What Is Suicide?
Suicide is intentionally causing your own death. It's one of the top causes of death in the U.S., with rates rising across the country. According to the CDC, 49,476 Americans died by suicide in 2022, a 36% increase since 2000.
What Is Suicidal Ideation?
It's when you spend time thinking about dying by suicide. It's also called “suicidal thoughts.” These thoughts can range from a general wish to die without a concrete plan to a detailed plan for suicide.
Suicidal ideation assessment
Suicidal ideation risk assessment is a way to find out how seriously you're thinking about and/or planning for a suicide. A mental health professional or doctor will:
Identify your risk factors. They’ll look at what life circumstances may be increasing your risk of suicide, such as substance use, mental health, past suicidal behavior, and trauma, and whether there are ways to reduce your risk.
Identify your protective factors. This looks at what kinds of tools you have access to that can help buffer suicidal thoughts. These are things like a supportive community, access to mental health care, and healthy relationships.
Conduct a suicide inquiry. They’ll ask questions about how often you think about suicide, if you have a plan for it, and whether you’ve attempted suicide before.
Determine your risk level. Using a system that looks at your answers to the questions, your practitioner will decide your risk level.
Plan an intervention. They’ll form a plan for what to do next: what tools to use, people to contact, and supportive measures to put into place.
Suicide Warning Signs
If you or someone you know is thinking about suicide, you can call or text the Suicide & Crisis Lifeline anytime at 988.
Any of these could be warning signs of suicide:
Severe sadness or moodiness. Long-lasting sadness, mood swings, and unexpected rage
Hopelessness. Feeling a deep sense of hopelessness about the future, with little expectation that circumstances can improve. You may feel there's no reason to live and you're a burden to others.
Pain. You may feel and mention unbearable pain, which can be physical or mental.
Sleep problems. You may have trouble sleeping, or sleep more than usual.
Sudden calmness. Suddenly becoming calm after a period of depression or altered mood can be a sign that you've made a decision to end your life.
Withdrawal. Choosing to be alone and avoiding friends or social activities also are possible symptoms of depression, a leading cause of suicide. This includes the loss of interest or pleasure in activities you previously enjoyed.
Changes in personality or appearance. You might show a change in attitude or behavior, such as speaking or moving with unusual speed or slowness. You might suddenly become less concerned about your personal appearance.
Dangerous or self-harmful behavior. Potentially dangerous behavior, such as reckless driving, engaging in unsafe sex, and increased use of drugs or alcohol, might indicate you no longer value your life.
Recent trauma or life crisis. A major life crisis might trigger a suicide attempt. Crises include the death of a loved one or pet, the end of a relationship, diagnosis of a major illness, loss of a job, or serious financial problems.
Making preparations. You might begin to put your personal business in order. This might include visiting friends and family members, giving away personal possessions, making a will, and cleaning up your room or home. Some people write a note before taking their own life. Some buy a firearm or other means, like poison.
Talking about suicide. Around 50% to 75% of those considering suicide will give someone – a friend or relative – a warning sign. It may not be an outright plan. You might talk an unusual amount about death or say things like, “It'd be better if I weren't here.” But not everyone considering suicide will say so, and not everyone who plans suicide will follow through with it. Every mention of suicide should be taken seriously.
Suicide Risk Factors
Suicide rates are highest in teens, young adults, and those over 55. People of non-Hispanic Native American/Alaska Native heritage are the ethnic/racial group with the highest rate of suicide, followed by people who are non-Hispanic White. Women are three times more likely to attempt suicide than men, although men are more likely to die by suicide.
Suicide risk also is higher in people who:
- Lose a spouse through death or divorce
- Have attempted suicide in the past
- Have a family history of suicide
- Know a friend or co-worker who have killed themselves
- Experienced a history of physical, emotional, or sexual abuse
- Are unmarried, unskilled, or unemployed
- Deal with with long-term pain or a disabling or terminal illness
- Are prone to violent or impulsive behavior
- Were recently released from a psychiatric hospitalization.
- Work in professions such as police officers and health care providers who deal with terminally ill patients
- Struggle with substance abuse problems
- Live with disabilities
- Are LGBTQ, especially if they're younger
These risks may come, in part, from heightened stress people in these groups experience from racism, discrimination, and other negative social conditions. The minority stress theory says the excess stress of living in a minority group (racial, sexual, ability-related, or otherwise) increases negative health outcomes, when compared to people in majority groups.
Individual risk factors
In addition to the larger-scale risks of suicide, these personal factors can increase your risk:
- Previous attempt(s) at suicide
- A history of depression or other mental illnesses
- Chronic pain or illness
- Criminal/legal problems
- Job or financial problems or loss
- A tendency toward impulsive or aggressive behavior
- Adverse childhood experiences (ACEs)
- Exposure to violence (as either the victim or the cause)
Suicide Prevention
Suicide can be preventable. And that starts with knowing what to look for and what to do.
Research suggests that the best way to prevent suicide is to know the risk factors, be alert to the signs of depression and other mental disorders, recognize the warning signs for suicide, and intervene before the person can complete the process of self-destruction.
Some of the ways a person can reduce their own suicide risk are:
- Learn and practice effective coping and problem-solving skills.
- Identify and remind yourself of your reasons for living (for example, family, friends, pets, etc.).
- Lean into your cultural identity to foster a strong sense of self.
- Nurture connections with others through social engagement, school, work, or family.
Widespread suicide prevention
The CDC’s Suicide Prevention Resource for Action is a suicide prevention plan for communities. These larger-scale supports include suggestions such as:
Strengthen economic supports. Focus on affordable housing and economic stability for everyone.
Create protective environments. Address substance abuse and reduce access to lethal means such as firearms.
Improve access and delivery of suicide care. Improve health insurance policies to cover mental health, increase providers in the area who deal with mental health, and focus on rapid response to remote areas.
Promote healthy connections. Boost community and peer support.
Identify and support people at risk. Provide training for people to better recognize suicide risk and help in crises.
Lessen harms and prevent future risk. Be mindful about how suicide is talked about and reported.
How to make a safety plan
A safety plan is a written plan with steps you or someone else can follow when at risk of suicide. It’s personalized for the person who will follow the plan and should include:
Warning signs. Be sure you know and can recognize the specific signs of crisis.
Coping strategies. A list of things that can help prevent a person harming themselves.
People to contact. Names and numbers of people who can help.
Professionals or organizations to contact. Program organization or mental health numbers into your phone. You can text or call the 988 Suicide & Crisis Lifeline anytime.
Places you can go. Write down details of a safe place you can go to get help and support.
What to Do if You Think Someone Is at Risk of Suicide
Take all suicide warning signs seriously. Your involvement and support may help save a life.
People who receive support from caring friends and family and who have access to mental health services are less likely to act on their suicidal impulses than are those who are socially isolated. If someone you know is showing warning signs of suicide:
- Don't be afraid to ask if they are depressed or thinking about suicide.
- Ask if they are seeing a therapist or taking medication.
- Rather than trying to talk the person out of suicide, let them know that depression is temporary and treatable.
- Avoid debating with them, lessening their problems, or giving them advice.
- In some cases, the person just needs to know that someone cares and is looking for the chance to talk about their feelings. You can then encourage the person to seek professional help.
If you believe someone you know is in immediate danger of killing themselves:
- Do not leave them alone. If possible, ask for help from friends or other family members.
- Ask them to give you any weapons they have. Take away or remove sharp objects or anything else they could use to hurt themselves.
- If they're already in psychiatric treatment, help them contact their doctor or therapist for help.
- Try to keep them as calm as possible.
- Call 911 or take them to an emergency room.
- Call or text the 988 Suicide & Crisis Lifeline anytime night or day for support.
What to Do if You’re Experiencing Suicidal Ideation
If you’re in an active crisis, get safe:
- Call or text 988 to talk to a trained supporter.
- Go to a safe location.
- Get through the next 5 minutes. Go minute by minute to make things more bearable.
- Follow your safety plan.
- Distract yourself: Hold an ice cube, tear paper, take a cold shower.
- Focus on your senses by identifying what you hear, smell, see, or touch right now.
- Steady your breathing with long, slow inhales and exhales.
- Tend to your needs with a snack, water, change of clothes, etc.
- Go outside or change your environment.
If you’re thinking about ending your life, no matter where you are in the spectrum of your thoughts, reach out to a trusted friend or family member, a mental health professional, or your doctor. Make plans you can look forward to. Make a list of reasons to live, and be kind to yourself in thoughts and in actions.
What to Do After a Suicide Attempt
There’s a wide range of emotions you might have after surviving a suicide attempt. You may feel:
- Relieved
- Numb
- Disappointed
- Angry
- Ashamed
- Guilty
- Embarrassed
- Alone
- Regretful
- Scared
- Confused
You may be in a hospital for treatment after a suicide attempt, and you may be there for a while if you have physical injuries or need tests. This will include a meeting with a mental health professional to come up with next steps for your safety and well-being.
If you have injuries from harming yourself, you may need physical rehabilitation. This can be overwhelming and difficult to deal with for some people. Now is the time to identify and use a mental health professional or facility that can help you recover and heal, as well as gain tools for the future.
You may not know how to talk about your suicide attempt to others. Opening up to people you trust can be a helpful strategy as you move forward. Support groups are another way to feel seen and less alone. You can connect with others who have been where you are. They can also help you navigate conversations with other people in your life.
Takeaways
Suicide is one of the top causes of death in the U.S. Recognizing the risk factors and warning signs of suicide can help you support a loved one and intervene in a crisis. Call or text the Suicide & Crisis Lifeline at 988 if you or someone you know is in crisis.
Suicide FAQs
What should I say if someone says they’re going to kill themselves?
Validate their feelings, don’t dismiss them. You can say something like, “Can you tell me more? I'm here to listen. You’re not alone.” If they mention a plan, means, or timeline, call 911. Don’t leave them alone. Ask if they have a safety plan. Remove guns, knives, medications, alcohol, and poisons from the area. Recruit other trusted support so you have help, too. Encourage the person to talk to a mental health professional as soon as possible. The Suicide & Crisis Lifeline is available 24/7 by calling or texting 988.
Who is more at risk of suicide?
Those at the highest risk of suicide include ages 10-14, 20-34, and over 55; military veterans; non-Hispanic Native American and Alaska Native people; and young people who identify as lesbian, gay, bisexual, or transgender.
Can you use the suicide hotline just to talk?
Yes. It’s OK to call at any time if you’re struggling. Many things can make life feel unmanageable, and having someone to talk to for emotional support can help.
