SUICIDE PREVENTION

Risk factors are characteristics that make it more likely that someone will consider, attempt, or die by suicide. They cannot cause or predict a suicide attempt, but they are important to be aware of.

• 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)

Some warning signs may help you determine if a loved one is at risk for suicide, especially if the behavior is new, has increased, or seems related to a painful event, loss, or change. If you or someone you know exhibits any of these, seek help by calling the Lifeline.

• 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

Now Matters Now – Safety Plan Guide
The above is something you can do before a crisis and can include your friends and family. Most safety plans are 1-2 pages. 

Means Matter – Recommendations for Families
The Harvard School of Public Health has information on the most commonly used means for suicide and attempts. 

Follow-up Matters
The National Suicide Prevention Lifeline offers follow-up services to support high-risk callers, suicide attempt survivors, and referrals from third parties. This creates continuity of care after a crisis. Call the Lifeline 1-800-273-TALK (8255) and request a follow-up call.

If you have health insurance, check with the insurance company about what providers and services are covered. If your workplace has an employee assistance program, you should be able to get confidential counseling through it. If you go to a school or college with a counseling center or school counselors, they can help you find a counselor.

Idaho Suicide Prevention Hotline
1-208-398-HELP (4357) should be able to help you with a therapy referral.

Idaho CareLine
2-1-1 is another way to find local resources.

National Suicide Prevention Lifelines
If you need to find a therapist and don’t know where to start, the national therapist locators above may be useful.

Advice and Resources from Suicide Attempt Survivors

Increasingly, people who have been at risk of suicide are taking leadership in suicide prevention. These resources can help you take care of yourself and connect you with people with similar experiences.

Now Matters Now
Support network for people who had suicidal thoughts and emotions and problems that felt unsolvable. They share their stories, including research-based ways for managing the most painful moments of life, and teach Dialectical Behavior Therapy skills.

SPRC – A Journey Toward Health and Hope
Booklet which offers interactive, practical tools for recovering and moving forward after surviving a suicide attempt.

National Suicide Prevention Lifelines
Resources and self-care tips from suicide attempt survivors.

YouTube – Voices of Hope Videos featuring those who have struggled with suicide: unscripted interviews with people speaking from their personal experience.

Looking out for the warning signs of suicide can help you determine if a loved one is at risk of suicide, especially if the behavior is new, has increased, or seems related to a painful event, loss, or change.

National Suicide Prevention Lifeline
The above lists the following warning signs. Warning signs may include but are not limited to:

• 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

How can you help them?

It can be scary when a friend or loved one is thinking about suicide. It’s hard to know how a suicidal crisis feels and how to act. Call a lifeline or hotline center at any time for help if a friend is struggling.

Idaho Suicide Prevention Hotline
Call or Text: 1-208-398-HELP (4357)

National Suicide Prevention Lifeline
1-800-273-TALK (8255) and 1-888-628-9454 for Spanish-speaking callers

BeThe1To – Five Action Steps
If you are concerned about someone else, the above steps for communicating with someone who may be suicidal are supported by evidence in the field of suicide prevention.

1. Be the one to ask.
   • Ask the tough question. When somebody you know shows warning signs, ask them directly: “Are you thinking about killing yourself?” 
   • Help Yourself Help Others – Take an online screening
2. Be the one to keep them safe.
   • Do they have access to medications, firearms, or other means of suicide? Ask if they’ve thought about how they would do it and separate them from anything they could use to hurt themselves.
   • Make a safety plan with them. Use gun locks, drug deactivation pouches, and lockboxes. Time and distance between a suicidal person and their means can save a life.
3. Be the one to be there.
   • People thinking about suicide can feel a burden to their loved ones. If your friend is thinking about suicide, listen to their reasons for feeling hopeless and in pain.
   • Listen with compassion and empathy without judgment. 
     Now Matters Now – Safety Plan Guide
     The above is something you can help them do before a crisis and can include their friends and family. Most safety plans are 1-2 pages.
4. Be the one to help them connect.
   • Help your friend connect to a support system, whether it’s Idaho Suicide Prevention Hotline 1-208-398-HELP (4357), the National Suicide Prevention Lifeline 1-800-273-TALK (8255), the crisis text line (text “HEAL” to 741741) family, friends, faith-based leaders, coaches, co-workers, health care professionals or therapists, so they have a network to reach out to for help.
   • Idaho CareLine
     2-1-1 is another way to find local resources.
5. Be the one to follow up.
   • Check in with the person you care about regularly.
   • Contacting a friend in the days and weeks after a crisis can make a difference in keeping them alive.
     Zero Suicide – Send a Caring Contact
     This could be a phone call, text, email, or letter.

Safe communication for suicide prevention:

• Using language that is helpful and respectful encourages an environment free of stigma, where we can talk more openly and safely about suicide and its prevention.
• Words matter in a world where silence or insensitivity can make matters worse. The more we are open and safe in our communication, the more likely it is that people can offer or seek help.
  • Canada Public Health – Language Matters: Safe Communication for Suicide Prevention
  • Speaking of Suicide

Source: 
NAMI – Your Language Matters

Storytelling | Healing, hope and help are happening every day:

• Stories of hope and recovery have the power to help others through a crisis and dispel stigma and myths about suicide.
• By sharing our experiences, we all can change the conversation about suicide from one of tragedy to one of hope and healing. If you are considering sharing your story, we recommend that you use this storytelling checklist below to help determine how to share your story safely and effectively – for yourself and others.
  • Suicide Prevention Lifeline – Storytelling for Suicide Prevention Checklist
  • Suicide Prevention Messaging – Guidelines for Telling Your Own Story

The type of means that someone at risk of suicide can use to kill themselves can often make a large difference in the lethality of an attempt. Firearms are used in suicides more than every other method combined and tend to be the most fatal of means. Should we only focus on firearms?

No, but firearms are typically the most serious, fatal, and irreversible out of all the means. According to a study conducted by the Centers for Disease Control and Prevention, having a firearm in the household is a major risk factor for suicide deaths. The use of gun locks and safe storage of firearms are effective ways to restrict a suicidal person access to firearms. Nonetheless, there are many methods that people can use to kill themselves. Loved ones and/or household members of a suicidal person need to be careful with all means. Time and distance between a suicidal person and their means can save a life.

Source:

IDHW – Suicide in Idaho Tracking Data

CDC – Firearm Homicides and Suicides in Major Metropolitan Areas – United States, 2012-2013 and 2015-2016

What if they don’t want help?
It can be difficult to know what to do when someone thinking about suicide doesn’t want help. The most important things you can do are to be available for when they are ready to talk and create a safety plan. Reduce access to lethal means they might use by locking up and safely storing medications and firearms. Specialists at the Idaho Suicide Prevention Hotline or the National Suicide Prevention can help you find local resources for when your loved one is ready to seek help.

Hotlines:

Child-Help USA Hotline – 1-800-422-4453
Crisis Text Line – Text “HEAL” to 741741
Idaho Suicide Prevention Hotline – Call or Text: 208-398-HELP (4357)
LGBTQIA+ National Hotline – 1-888-843-4564
Suicide Prevention Lifeline – 988 / Veterans, Press 1
Nebraska Regional Poison Center – 1-800-222-1222
SAMHSA Disaster Distress – 1-800-985-5990
SAMHSA National Helpline – For mental and/or substance use disorders: 1-800-662-HELP (4357)
Teen Link – 1-866-427-4747
The Trevor Project – For LGBTQIA+ Youth: Call or Text: 1-866-488-7386
Trans Lifeline – 1-877-565-8860 (English & Spanish)
Veterans Crisis Line – 1-800-273-8255, Press 1

Local Resources:
Idaho CareLine – 2-1-1
IDHW – Suicide Prevention Program

• • IDHW – Idaho Suicide Prevention Plan
  • IDHW – Suicide in Idaho Tracking Data

Idaho Lives Project (for Youth)
Idaho Suicide Prevention Hotline – Call or text 208-398-HELP (4357)
Mobile Crisis Unit – 208-334-0808
Pathways Community Crisis Center of Southwest Idaho – 208-489-8311
Nebraska Regional Poison Center – (serves Idaho) 1-800-222-1222
Northwest Portland Area Indian Health Board
The Speedy Foundation

Coping with Stress Resources:
American Psychological Association – Disasters & Terrorism
CDC – Coping with a Disaster or a Traumatic Event
Child-Help USA – 1-800-422-4453
Idaho Suicide Prevention Hotline – 208-398-HELP (4357)
National Suicide Prevention Lifeline – 1-800-273-TALK (8255) (1-888-628-9454 for Spanish-speaking callers; Press 1 for Veterans)
SAMHSA Disaster Distress – 1-800-985-5990
SAMHSA National Helpline – 1-800-662-HELP (4357)

CDC Articles and Resources:
CDC – Coping with a Disaster or Traumatic Event
CDC – Injury Center Funding Opportunity Announcements (FOAs)
CDC – Suicide in Rural America

Other Federal Resources:
BeThe1To
Indian Health Service Suicide Prevention Program
Action Alliance for Suicide Prevention
National Child Traumatic Stress Network (NCTSN)
National Institute of Mental Health (NIMH)
Suicide Prevention Lifeline
SPRC – Programs and Practices
Substance Abuse and Mental Health Services Administration – Suicide Prevention Program
Department of Defense – Suicide Prevention
Veterans Affairs (VA) – Suicide Prevention

Additional Online Resources:
American Association of Suicidology (AAS)
American Foundation for Suicide Prevention (AFSP)
The Jason Foundation, Inc. (JFI)
Jed Foundation
National Council for Suicide Prevention (NCSP)
Suicide Awareness Voices of Education (SAVE)
Suicide Prevention Resource Center (SPRC)
Training Institute for Suicide Assessment and Clinical Interviewing (TISA)
The Trevor Project
Zero Suicide

SPRC – Applied Suicide Intervention Skills Training (ASIST)
A two-day, two-trainer, workshop designed for members of all caregiving groups.

SPRC – Assessing and Managing Suicide Risk: Core Competencies for Mental Health Professionals (AMSR)
Assessing and Managing Suicide Risk (AMSR) is a series of one-day or half-day training designed for health and behavioral health professionals interested in the latest intersectional suicide care practices.

ISU – Behavioral Health and Substance Abuse Community Health Worker and Community Paramedic Training Module

CALM: Counseling on Access to Lethal Means

CAMS Training
A therapeutic framework for suicide-specific assessment and treatment of a patient’s suicidal risk.

NAMI – Crisis Intervention Team (CIT) Programs
An innovative, community-based approach to improve the outcomes of first responders in crisis encounters.

Idaho Lives Project Training
Helps schools implement comprehensive, evidence-based suicide prevention and wellness programs.

Mental Health First Aid
A skills-based training course that teaches participants about mental health and substance-use issues.

NAMI – Ending the Silence
Learn about the warning signs of mental health conditions and what steps to take if you or a loved one are showing symptoms of a mental health condition.

Native H.O.P.E. (Helping Our People Endure)
A peer-counseling (youth helping youth) curriculum that focuses on suicide prevention and the related risk factors such as substance abuse, violence, trauma, and depression.

QPR (Question, Persuade, and Refer) – Gatekeeper Training
3 simple steps which anyone can learn to help save a life from suicide.

ISU -Respond: Partnering for Campus Mental Health
An in-depth training designed to help faculty and staff feel more comfortable and better prepared to respond to students who are experiencing emotional distress by offering support but also knowing when to refer to a professional counselor.

VA – Suicide Prevention Gatekeeper Training
A one- to two-hour gatekeeper training program provided by VA suicide prevention coordinators to veterans and those who serve veterans.

NAMI – Say It Out Loud: Speaking with Teens about Mental Health
The National Action on Mental Illness (NAMI) created Say it Out Loud to get teens talking about mental health.

Tennessee Public Health – Shield of Care
A System-Focused Approach to Protecting Juvenile Justice Youth from suicide.

SPRC – SOS Signs of Suicide Middle School and High School Prevention Programs
A universal, school-based prevention program designed for middle school (ages 11-13) and high school (ages 13-17) students.

Sources of Strength
An ongoing, strength-based, comprehensive wellness program that focuses on suicide prevention but also impacts other issues such as substance abuse and violence.

YourMentalHealth -Suicide Alertness for Everyone (safeTALK)
A half-day training program that teaches participants to recognize and engage persons who might be having thoughts of suicide and to connect them with community resources trained in suicide intervention.

AFSP – Talk Saves Lives: An Introduction to Suicide Prevention
A community-based presentation that covers the general scope of suicide, the research on prevention, and what people can do to fight suicide.

THRIVE (Tribal Health: Reaching Out InVolves Everyone)
Works to reduce suicide rates among American Indians and Alaska Natives living in the Pacific Northwest by increasing tribal capacity to prevent suicide and by improving regional collaborations.

Youth Aware of Mental health (YAM)
YAM has a non-anticipatory methodology that provides youth with a safe space for reflection, role-play, and discussion.

Zero Suicide
The Zero Suicide framework is a system-wide, organizational commitment to safer suicide care in health and behavioral health care systems.

NAMI – September is National Suicide Prevention Month
All month, mental health advocates, prevention organizations, survivors, allies, and community members unite to promote suicide prevention awareness.

AFSP – National Suicide Prevention Week
A time to share resources and stories, as well as promote suicide prevention awareness.

IASP – World Suicide Prevention Day is September 10
A time to remember those affected by suicide, to raise awareness, and to focus efforts on directing treatment to those who need it most.

National Suicide Prevention Lifeline – BeThe1To
The message for National Suicide Prevention Month and beyond, which helps spread the word about actions we can all take to prevent suicide.

BeThe1To:

• Ask
  Research shows people who are having thoughts of suicide feel relief when someone asks after them in a caring way. Findings suggest acknowledging and talking about suicide may reduce rather than increase suicidal ideation.
• Keep Them Safe
  Several studies have indicated that when lethal means are made less available or less deadly, suicide rates by that method decline, and frequently suicide rates overall decline.
• Be There
  Individuals are more likely to feel less depressed, less suicidal, less overwhelmed, and more hopeful by speaking to someone who listens without judgment.
• Help Them Stay Connected
  Studies indicate that helping someone at risk create a network of resources and individuals for support and safety can help them take positive action and reduce feelings of hopelessness.
• Follow Up
  Studies have also shown that brief, low-cost intervention and supportive, ongoing contact may be an important part of suicide prevention, especially for individuals after they have been discharged from hospitals or care services.

CDC – National Violent Death Reporting System (NVDRS)
A comprehensive, state-based public health surveillance system, overseen by the federal Centers for Disease Control and Prevention (CDC), which allows states to collect comprehensive data on circumstances surrounding violent deaths.

IDHW – Behavioral Risk Factor Surveillance System (BRFSS)
A public health surveillance program developed and partially funded by the federal Centers for Disease Control and Prevention (CDC). The BRFSS is designed to provide state and sub-state estimates of the prevalence of chronic disease, injury, health conditions, and health-related behaviors associated with the major causes of death and disability.

IDHW – Idaho Violent Death Reporting System (IdVDRS)
Collects data on all violent deaths which occur annually in the State of Idaho. By collecting data on violent deaths, IdVDRS prevention partners can create targeted, evidence-based prevention strategies to help reduce the burden of violent deaths in Idaho.

IDHW – Idaho Suicide Prevention ED Visits