Clinical Corner

Suicide Prevention Month 2022 Week 4

Person Icon Stephanie Weatherly, DNP, PMH RN-BC, FACHE
Person Icon Chief Clinical Officer
Person Icon September 26, 2022

Today kicks off the last week of Suicide Prevention Month. Mental health is trending! Last week the US Preventative Services Task Force (USPSTF) recommended all adults under age 65 without a diagnosed mental health condition be screened for anxiety. This follows their 2016 recommendation to screen all adults for depression. USPSTF made these recommendations based on the net benefit to potential patients by early screening and detection of anxiety and depression. Initial screenings for anxiety and depression in primary care offices increase identification of mental health concerns which can subsequently lead to treatment for many undiagnosed individuals.

There is so much to discuss when it comes to suicide prevention and the importance of sharing risk factors and interventions. To conclude the Suicide Prevention Month notes, I am sharing identifying risk factors and immediate things you can do to help those in need.

Risk factors for increased suicide risk:

  • Mental disorders, particularly mood disorders, schizophrenia, anxiety disorders, and certain personality disorders
  • Alcohol and other substance use disorders
  • Hopelessness
  • Impulsive and/or aggressive tendencies
  • History of trauma or abuse
  • Major physical illnesses
  • Previous suicide attempt(s)
  • Family history of suicide
  • Job or financial loss
  • Loss of relationship(s)
  • Easy access to lethal means
  • Local clusters of suicide
  • Lack of social support and sense of isolation
  • Stigma associated with asking for help
  • Lack of healthcare, especially mental health, and substance abuse treatment
  • Cultural and religious beliefs, such as the belief that suicide is a noble resolution of a personal dilemma
  • Exposure to others who have died by suicide (in real life or via the media and Internet)

Warning signs of increased imminent risk:

  • Talking about wanting to die or to kill themselves
  • Looking for a way to kill themselves, like searching online or buying a gun
  • Talking about feeling hopeless or having no reason to live
  • Talking about feeling trapped or in unbearable pain
  • Talking about being a burden to others
  • Increasing the use of alcohol or drugs
  • Acting anxious or agitated; behaving recklessly
  • Sleeping too little or too much
  • Withdrawing or isolating themselves
  • Showing rage or talking about seeking revenge
  • Extreme mood swings

If you know someone experiencing thoughts of suicide or one of the above risk factors, follow these steps to help.

  • Tune-In
    • Tuning in to the possibility of suicide can lead to help and safety rather than suicide. 
    • Pay attention and notice what you hear, sense, feel, see, and learn about.
    • Take the time to follow your instincts. 
    • Notice when someone needs help and focus your attention on whether their thoughts and experiences could be about suicide. 
  • Ask About Suicide
    • People thinking about suicide may not know how to ask for help. 
    • Once you have “tuned-in” and believe they may be experiencing thoughts of suicide, Ask CLEARLY, DIRECTLY, and CALMLY. 
    • Example: “You seem to be overwhelmed, are you thinking about suicide?”
    • This question is clear and direct and cannot be mistaken for any other meaning. 
    • Remember:  It is important to ASK about suicide in a way that is non-judgmental.  Demonstrate that you want to hear the answer. 
    • Asking about suicide gives the person with thoughts of suicide permission to talk about their thoughts.  It is possible that up until now, this person may have felt they could not talk about the pain they were in. 
  • State that Suicide is Serious
    • Let the person know that you believe that suicidal thoughts are serious. 
    • Example: “You are thinking about suicide, that is serious.  Tell me more.  What happened?  When did this start.”
    • Example: “Thank you for telling me that you are thinking about suicide.  Having these thoughts is serious.  When did you begin thinking about suicide?  Let’s talk about it.”
    • After asking about suicide, you may learn how suicidal thoughts came to be on their mind.  You may also identify how or when they thought about suicide. 
    • Repeat back to them all you have heard them say about suicide. 
    • Stress the importance of connecting to help to be safe from suicide is important.
  • Connect
    • Connect the person to resources who possess the skills to support safety.
    • Make the connection as soon as possible. Do not put this off!
    • Do not leave a person with suicidal thoughts alone.
    • Getting help to ensure their safety demonstrates how seriously you take thoughts of suicide. 
    • Talk about and agree on a connection to a resource who supports safety from suicide.
    • It is important to ask if there has already been any harmful suicide action taken.  If there were pills taken or any injury inflicted, contact emergency medical services or the police for immediate help. 

These four steps won’t replace treatment, but they will increase the chance the person will get help.

The work that each of you has done to reduce stigma, increase treatment visibility, and provide valuable information to your communities has been outstanding! I appreciate all you do, and the world is a better place for it!

If you or someone you know is in need of a behavioral health placement, behavioral health referral, or experiencing a mental health emergency or crisis, please do not use this website. Instead, use these crisis resources to speak with someone now or access local support.