Social Stigma, Common Warning Signs, What to Do When Someone Needs Help

Nearly 50,000 Americans died by suicide in 2022, making it the 11th leading cause of death in the country and the second leading cause of death among people ages 10 to 14 and 25 to 34.

September is National Suicide Prevention Month, a time when health care providers, advocates, survivors, educators, and others work to change public perceptions on this topic and offer hope to those struggling with suicidal thoughts.

Dr. Neha Jain, associate professor of psychiatry at UConn Health, recently spoke with UConn Today about common misconceptions about suicide, what warning signs to look for, and how to find help.

What effect, if any, has the pandemic had on the problem of suicide?

As mental health providers, we were all very concerned that the pandemic would lead to an increase in suicide rates. But what we found is that suicide rates actually went down in the early days of the pandemic. And this was attributed to people coming together at a time of crisis: lots of people moving back home; lots of mental health awareness campaigns; lots of pushes to increase access to mental health care.

People spent more time with their families, so there was less social isolation. We didn’t see an increase in suicide. The numbers actually went down a little bit, although I have to say that the decline was mostly driven by white people and less by people of color. But in 2022, the numbers went back up and back to the trend that we were already seeing before the pandemic.

In general, what factors can increase someone’s risk of suicide?

I think risk factors for suicide fall into two broad categories: first, factors that we can’t change, and second, factors that we can change. For example, male gender has always been a risk factor for suicide. People who are single, divorced, or widowed, certain age groups like adolescents and young adults, and adults over 65 are at high risk.

In our field, we focus more on factors that can be modified; things like a history of suicide attempts, a history of mental illness or substance abuse, social isolation, loneliness, limited economic resources or economic insecurity, chronic pain, and physical illness. These are all risk factors for suicide that can be modified or treated.

One thing that we hear from students is that they want to know what the warning signs are. They want to know when it’s appropriate to intervene. But there seems to be a lot of, especially on social media, a lot of conflicting information about this, or misinformation, as it might be. So, what are some of the warning signs that people should be looking out for?

For students, I would say that any significant change in behavior is a potential warning sign. It could be a big change in eating or sleeping patterns. It could be someone just talking about wanting to die, feeling hopeless, feeling more depressed, talking about shame or guilt, talking about being a burden to others. It could be someone just completely withdrawing and not interacting with people.

Also an increase in anxiety, an increase in anger or agitation can be an indication. If someone describes a lot of emotional or physical pain that he/she cannot tolerate, that can be a warning sign. And then there are things that you can notice in terms of behavior, for example if someone is doing something that could be seen as researching suicide methods or making preparations for death.

Some of those preparations might include giving away important things, writing “goodbye” letters, doing dangerous things like speeding, drinking heavily, or using substances. These can all be warning signs. That said, sometimes suicides can happen without any warning signs. So it’s also important to realize that someone can look and act fine, but they could be feeling something that’s not outwardly visible.

Younger people seem to be more willing to talk about their mental health in general, certainly more so than people of my generation. But is there still a stigma attached to the topic of suicide? Are people still reluctant to talk about it for fear of upsetting or even triggering someone?

Absolutely. I think there are a lot of different things that play into this, besides the stigma around suicide in general. Some people are just too worried to ask, “What if I ask if this person is thinking about suicide, and they say yes. What do I do then?”

There is also this concern that asking about suicide will somehow increase the likelihood that someone will commit suicide, and I want to stress that this is not true. So, you should not be afraid to ask about suicide if you are concerned about it.

Can you explain what ‘suicide contagion’ is and how it can be prevented?

Suicide contagion is exactly what it sounds like, where one person’s suicidal behavior or suicide influences others to commit or attempt suicide. That effect seems to be stronger in adolescents and young people, and there have been many well-publicized clusters, particularly when there is a celebrity who commits suicide or attempts suicide.

It often leads to a cluster of contagion, and not necessarily in the same geographic area, of course, because the news is everywhere. It is important to realize that people will talk about suicide if there is a suicide. It will be reported in the media. It does not help to dismiss or hide a suicide, but suicide contagion is real, and it is not so much the actual suicide as how it is portrayed that can influence contagion behavior.

So if a suicide is presented in a sensational way, there can be a kind of excitement around it. In a 24-hour non-stop news cycle, there’s going to be a lot of description, a lot of drama and, and it can be presented as a strategy: “This person was so unhappy, this was their only way out.”

Sensationalized reporting can minimize the person’s struggles, stress, substance abuse, or other negative experiences they’ve dealt with. Suicide can and should be reported, but doing it factually, with the understanding that it’s often a much more complicated picture than it first appears, is the responsible way to do it.

What misconceptions are common about suicide?

The big one I see is, again, this idea that talking about it or asking someone about it increases the likelihood that they will commit suicide. I don’t think that’s true. I think there’s also this idea of, “Oh, this person looks fine. How can they end their life?”

But a person can hide a lot of depression, a lot of conflicts, a lot of stress. If you are worried about your friend, it can be very useful to ask him about it and talk about it, so we should not hesitate.

This ties in seamlessly with perhaps the most important question: what should someone do if they fear that a family member, friend or loved one is considering suicide?

Don’t hesitate to talk, even if you’re not entirely sure what they’re up to or considering. You can always offer them the crisis lifeline information. The suicide crisis lifeline phone number is 988. They can call that number to talk to a crisis worker. They can also contact the crisis text line, which is often people’s preferred option, and for that you text TALK to 741741.

Please feel free to share this information with anyone you think is struggling. Don’t be afraid to share this information where everyone can access it. If you think you are in a life-threatening situation, you can always call 911 or 211, Connecticut’s mental health hotline.

The CT Advisory Council on Suicide has a number of helpful resources on https://www.preventsuicidect.org/ Finally, I think it is always better to offer help yourself or ask for help.