Suicide. We would rather not talk about it. We hope it will never happen to anyone we know. But suicide is a reality, and it is more common than you might think. The possibility that suicide could claim the life of someone you love cannot be ignored. By paying attention to warning signs and talking about the “unthinkable,” you may be able to prevent a death.
Download and print our Preventing Suicide brochure.
Suicide means that someone ends their life on purpose. However, people who die by suicide or attempt suicide may not really want to end their life. Suicide may seem like the only way to deal with difficult feelings or situations.
There are many circumstances which can contribute to someone’s decision to end their life, but a person’s feelings about those circumstances are more important than the circumstances themselves. All people who consider suicide feel that life is unbearable. They have an extreme sense of hopelessness, helplessness, and desperation. With some types of mental illness, people may hear voices or have delusions which prompt them to kill themselves. People who talk about committing suicide or make an attempt do not necessarily want to die. Often, they are reaching out for help. Sometimes, a suicide attempt becomes the turning point in a person’s life if there is enough support to help them make necessary changes. If someone you know is feeling desperate enough to commit suicide, you may be able to help them find a better way to cope. If you yourself are so distressed that you cannot think of any way out except by “ending it all,” remember, help for your problems is available.
About 4,000 Canadians die by suicide every year. Suicide is the second-most common cause of death among young people, but men in their 40s and 50s have the highest rate of suicide. While women are three to four times more likely to attempt suicide than men, men are three times more likely to die by suicide than women. Suicide is a complicated issue. People who die by suicide or attempt suicide usually feel overwhelmed, hopeless, helpless, desperate, and alone. In some rare cases, people who experience psychosis (losing touch with reality) may hear voices that tell them to end their life. Many different situations and experiences can lead someone to consider suicide. Known risk factors for suicide include:
- A previous suicide attempt
- Family history of suicidal behaviour
- A serious physical or mental illness
- Problems with drugs or alcohol
- A major loss, such as the death of a loved one, unemployment, or divorce
- Major life changes or transitions, like those experienced by teenagers and seniors
- Social isolation or lack of a support network
- Family violence
- Access to the means of suicide
While we often think of suicide in relation to depression, anxiety, and substance use problems, any mental illness may increase the risk of suicide. It’s also important to remember that suicide may not be related to any mental illness.
Some warning signs that a person may be suicidal include:
- Repeated expressions of hopelessness, helplessness, or desperation
- Behaviour that is out of character, such as recklessness in someone who is normally careful
- Signs of depression – sleeplessness, social withdrawal, loss of appetite, loss of interest in usual activities
- A sudden and unexpected change to a cheerful attitude
- Giving away prized possessions to friends and family
- Making a will, taking out insurance, or other preparations for death, such as telling final wishes to someone close, making remarks related to death and dying, or an expressed intent to commit suicide. An expressed intent to commit suicide should always be taken very seriously.
If you are concerned that someone may be suicidal, take action.
- If possible, talk with the person directly. The single-most important thing you can do is listen attentively without judgement. Talking about suicide can only decrease the likelihood that someone will act on suicidal feelings. There is almost no risk that raising the topic with someone who is not considering suicide will prompt them to do it.
- Find a safe place to talk with the person, and allow as much time as necessary. Assure them of your concern and your respect for their privacy. Ask the person about recent events, and encourage them to express their feelings freely. Do not minimize the feelings involved. Ask whether the person feels desperate enough to consider suicide. If the answer is yes, ask, “Do you have a plan? How and where do you intend to kill yourself?” Admit your own concern and fear if the person tells you that he/she is thinking about suicide but do not react by saying, “You shouldn’t be having these thoughts; things can’t be that bad.” Remember, you are being trusted with someone’s deepest feelings. Although it may upset you, talking about those feeling will bring the person relief. Ask if there is anything you can do.
- Talk about resources that can be drawn on (family, friends, community agencies, crisis centres) to provide support, practical assistance, counselling or treatment. Make a plan with the person for the next few hours or days. Make contacts with them or on their behalf. If possible, go with the person to get help.
- Let the person know when you can be available, and then make sure you are available at those times. Also, make sure your limits are known, and try to arrange that there is always someone that he/she can call at any time of day. Ask who else knows about the suicidal feelings. Are there other people who should know? Is the person willing to tell them? Unfortunately, not everyone will treat this issue sensitively. Confidentiality is important, but do not keep the situation secret if a life is clearly in danger.
- Stay in touch to see how he/she is doing. Praise the person for having the courage to trust you and for continuing to live and struggle.
A person may try to commit suicide without warning or despite efforts to help. If you are involved in giving first aid, make every effort to be calm and reassuring, and get medical help immediately. The time following an attempt is critical. The person should receive intensive care during this time. Maintain regular contact, and work with the person to organize support. It is vital that he/she does not feel cut off or shunned as a result of attempting suicide. Be aware that, if someone is intent on dying, you may not be able to stop it from happening. You cannot and should not carry the responsibility for someone else’s choice.
Thoughts of suicide are distressing. The beginning of the way out is to let someone else in. This is very hard to do because, if you feel so desperate that suicide seems to be the only solution, you are likely very frightened and ashamed. There is no reason to be ashamed of feeling suicidal and no reason to feel ashamed for seeking help. You are not alone; many people have felt suicidal when facing difficult times and have survived, usually returning to quite normal lives. Take the risk of telling your feelings to someone you know and trust: a relative, friend, social service worker, or a member of the clergy for your religion. There are many ways to cope and get support. The sense of desperation and the wish to die will not go away at once, but it will pass. Regaining your will to live is more important than anything else at the moment. Some things that you can do are:
- Calling a crisis telephone support line.
- Connecting with family, friends, or a support group. It can be helpful to talk with others who have experienced thoughts of suicide to learn about their coping strategies.
- Talk to your family doctor; he/she can refer you to services in the community, including counselling and hospital services;
- Set up frequent appointments with a mental health professional, and request telephone support between appointments;
- Get involved in self-help groups;
- Talk every day to at least one person you trust about how you are feeling;
- Think about seeking help from the emergency department of a local hospital;
- Talk to someone who has ‘been there” about what it was like and how he/she coped;
- Avoid making major decisions which you may later regret.
- If you’re in crisis and aren’t sure what to do, you can always call 911 or go to your local emergency room.
- Some people find a safety plan useful. A safety plan is a list of personal strategies to use if you think you are at risk of hurting yourself or ending your life. You can create a plan on your own, with a loved one, or with your mental health care team. Your plan may include:
- Activities that calm you or take your mind off your thoughts;
- Your own reasons for living;
- Key people to call if you’re worried about your safety;
- Phone numbers for local crisis or suicide prevention helplines;
- A list of safe places to go if you don’t feel safe at home.
If you’re concerned about someone else, talk with them. Ask them directly if they’re thinking about suicide. Talking about suicide won’t give them the idea. If someone is seriously considering suicide, they may be relieved that they can talk about it. If someone you love says that they’re thinking about ending their life, it’s important to ask them if they have a plan. If they have a plan and intend to end their life soon, connect with crisis services or supports right away. Many areas have a crisis, distress, or suicide helpline, but you can always call 911 if you don’t know who to call. Stay with your loved one while you make the call, and don’t leave until the crisis line or emergency responders say that you can leave. The two most important things you can do are listen and help them connect with mental health services. Here are tips for talking with a loved one:
- Find a private place and let your loved one take as much time as they need.
- Take your loved one seriously and listen without judgement—their feelings are very real.
- Keep your word—don’t make promise you can’t keep or don’t intend to keep.
- Tell your loved one that they are important and that you care about them.
- If your loved one already sees a doctor or other mental health service provider, it’s important that they tell their service provider about any thoughts of suicide they may have been having. Depending on your relationship, you can offer to help—by helping your loved one schedule appointments or by taking them to their appointments, for example. If your loved one doesn’t see a mental health service provider, you can give them the phone number for a local crisis line and encourage them to see their doctor.
- Your loved one may also be able to access services through their school, workplace, cultural, or faith community.
- Supporting a loved one can be a difficult experience for anyone, so it’s important to take care of your own mental health during this time and seek support if you need it.