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The Rise of Firearm Suicide among Young Americans

9.10.2020

Summary

Firearm suicide is having a devastating impact on American youth. Over the past decade, the firearm suicide rate among young people has increased faster than in any other age group. Today, it is at an all-time high. As students begin an unpredictable school year in the middle of the COVID-19 pandemic, there is concern that the anxiety and loneliness already felt by many young people will continue to increase. This comes at the same time as the US has seen an unprecedented surge in gun sales, raising concern about the already growing rates of firearm suicide as many youth continue to stay home. But suicide, including firearm suicide, can be prevented. We know that removing access to firearms, a particularly lethal means, is the easiest and quickest intervention. We can potentially save lives by implementing policies that limit easy and immediate access to firearms, increasing awareness of risk factors, improving access to mental health care, and supporting America’s youth.

The following material aims to increase your knowledge and understanding of suicide and firearm suicide among young people in America. We understand that the content may be personal for you. If you or someone you know is in a time of emotional crisis or needs to talk to someone, please call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255), or text HOME to 741741 to reach the Crisis Text Line for free from anywhere in the US. See additional resources at the end of the page.

Remembering Ty-Key

“In the blink of an eye, my whole life changed.” My son, Ty-Key, wrote these lyrics—searching for the words to express the loss of his best friend, Keondrick, who was shot and killed. Ty-Key survived that shooting, but five years later, at age 22, he took his own life with a gun. Ty-Key was always doing things. He was a football player, rapper, and the cool guy on the block. He was smart, too—he even had the opportunity to skip a grade. People knew him. People loved him—they always had. I miss him every day. In response to my son’s suicide, I have dedicated my life to preventing gun suicide, and providing grief counseling to help others find healing, because I want other young people to know that they can find help and there is hope.

Miami Knight, Ty-Key’s mom and gun violence prevention advocate

Introduction

Death by suicide is a significant public health problem that claims the lives of thousands of young people in the US each year.1Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Web-based Injury Statistics Query and Reporting System (WISQARS) Fatal Injury Reports. A yearly average was developed using five years of most recent available data: 2014 to 2018. Young adults are defined as ages 10-24. The suicide rate among young people is at a record high, with increases every year since 2007. During this same period, the rate of homicides among young people has not increased each year, and adult suicide rates have been increasing at a slower rate.2Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Web-based Injury Statistics Query and Reporting System (WISQARS) Fatal Injury Reports. A percent change was developed using 2009 to 2018 crude rates for young adults (ages 10-24).

Suicide is the second leading cause of death for young Americans.

CDC Leading Causes of Death Reports, Ages 10-24, 2018.

Suicide among young people has increased at an alarming rate.

There are multiple factors that can elevate the risk of suicide, and action must be taken to address the root causes. But one thing is clear: Reducing access to firearms can significantly reduce risk.

Suicide risk increases when these three factors—if not addressed—coincide to create a sense of hopelessness and despair:3American Foundation for Suicide Prevention, “Risk Factors and Warning Signs,” accessed August 20, 2020, https://bit.ly/2bmWnQx.

current life stressors + historical risk factors + leathal means of harm combined increase the likelihood of a suicide attempt

COVID-19 and Back to School

The unprecedented COVID-19 pandemic has significantly disrupted the lives of teens and young adults well beyond the illness itself. A study from the Centers for Disease Control and Prevention (CDC) found that a quarter of young adults (ages 18–24) have contemplated suicide during the pandemic.4Mark É Czeisler et al., “Mental Health, Substance Use, and Suicidal Ideation During the COVID-19 Pandemic—United States, June 24–30, 2020,” Morbidity and Mortality Weekly Report 69, no. 32 (August 14, 2020): 1049-57, https://doi.org/10.15585/mmwr.mm6932a1. Experts are concerned that social isolation, along with fear about the virus, can increase feelings of anxiety and loneliness,5Centers for Disease Control and Prevention, “Coping with Stress,” Coronavirus Disease 2019 (COVID-19), July 1, 2020, https://bit.ly/3l4gq9u. two factors that elevate the risk of suicide for people of all ages. The COVID-19 pandemic’s negative effects on mental health will likely continue as many schools and universities cut back on in-person activities. Many young people, particularly teenagers, remain at home and will miss out on peer interactions and important social and developmental milestones.6US Department of Health & Human Services, Office of Population Affairs, “Adolescent Development Explained,” November 2018, https://bit.ly/34O5erx. Even as some schools open their doors, students and their families will have to learn how to adjust to a new normal.

The implementation of anonymous tip lines by school districts has been saving lives.

Initially developed as a mechanism for students to anonymously report concerns about their classmates in an attempt to stop school shootings, school tip lines are more frequently being used by students to report others who are at risk of self-harm or are feeling suicidal.34Tyler Kingkade, “School Tip Lines Were Meant to Stop Shootings, but Uncovered a Teen Suicide Crisis,” NBC News, February 1, 2020, https://nbcnews.to/3gi4kpB. In a single school year, Oregon’s statewide school safety tip line received 272 tips in which a student reported that another person was at risk of suicide. This is compared to the 125 tips regarding a threat of a planned school attack.35Safe Oregon, “Oregon Statewide School Safety Tip Line, 2018-2019 Annual Data Report, June 16, 2018-June 15, 2019,” 2019, https://bit.ly/2QbeQnR. Within a six-month period, Pennsylvania’s Safe2Say Something program received over 2,500 tips about cutting or self-harm, nearly 2,200 tips regarding suicide or suicidal ideation, and over 2,100 tips about depression and anxiety.36Commonwealth of Pennsylvania, Office of Attorney General, “Safe2Say Something Annual Report, 2018-2019 School Year,” 2019, https://bit.ly/3gesv8f. Given the unprecedented uptake of these programs, Everytown recommends that more school districts implement anonymous tip lines to address the rise in youth suicide and keep our students safe.

Schools should consider using Sandy Hook Promise’s Know the Signs campaign and Say Something program, which is currently being used in a few states, including Pennsylvania, which has used this program to develop its Safe2Say Something program. This program trains students on warning signs and encourages them to report a classmate who may be at risk of harming themselves or others.37Sandy Hook Promise, “Our Proven Programs Create Change That Leads to Safer Schools,” accessed August 26, 2020, https://bit.ly/34L0ymx.

11.8M

People in the US bought an estimated 11.8 million guns between March and August 2020.

Federal Bureau of Investigation (FBI), “NICS Firearm Checks: Month/Year by State and Type,” accessed August 20, 2020, https://bit.ly/3eldbXB; Jurgen Brauer, “Demand and Supply of Commercial Firearms in the United States,” The Economics of Peace and Security Journal 8, no. 1 (April 2013): 23-28, https://bit.ly/3eF6peJ.

This all comes at a time when the US has seen a surge in gun sales. Driven by fear and anxiety during the COVID-19 pandemic, people bought an estimated 11.8 million guns in the six-month period from March through August 2020.7Federal Bureau of Investigation (FBI), “NICS Firearm Checks: Month/Year by State and Type,” accessed August 20, 2020, https://bit.ly/3eldbXB; Jurgen Brauer, “Demand and Supply of Commercial Firearms in the United States,” The Economics of Peace and Security Journal 8, no. 1 (April 2013): 23-28, https://bit.ly/3eF6peJ. Everytown estimated the number of firearms sold for each month and year, using the same methodology used by the Small Arms Survey, an adaptation of the method used by Small Arms Analytics & Forecasting, which estimates that 1.1 firearms are sold for each handgun and long gun check, and 2 firearms are sold for each “multiple” check conducted. The state-level numbers are as provided by the FBI, and the sum of these numbers does not equal the US totals that the FBI provides in their reporting. Everytown also excluded the US territories from this analysis. Even before this surge, estimates indicate that a staggering 4.6 million American children lived in households with at least one unlocked and loaded firearm.8Deborah Azrael et al., “Firearm Storage in Gun-Owning Households with Children: Results of a 2015 National Survey,” Journal of Urban Health 95, no. 3 (June 2018): 295-304, https://doi.org/10.1007/s11524-018-0261-7. This ready access to guns is concerning given that nearly three in four firearm suicides by young people take place in or around a home,9Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, National Violent Death Reporting System (NVDRS), Ages 10-24, Five-Year Average: 2013 to 2017. and over 80 percent of firearm suicides by children (age 18 or younger) involve a gun belonging to a family member.10Renee M. Johnson et al., “Who Are the Owners of Firearms Used in Adolescent Suicides?” Suicide & Life-Threatening Behavior 40, no. 6 (2010): 609-11, https://bit.ly/3jwrlXU.

What is Secure Firearm Storage?

Illustration representing the proper way to secure a firearm. Guns must be unloaded, locked, and the gun and ammunition should be stored separately.

The COVID-19 crisis has created new challenges for parents. Kids are out of school and spending more time at home. The boredom and isolation they may be feeling pose additional risks to their safety. Securing all guns in the home—storing them locked, unloaded, and separate from ammunition—can save a child’s life.

Learn more about the Be SMART campaign to raise awareness that secure gun storage can save lives.

The Firearm Matters

Addressing the role of firearms is essential in suicide prevention. We know that removing access to firearms is the easiest and quickest intervention to reduce risk. Most people who attempt suicide do not die—unless they use a gun. Across all suicide attempts not involving a firearm, 4 percent will result in death. Conversely, approximately 90 percent of gun suicide attempts end in death.11Andrew Conner, Deborah Azrael, and Matthew Miller, “Suicide Case-Fatality Rates in the United States, 2007 to 2014: A Nationwide Population-Based Study,” Annals of Internal Medicine 171, no. 12 (2019): 885-95, https://doi.org/10.7326/M19-1324. Given that firearm suicide makes up over a third of all gun deaths and nearly half of suicides among young people,12CDC, WISQARS Fatal Injury Reports, Ages 10-24, Five-Year Average: 2014 to 2018. addressing firearm suicide is an essential element of any strategy to reduce suicide and gun violence in this country.

90%

90 percent of suicide attempts with a gun are fatal, while 4 percent of those not involving a gun are fatal.

Andrew Conner, Deborah Azrael, and Matthew Miller, “Suicide Case-Fatality Rates in the United States, 2007 to 2014: A Nationwide Population-Based Study,” Annals of Internal Medicine 171, no. 12 (2019): 885–95, https://doi.org/10.7326/M19-1324.

Each year, thousands of young people die by firearm suicide—an average of eight people every day.13CDC, WISQARS Fatal Injury Reports, Ages 10-24, Five-Year Average: 2014 to 2018. Boys and young men are disproportionately affected, representing nearly 9 out of 10 firearm suicide victims.14CDC, WISQARS Fatal Injury Reports, Ages 10-24, By Gender, Five-Year Average: 2014 to 2018.

3,000

Each year, nearly 3,000 young people die by firearm suicide.

CDC, WISQARS Fatal Injury Reports, Ages 10-24, Five-Year Average: 2014 to 2018.

56%

The rate of firearm suicide among young people has increased 56 percent over the past decade.

CDC, WISQARS Fatal Injury Reports, Ages 10-24, Percent Change: 2009 to 2018.

And the problem has only gotten worse. The rate of firearm suicide among those 10 to 24 years old has increased significantly over the past decade, with an even sharper increase among children 10 to 14. Among these pre-adolescents/young adolescents, the rate has increased a disturbing 213 percent from 2009 to 2018.15CDC, WISQARS Fatal Injury Reports, Ages 10-24, Percent Change: 2009 to 2018.

Young people have the fastest-growing firearm suicide rates of any age group over the last decade.

CDC, WISQARS Fatal Injury Reports, Ages 10-24, Percent Change: 2009 to 2018

Research has shown that access to firearms is strongly associated with higher youth (ages 10 to 19) suicide rates: For each 10 percent increase in household gun ownership in a state, the youth suicide rate increased by more than 25 percent.16Anita Knopov et al., “Household Gun Ownership and Youth Suicide Rates at the State Level, 2005–2015,” American Journal of Preventive Medicine 56, no. 3 (March 2019): 335-42, https://doi.org/10.1016/j.amepre.2018.10.027.

States with the highest rates of firearm suicide among young people are Alaska, Wyoming, Montana, Idaho, and New Mexico.17CDC, WISQARS Fatal Injury Reports, Ages 10-24, Five-Year Average: 2014 to 2018. States with the fastest-growing firearm suicide rates among young people over the past decade include Oregon (124% increase), Virginia (109%), Michigan (106%), Idaho (105%), and Missouri (105%).18CDC, WISQARS Fatal Injury Reports, Ages 10-24, Percent Change: 2009 to 2018.

Rates of Firearm Suicide by State (ages 10-24)

The rise in suicide rates, including firearm suicide, among youth is clear. Yet researchers have been able only to theorize what could be behind the trend, such as increased anxiety and depression,19Jean M. Twenge et al., “Increases in Depressive Symptoms, Suicide-Related Outcomes, and Suicide Rates Among US. Adolescents After 2010 and Links to Increased New Media Screen Time,” Clinical Psychological Science 6, no. 1 (November 2017): 3-17, https://journals.sagepub.com/doi/abs/10.1177/2167702617723376?journalCode=cpxa. social media,20Rosemary Sedgwick et al., “Social Media, Internet Use and Suicide Attempts in Adolescents,” Current Opinion in Psychiatry 32, no. 6 (November 2019): 534-541, https://journals.lww.com/co-psychiatry/fulltext/2019/11000/social_media,_internet_use_and_suicide_attempts_in.12.aspx. cyberbullying,21Sameer Hinduja and Justin W. Patchin, “Connecting Adolescent Suicide to the Severity of Bullying and Cyberbullying,” Journal of School Violence 18, no. 3 (August 2018): 333-346, https://www.tandfonline.com/doi/full/10.1080/15388220.2018.1492417. and stigma.22Cate Curtis, “Youth Perceptions of Suicide and Help-seeking: ‘They’d Think I Was Weak or “Mental,“‘ Journal of Youth Studies 13, no. 6 (July 2010): 699-715, https://www.tandfonline.com/doi/abs/10.1080/13676261003801747. We need more research to understand what is driving these increases.

Youth Firearm Suicide Among Groups

While some groups are more impacted than others, the devastating toll of firearm suicide is impacting communities all across the US. For youth in particular, young American Indians and Alaska Natives (AIANs) have the highest firearm suicide rate followed by white and Black youth.23CDC, WISQARS Fatal Injury Reports, Ages 10-24, Five-Year Average: 2014 to 2018. The rate among AIANs is likely an undercount. Research shows that deaths from all causes among AIAN people are underreported by roughly 30 percent, most likely due to medical examiners misclassifying AIAN decedents as another race.24Elizabeth Arias et al., “The Validity of Race and Hispanic Origin Reporting on Death Certificates in the United States,” Vital and Health Statistics 2, no. 148 (October 2008), https://bit.ly/31Q7qx8. Firearm suicide rates across all racial and ethnic groups have increased over the past decade, especially among young Asian and Pacific Islanders (APIs), who have seen a 179 percent increase over this period.25CDC, WISQARS Fatal Injury Reports, Ages 10-24, Percent Change: 2009 to 2018. The group with the second highest rate of increase is Black youth, with an 83 percent rise.26CDC, WISQARS Fatal Injury Reports, Ages 10-24, Percent Change: 2009 to 2018.

The firearm suicide rate among young American Indians and Alaska Natives is nearly four times higher than that of the group with the lowest rate (Asian and Pacific Islanders).

CDC, WISQARS Fatal Injury Reports, Ages 10-24, Five-Year Average: 2014 to 2018.

Young Asian and Pacific Islanders have the fastest growing firearm suicide rate of any racial/ethnic group.

CDC, WISQARS Fatal Injury Reports, Ages 10-24, Percent Change: 2009 to 2018.

Addressing the risk of suicide, whether by firearms or other means, requires culturally competent27Suicide Prevention Resource Center, “Culturally Competent Approaches,” accessed August 20, 2020, https://bit.ly/3hgdswj. approaches specifically tailored for each population. Views about suicide vary widely, so it is critical that all of these views and experiences are considered and addressed. An approach or solution that may work for one population, or even one subgroup within a population, may not be effective or appropriate for another. Research has shown that certain populations are at a much higher risk of suicide, a risk that can be exacerbated by easy access to firearms.

Learn more about suicide among:

  • American Indian and Alaskan Native Youth

    American Indians and Alaskan Natives have historically had some of the highest rates of suicide in the US, with younger AIAN people most heavily impacted. Substance abuse, exposure to violence, poverty, unemployment, intergenerational trauma, and mental health disorders have all compounded to elevate the risk of suicide among young AIAN people and lead to feelings of despair. Suicide prevention programs should be developed in partnership with tribal communities, and they should incorporate culture and traditions, which include known protective factors of belonging to one’s culture and a strong tribal/spiritual bond.

    Learn more about suicide prevention in AIAN communities at the Center for Native American Youth and the US Department of Health and Human Services’ Indian Health Service.

  • Rural Youth

    The firearm suicide rate among youth increases as counties become more rural. In fact, the firearm suicide rate among young people in the most rural areas is 2.6 times higher than the rate in the most urban areas.1Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Wide-ranging Online Data for Epidemiologic Research (WONDER) Underlying Cause of Death. A yearly average for young adults (ages 10-24) was developed using five years of most recent available data: 2014 to 2018. The most urban category includes Large Central Metro counties and the most rural category includes NonCore (Nonmetro) counties. This is particularly pronounced for white, Hispanic, and AIAN (see section above for more information) youth.2CDC, WONDER Underlying Cause of Death, Ages 10-24, Five-Year Average: 2014 to 2018. The most urban category includes Large Central Metro counties and the most rural category includes NonCore (Nonmetro) counties. Household gun ownership,3Knopov et al., “Household Gun Ownership and Youth Suicide Rates.” social isolation,4Jameson K. Hirsch and Kelly C. Cukrowicz, “Suicide in Rural Areas: An Updated Review of the Literature,” Journal of Rural Mental Health 38, no. 2 (2014): 65–78, https://doi.org/10.1037/rmh0000018. the opioid epidemic,5Nora Volkow, “Suicide Deaths Are a Major Component of the Opioid Crisis That Must Be Addressed,” National Institute on Drug Abuse (blog), September 19, 2019, https://bit.ly/3jm9NgW. and limited access to mental and behavioral health services6Centers for Disease Control and Prevention, “Preventing Suicide in Rural America,” Suicide Policy Brief, March 22, 2018, https://bit.ly/3bjo0Zg. are all associated with the high rural rates of suicide. Limiting access to firearms in a moment of personal crisis, expanding access to medical and mental health services, and conducting further research on firearm suicide among young people in rural America are all necessary to prevent suicide in these communities.

    Learn more about suicide prevention in rural areas.

  • Black Youth

    Research has shown an alarming increase in suicide deaths and attempts among young Black people over the past decade. Studies on Black teens have shown that depression; traumatic experiences such as exposure to racism, discrimination, and neighborhood violence; and poor familial support are risk factors for suicide among young Black people.7“Ring the Alarm: The Crisis of Black Youth Suicide in America” (Congressional Black Caucus, Emergency Taskforce on Black Youth Suicide and Mental Health, December 17, 2019), https://bit.ly/2COX5Yy. Important steps to prevent suicide include developing culturally competent guidelines for crisis center hotlines, such as ensuring values and beliefs are interwoven into any communication with a caller; and improving access to mental health care for Black youth, who are less likely than their white peers to receive care for issues such as depression.8“Ring the Alarm.”

    Learn more about how to address suicide among Black youth from the Congressional Black Caucus Emergency Taskforce’s report on Black Youth Suicide and Mental Health and The Mental Health Coalition.

  • Asian and Pacific Islander Youth

    There are many risk factors, in addition to those noted above, that elevate the risk of suicide among young Asians and Pacific Islanders, such as discrimination, ethnic marginalization, and acculturation.9Laura C. Wyatt et al., “Risk Factors of Suicide and Depression among Asian American, Native Hawaiian, and Pacific Islander Youth: A Systematic Literature Review,” Journal of Health Care for the Poor and Underserved 26, no. 2 (May 2015): 191–237, https://doi.org/10.1353/hpu.2015.0059. National data from the CDC’s 2019 Youth Risk Behavior Survey showed that one in five API high-schoolers reported having seriously considered suicide in the last year.10Centers for Disease Control and Prevention, “2019 High School Youth Risk Behavior Survey Data,” accessed on August 28, 2020, http://yrbs-explorer.services.cdc.gov/. Indeed, suicide is the leading cause of death among API youth.11CDC WISQARS Leading Causes of Death Reports, Ages 10-24, 2018. Given that API youth have had the fastest-growing firearm suicide rate among all racial and ethnic groups over the past decade, limiting immediate and easy access to firearms is crucial. The API community is incredibly diverse, with a wide range of cultural and linguistic subgroups, including third- and fourth-generation Americans, refugees who arrived in the 1970s and ’80s, and more-recent immigrants. Further research, especially research that disaggregates data by API subgroups, is needed to better understand this deeply concerning rise.

    Learn more about suicide prevention in the API community from the Suicide Prevention Resource Center and Asian American Psychological Association.

  • LGBTQ Youth

    Studies show that LGBTQ people, especially LGBTQ youth, are at a higher risk than their peers of contemplating and attempting suicide.12Laura Kann et al., “Youth Risk Behavior Surveillance—United States, 2017,” MMWR Surveillance Summaries 67, no. 8 (June 15, 2018): 1–114, https://doi.org/10.15585/mmwr.ss6708a1; Michelle M. Johns et al., “Transgender Identity and Experiences of Violence Victimization, Substance Use, Suicide Risk, and Sexual Risk Behaviors Among High School Students—19 States and Large Urban School Districts, 2017,” Morbidity and Mortality Weekly Report 68, no. 3 (January 25, 2019): 67–71, https://doi.org/10.15585/mmwr.mm6803a3. This elevated risk is due to the impact that social stigma, family rejection, bullying, and harassment have on their well-being.13Laura Kann et al., “Sexual Identity, Sex of Sexual Contacts, and Health-Related Behaviors Among Students in Grades 9-12—United States and Selected Sites, 2015,” Morbidity and Mortality Weekly Report. Surveillance Summaries 65, no. 9 (12 2016): 1–202, https://doi.org/10.15585/mmwr.ss6509a1; The Trevor Project, “Suicide Risk Factors,” accessed August 20, 2020, https://bit.ly/325IIaQ. Measures reducing the risk of suicide among LGBTQ youth include making culturally competent care more accessible, building strong connections to family members who accept their sexual orientation and/or gender identity, identifying positive role models they can relate to, and developing a school environment where they feel safe and connected.14Kann et al., “Sexual Identity, Sex of Sexual Contacts, and Health-Related Behaviors.”

    Learn more about preventing suicide among LGBTQ youth from The Trevor Project.

Recommendations for Action

Thousands of young lives are tragically cut short every year from suicide. There are actions we can take to mitigate the risk of suicide and potentially save lives. Effective suicide prevention among young people in the US requires a multi-faceted approach. Recommendations include:

Limit the easy and immediate access to firearms.

Mechanisms that create time and space between lethal means and someone in crisis can reduce the risk of suicide. The vast majority of all those who survive a suicide attempt do not go on to die by suicide.28David Owens, Judith Horrocks, and Allan House, “Fatal and Non-Fatal Repetition of Self-Harm: Systematic Review,” British Journal of Psychiatry 181, no. 3 (2002): 193-99, https://doi.org/10.1192/bjp.181.3.193. The following practices and policies limit the easy and immediate access to firearms and are proven to reduce firearm suicide rates.

  • Gun owners can make their homes and communities safer by storing their guns securely. This means storing them locked, unloaded, and separate from ammunition.
  • Extreme risk laws, sometimes referred to as “red flag” laws, allow loved ones or law enforcement to intervene by petitioning a court for an order to temporarily prevent someone in crisis from accessing guns.
  • Waiting period laws require a certain number of days to pass between the purchase of a gun and when the buyer can actually take possession of that gun. This creates a buffer between someone being in crisis and having access to a gun.
  • Permit-to-purchase laws, in addition to background checks, ensure that a person attempting to buy a gun is not legally prohibited from having a gun.

Know the risk factors and warning signs.

Knowing the risk factors and warning signs that may indicate someone is at risk of taking their life is critical to saving lives. While these factors and behaviors, whether in yourself or in a loved one, do not automatically mean someone is at a risk for suicide, they may be significant and are important to recognize, especially if they are new or have increased. To learn more, read the American Association of Suicidology’s flyer on the warning signs of acute suicide risk, which include:

  • Threatening or talking about wanting to hurt or kill themselves.
  • Looking for ways to kill themselves, such as attempting to acquire a firearm or pills.
  • Increased use of drugs and/or alcohol.
  • Feeling like they have no reason to live or no sense of purpose in life.
  • History or signs of depression, anxiety, agitation, and/or difficulty with sleep.
  • Withdrawal from friends, family, and society.
  • Reaching out to say goodbye to loved ones and/or giving away their possessions.
  • A sudden and unexplainable improvement in their mood.29American Foundation for Suicide Prevention, “Risk Factors and Warning Signs.”

Learn how to talk about mental health.

If a friend, family member, or loved one is exhibiting any of the above warning signs and you are worried they are contemplating suicide, it is important to have an open and honest conversation with them and not wait in the hope that they will start to feel better. Talking to loved ones about suicide does not make them suicidal or plant the idea in their head.30Christine Polihronis et al., “What’s the Harm in Asking? A Systematic Review and Meta-Analysis on the Risks of Asking about Suicide-Related Behaviors and Self-Harm with Quality Appraisal,” Archives of Suicide Research, July 25, 2020, https://doi.org/10.1080/13811118.2020.1793857. In fact, you can make a difference by offering support and help. Let them know you are listening and taking them seriously:

  • Show your support and that you care.
  • Encourage them to keep talking, and actively listen by expressing curiosity and interest in the details.
  • Ask them about changes in their life and how they are coping.
  • Be direct if you suspect they are thinking about suicide. Use the words “suicide” or “kill yourself” if asking about suicidal thinking.
  • Follow their lead and know when to take a break.
  • Find a way to bring up the benefits of professional help, and provide them with resources on how to do so.

Learn more about how to have a #RealConvo from the American Foundation for Suicide Prevention.

Reach out for help.

Suicide prevention hotlines, such as the National Suicide Prevention Lifeline (NSPL), are staffed by trained counselors who assess callers for suicide risk, provide crisis counseling, and offer referrals, including lethal-means counseling when someone mentions that they have firearms or other lethal means in the home. These hotlines are saving lives each day. The NSPL received 2.2 million calls in 2018,31Federal Communications Commission, “Report on the National Suicide Hotline Improvement Act of 2018,” August 14, 2019, https://bit.ly/3355iQS. and the Crisis Text Line exchanged over 159 million texts between August 2013 and August 2020.32Crisis Text Line, “Crisis Trends,” accessed September 1, 2020, https://crisistrends.org/. An evaluation of the NSPL found that 95 percent of callers reported that speaking with a NSPL counselor helped avert their suicide plans.33Federal Communications Commission, “Report on the National Suicide Hotline Improvement Act of 2018.” Free and confidential support when you, a loved one, or a peer needs to talk to someone is available.

Further resources:

  • Free and confidential crisis lines

    • Crisis Text Line provides free live texting with a trained crisis counselor. Text HOME to 741741 from anywhere in the US, anytime.
    • National Suicide Prevention Lifeline provides free and confidential support for people in distress or suicidal crisis. Call 1-800-273-8255 to talk with a counselor 24/7.
    • Teen Line connects teens who need someone to talk to with other trained teens who can listen and present available options. Call 800-852-8336 or text TEEN to 839863 from 6pm-9pm PST.
    • Trevor Project provides crisis intervention and suicide prevention services to LGBTQ young people under age 25. Call 1-866-488-7386, text START to 678-678, or chat with a counselor 24/7.
    • Trans Lifeline Hotline provides support services by trans people, for trans and questioning callers in crisis. Call 877-565-8860 24/7.
    • Veterans Crisis Line provides confidential support to anyone, regardless of Veteran Affairs status. Call 1-800-273-8255 and press 1, or 1-800-799-4889 for deaf and hard of hearing; text 838255; or chat 24/7.
    • Your Life Your Voice connects teens in need of help with crisis counselors. Call 1-800-448-3000 or text VOICE to 20121 24/7.
  • Suicide prevention and mental health organizations

    • Active Minds has chapters on more than 800 campuses that work to empower college students to openly talk about their mental health so that no one struggles alone.
    • Asian Mental Health Collective provides a list of culturally competent therapists for the AAPI community and works to raise awareness about the importance of mental health care and challenging the stigma surrounding it.
    • Black Mental Health Alliance aims to develop and promote culturally relevant trainings and services to support the health of Black people and other communities in the US.
    • Center for Native American Youth of the Aspen Institute works to improve the health and safety of Native American youth through research, advocacy, and policy change.
    • Loveland Foundation provides financial assistance to Black women and girls nationwide seeking therapy, with the goal of prioritizing opportunity, access, validation, and healing.
    • National Alliance for Hispanic Health is a science-based and community-driven organization that focuses on improving the health and well-being of Hispanic people and providing quality care to all.
    • American Association of Suicidology’s National Center for the Prevention of Youth Suicide works to identify youth at risk, develop strategies to move prevention upstream, and engage and empower youth to be partners in their suicide prevention efforts.
    • Society for the Prevention of Teen Suicide, founded by two dads who lost teenage children to suicide, encourages public awareness of teen suicide through the development and promotion of educational training programs.
    • You Matter, administered by the National Suicide Prevention Lifeline, creates a safe space for youth to share their stories about mental health.

Everytown Research & Policy is a program of Everytown for Gun Safety Support Fund, an independent, non-partisan organization dedicated to understanding and reducing gun violence. Everytown Research & Policy works to do so by conducting methodologically rigorous research, supporting evidence-based policies, and communicating this knowledge to the American public.

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