Suicide: Signs and Prevention

by James A. Bishop, M.S.

Suicide is the second leading cause of death among young adults, ages 15-25 (McIntosh & Drapeux, 2015). There are approximately 25 attempts for every death by suicide in the United States. It is the responsibility of clinicians and health professionals to identify and assess risk for suicide, however, lay community members, such as teachers and parents, can benefit from being able to correctly identify suicide risk and respond appropriately.

There are multiple risk factors that are associated with suicide. Knowing these risk factors can help determine individuals who may have the deck stacked against them.  Individuals who have these risk factors are statistically more likely to attempt or die by suicide (American Foundation for Suicide Prevention, 2015). These risk factors include mental illness, substance abuse, firearms in the household, previous suicide attempts, non-suicidal self-injury, exposure to friends’/family members’ suicide, and low self-esteem. None of these risk factors alone should be taken lightly or mean that a person will kill themselves.

Knowing the risks factors for suicide is just half the battle. Just because someone is at-risk for suicide, does not mean that the individual is going to attempt or die by suicide. An intimate knowledge of warning signs for suicide can help successfully identify someone at imminent risk for suicides in order to best intervene with appropriate resources.

A helpful strategy to identify warming signs for suicide is provided by the American Associate of Suicidology. IS PATH WARM is a mnemonic device that stands for Ideation, Substance Abuse, Purposelessness, Anxiety, Trapped, Hopelessness, Withdrawal, Anger, Recklessness, and Mood Changes. Assessing for these warning signs can allow for successful interventions.

Individuals at imminent risk most often show behaviors like threatening to hurt or kill themselves, talking about wanting to hurt or kill themselves, looking for ways to kill themselves (e.g., seeking access to firearms, pills, or other means of suicide), and talking or writing about death, dying, or suicide. Other warning signs for a suicide attempt include increase in substance (i.e., alcohol or drug) use, feelings of lack of purpose in life, and increased anxiety, agitation and increases (i.e., sleeping all of the time) or decreases (i.e., insomnia) in sleep. Additionally, individuals may feel trapped, hopeless, and withdraw from family, friends, and society. Individuals also may exhibit excessive anger, increased reckless or risk taking behavior, and dramatic changes in mood. These warning signs individually do not indicate that an individual is suicidal; however, taken together, these warning signs can help to identify someone who is in imminent danger of taking their own life.

If you believe someone is at-risk for suicide, there are a myriad of resources that are available to assist you and to the individual. The first step should be to contact a mental health professional or calling the National Suicide Prevention Lifeline at 1-(800) 273-8255. This is a 24/7 hotline that individuals in a suicidal crisis can call to talk with a trained counselor at the nearest crisis center. All calls to the Lifeline are confidential and free. Additionally, the trained counselors at the Lifeline can provide locally available mental health referrals.

For more information on identifying and managing suicide risk, please see the following resources:

National Suicide Prevention Lifeline

American Association of Suicidology 

National Action Alliance