Suicidal Thoughts or Threats

Prevention

Suicide can be prevented. While some suicides occur without warning, most do not. You can learn to recognize the warning signs of suicide and take action when the signs are present. Take action to evaluate your suspicions if you think that someone you know is considering suicide.

• The warning signs of suicide change with age. Know the warning signs of suicide:
  • Warning signs of suicide in children and teens may include preoccupation with death or suicide or a recent breakup of a relationship.
  • Warning signs of suicide in adults, such as alcohol or substance abuse, recent job loss, or divorce
  • Warning signs of suicide in older adults, such as the recent death of a partner or diagnosis of a life-limiting illness
• Take all warning signs seriously, even if the suicidal threat or attempt seems minor. Take any conversation about suicide seriously, even if the person mentions it in a joking manner.
• Don't be afraid to ask "What is the matter?" or bring up the subject of suicide. There is no evidence that talking about suicide leads to suicidal thinking or suicide.
• Be willing to listen. If a family member, friend, or coworker talks about suicide or wanting to die or disappear, even in a joking manner, the conversation must be taken seriously. Once you know the person's thoughts on the subject, you may be able to help prevent a suicide.
• Help the person make arrangements to see a doctor or mental health professional immediately.
  • Since a suicidal person may feel he or she cannot be helped, you may have to take an active role in finding a health professional and getting the person to the appointment.
  • If you are unfamiliar with mental health resources in your area, a doctor, counselor, community mental health agency, local suicide hotline, or the national suicide hotline (1-800-SUICIDE or 1-800-784-2433) may be able to help identify a health professional.
  • Make sure the person will have someone with him or her at all times until contact is made with a mental health professional.
  • Help the person identify other potential sources of support from people who care about him or her, such as family, friends, or a member of the clergy.
• Have the person promise not to do anything to harm himself or herself or anyone else until he or she talks with or meets with a mental health professional or talks to you first.
  • Make the person repeat the full promise, not just say "Okay," "Yes," or "I promise."
  • Ask the person to sign a contract promising to talk with a mental health professional or with you before doing anything to harm himself or herself.
• Follow up to find out how the person's treatment is going. A suicidal person may be reluctant to seek help and may not continue with treatment after the first visit with a health professional. Your support may help the person decide to continue treatment.
• Remove all firearms from the home. Firearms were used in about half of suicides committed in the United States during 2001.¹ Studies have shown that suicide attempts are more likely to lead to death in homes that have a gun, even if the gun is kept unloaded and securely locked up.
• Discard all prescription and nonprescription medicines that are not currently being used.

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Author:	Susan Van Houten, RN, BSN, MBA	Last Updated: January 12, 2007
Medical Review:	William M. Green, MD - Emergency Medicine Lisa S. Weinstock, MD - Psychiatry
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