Current Status of Suicide-Focused Assessment and Treatment: An Update for Professionals

Free Webinar | October 30, 2024

RESOURCES

The 988 Suicide & Crisis Lifeline: Upon calling the 988 Suicide & Crisis Lifeline, you will be connected to a trained certified crisis counselor at one of the 150 crisis centers in the Lifeline’s network. The crisis counselor can offer mental health support as well as referrals to local services. Calls are routed to the nearest available crisis center based on the caller’s area code. You can call the Lifeline (988) any time of the day or night. You can also chat online.

The Crisis Text Line: The Crisis Text Line provides free, 24/7 support via text messaging for those in crisis. Crisis is defined as “any painful emotion for which you need support.” To connect with a crisis counselor, text HOME to 741741 from anywhere in the United States.

On this website, you can also access the ACT® (Acknowledge, Care, Treatment), which outlines what you can do if someone you care about may be considering suicide.

For Service Members, Veterans, and their Families

In the ten years between 2007 and 2017, over 60,000 veterans have lost their lives to suicide. The risk of suicide is significantly higher among Veterans than non-veterans, with female veterans at particularly high risk.

Military Crisis Line/Veterans Crisis Line: Service members, veterans, and their families can call the Military Crisis Line/Veterans Crisis Line at 988 and select option 1, or text the Military Crisis Line/Veterans Crisis Line at #838255. The hotline is staffed by mental health professionals 24 hours a day, 7 days a week. The hotline is a free, anonymous, confidential resource. Registrations with VA or enrollment in VA health care is not necessary.

Service members, veterans, and their families can also chat online with trained counselors at www.MilitaryCrisisLine.net or www.VeteransCrisisLine.net. The VA also has full-time suicide prevention counselors at its VA hospitals nationwide.

Need crisis assistance while overseas? The following overseas locations have direct crisis line numbers:

Online Resources for Service Members, Veterans, and Their Families:

  • Veteran suicide prevention shareable materials: Downloadable resources and information to help support Veterans. Web Link: https://www.veteranscrisisline.net/support/shareable-materials
  • “Be There” public service announcement: Service members and Veterans talking about the small actions by friends and family members that made a big difference to them. Web Link: https://www.youtube.com/watch?v=MCSZ7FjTq5I
  • A.V.E. online suicide prevention video: Training to learn how to recognize suicide risk factors and warning signs. Web Link: https://psycharmor.org/courses/s-a-v-e/
  • Make the Connection: Stories of Veterans who have dealt with mental health issues, have found support (whether through treatment or with the help of a loved one), and are living healthy, productive lives. Web Link: https://maketheconnection.net/
  • VA Mental Health website: VA’s repository of mental health resources, information, and data materials, including VA’s National Strategy for Prevention Veteran Suicide 2018–2028. Web Link: https://www.mentalhealth.va.gov/
FOR PEOPLE WHO ARE DEAF, HARD OF HEARING, OR HAVE HEARING LOSS

If you are deaf, hard of hearing, or have hearing loss, you can chat with a 988 Suicide & Crisis Lifeline counselor 24/7 by:

  • Online chat: Click this link
  • For TTY users: Use your preferred relay service or dial 711 then 988
Social Media

If you see concerning posts about suicide or live streaming of suicidal behavior on social media, please call 911, contact the 988 Suicide & Crisis Lifeline (988), or text the Crisis Text Line (text HOME to 1-800-799-4889). You can connect with these resources whether or not you know the person who made these posts.

Many social media sites also have resources available for the public on how to respond to suicidal posts. These resources can be found on such platforms as:

  • Facebook – Use search terms “suicide” or “suicide prevention”
  • Instagram – Use search terms “suicide,” “self-injury,” or “suicide prevention”
  • Snapchat – Use search terms “suicide” or “suicide prevention”
  • Tumblr – Use search terms “counseling” or “prevention” 
  • Twitter – Use search terms “suicide,” “self-harm,” or “suicide prevention”
  • YouTube – Use search term = “suicide and self-injury”
Resources on Bullying

According to the Center for Disease Control and Prevention (CDC), bullying is an “unwanted, aggressive behavior among school-aged children that involves a real or perceived power imbalance.” Bullying includes making threats, spreading rumors, attacking someone physically or verbally, and excluding someone from a group on purpose. Students most at risk for being bullied are those with disabilities, learning differences, sexual/gender differences or cultural differences.

Negative outcomes of bullying may include depression, anxiety, interpersonal or sexual violence, substance abuse, poor social functioning, and poor school performance. Those who report being frequently bullied and those who report frequently bullying others can be at risk for suicide-related behavior.

Because school staff spend several hours a day with students, the CDC has put together a document for school administrators, teachers, and school staff titled “The Relationship between Bullying and Suicide: What We Know and What It Means for Schools.” The document includes evidence-based suggestions for dealing with bullying behavior in school settings and lists additional resources available on this topic through the CDC and other federal agencies.  

Online Federal Resources on Bullying:
https://www.stopbullying.gov/
https://www.cdc.gov/healthyyouth/protective/youth-connectedness-important-protective-factor-for-health-well-being.htm
www.cdc.gov/ViolencePrevention/pdf/ASAP_Suicide_Issue3-a.pdf
https://www.cdc.gov/violenceprevention/pdf/asap_bullyingsv-a.pdf
https://www.air.org/topic/education?type=projects&id=127
https://www.cfchildren.org/blog/category/bullying-prevention/

Resources for LGBTQ+ Youth and their families

LGBTQ youth have higher rates of suicidal attempts and completions than their heterosexual peers. According to the 2017 Youth Risk Behavior Survey, lesbian, gay, and bisexual high schoolers were 4 times more likely to have attempted suicide than heterosexual high schoolers. These higher rates may be due to stressors, including discrimination, bullying, and family rejection, which can contribute to anxiety, depression, substance use, and other mental health challenges. In 2017, 63% of lesbian, gay, and bisexual high schoolers reported feeling sad or hopeless for at least 2 weeks in a row, compared with 28% of their heterosexual peers.

Online Resources for LGBT Youth and their Families

Centers for Disease Control and Prevention: LGBT Youth
This website provides information for schools and parents about how they can implement a healthy environment for supporting LGBT youth.

Gay, Lesbian, and Transgender Health
This website, managed by the U.S. National Library of Medicine, the U.S. Department of Health and Human Services, and the National Institutes of Health, provides resources and information for specific health issues related to LGBTQ individuals.

The Movement Advancement Project
This PDF from the Movement Advance Project offers key recommendations for talking about suicide in safe and accurate ways with LGBTQ youth.

Resources on PERINATAL Depression and POSTPARTUM Psychosis

Perinatal depression is depression that begins during pregnancy or after the baby is born. Women with perinatal depression experience feelings such as extreme sadness, anxiety, fatigue, hopelessness, appetite changes, and difficulty concentrating. Some women with perinatal depression have thoughts about death, suicide, or harming themselves or the baby. Perinatal depression is a relatively common condition, affecting approximately 1 in 9 mothers.

Postpartum psychosis is much rarer than perinatal depression, affecting 1-2 in 1000 deliveries. Postpartum psychosis often begins with symptoms of depression or mania or a combination of the two. A woman with postpartum psychosis may lose touch with reality and have hallucinations or delusions. Other symptoms of postpartum psychosis include insomnia, agitation, irritability, irrational guilt, paranoia, rapid mood swings, and suicidal or infanticidal thoughts.   

The incidence of suicide among women who have given birth in the past year is lower than that of women who have not given birth. Having a child is thought to be protective against suicide because it can be a reason for living. However, suicides still occur during pregnancy and in the year after delivery. In fact, suicide is one of the most common causes of maternal death during the postpartum year. 

Perinatal depression and postpartum psychosis are both treatable with professional help. If you, a friend, or a loved one is pregnant or has recently given birth and is feeling depressed or is having suicidal thoughts, please contact the 988 Suicide & Crisis Lifeline (988), a health care provider, or go to the nearest hospital emergency department. Postpartum psychosis is a severe mental illness that can have potentially fatal consequences and needs immediate evaluation.  

Online Resources for Pregnant and Postpartum Women and their Partners

NAMI
The National Alliance on Mental Illness is a mental health organization dedicated to building better lives for the millions of Americans affected by mental illness.

Postpartum Support International
This organization seeks to increase awareness among public and professional communities about the emotional changes that women experience during pregnancy and during the year after the birth.

Moms’ Mental Health Matters
This initiative is designed to educate consumers and health care providers about who is at risk for depression and anxiety during and after pregnancy, the signs of these problems, and how to get help.

Postpartum Depression Fact Sheet
This fact sheet from the American Psychological Association discusses the symptoms, associated factors, prevention, and treatment for postpartum depression.

Video to Raise Awareness About Postpartum Depression
This video is part of the Mental Health Across the Lifespan Initiative created by the National Institute of Mental Health, the Eunice Kennedy Shriver National Institute of Child Health and Human Development, and Delta Sigma Theta Sorority, Inc.

Postpartum Psychosis: A Guide for Partners
Postpartum psychosis is traumatic for women as well as their partners. This guide is for the partners. It explains postpartum psychosis and its treatments. It also discusses the partner’s role during a hospital admission and during recovery from the illness.

Planning Pregnancy: A Guide for Women at Risk of Postpartum Psychosis
This guide is for women at risk for postpartum psychosis because of a history of bipolar disorder or other mental illness. It includes advice from both families and professionals about getting the necessary support when planning to become pregnant, during the pregnancy, and after the delivery.

Postvention: For Those Affected by a Suicide Death

The term “postvention” refers to interventions aimed at helping those who have been affected by a suicide death. Several studies have shown that exposure to suicide can have serious mental health consequences for family, friends, coworkers, teammates, and classmates. These consequences include depression, anxiety, and posttraumatic stress disorder as well as an increased incidence of suicidal ideation, suicide attempts, and suicides.

One of the purposes of postvention is to offer comfort and support to the bereaved. A death by suicide can leave behind a bevy of emotions that make the grieving process even more challenging. In addition, those grieving a suicide often receive less community support for their loss than those grieving deaths by other means, which can lead to greater isolation. The goals of postvention are to assist the bereaved with the grieving process and to reduce the risk of contagion or suicide clusters.

Suicide can be contagious, especially among adolescents. When suicide “contagion” or imitation occurs, a “suicide cluster” can develop. A “suicide cluster” refers to multiple suicides within an accelerated time frame, often within a defined geographical area. Studies indicate that up to 5% of adolescent suicide deaths are due to contagion or imitation. Postvention can help to reduce the risk of suicide contagion or imitation. Many schools and colleges have plans in place for postvention in the event of a student suicide. 

Studies find that an average of 4.5 to 7.5 immediate family members and 15-20 extended family, friends, and colleagues are “intimately and directed affected” by a suicide. As the box below indicates, friends, family, and others who were emotionally close to the deceased are more likely to require support and postvention services. Children may be particularly vulnerable; studies show that without early intervention, a significant proportion of children exposed to the suicide of a relative or sibling may go on to develop clinical depression or posttraumatic stress disorder.

Those Most Likely to Need Support Following a Suicide
  • Those emotionally close to the deceased (e.g., friends and family)
  • People who were already depressed and possibly suicidal before the death
  • Those who might psychologically identify with the deceased (e.g., similar in lifestyle, values, or life circumstances)
  • Family members and peers who were aware or suspicious of the plans
  • Members of the community who might have felt responsible for the wellbeing of the deceased (e.g., teachers, coaches, and school counselors)
  • Supervisors and colleagues in the deceased’s workplace

(Berkowitz et al., 2011)

Postvention can take many forms, including, but not limited to: individual counseling, group counseling, and other support services 

The American Foundation for Suicide Prevention has resources available on their website for those who have lost a loved one to suicide, including how to find a support group in your local community. These resources are free to the public and can be accessed here.  The 988 Suicide & Crisis Lifeline, the American Association of Suicidology, and the Suicide Awareness Voices of Education (SAVE) also have helpful information on their websites for those who have experienced a suicide death.

The Tragedy Assistance Program for Survivors (TAPS) provides a postvention program for military personnel, veterans, and their families. Since its inception over 10 years ago, TAPS has provided postvention support to over 9000 military family survivors.

ADDITIONAL RESOURCES

Suicide: Facts & Misconceptions You Should Know | Mass General Brigham
Is a suicide attempt a cry for help? Are psychiatrists or other mental health clinicians able to predict suicide? Is suicide preventable? Mark Schechter, M.D., Chair of Psychiatry at Salem Hospital, clears up some common misconceptions about suicide.

How to Help Teens Struggling With Mental Health
The New York Times recently published a series of articles calling attention to the fact that adolescents in the U.S. have been experiencing spiraling rates of suicide, NSSI, and other mental health disorders. The series also includes some FAQs on how to help teens who may be struggling with suicidal feelings or who may be using self-harm to manage their emotions. To access these FAQs, click here.

How to Host a Mental Health Screening Event on Campus
This guidebook for college campuses was developed by Nicole Scherr for MindWise Innovations. It discusses how to plan a mental health screening event on a college campus and why such screening events make a difference. The guidebook includes suggestions for student groups, such as athletic teams and Greek life.

Screening for Other Mental Health Disorders
MindWise Innovations has a variety of brief screenings on its website to determine if you or someone you care about should connect with a behavioral health professional. These include brief screens for depression, alcohol or substance use, bipolar disorder, disordered eating, gambling behavior, generalized anxiety, psychosis, and PTSD. Each screen takes only a few minutes and at the end presents the individual with results and recommendations.