Suicide is a pressing public health issue that affects people across all age groups, races, and socioeconomic backgrounds. In the United States, suicide is the 11th leading cause of death overall, with over 49,000 deaths annually, and over one million attempts in 2022 (AFSP, 2022). The factors contributing to suicide are complex, involving mental health disorders, trauma, substance abuse, and significant life stressors. Addressing suicide requires a proactive, multi-disciplinary approach in healthcare, as well as strong community and public awareness efforts.

• The age-adjusted suicide rate in 2022 was 14.21 per 100,000 individuals (AFSP, 2022)
• In 2022, men died by suicide 3.85 times more than women (AFSP, 2022)
• White males accounted for 68.46% of suicide deaths in 2022 (AFSP, 2022)
• In 2022, firearms accounted for 54.64% of all suicide deaths (AFSP, 2022)
• 94% of adults surveyed in the U.S. think suicide can be prevented (AFSP, 2022)

Suicide by Age Group

Children and Adolescents: Suicide is the second leading cause of death among individuals aged 10 to 14 and 15 to 24 years old (AFSP, 2022). Bullying, family conflict, academic pressure, and mental health conditions like depression and anxiety are major contributors to suicidal thoughts in younger populations. Warning signs often include withdrawal from friends, drastic changes in behavior, and frequent talk of death or self-harm.

Adults: Suicide is also a significant concern among adults, particularly for those dealing with financial stress, job loss, relationship breakdowns, or mental health disorders. Middle-aged adults, particularly men, face a high risk of suicide, as the pressures of work and family life, combined with untreated mental illness, can lead to feelings of hopelessness and despair (AFSP, 2022).

Older Adults: The elderly are another vulnerable group when it comes to suicide. For individuals aged 75 and older, the suicide rate is higher than in younger age groups (AFSP, 2022). Feelings of isolation, chronic illness, loss of independence, and grief over losing loved ones often contribute to suicidal ideation among older adults. They may express a desire to avoid being a “burden” to others, which is a key indicator of potential suicidal behavior.

The Role of Healthcare Providers

Healthcare providers across all settings—whether in primary care, emergency departments, mental health clinics, or long-term care—must be aware of the signs and symptoms of suicide. It’s crucial that providers, regardless of their role, recognize risk factors such as mood swings, expressions of hopelessness, withdrawal from social situations, or discussions of death. Mental health assessments should be part of routine care, especially for individuals presenting with depression, substance abuse, or significant life changes. Training all healthcare professionals to be aware of suicide warning signs can facilitate early intervention and save lives.

Strategies to prevent suicide (CDC, 2024):

• Strengthen economic supports through improving household financial security and stable housing.
• Create protective environments by reducing access to lethal means among persons at risk of suicide, creating healthy organizational policies and culture, and reducing substance use through community-based policies and practices.
• Improve access and delivery of suicide care by promoting the coverage of mental health conditions in health insurance policies, increasing provider availability in underserved areas, providing rapid and remote access to help, and creating safer suicide care through systems change.
• Promote healthy connections by demonstrating and activating healthy peer norms and engaging community members in shared activities.
• Teach coping and problem-solving skills through social-emotional learning programs, teaching parenting skills to improve family relationships, and supporting resilience through education programs.
• Identify and support people at risk by training gatekeepers, responding to crises, planning for safety and follow-up after an attempt, and providing therapeutic approaches.
• Lessen harms and prevent future risk by intervening after a suicide (postvention).

Ten Common Interventions for Suicide Attempts

1. Cognitive Behavioral Therapy (CBT): Helps individuals recognize and alter negative thought patterns.
2. Dialectical Behavior Therapy (DBT): Focuses on building coping skills and reducing emotional distress.
3. Safety Planning: A personalized, step-by-step plan for individuals to follow during suicidal crises.
4. Crisis Hotlines: Immediate access to trained professionals who can provide support in a moment of need.
5. Medication: Antidepressants or antipsychotic medications can stabilize mood and reduce suicidal ideation.
6. Hospitalization: In cases of acute suicide risk, inpatient treatment ensures 24-hour monitoring and care.
7. Peer Support: Involvement in groups where individuals share similar experiences of suicidal thoughts or attempts.
8. Family Therapy: Engaging family members to create a supportive environment and understand warning signs.
9. Restricting Access to Lethal Means: Securing firearms, medications, or other potential tools for suicide attempts.
10. Follow-up Care: Ensuring ongoing support and treatment after an individual has been discharged from the hospital or crisis center.

Community and Public Awareness

Public awareness campaigns and community-based initiatives are vital in preventing suicide and supporting survivors. Programs like National Suicide Prevention Month (September) and International Survivors of Suicide Loss Day help destigmatize the conversation around suicide and encourage people to seek help. Schools, workplaces, and community centers can offer training on suicide prevention and intervention, such as the “Question, Persuade, Refer” (QPR) technique. Additionally, organizations like the American Foundation for Suicide Prevention (AFSP) provide resources, hotlines, and outreach programs to support individuals at risk and those recovering from suicide attempts.

If you or someone you know are in crisis, call or text the 988 Suicide & Crisis Lifeline at 988, available 24 hours a day, 7 days a week. The Lifeline provides confidential support to anyone in suicidal crisis or emotional distress. Support is also available via live chat. Para ayuda en español, llame al 988.

Author: Jennifer Walker, RN, MSN, NPD-BC, GERO-BC, NE-BC

To learn more about Suicide Prevention, view CareerSmart’s course on Suicide Prevention: Recognizing and Assessing.

Contact us to learn about partnering with CareerSmart to provide this valuable training to your staff.

References

1. American Foundation for Suicide Prevention (AFSP). (2022).  “Suicide Statistics.” Accessed 09.13.24 from: https://afsp.org/suicide-statistics/
2. Centers for Disease Control and Prevention (CDC) (2024).  “Preventing Suicide.” Accessed: 09.13.24 from: https://www.cdc.gov/suicide/prevention/index.html
3. National Institute of Mental Health (NIMH). (2024). “Suicide.” Accessed: 09.13.24 from: https://www.nimh.nih.gov/health/statistics/suicide