What is suicide?

Suicide is a major public health concern. In 2021, suicide was the 11th leading cause of death overall in the United States, claiming the lives of over 48,100 people. Suicide is complicated and tragic, but it is often preventable. Knowing the warning signs for suicide and how to get help can help save lives. Suicide is when people harm themselves with the intent of ending their life, and they die as a result.
A suicide attempt is when people harm themselves with the intent of ending their life, but they do not die.
Avoid using terms such as “committing suicide,” “successful suicide,” or “failed suicide” when referring to suicide and suicide attempts, as these terms often carry negative meanings.

Symptoms

Warning signs that someone may be at immediate risk for attempting suicide include:

Suicide is not a normal response to stress. Suicidal thoughts or actions are a sign of extreme distress and should not be ignored. If these warning signs apply to you or someone you know, get help as soon as possible, particularly if the behavior is new or has increased recently.

What are the risk factors for suicide?

People of all genders, ages, and ethnicities can be at risk. Suicidal behavior is complex, and there is no single cause. The main risk factors for suicide are:

• Depression, other mental disorders, or substance use disorder
• Chronic pain
• Personal history of suicide attempts
• Family history of a mental disorder or substance use
• Family history of suicide
• Exposure to family violence, including physical or sexual abuse
• Presence of guns or other firearms in the home

Direct or indirect exposure to others' suicidal behavior—such as that of family members, peers, or celebrities—can increase risk for people with suicidal thoughts.
Most people who have risk factors will not attempt suicide, and it is difficult to tell who will act on suicidal thoughts. Although risk factors for suicide are important to keep in mind, someone who is actively showing warning signs of suicide may be at higher risk for danger and in need immediate attention.
Stressful life events (such as the loss of a loved one, legal troubles, or financial difficulties) and interpersonal stressors (such as shame, harassment, bullying, discrimination, or relationship troubles) may contribute to suicide risk, especially when they occur along with suicide risk factors.
Family and friends are often the first to recognize the warning signs of suicide, and they can take the first step toward helping a loved one find mental health treatment. See NIMH’s page with resources for finding help for mental illnesses if you're not sure where to start.
Identifying people at risk for suicide

• Universal screening: Research has shown that a three-question screening tool helps emergency room personnel identify adults at risk for suicide . Researchers found that screening all patients—regardless of the reason for their emergency room visit—doubled the number of patients identified as being at risk for suicide. The researchers estimated that suicide-risk screening tools could identify more than three million additional adults at risk for suicide each year.
• Predicting suicide risk using electronic health records: Researchers from NIMH partnered with the VA and others to develop computer programs that could help identify increased suicide risk among veterans receiving VA health care . Other healthcare systems are also beginning to use data from electronic health records to help identify people with suicide risk.

Medication

Some individuals at risk for suicide might benefit from medication. People can work with their health care providers to find the best medication or medication combination, as well as the right dose. Many people at risk for suicide often have a mental illness or substance use problems and may benefit from medication along with psychosocial intervention. Clozapine is an antipsychotic medication used primarily to treat individuals with schizophrenia. To date, it is the only medication with a specific U.S. Food and Drug Administration (FDA) indication for reducing the risk of recurrent suicidal behavior in patients with schizophrenia or schizoaffective disorder. If you are prescribed a medication, be sure you:

• Talk with a health care provider to make sure you understand the risks and benefits of the medications you're taking.
• Do not stop taking a medication without talking to your health care provider first. Suddenly stopping a medication may lead to worsening of symptoms. Other uncomfortable or potentially dangerous withdrawal effects also are possible.
• Report any concerns about side effects to a health care provider right away. They can help determine whether you need a change in the dose or a different medication.
• Often wanting to stay at home, rather than going out to socialize or doing new things
• Suicidal thinking or feelings, especially in older men

Protective Factors

The CDC recommends a comprehensive public health approach to suicide prevention and it identifies several strategies that states and communities can undertake, including such measures as teaching coping and problem-solving skills to help people manage challenges, expanding options for temporary assistance for those in need and connecting people at-risk to effective and coordinated mental and physical health care.

• Contacts with providers (such as, follow-up phone call from health care professional).
• Effective mental health care; easy access to a variety of clinical interventions.
• Feelings of strong connections to individuals, family, community and social institutions.
• Problem-solving and conflict resolution skills.

What You Can Do

988 Suicide Crisis and Lifeline has developed five steps to take to support a loved one that may be experiencing suicidal thoughts.

• Ask someone you are concerned about if they're thinking about suicide. Studies show that asking someone if they are having thoughts of suicide does not increase the likelihood of a completed suicide nor does it increase suicidal thoughts.
• Be there for them. This could be by phone or in person.
• Keep them safe. Reduce access to lethal means for those at risk.
• Help them connect with ongoing support.
• Follow up. Give them a call or visit. Send a text or an email to let them know that you are still present.