Suicide is considered a serious public health problem by the World Health Organization and the Centers for Disease Control and Prevention (CDC). The American Foundation for Suicide Prevention states that on average, 130 Americans die by suicide each day, and in Wisconsin, suicide rates increased by 40% between 2000 and 2017. Recent data from the National Institute of Mental Health showed there were more than 2 1/2 times as many suicides in the United States as homicides.

If your friend or loved one talks to you about suicidal thoughts, it can feel frightening and figuring out how to respond can be overwhelming. But it is important to realize that suicides are often preventable and by learning how to react, you could help save a life. Andrew Schramm, PhD, debunks four myths about suicide. He is a trauma psychologist with the Froedtert & MCW Trauma Center, eastern Wisconsin’s only adult Level I Trauma Center. He is also president of the Wisconsin Chapter of the American Foundation for Suicide Prevention.

Injury prevention, including suicide prevention, is part of the mission of the adult Level I Trauma Center at Froedtert Hospital — a responsibility to the community that Dr. Schramm and the trauma team take seriously.

MYTH 1: “Suicide only affects people with a mental illness.”

FACT: According to recent data from the CDC, 54% of people who died by suicide did not have a known mental health condition. Untreated mental illness is a major risk factor for suicide. Depression is the most commonly diagnosed mental health condition among people who die by suicide in Wisconsin, and 57% of people who died by suicide had symptoms of depression.

“Many people with a mental illness do not experience suicidal thoughts, and individuals without a formal diagnosis may die from suicide,” Dr. Schramm said. “The causes of suicide are complex and multifaceted. It is a preventable result of a combination of risk factors and stressors such as substance abuse, job or financial problems or relationship issues.”

MYTH 2: “Suicides happen without warning.”

FACT: Suicides do not usually happen “out of the blue.” Most of the time, people communicate their distress in advance to someone they feel close to, like a loved one or their doctor. According to the National Institute of Mental Health, 12 million adults had serious thoughts about suicide in 2019. Of those people, 3.5 million made suicide plans, 1.4 million made a suicide attempt and 217,000 made no plans and attempted suicide.

As suicides are often preceded by warning signs, you can help prevent suicide by being aware of the following red flags in someone you know:

  • Talking about wanting to die, feeling trapped or feeling unbearable pain
  • Expressing hopelessness
  • Trying to get access to a means of suicide, such as buying a firearm or accumulating medications
  • Major changes to behavior, such as self-isolation
  • Changes in mood, such as increased sadness or anxiety

“Trust your gut, and assume you are the only one who will reach out and act,” Dr. Schramm said. “Individuals who express thoughts about feeling trapped and having no hope that their life will get better are especially concerning.”

Dr. Schramm said there are three actions you can take to help a person who expressed suicidal thoughts or you suspect is having suicidal ideations.

  1. Ask the person directly if they want to die or are thinking about hurting themselves
  2. Listen to what they are experiencing and make them feel heard
  3. Refer them to experts and resources that can help, like a suicide prevention hotline

“Taking these steps has been shown to save lives,” Dr. Schramm said. “Suggest calling the hotline together, or call the hotline on your own and ask for guidance on how to get your friend or loved one help. If you feel the situation is an emergency, call 911 or go with the person to an emergency department to get assessed.”

Helpful resources include:

MYTH 3: “Talking about suicide with someone I’m concerned about will give them ideas or encourage them to take their own life.”

FACT: While you may hesitate to talk about suicide with a person who you think may be having suicidal thoughts for fear that it could make the situation worse, this couldn’t be farther from the truth, Dr. Schramm said.

“Research has shown that if a person is not having suicidal thoughts, asking about this will not negatively affect them,” he said. “But for the person who is considering suicide, asking them directly if they are thinking about killing themselves will often make them feel understood, heard and cared about — that someone is taking the time to check in on them.”

Having a conversation about suicide with a person you are worried about may also put you in a position to take preventive actions. You may be able to remove access to their means of suicide, by locking up a gun in a gun safe, for example. You may also take the opportunity to connect the person with experts who can help.

Suicide is a taboo topic, but talking about it reduces the stigma and raises awareness, which is an important part of prevention efforts.

“I urge everyone to advocate for mental health and suicide prevention initiatives,” Dr. Schramm said. “Because suicide is preventable, we have a collective responsibility to take action.”

MYTH 4: “Suicide rates increase around the winter holidays.”

FACT: Suicide is a public health concern year-round, but a common narrative is that suicides increase around the winter holidays. This is not true. Despite additional stress and loneliness that is commonly associated with the holidays or the seasonal depression that occurs during colder and darker months, suicide rates do not increase in the winter. In fact, the CDC says the suicide rate is at its lowest in December and peaks in the spring and fall. It is not well understood why these peaks occur. Some studies have examined the link between allergies and mood disorders and their effect on the suicide rate, but more research needs to be done.

Suicide and COVID-19

It is too soon to make any conclusive statements on the impact of the COVID-19 pandemic on suicide rates. However, data from past pandemics, such as the 2003 SARS pandemic and the 2009 H1N1 pandemic, shows a rise in rates of depression and alcohol use – risk factors for suicide.

“It is likely that during the COVID-19 pandemic, people are experiencing more suicide risk factors than they were pre-pandemic, particularly in terms of social isolation and financial stress,” Dr. Schramm said.

For those who are receiving mental health treatment, he said it is important to continue to see their provider, safely. Additionally, those who are experiencing new mental health concerns should not feel like they need to delay care.

“Telehealth options have become more widespread and sophisticated as a result of the pandemic,” Dr. Schramm said. “If virtual care is not an option, and your care is in a setting where COVID-19 screening and safety precautions are taken, you should feel confident that the risk of contracting COVID-19 is lowered. In other words, fear of COVID-19 should not prevent people from getting lifesaving treatment.”

If you or someone you know is at risk of suicide, call the Suicide Prevention Hotline at 800-273-8255. Learn more about suicide prevention and resources available to you.

Gerry Steele

This is great information we need to know. Sometimes no matter what a person does, suicide happens. It's important to acknowledge that those of us who remain here after losing dear friends tried to support through open dialogue and called the suicide hotline, but it wasn't enough. For me, it was twice in 4 months. The guilt we carry forward can be crushing.