Suicide 101
Myths vs. Facts of Suicide
People who talk about suicide don’t complete suicide.
People who die of suicide have given definite warnings
of their intentions.
Myths vs. Facts of Suicide
Suicide happens without warning.
Most people communicate warning signs of how they are reacting to or
feeling about stressful events in their lives whether it be a problem with
a significant other, family member, best friend, superiors, financial
matters or legal issues. Warning signs may present themselves as direct
statements, physical signs, emotional reactions, or behaviors such as
withdrawing from friends. When stressors and warning signs are
present suicide may be considered as the only option to escape pain,
relieve tension, maintain control, or cope with stress.
Myths vs. Facts of Suicide
Suicidal people have every intention on dying.
Most suicidal people are ambivalent about their
intentions right up to the point of dying. Very few are
absolutely determined or completely decided about
ending their life. Most people are open to a helpful
intervention, sometimes even a forced one. The
majority of those who are suicidal at some time in
their life find a way to continue living.
Myths vs. Facts of Suicide
There is no correlation between sex/gender and
Numbers from the National Center for Health
Statistics show this clearly. In the year 2000, the
latest year for which statistics are available, men died
four times as often as women did when they
attempted suicide, even though women were three
times more likely than men to try it in the first place.
Myths vs. Facts of Suicide
Asking a person about suicide and talking about
suicide will push them to complete suicide.
Talking about suicide does not create nor increase the
risk. The best way to identify if someone is thinking
about suicide is to ask them directly. Avoiding the
subject of suicide may contribute to suicide. Avoiding
the subject reinforces a suicidal persons thought that
no one cares.
Myths vs. Facts of Suicide
If the person seems better after hospitalization the
risk is over.
Compared with controls, patients in the first week of
psychiatric hospitalization had significantly increased risks
for suicide (60 times higher for men and 82 times higher
for women). Patients in the week after hospital discharge
also had significantly increased suicide risks (102 times
higher for men and 246 times higher for women).
Myths vs. Facts of Suicide
Suicide increases over the holidays.
CDC’s National Center for Health Statistics reports
that the suicide rate is, in fact, the lowest in
December.2 The rate peaks in the spring and the fall.
This pattern has not changed in recent years. The
holiday suicide myth supports misinformation about
suicide that might ultimately hamper prevention
Risk factors
 Psychiatric Disorders
At least 90 percent of people who kill themselves have a diagnosable
and treatable psychiatric illnesses -- such as major depression, bipolar
depression, or some other depressive illness, including:
Alcohol or drug abuse, particularly when combined with depression
Posttraumatic Stress Disorder, or some other anxiety disorder
Bulimia or anorexia nervosa
Personality disorders especially borderline or antisocial
Risk factors
 Past History of Attempted Suicide
Between 20 and 50 percent of people who kill themselves had
previously attempted suicide. Those who have made serious suicide
attempts are at a much higher risk for actually taking their lives.
 Genetic Predisposition
Family history of suicide, suicide attempts, depression or other
psychiatric illness.
Risk factors
 Neurotransmitters
A clear relationship has been demonstrated between low
concentrations of the serotonin metabolite 5-hydroxyindoleactic acid
(5-HIAA) in cerebrospinal fluid and an increased incidence of
attempted and completed suicide in psychiatric patients.
 Impulsivity
Impulsive individuals are more apt to act on suicidal impulses.
 Demographics
Sex: Males are three to five times more likely to die by suicide than
Age: Elderly Caucasian males have the highest suicide rates.
In 2005, suicide ranked as the third leading cause of death for young people
(ages 15-19 and 15-24); only accidents and homicides occurred more frequently.
Suicide rates, for 15-24 year olds, have more than doubled since the 1950’s,
and remained largely stable at these higher levels between the late 1970’s and
the mid 1990’s. They have declined 28.5% since 1994.
Males between the ages of 20 and 24 were 5.8 times more likely than females
to complete suicide. Males between 15 and 19 were 3.6 times more likely than
females to complete suicide (2005 data).
 Firearms remain the most commonly used suicide method among youth,
accounting for 49% of all completed suicides.
Some warning signs
 Talking about wanting to die or to kill oneself.
 Looking for a way to kill oneself, such as searching online or buying a
Talking about feeling hopeless or having no reason to live.
Talking about feeling trapped or in unbearable pain.
Talking about being a burden to others.
Increasing the use of alcohol or drugs.
Acting anxious or agitated; behaving recklessly.
Sleeping too little or too much.
Withdrawing or feeling isolated.
Showing rage or talking about seeking revenge.
Displaying extreme mood swings.
Signs of a potential suicide crisis
 Precipitating Event
A recent event that is particularly distressing such as loss of loved one or
career failure. Sometimes the individuals own behavior precipitates the
event: for example, a man's abusive behavior while drinking causes his wife
to leave him.
 Intense Affective State in Addition to Depression
Desperation (anguish plus urgency regarding need for relief), rage, psychic
pain or inner tension, anxiety, guilt, hopelessness, acute sense of
 Changes in Behavior
Speech suggesting the individual is close to suicide. Such speech may be
indirect. Be alert to such statements as, "My family would be better off
without me." Sometimes those contemplating suicide talk as if they are
saying goodbye or going away.
Actions ranging from buying a gun to suddenly putting one's affairs in
Deterioration in functioning at work or socially, increasing use of
alcohol, other self-destructive behavior, loss of control, rage explosions.
What can you do to help?
 Too often, victims are blamed, and their families and friends are left
stigmatized. As a result, people do not communicate openly about
suicide. Thus an important public health problem is left shrouded in
secrecy, which limits the amount of information available to those
working to prevent suicide.
 Talk
about suicide
 Listen
 Offer
non-judgmental support
 Educate
 Let them tell their story
 Don’t be afraid of emotion
 Ask questions
• Are you thinking about suicide?
• What thoughts or plans do you have?
• How long have you been thinking about suicide?
• Have you thought about how you would do it?
• Do you have __? (Insert the lethal means they have
Having the conversation of suicide
Be direct but non-confrontational
Reflect what you hear
Take ALL talk of suicide seriously
If you are concerned that someone may take their life, trust your
Use language appropriate for age of person
Do not worry about doing or saying exactly the "right" thing. Your
genuine interest is what is most important.
What is a Safety Plan
 A list of coping strategies and resources to use during
a suicidal crisis.
 Helps with a sense of control over suicidal urges and
 Can serve to motivate.
 It is NOT a no suicide contract, we are not asking or
telling them to stay alive.
What is helpful about a Safety Plan
 A safety plan is developed together with a caring
 Helps to enhance individual’s sense of control or
empowerment over the suicidal urges or thoughts.
 Involving family members and/or friends with the
safety plan can help de-stigmatize the suicidal
When to complete a Safety Plan
 Can be done at anytime a person is exhibiting
suicidal urges or thoughts.
 Is developed after the imminent risk of suicide or
crisis is dealt with.
 Not appropriate when someone is at imminent risk
for suicide or has profound cognitive impairment.
How to complete a Safety Plan
 Listen
 Let them tell their story.
 Hear why they want to die, with no judgment.
 Don’t be afraid of emotion.
 Don’t rush them.
Safety Plan Steps
Step 1: Warning signs:
Step 2: Internal coping strategies - Things I can do to take my mind off my problems without
contacting another person:
1. ____________________________________________________________
Safety Plan Steps
 Step 3: People and social settings that provide distraction:
 Step 4: People whom I can ask for help:
Safety Plan Steps
Step 5: Professionals or agencies I can contact during a crisis:
Clinician Name_________________________ Phone____________________
Clinician Pager or Emergency Contact #________________________________
Clinician Name_________________________ Phone____________________
Clinician Pager or Emergency Contact #________________________________
Suicide Prevention Lifeline: 1-800-273-TALK (8255)
Local Emergency Service __________________________________________
Emergency Services Address_______________________________________
Emergency Services Phone ________________________________________
Step 6: Making the environment safe:
1. _______________________________________________________________
 National Suicide Prevention Lifeline 1-800-273-8255
 24 Hour Crisis Line for Beltrami County & Mobile
Crisis Team
 Crisis Connection 612-379-6363 or
Further Information on Safety Planning:
Gregory K. Brown, Ph.D.
Research Associate Professor
of Clinical Psychology in
Department of Psychiatry
University of Pennsylvania
3535 Market Street, Room
Philadelphia, PA 19104-3309
Office: 215-898-4104
Barbara Stanley, PH.D.
Director, Suicide Intervention
Research Scientist,
Department of Neuroscience
Lecturer, Department of
Columbia University/New
York State Psychiatric
1051 Riverside Drive, Unit 42
New York, NY 10032
Phone: 212 543 5918
Fax: 212 543 6946
Contact Information
Traci Chur, MA
Text Coordinator
And Crisis Line Counselor
HSI-Crisis Connection
PO Box 23090
Richfield, MN 55423
fax 612-379-6391
Mary Brooks, MS
Crisis Line Counselor,
Volunteer Supervisor
and Registered ASIST
HSI-Crisis Connection
PO Box 23090
Richfield, MN 55423
fax 612-379-6391