Facts about suicide

Causes of suicidal feelings

Suicidal thoughts are often linked to intense emotional pain and a feeling of being alone or disconnected from others. It may feel as though no one understands the situation or can provide support. When despair becomes overwhelming, suicide can seem like the only possible way to escape the pain. Feelings of hopelessness can make it difficult to see other options or sources of help.

Risk factors and warning signs

Critical life events

• Loss of a close family member, relationship, job, social position, or financial security.
• Major disappointments, such as failing an exam or degree, missing out on a promotion, bullying, or experiences of abuse or violation.
• Illness, including depression, psychosis, severe physical illness, or substance use problems.

Behavioral changes

Changes in behavior should always be taken seriously, especially if they create concern. A person may become withdrawn, sad, or unusually irritable. Some people talk about hopelessness or feeling helpless or worthless. Others may stop caring about their appearance or express thoughts about death through drawings, stories, music, or conversations. Saying goodbye to others or giving away personal belongings can also be warning signs.

Some people may engage in risky or self-destructive behavior. In some cases, a person who is suicidal may suddenly seem unusually calm. This can sometimes indicate that the person has made a decision about suicide.

What can help?

Many people who experience suicidal thoughts get through the crisis with support from others. Support from family, friends, and healthcare professionals can make an important difference. The guidance below explains how to support someone who may be thinking about suicide.

1. Take the situation seriously

Reach out as early as possible. Do not assume that the situation will improve on its own or that the person will ask for help without support.

2. Notice personal reactions

Fear, uncertainty, or a wish to avoid the situation are common reactions. Support from someone trusted can make it easier to stay involved and provide support over time. Without support, there may be pressure to find a quick solution instead of focusing on what the person needs.

3. Be available and listen

Spend time with the person and listen without judging, criticizing, or becoming angry. Encourage conversation and listen carefully to what is being said. Talking openly can sometimes make difficult feelings easier to manage.

4. Ask directly about suicide

The clearest way to understand whether someone is thinking about suicide is to ask directly. Although the conversation may feel difficult, asking shows concern and willingness to listen. Talking about suicide does not increase the risk of suicidal behaviour. Open conversations can help the person describe their feelings and make it easier to seek support.

Avoid agreeing to keep suicidal thoughts secret. Additional support may be needed to help keep the person safe.

5. Check immediate safety

If someone is considering suicide, it is important to understand how serious the situation is. Questions such as the following may help:

• Have thoughts about suicide included a specific plan or time?
• Is there access to anything that could be used to carry out the plan?
• What helps the person feel safer or more supported right now?

It can also help to ask what sources of support or meaning are important, such as family, friends, pets, beliefs, interests, or personal strengths.

6. Agree on next steps together

After discussing safety, decide together what support is needed next. This may include contacting healthcare services or reaching out to trusted people such as a partner, parent, family member, or friend. Practical support with taking the first step can be helpful.

7. Where support is available

• Primary healthcare centres or medical clinics
• Psychiatric services
• School staff, such as teachers, school nurses, counsellors, psychologists, or youth workers
• Youth health clinics
• Religious leaders or faith-based support

Support may include helping the person prepare for a conversation or accompanying them to an appointment. Afterwards, ask what support was offered and help them follow recommendations where possible.

8. Encourage ongoing support and hope

Suicidal thoughts can return. Encourage the person to seek help again if these thoughts come back and to tell someone they trust about how they are feeling. Continued support, understanding, and hope are important.

9. Take care of personal wellbeing

Supporting someone with suicidal thoughts can be emotionally demanding, especially over a longer period of time. It is important to have support from friends, family, or a professional when needed.

10. Stay involved

Suicidal thoughts usually do not disappear without support or changes in the person’s situation. Ongoing involvement from family, friends, and other supportive people can help the person manage difficult thoughts and continue seeking help.

Produced by HFS – Region Stockholm Healthcare in collaboration with Uppsala University Hospital, Västerbotten County Council, and the County Council in Östergötland.

Updated by Zero Suicide in Stockholm County. Fact reviewed by psychiatrist Daniel Frydman. March 2011.Myths about suicide

Common misconceptions about suicide

1. "Nothing can stop a person who has decided to die by suicide."

Between 85-90 % of individuals who have made serious suicide attempts do not ultimately complete the act. Many suicide survivors often reflect, asking themselves, “What was I thinking?”

2. "People who talk about suicide will not attempt it."

Most people who die by suicide do talk about it, more or less explicitly. But the people around them do not always recognise the message.

3. "Talking or writing about suicide is dangerous."

Research indicates that discussing suicide can have a preventative effect by increasing awareness and encouraging people to seek help.

4. "Sweden has one of the world's highest suicide rates."

Sweden's suicide statistics are comparable to the rest of Europe.

Sources: Barn i utsatta livssituationer, chapter by Britta Alin Åkerman (editor Jane Brodin), Gleerups 2008. | Oxford textbook of suicidology and suicide prevention. A global perspective by Danuta Wasserman and Camilla Wasserman, Oxford University Press 2009. | National Centre for Suicide Research and Prevention of Mental Ill-Health (NASP).

WHO’s resource series for suicide prevention

The World Health Organization (WHO) has produced a resource series with guidelines for emergency services, general practitioners, journalists and media professionals, teachers and school staff, primary health care services, prisons, and workplaces (available in several languages).

Preventing suicide: A resource series