Mental Health UK

Suicide Prevention What Works

Suicide Prevention What Works

Suicidal behavior is behavior that manifests itself in the form of fantasies, thoughts or actions aimed at self-harm or self-destruction.

Internal forms of suicidal behavior include reflections on the lack of value in life, fantasies about one’s own death, developing a plan for suicide and making a decision to implement it (suicidal tendencies).

External forms of suicidal behavior include:

  • Suicide – intentional, deliberate and rapid deprivation of life;
  • A suicide attempt (parasuicide) is intentional self-injury or self-poisoning that did not end in death. Parasuicides also include acts undertaken with the intention of self-harm or suicide, but not resulting in physical injury. For example, interference by outsiders prevented self-hanging; the person was “removed” from the rails before the train aisle, etc.

People who commit suicide usually suffer from severe mental pain and stress, as well as feel unable to cope with their problems, and look to the future without hope.

The goals and motives of both suicide and parasuicides are very diverse. Usually, they are associated both with an attempt to influence the social environment (relatives, partners, medical workers), and with ideas of death or deliverance from suffering, fear and other difficult experiences.

Every year, about 1 million suicides are committed in the world and about 10 times more suicide attempts. Suicide in Northern Ireland is the second leading cause of death after road traffic accidents (RTA) in the 15-35 age range.

Misconceptions about suicide

  • Suicides are committed by mentally abnormal people. But studies have shown: 80 – 85% of suicides were completely healthy people;
  • Suicide cannot be prevented. But a period of crisis is a temporary phenomenon, and at this moment a person needs warmth, help and support. Having received this, a person often abandons his/her intentions;
  • There is a type of person who is prone to suicide. But it all depends only on the situation and on its personal assessment. As well as there are no signs that would indicate why a person decided to commit suicide;
  • The person before committing suicide will talk about it, but others will take it as a joke. In most cases, if you do not take into account affective suicides, then a person always warned others about his intentions;
  • The decision to commit suicide comes suddenly, without prior preparation. But analysis has shown that a suicidal crisis can last for weeks, even months;
  • If a person has attempted suicide, he/she will never try it again. In fact, if a person makes an attempt, then the risk of a second attempt is very high. Most likely in the first 1-2 months;
  • The urge to commit suicide is inherited. This statement has not yet been proven by anyone;
  • The reduction in the suicide rate is facilitated by articles in the media describing how and why the suicide was committed. But this is not true;
  • Suicide can be prevented by keeping people busy. This is also not true;
  • Drinking alcohol can help relieve suicidal feelings. But this often causes the opposite effect: anxiety increases, conflicts intensify, thereby contributing to suicide.

Suicide awareness: How to prevent suicide

None of the people are completely suicidal. Even the most passionate desire to die is in its psychological essence contradictory. Part of the personality wants to live, the other seeks to disappear into oblivion. The suicidal mood of the soul is transient – these feelings can appear, disappear, arise again, but almost always pass. This pattern is the basis for providing assistance in case of potential suicide.

  1. Look for signs of potential danger: suicidal threats, prior suicide attempts, signs of depression, significant changes in a person’s behavior or personality, and preparation for the final act of will. Catch the manifestations of helplessness and hopelessness and determine if the person is lonely and isolated. The more people who realize these warnings, the more significant the chances of suicide disappearing from the list of leading causes of death;
  2. Establish a caring relationship. There are no all-encompassing answers to such a serious problem as suicide. But you can take a giant step forward if you take the position of confident acceptance of the discouraged person. In the future, a lot depends on the quality of your relationship. They should be expressed not only in words, but also in facial expressions, gestures; in these circumstances, support rather than moralizing is more appropriate. Instead of suffering from self-condemnation and other experiences, the anxious person should try to understand their feelings. For a person who feels that he/she is useless and unloved, the caring and participation of a sympathetic person are powerful encouraging agents. This is how you best penetrate the isolated soul of a desperate person;
  3. Do not leave the person alone in a situation of high suicidal risk. Stay with him/her as long as possible or ask someone to stay with him/her until the crisis is resolved or help arrives. You may need to call an ambulance station or see a specialist. Remember, support comes with a certain responsibility;
  4. Be a careful listener. Suicides especially suffer from intense feelings of alienation. Because of this, they are not inclined to ac-cept your advice. Much more they need to discuss their pain, frustration and what they say: “I have nothing to live for.” If a person suffers from depression, then he/she needs to talk more than listen. You may develop irritation, resentment, or anger if the person does not immediately respond to your thoughts and needs. Realizing that the person you care for is suicidal usually causes the helper to fear rejection, unwillingness, powerlessness, or unnecessary use. Regardless, remember that it is difficult for this person to focus on anything other than their desperation. He/she wants to get rid of the pain but cannot find a healing outlet. If someone confesses to you that they are thinking about suicide, do not blame them for these statements. Try to remain calm and understanding as much as possible. You might say, “I really appreciate your candor because it takes a lot of courage from you to share your feelings.” You can be of invaluable help by listening to words that express the person’s feelings, be it sadness, guilt, fear, or anger. Sometimes, if you just sit silently with the person, THIS will be proof of your interested and caring attitude;
  5. Don’t argue. When faced with a suicidal threat, friends and relatives often answer: “Think, you are living much better than other people; you should thank fate.” This response immediately blocks further discussion; such remarks cause even more depression in the unhappy person. Wanting to help in this way, loved ones contribute to the opposite effect. You can often come across another familiar remark: “Do you understand what misfortune and shame you will bring on your family?” But, perhaps, behind him/her lies exactly the thought that the suicide wants to carry out. Never be aggressive if you are present when talking about suicide, and try not to express shock at what you hear. Entering into a discussion with a depressed person, you can not only lose the argument but also lose him/her;
  6. Ask questions. The best way to intervene in a crisis is to carefully ask a direct question: “Are you thinking of suicide?” He/she will not lead to such a thought if the person did not have it; on the contrary, when he/she thinks about suicide and finally finds someone who cares about his/her feelings and who agrees to discuss this forbidden topic, he/she often feels relieved, and he/she is given the opportunity to understand his/her feelings and respond to them. You should calmly and intelligibly ask about the disturbing situation, for example: “Since when do you consider your life so hopeless? Why do you think you have these feelings? Do you have any specific thoughts on how to end your life? If you’ve contemplated suicide before, what’s stopping you?” To help the suicidal person sort out his/her thoughts, you can sometimes paraphrase, repeat his/her most significant answers: “In other words, you say …” Your agreement to listen and discuss what they want to share with you will be a great relief for a desperate person who is experiencing fear that you will judge him/her, and is ready to leave;
  7. Don’t offer unnecessary consolations. A person can be driven to suicide by banal consolations just when he/she desperately needs a sincere, caring and frank participation in his/her fate. If you are not interested and responsive, the de-pressed person may view judgments like “You really don’t think so” as a manifestation of rejection and distrust. If you conduct a conversation with him/her with love and care, then this will significantly reduce the threat of suicide. Suicidal people disdain remarks like “It’s ok, everyone has the same problems as you,” and other similar clichés, as they are in stark contrast to their suffering. These conclusions only minimize, demean their feelings and make them feel even more unnecessary and useless;
  8. Suggest constructive approaches. Instead of telling the suicidal person, “Think about the pain your death will bring to your loved ones,” ask them to think about alternative solutions that may not have occurred to him/her yet. One of the most important goals of suicide prevention is to help identify the source of mental discomfort. This can be difficult because secrecy is the breeding ground for suicide. The most appropriate questions to stimulate discussion might be, “What happened to you lately? When did you feel worse? What has happened in your life since these changes occurred? To whom of those around did they relate?” The would-be suicidal person should be encouraged to identify the problem and pinpoint what is aggravating it as accurately as possible. The desperate person needs to be reassured that they can talk about feelings without hesitation, even negative emotions such as hatred, bitterness, or a desire for revenge. If the person still does not dare to show his/her innermost feelings, then perhaps you will be able to lead to the answer, noting: “I think you are very upset” – or: “In my opinion, you will cry now.” It also makes sense to say, “You are still excited. Maybe if you share your problems with me, I will try to understand you.” If the crisis situation and emotions are expressed, then the next step is to find out how the person resolved similar situations in the past. This is called “assessing the means available to solve the problem.” It involves listening to descriptions of previous experiences in a similar situation. For initiation, the question may be asked: “Have you had similar experiences before?” There is a unique opportunity to jointly explore the ways in which a person has dealt with a crisis in the past. They can be useful for resolving real conflict as well. Try to find out what remains, however, positively meaningful to the person. What else does he/she appreciate? Look for signs of emotional revival when it comes to the “best time of your life”, especially watch his/her eyes. Who are the people who continue to excite him/her? And now that the life situation has been analyzed, have not any alternatives emerged? Is there a ray of hope?;
  9. Provide hope. Hope helps a person get out of their suicidal thoughts. The loss of hopes for a decent future is reflected in the notes left by suicides. Self-destruction occurs when people lose the last drops of optimism, and their loved ones somehow confirm the futility of hopes. Someone wittily remarked on this: “We laugh at people who hope, and send those who have lost hope to hospitals.” Be hope must come from reality. It makes no sense to say, “Don’t worry, everything will be fine,” when everything cannot be fine. Hope cannot be built on empty consolations. Hope arises not from fantasies but from the existing ability to desire and achieve. A loved one who has died cannot return, no matter how much you hope and pray. But his/her loved ones can discover a new understanding of life. Hopes must be justified: when a ship crashes against rocks, there is a difference between the hope of “sailing to the nearest shore or reaching the opposite shore of the ocean.” When people completely lose hope for a decent future, they need supportive advice, some kind of alternative. “How could you change the situation?”, “What outside interference could you resist?”, “Who could you ask for help?” Since suicidal individuals suffer from internal emotional discomfort, everything around them seems gloomy. But it is important for them to discover that it makes no sense to get stuck on one pole of emotions;
  10. Conclusion of an anti-suicidal contract. In order to show the person that others care about him/her and create a sense of life prospects, you can conclude with him/her a so-called anti-suicidal contract – ask for a promise to contact you before he/she decides on suicidal actions in the future in order to once again you were able to discuss possible alternatives of behavior. Such an agreement can be very effective. If clients go to the conclusion of an anti-suicidal contract, then they probably retain some degree of self-control, and their suicidal intentions are most likely weak or moderate;
  11. Seek professional help. Working with self-destructive people is serious and responsible. In most cases, suicides need the help of specialists in resolving a difficult life situation. Sometimes the only alternative to helping a suicide, if the situation is hopeless, is hospitalization in a psychiatric hospital. Delay can be dangerous; hospitalization can bring relief to both the patient and the environment.

Suicide Prevention Organizations

If you or someone you know have suicidal thoughts, below are some resources that will give you emergency, free and confidential help.

Suicide help: a global website

  • Befrienders Worldwide

USA and Canada

  • National Suicide Prevention Lifeline (USA and Canada)
  • Canadian Association for Suicide Prevention (Canada)
  • Crisis Text Line (USA)
  • To Write Love on Her Arms (USA)
  • National Eating Disorders Association (USA)
  • The Trevor Project (for LGBTQ ages 13-24, USA)
  • Trans Lifeline (USA and Canada)
  • Your Life Your Voice (assistance to youth and young adults, USA)
  • National Domestic Violence Hotline (USA)
  • National Sexual Assault Telephone Hotline (USA)
  • Hackblossom: DIY Cybersecurity for Domestic Violence (USA)
  • Crisis Services Canada (Canada)


  • • TelefonSeelsorge (Austria)
  • • Center de prévention du Suicide (Belgium, France)
  • • Centrum Ter Preventie Van Zelfdoding (Belgium, Netherlands)
  • • Tel 143 – Die Dargebotene Hand (Switzerland)
  • TelefonSeelsorge (Germany)
  • El Telefono de la Esperanza (Spain)
  • Suicide Ecoute (France)
  • Pieta House (Ireland)
  • Telefono Amico (Italy)
  • SOS Détresse – Hëllef iwwer Telefon (Luxembourg)
  • 113 Zelfmood Preventie (Netherlands)
  • Voz de Apoio (Portugal)
  • Samaritans (UK)
  • National Domestic Violence Helpline (United Kingdom)
  • Pro Juventute (Switzerland)

Latin America

  • S.O.S. Un Amigo Anónimo (Argentina)
  • Centro de Valorização da Vida (CVV) (Brazil)
  • Todo Mejora (Colombia)
  • Corpolatin (Colombia)
  • SAPTEL (Mexico)

Asia and Australia

  • AASRA (India)
  • Befrienders Japan (Japan)
  • Korean Suicide Prevention Center (Korea)
  • Natasha Goulborn Foundation (Philippines)
  • Institute of Mental Health (Singapore)
  • Samaritans (Thailand)
  • Lifeline (Australia)
  • Headspace (Australia)
  • Mental Health Helpline 1323 (Thailand)