Suicide prevention starts with recognizing the warning signs, taking them seriously, and taking action.

If you think a friend or family member is considering suicide, you might be afraid to bring up the subject. But talking openly about suicidal thoughts could save a life.

“The best way to prevent suicide is to know and watch for warning signs and to get involved if you spot them,” says Fred Cutter, Ph.D., a psychologist in private practice in Morro Bay, Calif. “Most suicidal people are ambivalent about ending their lives, which is why intervention can change their minds.”

Warning Signs and Symptoms
People with the following behaviors are at high risk for suicide.

• People who are considering or talking about it. It’s a misconception that people who talk about suicide don’t attempt it. In fact, most offer some kind of hint or cry for help.
• People who have a plan. Among those who consider suicide, only 3 percent plan how to do it. They are the ones who are most likely to attempt it.
• People who feel hopeless or think they’re a burden to families. Hopelessness is a strong predictor of suicide, Cutter says. “Essentially, hopelessness is a symptom of depression, but most people who are depressed are not suicidal—however, almost all people who kill themselves are depressed.” They may talk of “unbearable” feelings or a bleak future.

  People may feel they’re a burden because of their medical bills or care needs, Cutter says, “and they think their families would be better off without them. But in many cases they never ask their families if this is the case, and in fact the family is often dedicated to doing whatever the person needs.”

• People with access to firearms. According to the National Institute of Mental Health, more than half of all suicides are committed with a gun. Prescription medications are another lethal means.
• People with a chronic mental health challenge—such as depression, bipolar disorder, schizophrenia, or drug or alcohol abuse. The U.S. Department of Health and Human Services says more than 90 percent of people who commit suicide suffer from depression, alcoholism, or a combination of mental disorders.
• People who experience sudden difficulties—such as losing a job, getting a divorce, or a death in the family. “Such significant losses put them at greater risk for suicide, especially if they experience a combination of difficulties,” Cutter says.

Steps to Take
If someone you love talks about suicide, take these steps.

• Remove firearms and other lethal means from the person’s possession.
• Help the person solve problems. If it’s a job loss, help with a job search. If someone is grieving a death, encourage joining a support group.
• Seek medical care. If the person has attempted suicide by any means, take him or her to the emergency room.
• Engage the person in conversation. Often people fear that talking about suicide may encourage the person to act. “In fact, it can open the door to a discussion of what is going on in the person’s life, what you could do to help, and reassurances that help is available,” Cutter says.

Barbara Floria spoke with Fred Cutter, Ph.D., a psychologist in private practice in Morro Bay. Calif. If you believe someone is at imminent risk for suicide or has made a suicide attempt, don’t leave the person alone. Call 911 or the National Suicide Prevention Lifeline at 800-273-8255.

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