such as:

  • National Suicide Prevention Lifeline / (800) 273-8255
  • Gryphon Place / (888) 373-6200 (Allegan, Berrien, Cass, Kalamazoo, VanBuren counties)
  • Summit Pointe / (800) 632-5449 (Calhoun County)
  • Family & Children Services staffs the 24-hour Kalamazoo Community Mental Health and Substance Abuse Services Mobile Crisis Response team for youth under age 18 who are in crisis. Call (269) 373-6000 or (888) 373-6200.
  • Crisis Text Line is available by texting HOME to 741741.

Mention warning signs that you have seen and ask directly: “Are you thinking about suicide?” If the answer is “Yes,” then ask if they have a specific plan in mind on how to do it. If you feel the suicide is imminent, call 911 or take the person to a hospital emergency department. Don’t put yourself in danger.

Talk about suicide like you would talk about any other serious health problem. Be willing to actively listen and don’t pass judgment. Be calm, but also allow your emotions to come through.

Don't pass judgment or tell them to get over it. Reassure them that help is available, they have reasons to live, and that you and others are on their side.

Promise to respect their privacy, but don’t promise to keep their secret if they refuse to ask for help. Offer to make a call to a helpline with them or drive them to a therapy appointment.

Don't leave the person alone, if possible. Follow up, frequently, until they ask for help. Above all, don’t stay silent. Talking about suicide will not make the situation worse. I can only make it better.

“Suicide is preventable,” says Susan Davis. “If you have thoughts about suicide, please know that help is available. Asking for help shows that you want to live. Pick up the phone and call a trusted friend or relative. Better still, call a helpline. We are standing by to help you.”

Susan Davis

Susan Davis