This National Suicide Prevention Week, learn the signs someone is at risk for suicide

This year marks National Suicide Prevention Week, running from September 4th to September 10th, as part of Suicide Awareness Month. According to recent statistics from the Centers for Disease Control and Prevention, over 46,000 people in the United States took their own lives in 2020, equating to one death every 11 minutes. Globally, nearly 800,000 people succumb to suicide each year, with 1.2 million attempting suicide in 2020.

Justin Baker, clinical director of the Veterans Suicide and Trauma Reduction Program at the Wexner Medical Center of the Ohio State University, shared his insights on this pressing issue. Regrettably, researchers still haven't discovered a foolproof method to predict who might attempt suicide or is at risk. As Baker frankly admitted, "It's very, very difficult."

"If someone attempts or dies, you can look back and say, 'Look at all these things that happened in their life.' But the issue is multiple people deal with those stress factors or experience them, but not all of them attempt suicide," Baker said. "The window can be very, very short."

Expert sources caution against overlooking signs of impending suicide, which may not always be apparent. Some individuals may display normal behavior or act as usual, while others may exhibit changes in behavior that deviate from their standard patterns. Special attention should be paid to the following behavioral changes, verbal signals, and emotional risk factors identified by psychologists and mental health organizations:

Verbal cues to watch out for:

1. Expressions about wanting to die or committing suicide
2. Direct threats to harm or kill oneself

Behavioral changes:

1. Practicing self-harm or preparing for it, such as misusing weapons, pills, or other hazardous items
2. Preoccupation with death, including bringing up, writing about, drawing, or posting online topics related to death or suicide
3. The existence of a detailed plan for an attempt, which increases the risk when that plan is in place

Emotional risk factors:

1. Feeling hopeless, helpless, worthless, or sad
2. Loss of interest in previously enjoyable activities
3. Alterations in eating and sleeping patterns
4. Exhaustion, low energy
5. Feeling anxious, restless, or irritable
6. Physical pain without a medical cause
7. Struggles to focus or make decisions
8. Desiring solitude
9. Thoughts of death or suicide

Other risk factors to consider:

1. Substance misuse
2. Previous suicide attempts
3. Family history of depression or suicide
4. Major loss (death, relationship, home)
5. Events causing shame, guilt, or disgrace
6. Physical health problems, including chronic pain
7. Exposure to someone else's suicidal behavior
8. Easy access to means of suicide
9. Being impulsive or isolated

Environmental and social stressors:

1. Bullying, harassment, unemployment, financial stress, divorce, and death
2. Stress, isolation, and bias

If any of these warning signs are observed, it's essential to take immediate action. Reaching out to Suicide & Crisis Lifeline (dial 988 in the United States) or national resources listed below can provide crucial support:

• Crisis Text Line: Text HOME to 741741
• The Trevor Project: Text START to 678-678

Recognizing these warning signs can potentially help save lives. If you or someone you know is at risk, seek help immediately.

Beyond the mentioned warning signs and resources, several additional strategies and resources can be employed to identify and address suicide risk factors:

1. Therapeutic Risk Management (TRM) Model:
2. Chain Analysis:Implement chain analysis to further explore the function of Veteran’s suicidal thoughts, helping to identify underlying triggers and patterns.
3. Lethal Means Safety Guidance: Implement lethal means safety guidance and recommendations to reduce access to means of suicide.
4. Collateral Data: Obtain collateral data for support persons in the Veteran’s life to gain a more comprehensive understanding of the individual’s situation.
5. Welfare Checks: Conduct welfare checks as part of therapeutic risk management to ensure the safety of at-risk individuals.
6. Postvention Planning: Provide postvention planning and services for suicide loss survivors to support them in their grief and recovery.
7. Army Suicide Prevention Program:
8. Comprehensive Public Health Approach: Implement a comprehensive public health approach that includes coordinated efforts for an integrated prevention approach to suicide.
9. Stigma Reduction Efforts: Engage in stigma reduction efforts to create a supportive environment where individuals feel comfortable seeking help.
10. Help-Seeking Behaviors: Promote help-seeking behaviors and proactive activities such as financial literacy and skill building to support individuals before the point of crisis.
11. Primary Care Interventions:
12. Universal Screening: Implement universal screening for suicide risk in primary care using tools like the Patient Health Questionnaire (PHQ-9), which includes questions about suicidal ideation.
13. Population-Based Suicide Care Model: Use a population-based suicide care model that includes annual universal depression screening and screening for alcohol use.
14. Same-Day Safety Planning: Connect patients who report any level of intent or planning for a suicide attempt with designated members of the care team for same-day safety planning.
15. VA/DOD Clinical Practice Guideline:
16. Clinical Modules: Utilize the VA/DOD Clinical Practice Guideline for Suicide Prevention, which includes three clinical modules: Identification of Patients at Acute Risk for Suicide, Comprehensive Suicide Risk Assessment by Provider, and Management of Patients at Acute Risk for Suicide.
17. Leadership and Team Support:
18. Leadership Strategies: Leaders should apply consistent and systematic whole-of-person and whole-of-unit strategies to positively affect individual and unit resilience outcomes.
19. Team Support: Provide supportive conversations with team members who may be struggling, and learn about vital resources available to help.