A combination of individual, relational, community and societal factors contribute to the risk of suicide. Risk factors are those characteristics associated with suicide—they may or may not be direct causes.
- Family history of suicide
- Family history of child maltreatment
- Previous suicide attempt(s)
- History of mental disorders, particularly depression
- History of alcohol and substance abuse
- Feelings of hopelessness
- Impulsive or aggressive tendencies
- Cultural and religious beliefs (e.g., belief that suicide is noble resolution of a personal dilemma)
- Local epidemics of suicide
- Isolation, a feeling of being cut off from other people
- Barriers to accessing mental health treatment
- Loss (relational, social, work, or financial)
- Physical illness
- Easy access to lethal methods
- Unwillingness to seek help because of the stigma attached to mental health and substance abuse disorders or to suicidal thoughts
Protective factors buffer individuals from suicidal thoughts and behavior. To date, protective factors have not been studied as extensively or rigorously as risk factors. Identifying and understanding protective factors are, however, equally as important as researching risk factors.
- Effective clinical care for mental, physical, and substance abuse disorders
- Easy access to a variety of clinical interventions and support for help seeking
- Family and community support (connectedness)
- Support from ongoing medical and mental health care relationships
- Skills in problem solving, conflict resolution, and nonviolent ways of handling disputes
- Cultural and religious beliefs that discourage suicide and support instincts for self-preservation (U.S. Public Health Service 1999)
The following are signs that may signal a depressed teen who could be considering suicide:
- withdrawal from friends and family members
- trouble in romantic relationships
- difficulty getting along with others
- changes in the quality of schoolwork or lower grades
- rebellious behaviors
- unusual gift-giving or giving away own possessions
- appearing bored or distracted
- writing or drawing pictures about death
- running away from home
- changes in eating habits
- dramatic personality changes
- changes in appearance (for the worse)
- sleep disturbances
- drug or alcohol abuse
- talk of suicide, even in a joking way
- having a history of previous suicide attempts
If you're concerned about how to help a depressed teen, don't be afraid to talk to him or her about the problem. It can help to reassure them that they are loved and that you are available to help work out any problems. Be a good listener, don't judge, and don't dismiss any of your their concerns. It's OK to directly ask if he or she has ever thought of killing him or herself. If you suspect this teen is suicidal, seek professional help immediately.
Take it Seriously
- 50% to 75% of all people who attempt suicide tell someone about their intention.
- If someone you know shows risk factors and warning signs, the time to act is now.
- Begin by telling the suicidal person you are concerned about them.
- Tell them specifically what they have said or done that makes you feel concerned about suicide.
- Don't be afraid to ask whether the person is considering suicide, and whether they have a particular plan or method in mind. These questions will not push them toward suicide if they were not considering it.
- Ask if they are seeing a clinician or are taking medication so the treating person can be contacted.
- Do not try to argue someone out of suicide. Instead, let them know that you care, that they are not alone and that they can get help. Avoid pleading and preaching to them with statements such as, “You have so much to live for,” or “Your suicide will hurt your family.”
Encourage Professional Help
- Actively encourage the person to see a physician or mental health professional immediately.
- People considering suicide often believe they cannot be helped. If you can, assist them to identify a professional and schedule an appointment. If they will let you, go to the appointment with them.
- If the person is threatening, talking about, or making specific plans for suicide, this is a crisis requiring immediate attention. Do not leave the person alone.
- Remove any firearms, drugs, or sharp objects that could be used for suicide from the area.
- Take the person to a walk-in clinic at a psychiatric hospital or a hospital emergency room.
- If these options are not available, call 911 or the National Suicide Prevention Lifeline at 1-800-273-TALK (8255) for assistance.
Follow-Up on Treatment
- Still skeptical that they can be helped, the suicidal person may need your support to continue with treatment after the first session.
- If medication is prescribed, support the person to take it exactly as prescribed. Be aware of possible side effects, and notify the person who prescribed the medicine if the suicidal person seems to be getting worse, or resists taking the medicine. The doctor can often adjust the medications or dosage to work better for them.
- Help the person understand that it may take time and persistence to find the right medication and the right therapist. Offer your encouragement and support throughout the process, until the suicidal crisis has passed.