Suicide Prevention

SAMHSA provides suicide prevention information and other helpful resources to behavioral health professionals, the general public, and people at risk.

Overview

Suicide is a serious public health problem that causes immeasurable pain, suffering, and loss to individuals, families, and communities nationwide. The causes of suicide are complex and determined by multiple combinations of factors, such as mental illness, substance abuse, painful losses, exposure to violence, and social isolation. Suicide prevention efforts seek to:

Reduce factors that increase the risk for suicidal thoughts and behaviors
Increase the factors that help strengthen, support, and protect individuals from suicide

Ideally, these efforts address individual, relationship, community, and societal factors while promoting hope, easing access into effective treatment, encouraging connectedness, and supporting recovery.

Nearly 40,000 people in the United States die from suicide annually, or 1 person every 13 minutes. This exceeds the rate of death from homicide and AIDS combined. More people die by suicide than from automobile accidents.

The suicide rate has been rising over the past decade, with much of the increase driven by suicides in mid-life, where the majority of all suicides in the United States now occur. From 1999 to 2013, the age-adjusted suicide rate for all ages in the United States increased (10.5% to 13.5%). Half of these deaths occur by use of a firearm.

Of all the death attributed to suicide in 2013, 78% of those are male. In 2013, the latest year for which data is available, the highest number of suicides among both men and women occurred among those aged 45 to 54. The highest rates of suicides (suicides per 100,000) occurred among men aged 75 and up and among women aged 45 to 54. Suicide was the second leading cause of death for young people ages 15 to 24 and for those aged 25 to 34.

Suicidal thoughts are also a significant concern. Having serious thoughts of suicide increases the risk of a person making an actual suicide attempt. There are more than 25 attempted suicides for each suicide death. In 2014, an estimated 9.4 million adults (3.9%) aged 18 or older had serious thoughts of suicide in the past year. A report on Suicidal Thoughts and Behaviors Among Adults from the 2014 NSDUH report (PDF | 3.4 MB) showed that the percentage was highest among people aged 18 to 25, followed by people aged 26 to 49, then by people aged 50 or older. Among high school students, more than 17% (approximately 2.5 million ninth through twelfth graders) have seriously considered suicide, more than 13% have made a suicide plan, and more than 8% have attempted suicide.

The most critical risk factors for suicide are prior suicide attempts, mood disorders (such as depression), alcohol and drug use, and access to lethal means. In 2008, alcohol was a factor in approximately one-third of suicides reported in 16 states. According to SAMHSA’s Drug Abuse Warning Network report on drug-related emergency department visits, in 2011, there was a 51% increase in drug-related suicide attempt visits to hospital emergency departments among people aged 12 and older.

Suicide touches all ages and backgrounds, all racial and ethnic groups, in all parts of the country. However, some populations are at higher risk for suicidal behavior. For example, the emotional toll of a person’s suicide can put surviving family, friends, and other loved ones at greater risk of dying by suicide.

Fortunately, there is strong evidence that a comprehensive public health approach is effective in reducing suicide rates. Released by the U.S. Surgeon General and the National Action Alliance for Suicide Prevention(link is external) in 2012, the National Strategy for Suicide Prevention is intended to guide suicide prevention actions in the United States over the next decade. The strategy provides guidance for schools, businesses, health systems, clinicians, and others, and emphasizes the role every American can play(link is external) in protecting their friends, family members, and colleagues from suicide.

SAMHSA is a proud partner of the National Action Alliance for Suicide Prevention(link is external), a public-private partnership with more than 200 participating organizations advancing the national strategy for suicide prevention. SAMHSA funds the Suicide Prevention Resource Center to act as Executive Secretariat to the Action Alliance. Learn about the Action Alliance’s Your Life Matters! campaign, which gives faith communities of every tradition, philosophy, sect, or denomination an opportunity to dedicate one Sabbath each year, preferably corresponding to World Suicide Prevention Day, to celebrate life, hope, and reasons to live.

SAMHSA is committed to continuing to working with its federal partners and private organizations to provide states, territories, tribal entities, communities, and the public with the assistance and prevention resources they need. SAMHSA offers:

Learn more about:

Warning Signs of Suicidal Behavior

These signs may mean that someone is at risk for suicide. Risk is greater if the behavior is new, or has increased, and if it seems related to a painful event, loss, or change:

Talking about wanting to die or kill oneself
Looking for a way to kill oneself
Talking about feeling hopeless or having no reason to live
Talking about feeling trapped or being 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 feeling isolated
Showing rage or talking about seeking revenge
Displaying extreme mood swings

Download the National Suicide Prevention Lifeline Wallet Card: Learn the Warning Signs – 2005 in English or en Español.

What You Can Do

If you believe someone may be thinking about suicide:

Ask them if they are thinking about killing themselves. (This will not put the idea into their head or make it more likely that they will attempt suicide.)
Listen without judging and show you care.
Stay with the person (or make sure the person is in a private, secure place with another caring person) until you can get further help.
Remove any objects that could be used in a suicide attempt.
Call SAMHSA’s National Suicide Prevention Lifeline at 1-800-273-TALK (8255) and follow their guidance.
If danger for self-harm seems imminent, call 911.

Everyone has a role to play in preventing suicide. For instance, faith communities can work to prevent suicide simply by fostering cultures and norms that are life-preserving, providing perspective and social support to community members, and helping people navigate the struggles of life to find a sustainable sense of hope, meaning, and purpose. For information about how you can help, visit the Suicide Prevention Resource Center's customized information sheets for parents, teachers, co-workers, and others(link is external).

Schools and Campus Suicide Prevention

SAMHSA’s Garrett Lee Smith Campus Suicide Prevention Program(link is external) provides funding to institutions of higher education to identify students who are at risk for suicide and suicide attempts, increase protective factors that promote mental health, reduce risk factors for suicide, and reduce suicides and suicide attempts.

Many of SAMHSA’s Garrett Lee Smith Youth Suicide Prevention and Early Intervention(link is external) grantees focus efforts on middle and high schools. SAMHSA also funded the development of Preventing Suicide: A Toolkit for High Schools – 2012 to help high schools, school districts, and their partners design and implement strategies to prevent suicide and promote behavioral health among their students.

Now Is The Time—Prevention and Early Intervention

On January 16, 2013, President Barack Obama released the Now Is The Time plan, which outlines how the nation can better support the behavioral health needs of young people. Since then, SAMHSA has played a key role in supporting activities outlined in the plan, including developing and funding new grant programs.

Screening and Assessment Tools

Most people who die by suicide had seen a health care provider in the year prior to their suicide. Further, many people visited a health care provider in the month prior to their suicide. Screening and assessing for suicide risk is an important aspect of suicide prevention. Available screening tools include:

SAFE-T (Suicide Assessment Five-Step Evaluation and Triage) – 2009, developed for mental health professionals, identifies risk and protective factors, inquires about suicidal thoughts, determines risk levels, and makes recommendations for intervention and follow-up.
Patient Health Questionnaire (PHQ-9) – 2005 (PDF | 484 KB) is the most common screening tool to identify depression. Question 9 screens for suicide.
Columbia-Suicide Severity Rating Scale (C-SSRS) – 2008 (DOCX | 21 KB)(link is external) assesses for suicide risk.
Suicide Behaviors Questionnaire (SBQ-R) – 2001 (PDF | 45 KB) assesses suicide-related thoughts and behaviors.
Suicidal Ideation Questionnaire (SIQ)(link is external) assesses the frequency of suicidal thoughts in adolescents and may be used to evaluate or monitor troubled youths.

SAMHSA also works with health care professionals to help them prevent and deal with suicide attempts and developed a Quick Guide for Addressing Suicidal Thoughts and Behaviors in Substance Abuse Treatment – 2013.

Suicide Attempt Survivors

Although prior suicide attempts is one of the strongest risk factors for suicide, the vast majority of people who attempt suicide (9 in 10) do not ultimately die by suicide. A growing number of people who have lived through suicidal experiences are writing and speaking about their experiences, connecting with one another, and sharing their pathways to wellness and recovery. Additional resources include: