Stop a Suicide Today

If you, a friend, or a loved one is suicidal or exhibiting any suicidal warning signs, please contact the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255). You can also dial 911 or go to the nearest emergency department. Treat it in the same way you would treat any other medical emergency – like choking or a heart attack– and get help immediately!

The National Suicide Prevention Lifeline

Upon calling the National Suicide Prevention Lifeline, you will be connected to a trained certified crisis counselor at one of the 150 crisis centers in the Lifeline’s network. The crisis counselor can offer mental health support as well as referrals to local services. Calls are routed to the nearest available crisis center based on the caller’s area code. You can call the Lifeline (1-800-273-8255) any time of the day or night. You can also chat online.

Why Should I call the Lifeline?

Lifeline counselors are trained in crisis intervention. They can provide mental health support services. The counselors can help determine whether you or your loved one is at imminent risk of engaging in suicidal behavior and in need of emergency intervention. Research has shown that by the end of the call, the majority of Lifeline callers will feel less emotional stress and less suicidal.

The National Suicide Prevention Lifeline was established by the Substance Abuse and Mental Health Services Administration (SAMHSA) in 2005. In 2017, it answered over two million calls. Madelyn Gould and her colleagues from Columbia University examined data from 1507 monitored calls to the Lifeline. The results showed that callers felt significantly less depressed, less suicidal, less overwhelmed, and more hopeful by the end of calls.

In a more recent study, Gould and colleagues looked at the benefits of the SAMHSA-funded initiative to provide follow-up calls to Lifeline callers who reported suicidal ideation or “desire.” Those who received the follow up calls reported that the intervention stopped them from killing themselves and kept them safe. Those who were at higher risk of suicide at the time of their calls to the lifeline found the follow-up intervention to be more valuable than those at lower risk. Not every crisis center is able to offer follow-up services, but many do. Follow-ups, when offered to the caller, are optional.

The Crisis Text Line

The Crisis Text Line provides free, 24/7 support via text messaging for those in crisis. Crisis is defined as “any painful emotion for which you need support.” To connect with a crisis counselor, text HOME to 741741 from anywhere in the United States. It usually takes less than five minutes to connect, but may take longer during high-traffic times. The crisis counselor is a trained volunteer who will provide support, but not medical advice. You will then text back and forth with the Crisis Counselor. The goal of any conversation is to get you to a “calm, safe place.” Sometimes that means providing you with a referral to further help, and sometimes it just means “being there and listening.” A texting conversation usually lasts anywhere from 15-45 minutes.

A common misconception is that asking people about suicide will put the idea into their heads. This is simply not true. A recent review of 13 studies on the topic found that “acknowledging and talking about suicide may in fact reduce, rather than increase, suicidal ideation…” In fact, many people with suicidal thoughts are relieved by talking about them.

The National Suicide Prevention Lifeline has also recently initiated the “#BeThe1To” campaign. This initiative gives family and loved ones a plan with “5 action steps” for reaching out and helping those who may be suicidal. These steps are:

• Ask whether they are thinking about suicide
• Keep them safe by reducing their access to lethal means
• Be there for them
• Help them connect with support
• Follow up to see how they are doing

On this website, you can access the ACT® (Acknowledge, Care, Treatment) which also discusses what you can do if someone you care about may be considering suicide.

For Service Members, Veterans, and their Families

Veterans Crisis Line: Service members, Veterans, and their families also have the option of calling the Veterans Crisis Line at 1-800-273-8255 (1-800-273-TALK) or can TEXT the Crisis Line at #838255. The VA hotline is staffed by mental health professionals 24 hours a day, 7 days a week. The hotline is a free, anonymous, confidential resource. Registrations with VA or enrollment in VA health care is not necessary.

Veterans and their families can also chat online with trained counselors at www.VeteransCrisisLine.net. The VA also has full-time suicide prevention counselors at its VA hospitals nationwide.

Need crisis assistance while overseas? The following overseas locations have direct crisis line numbers:

• In Europe: Call 00800 12738255 or DSN 118
• In Korea: Call 0808 555 118 or DSN 118
• In Afghanistan: Call 00 1 800 273 8255 or DSN 111
• Crisis chat support is available internationally.

Veterans Health Administration (VHA) Data and Guidelines

In 2013, the Veterans Health Administration issued its first comprehensive report on veterans who die by suicide. Prior to this report, data on Veterans who died by suicide was only available for those veterans who had sought VA healthcare services. An updated report was issued in 2016, including data from 1979 through 2014. The risk of suicide among Veterans was 21% greater than among civilian adults. In 2017, the VHA released additional data, which showed the risk of suicide to now be 22% higher among Veterans when compared to non-Veteran adults. Female veterans are particularly at risk. They are 250% more likely than non-Veteran adult women to die by suicide.

The VHA also recently updated suicide prevention guidelines. The guidelines recommend both screening and evaluation for suicide risk. Newly discharged veterans should be carefully monitored for suicidality, as suicide risk has been shown to be significantly increased in the first 4 weeks following discharge from military service.

Online Resources for Service Members, Veterans, and Their Families

• Veteran suicide prevention shareable materials: Downloadable resources and information to help support Veterans.
• “Be There” public service announcement: Service members and Veterans talking about the small actions by friends and family members that made a big difference to them.
• S.A.V.E. online suicide prevention video: Training to learn how to recognize suicide risk factors and warning signs.
• Make the Connection: Stories of Veterans who have dealt with mental health issues, have found support (whether through treatment or with the help of a loved one), and are living healthy, productive lives.
• VA Mental Health website: VA’s repository of mental health resources, information, and data materials, including VA’s National Strategy for Prevention Veteran Suicide 2018–2028. For more information about the information presented in this report, contact VASPDataRequest@va.gov.

Social Media

If you see concerning posts about suicide or live streaming of suicidal behavior on social media, please call 911, contact the National Suicide Prevention Lifeline (1-800-273-TALK), or text the Crisis Text Line (text HOME to 1-800-799-4889).

Many social media sites also have resources available for the public on how to respond to suicidal posts. These resources can be found on such platforms as:

• Facebook - Use search terms “suicide” or “suicide prevention”
• Instagram - Use search terms “suicide,” “self-injury,” or “suicide prevention”
• Snapchat - Use search terms “suicide” or “suicide prevention”
• Tumblr - Use search terms “counseling” or “prevention”
• Twitter - Use search terms “suicide,” “self-harm,” or “suicide prevention”
• YouTube - Use search term = “suicide and self-injury”

Resources on Bullying

According to the Center for Disease Control and Prevention (CDC), bullying is an “unwanted, aggressive behavior among school-aged children that involves a real or perceived power imbalance.” Bullying includes making threats, spreading rumors, attacking someone physically or verbally, and excluding someone from a group on purpose. Students most at risk for being bullied are those with disabilities, learning differences, sexual/gender differences or cultural differences.

Negative outcomes of bullying may include depression, anxiety, interpersonal or sexual violence, substance abuse, poor social functioning, and poor school performance. Those who report being frequently bullied and those who report frequently bullying others are both at significant risk for suicide-related behavior, including suicide ideation, attempt, and completion.

Because school staff spend several hours a day with students, the CDC has put together a document for school administrators, teachers, and school staff titled “The Relationship between Bullying and Suicide: What We Know and What It Means for Schools.” The document includes evidence-based suggestions for dealing with bullying behavior in school settings and lists additional resources available on this topic through the CDC and other federal agencies.

Online Federal Resources on Bullying

• www.stopbullying.gov/what-is-bullying/roles-kids play/index.html
• http://www.stopbullying.gov/respond/support-kids-involved/index.html#address
• www.cdc.gov/healthyyouth/adolescenthealth/connectedness.htm
• www.cdc.gov/ViolencePrevention/pdf/ASAP_Suicide_Issue3-a.pdf
• www.cdc.gov/violence prevention/pdf/asap_bullyingsv-a.pdf
• www.air.org/focs-area/education/?type=projects&id=127
• www.cfchildren.org/steps-to--respect.aspx
• www.stopbullying.gov/respond/index.html
• www.stopbullying.gov/prevention/training-center/index.html
• www.afsp.org/advocacy-public-policy/state-policy/anti-bullying-and-anti-cyberbullying-policies

Resources on Postpartum Depression and Psychosis

Postpartum depression is common, affecting 1 in 7 women, according to the CDC. Post-partum psychosis is rare, affecting 1-2 in 1000 deliveries.

The incidence of suicide among women who have given birth in the past year is lower than that of women who have not given birth. Having a child, or a reason for living, is thought to be protective against suicide. However, suicides still occur during pregnancy and in the year after delivery. In fact, suicide is one of the most common causes of maternal death during the postpartum year.

Postpartum depression and postpartum psychosis are both treatable with professional help. However, they are medical emergencies. If you, a friend, or a loved one is pregnant or has recently given birth and is feeling depressed or is having suicidal thoughts, please call the National Suicide Prevention Lifeline (1-800-273-8255), dial 911, or go to the nearest hospital emergency department for an evaluation.

Online Resources for Pregnant and Postpartum Women and their Partners

• NAMI: The National Alliance on Mental Illness is a mental health organization dedicated to building better lives for the millions of Americans affected by mental illness
• Postpartum Support International: This organization seeks to increase awareness among public and professional communities about the emotional changes that women experience during pregnancy and during the year after the birth.
• Moms’ Mental Health Matters: This initiative is designed to educate consumers and health care providers about who is at risk for depression and anxiety during and after pregnancy, the signs of these problems, and how to get help.
• Postpartum Depression Fact Sheet: This fact sheet from the American Psychological Association discusses the symptoms, associated factors, prevention, and treatment for postpartum depression.
• Video to Raise Awareness About Postpartum Depression: This video is part of the Mental Health Across the Lifespan Initiative created by the National Institute of Mental Health, the Eunice Kennedy Shriver National Institute of Child Health and Human Development, and Delta Sigma Theta Sorority, Inc.
• Postpartum Psychosis: A Guide for Partners: Postpartum psychosis is traumatic for women as well as their partners. This guide is for the partners. It explains postpartum psychosis and its treatments. It also discusses the partner’s role during a hospital admission and during recovery from the illness.
• Planning Pregnancy: a Guide for Women at Risk of Postpartum Psychosis: This guide is for women at risk for postpartum psychosis because of a history of bipolar disorder or other mental illness. It includes advice from both families and professionals about getting the necessary support when planning to become pregnant, during the pregnancy, and after the delivery.

Postvention: For Those Affected by a Suicide Death

Postvention

The term “postvention” refers to interventions aimed at helping those who have been affected by a suicide death. Several studies have shown that exposure to suicide can have serious mental health consequences for family, friends, coworkers, and classmates. These consequences include depression, anxiety, and posttraumatic stress disorder as well as an increased incidence of suicidal ideation, suicide attempts, and suicides.

One of the purposes of postvention is to offer comfort and support the bereaved. A death by suicide can leave behind a bevy of emotions that make the grieving process even more challenging. In addition, those grieving a suicide often receive less community support for their loss than those grieving deaths by other means, which can lead to greater isolation. The goals of postvention are to assist the bereaved with the grieving process and to reduce the risk of contagion or suicide clusters.

Suicide can be contagious, especially among adolescents. When suicide “contagion” or imitation occurs, a “suicide cluster” can develop. A “suicide cluster” refers to multiple suicides within an accelerated time frame, often within a defined geographical area. Studies indicate that up to 5% of adolescent suicide deaths are due to contagion or imitation. Postvention can help to reduce the risk of suicide contagion or imitation. Many schools and colleges have plans in place for postvention in the event of a student suicide.

Studies find that an average of 4.5 to 7.5 immediate family members and 15-20 extended family, friends, and colleagues are “intimately and directed affected” by a suicide. As the following table indicates, friends, family, and others who were emotionally close to the deceased are more likely to require support and postvention services. Children may be particularly vulnerable; studies show that without early intervention, a significant proportion of children exposed to the death of a relative or sibling go on to develop major depression or posttraumatic stress disorder.

Postvention can take many forms. You may be offered individual counseling, group counseling, or other support services.

The American Foundation for Suicide Prevention has resources available on their website for those who have lost a loved one to suicide, including how to find a support group in your local community. These resources are free to the public and can be accessed at https://afsp.org/find-support/ive-lost-someone/resources-loss-survivors/. The National Suicide Prevention Lifeline and the American Association of Suicidology also have helpful information on their websites for those who have experienced a suicide death.

The Tragedy Assistance Program for Survivors (TAPS) provides a postvention program for military personnel, veterans, and their families. Since its inception over 10 years ago, TAPS has provided postvention support to over 9000 military family survivors.