September is Suicide Prevention and Awareness Month. Washington Parent is dedicated to the mission of ending suicide, especially among children and teens, by providing parents, caregivers, teachers and peers the tools needed to identify at-risk individuals and educating them on what they can do to help prevent suicide.

U.S. suicide statistics

The most accurate statistical reporting for suicide comes from the CDC’s Data & Statistics Fatal Injury Report, last conducted in 2019 and made public in February of this year. The CDC has learned that:

• Suicide is the 10th leading cause of death in the U.S. and is the second leading cause of death for people ages 10-34.
• In 2019, 47,511 Americans died by suicide.
• From 1999 to 2019, the overall suicide rate in the U.S. increased by 35%.
• In 2019, 12 million American adults seriously thought about suicide, 3.5 million planned a suicide attempt and 1.4 million attempted suicide.
• Lesbian, gay and bisexual youth are four times more likely to attempt suicide than straight youth.

The annual prevalence of serious thoughts of suicide by U.S. demographic group is:

• 4.8% of all adults11.8% of young adults aged 18-25
• 18.8% of high school students
• 46.8% of lesbian, gay, and bisexual high school students
• Approximately 2.5% of all students reported making a suicide attempt that required treatment by a doctor or nurse.
• For those requiring treatment, rates were highest for multiple-race students (4.1%).
• 8.9% of youth in grades 9-12 reported that they had made at least one suicide attempt in the past 12 months.
• Female students attempted almost twice as often as male students (11% vs. 6.6%).
• American Indian or Alaska Native students reported the highest rate of attempts (25.5%) with white students at 7%.
• For children under age 12, research indicates that Black children have a higher rate of suicide death than White children.

Who is at risk for suicide?

Suicide can effect people of all ages, genders and ethnicities and there is no single cause of suicide. The following list are the most prominent risk factors:

• A history of suicide attempts
• Depression or other mental disorders, especially mood disorders
• Chronic diseases, pain or other disability
• Social isolation
• Misuse and abuse of drugs or alcohol
• Family history of depression and mental illness
• Family history of suicide
• Exposure to family violence, physical or sexual abuse
• Presence of weapons or firearms in the home
• Having recently been released from prison or jail
• Legal or employment troubles
• Exposure, directly or indirectly, to another’s suicidal behavior: family members, peers or celebrities

With regards to children and teens, the following risk factors should be carefully considered:

• Bullying, either as victim or perpetrator
• Child abuse and neglect
• Feelings of social isolation or increased boredom
• Conduct/disruptive behaviors disorders
• Problem at school or at work
• Parental health problems
• Parental divorce
• Death of a parent or loved one
• Self-injury (without intent to die)
• Violent behaviors or tendencies
• Lack of respect and fair treatment
• Lack of respect for the cultures of all students
• Exposure to discrimination (race, sexual orientation, disability, physical characteristics)

Most people who have a risk factor will never attempt suicide, but it’s important to understand that these risk factors can vary across groups depending on the individual’s age, sex, culture and other identity markers. For example, The Suicide Prevention Resource Center (SPRC) notes that “stress resulting from prejudice and discrimination (family rejection, bullying, violence) is a known risk factor for suicide attempts” among lesbian, gay, bisexual and/or transgender (LGBT) youth. Identifying the risk factors for potential suicide is the first step in prevention.

What are the warning signs of suicide?

Often there are warning signs that we can use to identify someone at immediate risk for suicide. The National Institute of Mental Health (NIMH) has compiled the following list:

• Talking about wanting to die or wanting to kill themselves
• Talking about feeling empty or hopeless or having no reason to live
• Talking about feeling trapped or feeling that there are no solutions
• Feeling unbearable emotional or physical pain
• Talking about being a burden to others
• Withdrawing from family and friends
• Giving away important possessions
• Saying goodbye to friends and family
• Putting affairs in order, such as making a will
• Taking great risks that could lead to death, such as driving extremely fast
• Talking or thinking about death often

Other serious warning signs that someone may be at risk for attempting suicide include:

• Displaying extreme mood swings, suddenly changing from very sad to very calm or happy
• Making a plan or looking for ways to kill themselves, such as searching for lethal methods online, stockpiling pills or buying a gun
• Talking about feeling great guilt or shame
• Using alcohol or drugs more often
• Acting anxious or agitated
• Changing eating or sleeping habits
• Showing rage or talking about seeking revenge

How do I know if my child or teen is truly at risk or just experiencing a mood swing?

Puberty and other factors can alter your child’s behaviors day to day or week to week. These behaviors — such as moodiness, irritability or separation — can seem like risk factors for suicide, but they can also be activity within the normal range of adolescent development. The differences to look out for are behaviors that may indicate hopelessness, worthlessness and suicidal thinking or conduct. If your child is exhibiting these signs, including increased separation and isolation from friends, family or activities, this could be more than just typical child and teen behavior.

In these scenarios, trust that you know your child and that you know what behaviors are normal for them and what behaviors are abnormal. Don’t be afraid to engage your child in a conversation about their mood or even about suicide. NIMH says studies show that asking someone directly about their suicidal thoughts or behaviors doesn’t increase those thoughts or desires. If your child or teen’s behavior doesn’t return to normal within a few days to a week, have them see your pediatrician or a mental health practitioner.

What can you do to help someone you identify as at risk for suicide?

As parents, teachers, caregivers and friends, we should act on the belief that we’re the only one who can help someone that we identify as at risk for suicide. Most often, it is someone’s family and friends who first notice the warning signs. If someone communicates to you that they are contemplating suicide, take them seriously. If someone tells you that they are going to kill themselves, do not leave them alone. Stay with them and contact help such as a trusted friend, family member or other trusted adult. You may also consider contacting a mental health professional, school nurse or administrator to assist you further.

The American Foundation for Suicide Prevention (AFSP) advises having an honest conversation with anyone thinking about suicide by:

• Talking to them in private
• Listening to their story
• Telling them you care about them
• Asking directly if they are thinking about suicide
• Encouraging them to seek treatment or contact their doctor or therapist
• Avoiding debating the value of life, minimizing their problems or giving advice

Feelings of embarrassment and shame commonly accompany thoughts of suicide, so consider speaking in private. However, never promise to keep someone’s thoughts or plans for suicide a secret. It is paramount that you immediately inform someone who can provide support. After identifying the warning signs of suicide, strive to remove the person away from any obviously dangerous objects such as firearms, drugs or other weapons. If possible, help escort them directly to mental health services or an emergency room.

In a crisis situation, the best course of action is to contact the National Suicide Prevention Lifeline. It is staffed 24 hours a day, seven days a week with trained counselors who can provide guidance on the most appropriate next steps and resources. Their services are free and confidential and they can connect you with the nearest crisis center for counseling or mental health referrals:

Call 1-800-273-TALK (8255) En español 1-888-628-9454 OR Text the Crisis Text Line Text “HELLO” to 741741

Remember, calling 911 is the best situation for when self-harm is occurring or is about to occur.

What do I do if I see suicidal messages on social media?

In the same way that someone may confide in you that they’re having suicidal thoughts, social media can be an outlet for individuals signaling for help, especially among teens and young adults. If someone’s messages or livestreams are showing directly harmful behavior, immediately call 911 or the National Suicide Prevention Lifeline at 1-800-273-TALK (8255).

Most social media platforms have their own policies for suicide prevention, and if the individual’s messaging or behavior doesn’t constitute an immediate risk, it is recommended that you contact a community moderator working for the platform. The National Suicide Prevention Lifeline has an online tool kit with links for contacting popular social media platforms regarding suicidal messaging or content: suicidepreventionlifeline.org/help-someone-else/safety-and-support-on-social-media/

What can I do if I’m struggling with suicidal thoughts and behaviors?

If you are thinking about or planning suicide, do not wait for someone to reach out. Seek mental health treatment or tell your health care provider about your thinking. They will listen to your concerns and can help you figure out your next steps.

To find mental health treatment services in your area, call the Substance Abuse and Mental Health Services Administration (SAMHSA) Treatment Referral Helpline at 1-800-662-HELP (4357) or use the SAMHSA Behavioral Health Treatment Services Locator.

You are not alone. Someone is here to listen.