Suicide Prevention and Resources

Roughly 50,000 people in the United States die by suicide every year, and many more attempt suicide. In our mental and behavioral health program at the Ohio State Wexner Medical Center, we believe this serious issue deserves serious attention.

Suicide, or taking one’s own life, can be the response of struggling with a mental health condition, such as depression, post-traumatic stress disorder, schizophrenia or substance use disorder, or it can be a sudden and tragic reaction to a stressful situation.

At Ohio State, we view suicide as its own unique problem, with its own contributors and drivers, instead of simply a symptom. This allows us to get to the heart of people’s risk factors for suicide and provide a more targeted therapy with more successful outcomes.

Risk factors for suicide

People with and without a diagnosed mental health condition can struggle with suicidal thoughts and behaviors. This makes identifying who and when someone may attempt suicide very difficult. However, the research shows there are some risk factors that do increase the vulnerability for suicide to occur. These include:

• Personal decision-making styles
• Low self-esteem
• Level of intensity in reaction to stressors
• Dramatic personality or mood changes, including strong anger or rage
• Lack of impulse control
• Lack of family or social support network
• Feeling hopeless, helpless or trapped
• Drug and alcohol abuse
• Availability of lethal means, such as firearms
• Presence of a stressor or trigger, like a recent breakup or financial strain

Most suicide attempts occur following negative life experiences (loss of job, divorce, abuse) as people struggle to manage their overwhelming emotions and identify solutions to resolve their distress. Suicide in those moments may seem like a way to get relief from the overwhelming pain they’re experiencing.

Not everyone exhibits clear signs of suicide, but there are often indications that someone may need help. While some people at risk for suicide might talk about death or suicide, including expression through art, music or writing, and it’s important to listen to these suicidal thoughts, we need to be alert to other signs of severe distress, even when someone isn’t talking about suicide.

Newer research has shown that people who attempt suicide often have very negative perceptions of themselves that can be heard in the things they say. These statements indicate elevated suicide risk even though they do not include explicit mention of death or suicide. For example:

• “I can never be forgiven.”
• “I mess everything up.”
• “I can’t take this any longer.”
• “No one can help me solve my problems.”
• “I deserve to be punished.”
• “People would be better off without me.”

These statements can be understood as a “coded language of suicide,” and if someone expresses these thoughts, it should be taken seriously. Of course, everyone is unique and may express their own troubling thoughts in other ways, so it’s important to trust your feelings of concern, and if anything feels “off” or there’s a troubling change in behavior, seek help immediately.

What should you do if a loved one expresses having thoughts of suicide or is considering attempting suicide?

Discussing suicide is never easy, but don’t let that stop you. Voicing your concerns to a loved one can be one of the easiest ways to prevent suicide.

At the Ohio State Wexner Medical Center, we encourage everyone to learn to talk about suicide, so no one feels alone. Our TALK campaign reminds people what to do if someone expresses thoughts of harming themselves. TALK stands for:

• TELL them you care. If you’re concerned about someone, start the conversation by letting them know you want to help.
• ACT immediately. If you suspect someone is about to harm themselves, call the suicide hotline 988 or 911 and ask for help immediately.
• LISTEN without judgment. When someone talks about suicide, they need to be heard to feel understood.
• KNOW that treatment works. Let the person know there are confidential treatment options available that are very effective.

IF SUICIDE APPEARS TO BE AN IMMEDIATE THREAT, STAY WITH THE INDIVIDUAL, REMOVE HARMFUL ITEMS AND CALL 988.

While you wait for help to arrive, you can practice calming breathing techniques with the person, reassure them you’re not leaving and ask them how you can help. It’s also good to consider making the environment safe by decreasing access to lethal means by removing weapons or pills as you wait with your loved one.

Suicidal ideation care at Ohio State

Treating people who are suicidal requires specialized training, which many providers throughout the academic medical center have. We have levels of care depending on the severity of your situation and can create a personalized treatment plan for you. Many people can get better with early intervention and psychotherapy.

For example, if you’re experiencing current thoughts of suicide and increasing stressors making life difficult to navigate, but you don’t have any plan or intent to attempt suicide, you might benefit from our outpatient services.

Our outpatient services include:

Psychotherapy

Across our mental and behavioral health services, we have expert and dedicated psychotherapists who provide a variety of effective talk therapy methods that can help you prevent suicide or recover from a suicide attempt. Many of our providers are trained in Crisis Response Planning, which focuses on understanding behavior, thoughts, feelings and other factors that predispose someone to suicide.

Types of therapy available include:

• Brief cognitive behavioral therapy (BCBT) – Quickly becoming a preferred treatment for people with suicidal thoughts, BCBT focuses initially on building emotion regulation and crisis management skills followed by dismantling the individual’s suicidal belief system. BCBT is typically administered over 10-12 weekly appointments.
• Dialectical behavioral therapy (DBT) – This form of psychotherapy helps people who have problems regulating feelings and tolerating stress while also teaching them how to live more in the moment and improve relationships. DBT involves weekly individual therapy sessions and group skills training classes, typically lasting from 6 to 12 months.
• Prolonged grief therapy – This therapy aims to help someone through the grief process after the death of a loved one and can be an effective suicide prevention treatment, if someone’s suicidal thoughts are linked to losing someone in their life.

Medications

Sometimes medications, like antidepressants, are part of a treatment plan for someone with thoughts of suicide.

Suicide and Trauma Reduction Initiative (STRIVE)

STRIVE is an innovative program that offers advanced treatments for people struggling with trauma, suicidal thoughts or recent suicidal behavior. STRIVE clinicians are specially trained to deliver the most effective treatments for these conditions, and work side-by-side with the world’s leading suicide prevention researchers, ensuring that new discoveries are quickly implemented in the clinic. STRIVE helps people to better manage their distress and improve their quality of life.

Depression Recovery Center

The Depression Recovery Center aims to treat people with difficult-to-treat depression using a variety of methods, including medications, psychotherapy and interventional psychiatry approaches. Interventional psychiatry encompasses innovative treatments (not medications or psychotherapy) like transcranial magnetic stimulation, electroconvulsive therapy and ketamine therapy.

Emergency services for suicidal thoughts

If you’re currently having persistent thoughts of suicide, you have a plan and you’re not sure you can keep yourself safe, you should seek emergency services.

Our emergency services include:

Psychiatric Emergency Services

Our emergency department, with Psychiatric Emergency Services (PES), is the best place to make sure you stay safe during a crisis. PES is available 24 hours a day, seven days a week. Our mental and behavioral health providers in our emergency departments will talk you through what might be going on and help determine the right level of care for you.

Inpatient care at Harding Hospital

If our PES providers admit you to inpatient services, you’ll receive round-the-clock care that focuses on reducing your suicidal thoughts and ensuring your safety while you work toward stability. We have a well-established inpatient mental health program at Harding Hospital that uses evidence-based treatments to help you transition back to independent living.

Other suicide prevention resources

Here are some important phone numbers and resources if you or someone around you is contemplating suicide:

• National Suicide Prevention Lifeline – 988
• Netcare Access Crisis Hotline – 614-276-2773 (CARE)
• Ohio State Department of Psychiatry and Behavioral Health – 614-293-9600
• American Foundation of Suicide Prevention     
• Centers for Disease Control     
• Harvard School of Public Health Means Matter Program     
• National Suicide Prevention Lifeline     
• National Prescription Drug Take Back Days     
• Free gun locks