Suicide
September is Suicide Prevention Month, so it seems like the appropriate time to discuss suicide and grief surrounding it (although we should address suicide and mental health year-round). Let’s start with statistics:
Worldwide, approximately 800,000 people die by suicide annually, which is about 1 death every 40 seconds.
It is the 2nd leading cause of death in people aged 15-24 worldwide.
It is the 10th leading cause of death in America.
40-50% percent of the US population has been exposed to suicide in their lifetime (exposed= knowing someone personally who has died by suicide).
There are more than 5.3 million survivors of suicide loss in the US.
There isn’t one type of person (based on age, race, sex) who is more likely to be suicidal, but certain conditions or situations can put someone more at risk. These include:
Traumatic brain injury;
Chronic pain/illness;
Mental health problems (please note- not everyone with mental health problems is suicidal and not everyone who is suicidal has underlying mental health problems);
Prolonged stress
Major life changes
Someone else’s suicide;
Family history of suicide;
Previous personal history of a suicide attempt;
Childhood abuse.
Part of the problem is the stigma surrounding mental health; if someone feels that they cannot reach out for help, suicide may seem like the only option. On top of that, there is huge stigma surrounding discussing suicide, which may prevent us from talking to someone, even if there is concern that they are feeling suicidal. This stigma even extends to those grieving someone who died by suicide; they are at higher risk of experiencing disenfranchised grief because they cannot grieve in a socially supported way (read more about disenfranchised grief here).
All of this sounds pretty grim, so what, if anything, can be done? Luckily there are things we can do. The first is to learn the warning signs:
Talking about things like feeling hopeless, having no reason to live, being a burden, unbearable pain;
Increased drug and/or alcohol use;
Withdrawing from activities;
Isolating themselves from loved ones;
Increase or decrease in sleeping;
Giving away possessions
The next thing is, don’t avoid the conversation. This means both if someone wants to talk about their mental health and/or suicidal ideation as well as if you are concerned that someone may be feeling suicidal. Talking about suicide won’t put the idea in someone’s head, so it’s better to have the conversation. Things that are helpful during a conversation are:
Listening. This may seem obvious but often our first instinct is to try to fix things, and when we rush to fix we often miss what the person is trying to tell us.
Asking how you can help. What you think your loved one needs may not be what they actually need. They also may not be ready for doing anything else, which is fine. Opening up is a difficult step and they need to be able to move at their own pace.
Don’t “should” or “shouldn’t” them. This means no “you should look on the bright side”, “you should be grateful for what you have”, and “you shouldn’t feel like this, you have so many things to live for.”
Don’t promise to keep the conversation a secret. If the person is in imminent danger this should be reported for their safety.
If you are wondering what to do for a loved one who has lost someone to suicide, the answer is easy and difficult- acknowledge the loss. Not acknowledging what they’re going through can cause feelings of isolation as well as perpetuate the stigma surrounding suicide. It can also be helpful to take it a step further and ask if they want to talk about it; they may be waiting to know that it’s okay to talk about, again due to stigma. This internalized stigma and isolation can lead to disenfranchised grief and letting them know that it’s okay to talk can help prevent that.
Other things that may be helpful are just what you would do if the death was due to another cause. Ask if there’s anything you can do to help them, let them know you’re there if and when they want to talk, and let them know it’s okay to grieve in their own time. There are some things that should be avoided (again, these are applicable no matter what the cause of death). These include asking for details of what happened, telling them you know how they feel, and giving platitudes like “they’re in a better place”, “time heals all wounds” (unless the affected individual leads the conversation in this direction).
If you’re feeling suicidal there are many resources available. These include:
National Suicide Prevention Lifeline: call 1-800-273-8255 or go to suicidepreventionlifeline.org (online chat support)
Crisis Text Line: text HOME to 741741
The Trevor Project: call 1-866-488-7386 or go to thetrevorproject.org
911- if you or a loved one is in immediate danger.
References
https://save.org/about-suicide/suicide-facts/
https://www.apa.org/monitor/2019/01/numbers
https://www.crisistextline.org/blog/change-the-stats
https://www.crisistextline.org/get-help/suicide
https://suicidology.org/
https://www.self.com/story/help-friend-suicide-loss-survivor