Suicidality: Let’s Talk About It

Open Conversations Can Reduce Suicide Risk

Suicide is among the leading causes of death in the U.S., and there is a critical need for education around the issue. In this session, Conwell and Precht provide an overview of suicide, exploring topics from the scope of the issue to risk factors, signs, and prevention strategies.

Watch now to learn more about:

• Why language and terminology around suicide is important
• How to recognize risk factors of suicide
• How to talk about suicide

The rates of suicide in the U.S. and globally are sobering. Approximately 50,000 people in the U.S., and 700,000 people globally, die by suicide each year.

While many believe the pandemic escalated the suicide crisis, this is not the whole picture. The numbers have been rising steadily since 2000.

Suicide is an enormous public health concern. In this session, Conwell and Precht outline risk factors for suicide, such as a person’s access to lethal means. However, they also point out that stigma, including fear of talking about the topic, increases suicide risk.

In addressing suicide, the language we use is important. For example, as Precht points out, people should avoid using the stigmatizing phrase “commit suicide.”

“When you say the word ‘commit,’ it conjures up a historical version of suicide—being a sin or a crime,” Precht says. “People commit sins. They commit crimes.”

Instead, using terms such as “ending one’s life” or “dying by suicide” removes stigma from the conversation, Precht shares.

Removing shame from any discussion of suicide is paramount. Contrary to the myth that asking someone if they are suicidal will increase the risk of suicide, talking about suicide and bringing the topic out in the open is actually helpful.

Precht and Conwell emphasize that clinicians, family members, and others in a person’s life should not be scared of talking about the topic. Broaching the subject of suicide, and talking about it in a compassionate way, allows those struggling with suicidal thoughts to be vulnerable about their painful feelings. It opens them up to receiving help.

This is especially important because people who are struggling with suicidal thoughts often do not want to die.

According to Conwell, “Every suicidal person is ambivalent: They may want to die, but they also want to live.”

Health professionals can help a suicidal person become more flexible and find solutions that shift them away from a drive to end their life. “We can help them reimagine what the positive side of that ambivalence is about, where their uncertainty is coming from, and why there might be reasons to live,” he says.

Audience Questions

• Can you give us working definitions of suicide, suicidal ideation, and non-suicidal self-injury?
• There has been a lot of focus on the way we talk about suicide as a society. Can you explain the importance of this effort?
• What are some of the common myths and misconceptions about suicide?
• What can you tell us about the current prevalence and demographic characteristics of suicide?
• What do we know about risk factors? Is it possible to identify people most at risk of attempting suicide?
• Could you talk about the relationship between chronic illness or pain and suicidality?
• Do most people who attempt suicide give some warning signs about their intent?
• How is suicidality assessment typically done?
• Can you talk about the relationship between bullying in teens and adolescents and suicide?
• What should we know about passive suicidal thoughts? What are some examples? When should we be concerned?
• How does exposure to suicide attempts affect one’s risk of suicide?
• Do histories of traumatic or adverse childhood events impact suicide risk?
• Is there any truth to the thinking that holding a workshop around suicide prevention for students could lead to some of them becoming at risk?
• What are some broad initiatives that can help prevent suicides?
• How does gender factor into suicide risk?
• What is borderline personality disorder? And what should we know about those with BPD when it comes to self-harming and experiencing suicidal ideation?

The information discussed is intended to be educational and should not be used as a substitute for guidance provided by your health care provider. Please consult with your treatment team before making any changes to your care plan.

Resources

You may also find this information useful:

• 988 Suicide and Crisis Lifeline
• Patient Health Questionnaire-9 (PHQ-9)
• Columbia-Suicide Severity Rating Scale (C-SSRS)
• Ask Suicide-Screening Questions Toolkit (ASQ)
• Video: Managing Grief and Loss
• Video: Suicide Prevention – Learning From Someone Affected by Suicide
• Suicide: Know the Signs and What To Do
• Video: Suicide Assessment and Intervention in Clinical Practice – Application of the 988 Lifeline Model
• Video: The Power of Dialectical Behavior Therapy
• Access the full Heroes of Hope: Suicide Prevention course
• McLean’s suicide prevention resource hub

About Dr. Conwell

Yeates Conwell, MD, is a professor in the Department of Psychiatry at the University of Rochester Medical Center. He has served as founding co-director of the University of Rochester Center for the Study and Prevention of Suicide and has lectured and written extensively on suicide and depression in later life.

About Dr. Precht

Anna Precht, PsyD, is a clinical psychologist and a senior clinical consultant at McLean’s Arlington School, a high school for students with mental health challenges. She specializes in the use of evidence-based treatments including DBT and CBT.