Suicide is still a leading cause of death in the United States; in 2022, 49,449 people died by suicide. After increasing for two decades, the rate of suicide has been fluctuating less and seems to be leveling at this high rate. The Centers for Disease Control and Prevention’s recent publication of provisional data on suicide deaths demands that we pay attention and take action. As an urgent national public health problem, suicide can only be addressed with meaningful action at the individual, community and national levels. Bringing down the suicide rate requires a lot of work, but I am optimistic because suicide can be prevented.
I am optimistic because suicide can be prevented.
Suicide is complex and has no single cause. It is the combination of risk factors in the face of stress that can precipitate suicidal behavior. These risk factors include one’s mental and physical health, chronic pain, history of family mental illness and suicide, among others. When a person with several risk factors experiences stressors and has access to lethal means, the risk of death by suicide can increase. The key to surviving that period of stress is giving that person the tools and resources to get through that crisis.
When I started out almost 40 years ago, we were just beginning to understand suicide risk. I’m hopeful because we now have several proven prevention strategies — I use these in my therapy practice with my patients — and more will emerge with research. To save lives, these strategies need to be customized and scaled to a national level more quickly. We must invest in a national suicide prevention strategy that includes research, education and intervention programs, and we need to push our leaders to improve access to those resources.
All we know about suicide and suicide prevention comes from research. There is still so much to uncover, and research is key to developing meaningful education and intervention strategies that decrease suicide rates. It’s imperative to fund studies across scientific disciplines and to consider both clinical and community interventions. Such research can have major implications, for example, on what can de-escalate people in crisis who seek help at various points throughout the health system, whether that’s in counseling, via crisis lines or in emergency departments.
The next step is putting the insights we discover through research into people’s hands. Developing and providing effective, widely accessible prevention education is critical. When people know more about mental health and suicide prevention, suicide rates go down. Just like recognizing the signs of a heart attack, imagine the difference we could make if we all knew the warning signs of suicide and how to help. It’s especially important that this information connects with people on a cultural level. We need more innovative education programs to reach minority communities.
When implemented broadly and in culturally relevant ways, interventions can help millions and save thousands of lives. Clinicians in health care and emergency departments aren’t often equipped with the guidance and support to make suicide prevention strategies work. Investment in making this a standard practice is crucial and there is some movement in a positive direction. The Joint Commission, the body that provides oversight for health care in hospitals, emergency departments and behavioral health settings, recently revised its suicide safety goal to include use of a validated screening tool for anyone with a mental health concern, the implementation of an evidence-based assessment and a follow-up plan for anyone identified with potential suicide risk, and training for staff. We need to support the use and accessibility of these strategies — as well as psychotherapies, medications and other treatments — in our communities, health centers, schools and other places where suicide is prevalent, such as correctional systems.
More than ever, negative beliefs around suicide are decreasing, while personal and community action is increasing.
The good news is that, more than ever, negative beliefs around suicide are decreasing, while personal and community action is increasing. People are seeking connection, support and treatment — it makes a difference. In 2022, the crisis line 988 received 2 million more calls than in the previous year, according to the Department of Health and Human Services. That alone shows that people are open to help and willing to have difficult conversations; it’s imperative that we respond to this need with adequate support and services. People are reaching out for help, and we must be there to meet them.
We can all take action to prevent suicide. Start by learning to recognize when someone may be grappling with their mental health. Reach out directly to someone if you are worried about them or contact someone who can connect with them. Have caring and nonjudgmental conversations — research shows that you can’t make someone suicidal by asking if they are thinking of ending their life and you can help them feel better or get help. Connect family, friends and colleagues who are struggling to resources that can make a difference, such as a crisis line, like 988.
You can learn more about suicide prevention at afsp.org and at afsp.org/talkawaythedark.
If you or someone you know is in crisis, call or text 988 to reach the Suicide and Crisis Lifeline or chat live at 988lifeline.org. You can also visit SpeakingOfSuicide.com/resources for additional support.
Jill Harkavy-Friedman
Jill Harkavy-Friedman, Ph.D., is the senior vice president of research at the American Foundation for Suicide Prevention. During her 35 years as a clinician and researcher, Harkavy-Friedman has published over 100 peer-reviewed articles and trained clinicians nationwide.