By Mary Chase Mize, Ph.D., APC, NCC, with Afroze Shaikh, Hannah Cowart, Felicia Gatewood, Miranda Barzey and Sarah Evers
September is National Suicide Prevention Month, and today is World Suicide Prevention Day — a day where the fight to end suicide is recognized on a global platform. Here at the H.O.P.E. Lab, suicide prevention is a part of our daily work and is the driving force behind our research and community outreach. We’d like to share ten things we wish everyone knew about suicide prevention.
Here are the top 10 things:
1. Anyone can be at risk of suicide.
Joiner’s Interpersonal Theory of Suicide tells us desire for suicide can develop from the presence of two things: thwarted belongingness and perceived burdensomeness. When people feel they do not belong, and when they feel like they are a burden to others and others would be better off without them, the desire for suicide can develop. When suicide desire develops and a person has the acquired capability to inflict painful self-injury, suicide or a serious attempt is likely.
Certain groups of people may be more vulnerable to suicide — veterans, LGBTQ+ youth, older adults, etc. Since 2018, the H.O.P.E. Lab has engaged in community-based research to combat suicide among older adults who receive home-based services.
Understanding the prevalence of suicide risk is a first step in helping combat the stigma of suicide and start life-saving conversations.
2. Fight the stigma.
Thoughts of suicide are not all or nothing; feeling thwarted belongingness and perceived burdensomeness can happen on a continuum. Being able to move past fear, distress, shame, or any other stigma-inducing emotion to make conversations about suicide more common is the first step in building a world that is safer from suicide. While much progress has been made in recent years with regard to erasing the stigma of talking about suicide, it may still be difficult and challenging. However, you are not alone. Most people have been impacted in one way or another by suicide — and the more we talk about suicide prevention, the more we can help fight the stigma.
3. Asking someone directly if they are having thoughts of suicide can help save their life. (spoiler alert: asking a person directly does not encourage them to have thoughts of suicide!)
Being willing to talk about suicide is a critical aspect of suicide prevention. It may be nerve-wracking to ask someone if they are thinking of suicide — maybe you’ve noticed some warning signs, but you aren’t sure if they are actually experiencing suicidal thoughts. The only way to know is to ask directly. Asking a person about suicide does not make things worse, or give the person the idea of considering suicide. In fact, it has the opposite effect: research shows asking directly about suicide may help save a person’s life and reduce thoughts of suicide.
4. Suicidal thoughts are steeped in uncertainty.
When someone is having thoughts of suicide, they are in a state of ambivalence about living or dying. Thoughts of suicide can even fluctuate during a conversation. If you are worried someone may be having thoughts of suicide, ask them directly. If they talk to you about their feelings, that in and of itself shows you a part of them may want to live! Numerous accounts of individuals who survive attempting suicide affirm this experience — especially among individuals who survive jumping off of the Golden Gate Bridge. Kevin Hines, a suicide attempt survivor and activist, said he felt “instant regret” as soon as he jumped. This ambivalence — this uncertainty about death by suicide — is present even during an active attempt.
Knowing how to address this uncertainty is key in preventing deaths by suicide.
5. Perceptions are powerful.
Perceived burdensomeness is just that — the perception that one is a burden. You may find yourself talking with someone who may say things like, “I’m worthless, I’m a problem to everyone I know, I keep screwing everything up. I think other people’s lives would be better if I was gone”— and you may want to say, “You are not a problem, and I wouldn’t be better off without you! How could you say that?” Someone who is experiencing perceived burdensomeness may not be able to see your point. While it may be painful to hear someone truly believe they think they’re a burden, if you can listen to them tell you about their pain, you are communicating to them that they are not a burden at all.
6. Listening goes a long way.
Being able to listen and have empathy with someone who is having thoughts of suicide can be life-saving. If you notice someone who may be at risk of suicide and ask them about it, they may be telling someone for the first time about their pain. Additionally, it may be helpful to think about suicide in the context of understanding pain. Kevin Hines describes this pain in many of his public speaking events — when a person is experiencing excruciating pain, the natural course of action is to do everything one can to get the pain to stop. This can be applied to emotional pain as well. When someone is in intense emotional pain, they want the pain to stop. Being able to talk about and listen to someone’s pain can go a long way in preventing deaths by suicide.
7. Keep a list of resources.
You are never alone when it comes to suicide prevention. Find sources of connection in your community — professional counselors, healthcare workers, clergy, etc. — who may be able to help someone through a suicide crisis. Here’s a shortlist to help you get started.
National Suicide Prevention Lifeline: 1-800-273-8255
Georgia Crisis and Access Line (GCAL): 1-800-715-4255
The Trevor Project: 1-866-488-7386
Trans Lifeline: 877-565-8860
American Foundation for Suicide Prevention (find support groups, etc.): afsp.org
8. Don’t wait.
Don’t wait until you are personally affected by suicide before engaging in suicide prevention efforts. Steps toward prevention do not always have to require an extravagant effort and can be as simple as a phone call or text to provide a connection to someone who may be feeling hopeless or alone. In our research, we’ve found older adults who did not receive any kind of real-time connection (such as a phone call or in-person visit) had greater loneliness, felt like they had lower social support, and had higher thwarted belongingness and perceived burdensomeness than those who did receive such a connection.
9. Invest in suicide intervention training.
Applied Suicide Intervention Skills Training (ASIST) is the gold standard in suicide intervention training programs. ASIST is a two-day, standardized, evidence-based training that has been recognized by the Centers for Disease Control and Prevention (CDC), used in crisis centers across the United States, and adopted by branches of the U.S. Armed Forces. Here at GSU, master’s level counselors in training have the opportunity to receive ASIST training prior to their first clinical experiences. We’ve also trained over 160 Aging Services Network volunteers and providers in ASIST. People who receive ASIST training learn the Pathway for Assisting Life (PAL) model, and how to help respond to a person who is having thoughts of suicide at the moment when an intervention is most needed. Click to find ASIST training in your area.
10. Life will prevail when supported.
Being able to identify someone who may be at risk of suicide, asking them directly about suicide, and listening to their distress are ways to support a person’s life at the moment when they are experiencing crisis; and supporting life also happens before the suicide intervention. Suicide prevention involves access to mental health resources, hotlines, community training, and awareness efforts. But suicide prevention is also access to housing, food, healthcare, community, education and many other life-giving resources. You can be a part of preventing deaths by suicide — one conversation could mean the difference between life and death. Remember, when it comes to suicide prevention, you are never alone.
Mary Chase Mize is a postdoctoral research associate in the Department of Counseling and Psychological Services at Georgia State University. She can be reached at email@example.com.