Suicide Risk Factors and Warning Signs

We, at MUSC Counseling and Psychological Services, would like to provide some information regarding suicide, including risk factors and warning signs, and what you can do to help yourself, a friend, or a colleague about whom you are concerned.

Resources and Phone Numbers

• In an emergency (if your safety or the safety of a friend is in immediate danger), call 911 or go to the nearest emergency room. When in doubt, call 911. Err on the side of caution and get help immediately.
• MUSC Public Safety – emergency line – 843-792-4196
• Counseling and Psychological Services (CAPS) – 843-792-4930
• Suicide/Crisis Hotlines
  • National Suicide Prevention Lifeline – 1-800-273-TALK (800-273-8255)
    • Specialty trained counselors available for military veterans (press 1) or Spanish-speaking individuals (press 2)
  • National Hopeline Network – 1-800-SUICIDE (800-784-2433)
  • Crisis Text Line – Text START to 741-741

Facts about Suicide

• Suicide is believed to be the second leading cause of death for emerging and young adults (ages 15-34; CDC, 2015).
• Regarding gender differences, men are more likely to make successful suicide attempts, given their propensity to use more lethal methods, such as firearms. Women, however, are more likely than men to have suicidal thoughts and make a suicide attempt.
• Among individuals who commit suicide, over 1/3 had alcohol in their system (Parks et al., 2010).
• More than 1 million people reported making a suicide attempt in the past year, and most people who engage in suicidal behavior never seek mental health services (CDC, 2015).

It should be noted that, while most people who attempt suicide are also depressed, the majority of individuals who experience depression do not consider, or attempt, suicide. That said, suicide prevention is an important issue on any university campus, and ensuring the health and well-being of students is MUSC’s primary concern. Services at CAPS are available to help with any and all aspects of student mental and emotional health. Please do not hesitate to contact us.

Suicide Risk Factors

(from the Suicide Prevention Resource Center and the American Foundation for Suicide Prevention)

Risk factors can often be confused with warning signs of suicide. However, it is important to note that factors that have been identified as increasing the risk of suicide are not factors that cause or predict a suicide attempt. Risk factors are characteristics that make it more likely that an individual will consider, attempt, or die by suicide.

• Previous suicide attempts
• Family history of suicide attempts and/or completed suicide
• Mental health conditions, including depression, bipolar disorder, borderline personality disorder, antisocial personality disorder, anxiety disorders, or psychotic disorders.
• Alcohol and/or substance use disorders, including using over-the-counter or prescription medication in a non-indicated manner
• Impulsive and/or aggressive tendencies
• Serious and/or chronic health conditions
• Chronic pain
• Recent stressful life events, including a death of a loved one, divorce or relationship breakup, or job loss
• Chronic stressors, such as harassment, bullying, relationship problems, unemployment, and financial difficulties
• History of trauma and/or physical or sexual abuse
• Access to lethal means, including firearms and/or drugs
• Exposure to another person’s suicide, or to graphic or sensationalized accounts of suicide (either in real life or via the media/Internet)
• Lack of social support and a sense of isolation
• Lack of health care or stigma associated with seeking help, especially mental health and/or substance abuse

Suicide Warning Signs

There is no single cause for suicide. According to the American Foundation for Suicide Prevention, most people who commit suicide exhibit one or more warning signs, either through what they say or what they do. Changes in behavior, especially drastic changes, are concerning. The following behaviors may be warning signs that someone is at risk for suicide –

• Talking about being a burden to others, feeling trapped, or experiencing unbearable pain and a hopelessness about positive change
• Talking about having no reason to live, wishing they were dead, or wanting to kill themselves
• Looking for ways to kill themselves, such as searching online for materials or means
• Increased use of alcohol or drugs
• Changes in mood, including an increase in depression, irritability/rage, anxiety, and/or hopelessness
• Withdrawing or losing interest in activities (e.g., social activities, work/school responsibilities, hobbies)
• Isolating from family and friends
• Acting recklessly or impulsively, including aggressive behavior
• Visiting or calling people to say goodbye and/or giving away meaningful possessions
• Preparing for death by writing a will or making final arrangements

What Can You Do?

If you are contemplating suicide or if you suspect a friend or colleague may be at risk for committing suicide, there are a number of things that you can do to help.

• It is vitally important that you do not assume that the situation will take care of itself or resolve on its own. Any concern you have for yourself or your friend should be addressed, and not ignored. Do not assume that others will step in and provide assistance. If you are unsure about the level of risk, err on the side of caution, and call 911.
• Do not promise to keep what he/she tells you a secret, regardless of concerns you may have about angering your friend. Remember that your friend’s welfare takes precedence over hurt feelings. Taking steps to prevent suicide is an expression of love, care, and deep concern.
• If you would like to talk to your friend, but you are not sure how to approach the conversation, CAPS staff can assist you in determining how best to discuss the topic with your friend. Please give us a call.
• Be willing to listen. This is one of the most important ways you can help a friend in crisis. Even if professional help is needed, your friend will be more likely to seek help if you have listened to him/her.
• Voice your concern. Ask what is troubling your friend and attempt to overcome reluctance to talk about it. Although this can be a difficult conversation, it is important to not avoid it because it is uncomfortable or awkward. Don’t be judgmental and do not invalidate their feelings. Even though you may not see things the same way or agree with how they are thinking about things, the way they feel is valid. Do not argue with your friend or debate the morality of suicide. Let them know that you are concerned about them, and that you are available to support them. Be gentle, kind, and understanding, but get help. You may have to be insistent in order for them to seek help. If you are willing to call CAPS (or another mental health provider) with your friend and/or accompany them to their appointment, your friend may be more likely to seek help.
• Take it seriously. Do not dismiss or undervalue what someone shares with you. Over 75% of individuals who commit suicide talk to a friend or family member about it first. All suicidal talk should be taken seriously, even if your friend assures you that he/she will be fine.
• Ask if your friend has a specific plan for committing suicide, and how far he/she has gone towards carrying it out. It is not true that simply asking about suicide will cause the person to think about it or commit suicide.
• Let them know you care. Reassure your friend that he/she is not alone and that, although powerful, feelings related to suicide are temporary. Problems can be solved, and help is available. Depression can get better, especially if they are willing to see help. Suicide is permanent.
• Get professional help. If you are concerned about your own or your friend’s immediate safety, seek assistance. In an acute safety situation, call 911, go/escort your friend to the nearest emergency room, and/or call the MUSC Public Safety emergency line (843-792-4196). If your friend is at high risk of suicide, do not leave him/her alone until professional help arrives.
• If the person talks about using a firearm that he or she owns for suicide, call the police so they may remove the firearm(s). Firearms are commonly used in suicides, and those who use a firearm usually do not survive. Therefore, it is an emergency that needs to be immediately handled by the police.
• If you have concerns about a friend that do not involve imminent safety risks, you may contact CAPS anonymously and speak with a trained therapist who will then assist you in determining the proper steps to take. In addition, if you are uncomfortable personally confronting your friend, you may anonymously report your concerns to CAPS staff members, who will then take appropriate measures to address the safety and well-being of your friend.
• Ensure that your own needs are being met. Assisting others in this way can be stressful and emotionally draining. Consider talking to someone you trust about how you are feeling, and know that CAPS is available to help you address your own experience and reactions.
• Follow up with your friend on a regular basis. Suicidal feelings may come and go, so follow up and continue to show ongoing support.  If suicide risk increases again, take immediate steps to help him/her.