Teen Suicide Prevention


If you are in crisis, text "SOS" to 741741 or call 800.273-TALK (8255). If you are in extreme crisis, call 911 while you're looking in the front of your local yellow pages for the number of the local suicide prevention hotline. If you can't get through to either of those, click on Emergency Numbers. Also visit www.metanoia.org/suicide which contains conversations and writings for suicidal persons to read, gay youth suicide at www.sws.soton.ac.uk/gay-youth-suicide and youth: suicide at www.virtualcity.com/youthsuicide .

Disclaimer - Information is designed for educational purposes only and is not engaged in rendering medical advice or professional services. Any medical decisions should be made in conjunction with your physician. We will not be liable for any complications, injuries or other medical accidents arising from or in connection with, the use of or reliance upon any information on the web.

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Text SOS to 741741

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Movement for Wellness. Never end the sentence.

Promise a good friend that you will not end your life without first talking to them about doing it.
Source: www.mtv.com/news/2204380/project-semicolon-tattoo/

Awkward Silence

Suicide prevention must be transformed by integrating injury prevention and mental health perspectives to develop a mosaic of common risk public health interventions that address the diversity of populations and individuals whose mortality and morbidity contribute to the burdens of suicide and attempted suicide. Emphasizing distal preventive interventions, strategies must focus on people and places—and on related interpersonal factors and social contexts—to alter the life trajectories of people before they become suicidal. Attention also must be paid to those in the middle years—the age with the greatest overall burden. We need scientific and social processes that define priorities and assess their potential for reducing what has been a steadily increasing rate of suicide during the past decade. - American Public Health Association

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Bullying and Suicide
About Suicide
Thanks to Logic's Song, the Phones at “1-800-273-8255” Are Ringing off the Hook
Risk and Protective Factors
Warning Signs for Suicide
Effective Suicide Prevention
A Comprehensive Approach to Suicide Prevention
Strategic Planning
Keys to Success
Evidence-Based Prevention
Cost of suicide
Resources & Programs
Training and Events
How Emergency Departments Can Help Prevent Suicide among At-Risk Patients: Five Brief Interventions
Topics and Terms
How Emergency Departments Can Help Prevent Suicide among At-Risk Patients: Five Brief Interventions
CALIFORNIA: Study Shows Transgender Students Are at Significant Risk for Suicidal Thoughts
Oregon Health Authority Training Communities to Recognize and Respond to Signs of Suicide Risk
Online SPRC Courses
Warning signs of suicide include: (National Institutes of Mental Health)
What We Can All do to Help
National Resources
Suicide: risk factors and warning signs
Are you a gatekeeper brochure Alaska
Culturally Competent Approaches
Reporting on Suicide

Bullying and Suicide

There is a strong link between bullying and suicide, as suggested by recent bullying-related suicides in the US and other countries. Parents, teachers, and students learn the dangers of bullying and help students who may be at risk of committing suicide.

In recent years, a series of bullying-related suicides in the US and across the globe have drawn attention to the connection between bullying and suicide. Though too many adults still see bullying as “just part of being a kid,” it is a serious problem that leads to many negative effects for victims, including suicide. Many people may not realize that there is also a link between being a bully and committing suicide.

The statistics on bullying and suicide are alarming:

  • Suicide is the third leading cause of death among young people, resulting in about 4,400 deaths per year, according to the CDC. For every suicide among young people, there are at least 100 suicide attempts. Over 14 percent of high school students have considered suicide, and almost 7 percent have attempted it.
  • Bully victims are between 2 to 9 times more likely to consider suicide than non-victims, according to studies by Yale University
  • A study in Britain found that at least half of suicides among young people are related to bullying
  • 10 to 14 year old girls may be at even higher risk for suicide, according to the study above
  • According to statistics reported by ABC News, nearly 30 percent of students are either bullies or victims of bullying, and 160,000 kids stay home from school every day because of fear of bullying

Bully-related suicide can be connected to any type of bullying, including physical bullying, emotional bullying, cyberbullying, and sexting, or circulating suggestive or nude photos or messages about a person.

Some schools or regions have more serious problems with bullying and suicide related to bullying. This may be due to an excessive problem with bullying at the school. It could also be related to the tendency of students who are exposed to suicide to consider suicide themselves.

Some of the warning signs of suicide can include:

  • Showing signs of depression, like ongoing sadness, withdrawal from others, losing interest in favorite activities, or trouble sleeping or eating
  • Talking about or showing an interest in death or dying
  • Engaging in dangerous or harmful activities, including reckless behavior, substance abuse, or self injury
  • Giving away favorite possessions and saying goodbye to people
  • Saying or expressing that they can’t handle things anymore
  • Making comments that things would be better without them

If a person is displaying these symptoms, talk to them about your concerns and get them help right away, such as from a counselor, doctor, or at the emergency room.

In some cases, it may not be obvious that a teen is thinking about suicide, such as when the suicide seems to be triggered by a particularly bad episode of bullying. In several cases where bullying victims killed themselves, bullies had told the teen that he or she should kill him or herself or that the world would be better without them. Others who hear these types of statements should be quick to stop them and explain to the victim that the bully is wrong.

Other ways to help people who may be considering suicide include:

  • Take all talk or threats of suicide seriously. Don’t tell the person they are wrong or that they have a lot to live for. Instead, get them immediate medical help.
  • Keep weapons and medications away from anyone who is at risk for suicide. Get these items out of the house or at least securely locked up.
  • Parents should encourage their teens to talk about bullying that takes place. It may be embarrassing for kids to admit they are the victims of bullying, and most kids don’t want to admit they have been involved in bullying. Tell victims that it’s not their fault that they are being bullied and show them love and support. Get them professional help if the bullying is serious.
  • It is a good idea for parents to insist on being included in their children’s friends on social networking sites so they can see if someone has posted mean messages about them online. Text messages may be more difficult to know about, so parents should try to keep open communications with their children about bullying.
  • Parents who see a serious bullying problem should talk to school authorities about it, and perhaps arrange a meeting with the bully’s parents. More states are implementing laws against bullying, and recent lawsuits against schools and criminal charges against bullies show that there are legal avenues to take to deal with bullies. If school authorities don’t help with an ongoing bullying problem, local police or attorneys may be able to.

People who are thinking about suicide should talk to someone right away or go to an emergency room. They can also call a free suicide hotline, such as 1-800-273-TALK (8255) or text "SOS to 741741

Friends and relatives of suicide victims also need to find someone to talk to as they grieve, especially if they are suffering from depression or suicidal thoughts themselves.


Bullying Statistics

1.Every 7 MINUTES a child is bullied. Adult intervention – 4%. Peer intervention – 11%. No intervention – 85%.

2.Biracial and multiracial youth are more likely to be victimized than youth who identify with a single race.

3.Bullied students tend to grow up more socially anxious, with less self-esteem and require more mental health services throughout life.

4.Only 7% of U.S. parents are worried about cyberbullying; yet 33% of teenagers have been victims of cyberbullying

5.Kids who are obese, gay, or have disabilities are up to 63% more likely to be bullied than other children.

6.1 MILLION children were harassed, threatened or subjected to other forms of cyberbullying on FACEBOOK during the past year.

7.86% of students said, “other kids picking on them, making fun of them or bullying them” causes teenagers to turn to lethal violence in schools.

8.It is estimated that 160,000 children miss school every day due to fear of attack or intimidation by other students. Source: National Education Association.

9.American schools harbor approximately 2.1 million bullies and 2.7 million of their victims. Dan Olweus, National School Safety Center.

Suicide Statistics:

1.Suicide remains among the leading causes of death of children under 14. In most cases, the young people die from hanging.

2.Suicide rates among 10 to 14-year-olds have grown more than 50 percent over the last three decades. (The American Association of Suicidology, AAS)

3.A new review of studies from 13 countries found signs of an apparent connection between bullying, being bullied, and suicide. (Yale School of Medicine)

4.Suicide rates among children between the ages of 10 & 14 are very low, but are “creeping up.” (Ann Haas, Director of the Suicide Prevention Project at the American Foundation for Suicide Prevention)

5.The suicide rate among young male adults in Massachusetts rose 28 percent in 2007. However, that does not reflect deaths among teenagers and students Carl’s age. (Massachusetts Dept. of Public Health, in a report released April 8, 2009)

6.Since 2002, at least 15 schoolchildren ages 11 to 14 have committed suicide in Massachusetts. Three of them were Carl’s age. (“Constantly Bulled, He Ends His Life at Age 11,” by Milton J. Valencia. The Boston Globe, April 20, 2009)

7.In 2005 (the last year nationwide stats were available), 270 children in the 10-14 age group killed themselves. (AAS)

8.1 in 7 Students in Grades K-12 is either a bully or a victim of bullying.

9.56% of students have personally witnessed some type of bullying at school.

10.15% of all school absenteeism is directly related to fears of being bullied at school.

11.71% of students report incidents of bullying as a problem at their school.

12.1 out of 20 students has seen a student with a gun at school.

13.282,000 students are physically attacked in secondary schools each month.

14.Those in the lower grades reported being in twice as many fights as those in the higher grades. However, there is a lower rate of serious violent crimes in the elementary level than in the middle or high schools.

15.90% of 4th through 8th graders report being victims of bullying.

16.Among students, homicide perpetrators were more than twice as likely as homicide victims to have been bullied by peers.

17.Bullying statistics say revenge is the strongest motivation for school shootings.

18.87% of students said shootings are motivated by a desire to “get back at those who have hurt them.”

19.86% of students said, “other kids picking on them, making fun of them or bullying them” causes teenagers to turn to lethal violence in the schools.

20.61% of students said students shoot others because they have been victims of physical abuse at home.

21.54% of students said witnessing physical abuse at home can lead to violence in school.

22.According to bullying statistics, 1 out of every 10 students who drops out of school does so because of repeated bullying.

23.Harassment and bullying have been linked to 75% of school-shooting incidents.

LGBT Bullying Statistics

1.In a 2007 study, 86% of LGBT students said that they had experienced harassment at school during the previous year. (Gay, Lesbian and Straight Education Network — GLSEN)

2.Research indicates that LGBT youth may be more likely to think about and attempt suicide than heterosexual teens. (GLSEN)

3.In a 2005 survey, students said their peers were most often bullied because of their appearance, but the next top reason was because of actual or perceived sexual orientation and gender expression. (“From Teasing to Torment: School Climate of America” — GLSEN and Harris Interactive)

4.According to the Gay, Lesbian and Straight Education Network 2007 National School Climate Survey of more than 6,000 students…

5.Nearly 9 out of 10 LGBT youth reported being verbally harassed at school in the past year because of their sexual orientation

6.Nearly half (44.1 percent) reported being physically harassed

7.About a quarter (22.1 percent) reported being physically assaulted.

8.Nearly two-thirds (60.8 percent) who experienced harassment or assault never reported the incident to the school

9.Of those who did report the incident, nearly one-third (31.1 percent) said the school staff did nothing in response


Cyberbulying Statistics:

1.32% of online teens say they have been targets of a range of annoying or potentially menacing online activities. 15% of teens overall say someone has forwarded or posted a private message they’ve written, 13% say someone has spread a rumor about them online, 13% say someone has sent them a threatening or aggressive message, and 6% say someone has posted embarrassing pictures of them online.

2.38% of online girls report being bullied, compared with 26% of online boys. In particular, 41% of older girls (15-17) report being bullied—more than any other age or gender group.

3.39% of social network users have been cyber bullied in some way, compared with 22% of online teens who do not use social networks.

4.20% of teens (12-17) say “people are mostly unkind” on online social networks. Younger teenage girls (12-13) are considerably more likely to say this. One in three (33%) younger teen girls who use social media say that people their age are “mostly unkind” to one another on social network sites.

5.15% of teens on social networks have experienced someone being mean or cruel to them on a social network site. There are no statistically significant differences by age, gender, race, socioeconomic status, or any other demographic characteristic.

6.13% of teens who use social media (12-17) say they have had an experience on a social network that made them feel nervous about going to school the next day. This is more common among younger teens (20%) than older teens (11%).

7.88% of social media-using teens say they have seen someone be mean or cruel to another person on a social network site. 12% of these say they witness this kind of behavior “frequently.”

8.When teens see others being mean or cruel on social networks,frequently 55% see other people just ignoring what is going on, 27% see others defending the victim, 20% see others telling the offender to stop, and 19% see others join in on the harassment.

9.36% of teens who have witnessed others being cruel on social networks have looked to someone for advice about what to do.

10.67% of all teens say bullying and harassment happens more offline than online.

11.1 in 6 parents know their child has been bullied over social media. In over half of these cases, their child was a repeat victim. Over half of parents whose children have social media accounts are concerned about cyberbullying and more than three-quarters of parents have discussed the issue of online bullying with their children.

12.11% of middle school students were victims of cyberbullying in the past two months. Girls are more likely than boys to be victims or bully/victims.

13.“Hyper-networking” teens (those who spend more than three hours per school day on online social networks) are110% morelikely to be a victim of cyberbullying, compared to those who don’t spend as much time on social networks.

14.95% of social media-using teens who have witnessed cruel behavior on social networking sites say they have seen others ignoring the mean behavior; 55% witness this frequently. (Pew Internet Research Center, FOSI, Cable in the Classroom, 2011) 1.84% have seen the people defend the person being harassed; 27% report seeing this frequently.

2.84% have seen the people tell cyberbullies to stop bullying; 20% report seeing this frequently.

15.66% of teens who have witnessed online cruelty have also witnessed others joining; 21% say they have also joined in the harassment. (Pew Internet Research Center, FOSI, Cable in the Classroom, 2011)

16.Only 7% of U.S. parents are worried about cyberbullying, even though 33% of teenagers have been victims of cyberbullying (Pew Internet and American Life Survey, 2011)

17.85% of parent of youth ages 13-17 report their child has a social networking account. (American Osteopathic Association, 2011)

18.52% of parents are worried their child will be bullied via social networking sites. (American Osteopathic Association, 2011)

19.1 in 6 parents know their child has been bullied via a social networking site. (American Osteopathic Association, 2011)

20.One million children were harassed, threatend or subjected to other forms of cyberbullying on Facebook during the past year. (Consumer Reports, 2011)

21.43% of teens aged 13 to 17 report that they have experienced some sort of cyberbulying in the past year.

22.More girls are cyberbullys than boys (59% girls and 41% boys).

23.Cyberbullies spend more time online than other teens overall (38.4 hours compared to 26.8 hours).




School Violence STATISTICS:

  • 100,000 students carry a gun to school each day
  • 28% of youths who carry weapons have witnessed violence at home
  • Among students, homicide perpetrators were more than twice as likely as homicide victims to have been bullies by peers.
  • More youth violence occurs on school grounds as opposed to on the way to school.
  • 1/3 of students surveyed said they heard another student threaten to kill someone.

Teachers & Bullying:

  • Teachers are also assaulted, robbed & bullied. 84 crimes per 1,000 teachers per year.


  • Bureau of Justice Statistics – School Crime & Safety









“(The group) made me not afraid to ask for help. Without this, I don’t know what I would do.” - Support Group Participant

Suicide attempts are far more common than most people realize. In a recent U.S. survey, one in 200 adults — or approximately 1.1 million adults — reported 8Manual for Support Groups for Suicide Attempt Survivors having attempted suicide in the past year. One in 500 adults reported that they stayed overnight or longer in a hospital as a result of a suicide attempt (Substance Abuse and Mental Health Services Administration, 2009).




House Education Committee meeting


World Suicide Prevention Day


Brochure https://www.iasp.info/wspd/pdf/2016/2016_wspd_brochure.pdf

International Association for Suicide Prevention (IASP) - Resources: World Suicide Prevention Day 2016


School Accreditation Application Form


Myths about suicide


BHSD Crisis Prevention Plan file:///C:/Users/Gordon/Downloads/crisis%20intervention%20plan%20(1).pdf


Logic 800-273-8255

https://www.youtube.com/watch?v=cycUHgg0zzU audio only

Opioid Overdose Prevention Toolkit


Suicide among Current and Former Service Members

Thanks to Logic's Song, the Phones at “1-800-273-8255” Are Ringing off the Hook

CALIFORNIA: Study Shows Transgender Students Are at Significant Risk for Suicidal Thoughts

WASHINGTON: Gun Dealers, Suicide Prevention Advocates Partner to Save Lives

About Suicide

Scope of the Problem http://www.sprc.org/about-suicide/scope

Accurate and timely data will help you better understand the scope of the suicide problem in the United States and in your local community. These data include information on suicide deaths, attempts, ideation, means of suicide, and differences among demographic groups.

SPRC encourages suicide prevention practitioners, health care professionals, policymakers, journalists, and others to use current data related to the suicide problem. In this section of our website you will find regularly updated data on the magnitude and patterns of suicidal behavior in the United States.

Suicide Deaths in the United States http://www.sprc.org/scope/united-states

Suicide rates by sex, homicide and suicide, and the geographic distribution of suicide.

Suicide by Age www.sprc.org/scope/age

Suicide rates by age, trends over time, and the leading causes of death by age group.

Suicidal Thoughts and Suicide Attempts

Rates of suicidal ideation and attempts by age and sex.

Means of Suicide

Data on the methods people use to end their lives.

Racial and Ethnic Disparities

Suicide rates and patterns among racial and ethnic groups.

PowerPoint Icon ImageThe charts and graphs in this section are also available as a PowerPoint slide set. Feel free to use this slide set to deliver a presentation about the scope of the suicide problem.

Recommended Resources

Facts at a glance 2015 2 page PDF www.cdc.gov/violenceprevention/pdf/suicide-datasheet-a.pdf

Thanks to Logic's Song, the Phones at “1-800-273-8255” Are Ringing off the Hook

Following the April release of Logic’s hit song about the National Suicide Prevention Lifeline, calls to the crisis hotline have increased in record numbers. Titled “1-800-273-8255” after the Lifeline phone number, the song encourages those who are struggling to reach out for help. "We had the second-highest call volume in the history of our service the day of the song's release," said Lifeline Director John Draper. “It’s remained high ever since.” Compared to 2016, call volume has risen more than 30 percent and Facebook engagement is three times higher. The number of visitors to the Lifeline website has also increased from 300,000 to 400,000 per month. In August, Logic performed the song at the MTV Video Music Awards and was joined on stage by performers and volunteers who have lived experience of suicide. Volunteers wore T-shirts that displayed the Lifeline’s phone number. "To stand up there, not only with the number on their backs, but the message that you're not alone—that, we thought, was most important to get out there,” said Draper.

Source: www.sprc.org/news/thanks-logics-song-phones-%E2%80%9C1-800-273-8255%E2%80%9D-are-ringing-hook

Risk and Protective Factors

Suicide prevention seeks to reduce the factors that increase suicide risk while increasing the factors that protect people from suicide.

Risk Factors

Risk factors are characteristics of a person or his or her environment that increase the likelihood that he or she will die by suicide (i.e., suicide risk).

Major risk factors for suicide include:

  • Prior suicide attempt(s)
  • Misuse and abuse of alcohol or other drugs
  • Mental disorders, particularly depression and other mood disorders
  • Access to lethal means
  • Knowing someone who died by suicide, particularly a family member
  • Social isolation
  • Chronic disease and disability
  • Lack of access to behavioral health care

Risk factors can vary by age group, culture, sex, and other characteristics. For example:

  • Stress resulting from prejudice and discrimination (family rejection, bullying, violence) is a known risk factor for suicide attempts among lesbian, gay, bisexual, and transgender (LGBT) youth.
  • The historical trauma suffered by American Indians and Alaska Natives (resettlement, destruction of cultures and economies) contributes to the high suicide rate in this population.
  • For men in the middle years, stressors that challenge traditional male roles, such as unemployment and divorce, have been identified as important risk factors.

Protective Factors

Protective factors are personal or environmental characteristics that help protect people from suicide.

Major protective factors for suicide include:

Effective behavioral health care

  • Connectedness to individuals, family, community, and social institutions
  • Life skills (including problem solving skills and coping skills, ability to adapt to change)
  • Self-esteem and a sense of purpose or meaning in life
  • Cultural, religious, or personal beliefs that discourage suicide

Precipitating Factors

Precipitating factors are stressful events that can trigger a suicidal crisis in a vulnerable person. Examples include:

  • End of a relationship or marriage
  • Death of a loved one
  • An arrest
  • Serious financial problems

Warning signs are behaviors that indicate that someone may be at immediate risk for suicide. For more, see Warning Signs

Source: /www.sprc.org/about-suicide/risk-protective-factors


Warning Signs for Suicide

Immediate Risk

Some behaviors may indicate that a person is at immediate risk for suicide.

The following three should prompt you to immediately call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255) or a mental health professional. Text SOS to 741741

  • Talking about wanting to die or to kill oneself
  • Looking for a way to kill oneself, such as searching online or obtaining a gun
  • Talking about feeling hopeless or having no reason to live

Serious Risk

Other behaviors may also indicate a serious risk—especially if the behavior is new; has increased; and/or seems related to a painful event, loss, or change.

  • Talking about feeling trapped or in unbearable pain
  • Talking about being a burden to others
  • Increasing the use of alcohol or drugs
  • Acting anxious or agitated; behaving recklessly
  • Sleeping too little or too much
  • Withdrawing or feeling isolated
  • Showing rage or talking about seeking revenge
  • Displaying extreme mood swings

National Suicide Prevention Lifeline

1-800-273-TALK (8255)

Crisis Text Line: Text SOS to 741741


The Suicide Prevention Resource Center (SPRC) is supported by a grant (1 U79 SM062297) from the Substance Abuse and Mental Health Services Administration (SAMHSA), U.S. Department of Health and Human Services (DHHS). No official endorsement by SAMHSA or DHHS for the information on this website is intended or should be inferred.

SPRC is a project in EDC’s Health and Human Development Division.

Effective Suicide Prevention

Suicide is a complex problem. Many factors can increase suicide risk, while other factors can help protect people from suicide (see Risk and Protective Factors page). These factors can change over time and vary across groups.

Many studies have explored ways to prevent suicide among different groups, such as college students, veterans, or patients. Findings suggest that many strategies can help prevent suicide—particularly when they are used together as part of a carefully planned program.

This section of our website is meant to help you carry out suicide prevention efforts that are most likely to be effective. Its four sections feature models and guidance developed by SPRC based on current knowledge of suicide prevention.

A Comprehensive Approach to Suicide Prevention

Strategies, Programs, and Practices to Consider

Suicide prevention efforts should combine multiple efforts that work in sync to create change rather than relying on standalone programs to do so. This section describes the nine strategies that make up SPRC’s comprehensive approach to suicide prevention

Effective suicide prevention is comprehensive: it requires a combination of efforts that work together to address different aspects of the problem.

The model above shows nine strategies that form a comprehensive approach to suicide prevention and mental health promotion. Each strategy is a broad goal that can be advanced through an array of possible activities (i.e., programs, policies, practices, and services). This model of a comprehensive approach was adapted from a model developed for campuses by SPRC and the Jed Foundation, drawing on the U.S. Air Force Suicide Prevention Program.

Identify and Assist Persons at Risk

Many people in distress don’t seek help or support on their own. Identifying people at risk for suicide can help you reach those in the greatest need and connect them to care and support. Examples of activities in this strategy include gatekeeper training, suicide screening, and teaching warning signs.

Increase Help-Seeking

By teaching people to recognize when they need support—and helping them to find it—you can enable them to reduce their suicide risk. Self-help tools and outreach campaigns are examples of ways to lower an individual’s barriers to obtaining help, such as not knowing what services exist or believing that help won’t be effective. Other interventions might address the social and structural environment by, for example, fostering peer norms that support help-seeking or making services more convenient and culturally appropriate.

Ensure Access to Effective Mental Health and Suicide Care and Treatment

A key element of suicide prevention is ensuring that individuals with suicide risk have timely access to evidence-based treatments, suicide prevention interventions, and coordinated systems of care. Suicide prevention interventions such as safety planning and evidence-based treatments and therapies delivered by trained providers can lead to significant improvement and recovery. SPRC encourages health and behavioral health care systems to adopt the Zero Suicide framework for integrating these approaches into their systems. Reducing financial, cultural, and logistical barriers to care is another important strategy for ensuring access to effective mental health and suicide care treatment.

Support Safe Care Transitions and Create Organizational Linkages

You can reduce patients’ suicide risk by assuring them an uninterrupted transition of care and by facilitating the exchange of information among the various individuals and organizations that contribute to their care. Individuals at risk for suicide and their support networks (e.g., families) must also be part of the communication process. Tools and practices that support continuity of care include formal referral protocols, interagency agreements, cross-training, follow-up contacts, rapid referrals, and patient and family education.

Respond Effectively to Individuals in Crisis

Individuals in your school, organization, or community who are experiencing severe emotional distress may need a range of services. A full continuum of care includes not only hotlines and helplines but also mobile crisis teams, walk-in crisis clinics, hospital-based psychiatric emergency services, and peer-support programs. Crisis services directly address suicide risk by providing evaluation, stabilization, and referrals to ongoing care.

Provide for Immediate and Long-Term Postvention

A postvention plan is a set of protocols to help your organization or community respond effectively and compassionately to a suicide death. Immediate responses focus on supporting those affected by the suicide death and reducing risk to other vulnerable individuals. Postvention efforts should also include intermediate and long-term supports for people bereaved by suicide.

Reduce Access to Means of Suicide

One important way to reduce the risk of death by suicide is to prevent individuals in suicidal crisis from obtaining and using lethal methods of self-harm. Examples of actions to reduce access to lethal means include educating the families of those in crisis about safely storing medications and firearms, distributing gun safety locks, changing medication packaging, and installing barriers on bridges.

Enhance Life Skills and Resilience

By helping people build life skills, such as critical thinking, stress management, and coping, you can prepare them to safely address challenges such as economic stress, divorce, physical illness, and aging. Resilience—the ability to cope with adversity and adapt to change — is a protective factor against suicide risk. While it has some overlap with life skills, resilience also encompasses other attributes such as optimism, positive self-concept, and the ability to remain hopeful. Skills training, mobile apps, and self-help materials are examples of ways to increase life skills and build resilience.

Promote Social Connectedness and Support

Supportive relationships and community connectedness can help protect individuals against suicide despite the presence of risk factors in their lives. You can enhance connectedness through social programs for specific population groups (such as older adults or LGBT youth) and through other activities that reduce isolation, promote a sense of belonging, and foster emotionally supportive relationships.
Source: www.sprc.org/effective-prevention/comprehensive-approach

Strategic Planning

Suicide prevention efforts should use a systematic, data-driven process to understand the suicide problem, set clear goals, and prioritize activities that are most likely to make a difference. Follow SPRC’s step-by-step strategic planning process to help you decide what to implement.

How to Decide What to Implement

Any suicide prevention activity, program, or other effort should be guided by a strategic planning process. The strategic approach described below can be applied to any aspect of your work—whether you are starting a new program or assessing your progress midway through a project.

The Strategic Planning Approach

SPRC’s strategic planning approach to suicide prevention includes the following six steps.

Step 1. Describe the problem and its context. Use data and other sources to understand how suicide affects your community and describe the problem and its context.

Step 2. Choose long-term goals. Identify a small set of long-term goals (e.g., reduce the suicide rate among a particular group).

Step 3. Identify key risk and protective factors. Prioritize the key risk and protective factors on which to focus your prevention efforts.

Step 4. Select or develop interventions. Decide which combination of strategies (e.g. increase connectedness, increase access to evidence-based treatments) best address your key risk and protective factors and will be a part of your comprehensive approach to suicide prevention. Then find and review existing programs and practices to select approaches that have evidence of effectiveness and are a good fit for your settings, populations, needs, and resources. If you can't find a program that meets your needs, you may need to adapt a program or create a new one (see Evidence-Based Prevention).

Step 5. Plan the evaluation. Use your evaluation plan to track progress toward your long-term goals, show the value of your suicide prevention efforts, and decide how to expand them.

Step 6. Implement, evaluate, and improve. Implement and evaluate your activities, using your evaluation data to monitor implementation, solve problems, and enhance your prevention efforts.
Source: www.sprc.org/effective-prevention/strategic-planning

Keys to Success

Effective suicide prevention efforts use a number of guiding principles, or keys to success. This section describes five such principles identified by SPRC.

Guiding Principles for Doing the Work

Suicide prevention efforts should use a comprehensive approach that combines multiple strategies, and be guided by a systematic, data-driven strategic planning process. Your suicide prevention efforts will also be more likely to succeed if they follow five guiding principles, or keys to success.

Learn more about these keys to success:

Engaging People with Lived Experience

People with lived experience are individuals who have first-hand knowledge of suicidal thoughts and behaviors because they have lived through one or more suicidal experiences. When planning your suicide prevention efforts, be sure to solicit the unique perspectives of people with lived experience and engage them in prevention planning, treatment, and community education.

Why It's Important

  • People who have attempted suicide are more likely to die by suicide. Engaging them in their own care can help reduce suicide risk among this group.
  • People with lived experience can serve as models of hope for others at risk for suicide.
  • The insights of people with lived experience can be extremely valuable in prevention planning, treatment, and education, contributing to improved care, enhanced safety, and reduced suicide attempts and deaths.
  • Involving people with lived experience in your suicide prevention efforts can help increase awareness and understanding of suicide and mental illness among members of your team and others who participate in your activities.

What You Can Do

  • Embrace the core values (see below) identified in The Way Forward,1 a resource developed by the Suicide Attempt Survivors Task Force of the National Action Alliance for Suicide Prevention.
  • Hire people with lived experience to contribute to your suicide prevention efforts (e.g., by serving as a speaker in an educational program). Do not invite them to participate only as guests.
  • Involve people with lived experience in decisions about their own treatment and care.
  • Engage them to provide peer support for people at risk for suicide.
  • Partner with peer support services and organizations operated by people with lived experience, especially if you provide crisis and emergency services.

Core Values for Supporting People with Lived Experience

All activities designed to help attempt survivors, or anyone who has been suicidal, should be consistent with one or more of the following core values:1

  • Foster hope and help people find meaning and purpose in life
  • Preserve dignity and counter stigma, shame, and discrimination
  • Connect people to peer supports
  • Promote community connectedness
  • Engage and support family and friends
  • Respect and support cultural, ethnic, and/or spiritual beliefs and traditions
  • Promote choice and collaboration in care
  • Provide timely access to care and support


Suicide Attempt Survivors Task Force. (2014). The way forward: Pathways to hope, recovery, and wellness with insights from lived experience. Washington, DC: Author.

Partnerships and Collaboration

A successful suicide prevention strategy needs help and input from different people in your system or community. Involving others in planning and carrying out your collaborative efforts is key to ensuring the work you do together results in real change for your target group.

Potential partners can include:

  • Individuals and organizations representing your target population
  • Health care and behavioral health providers
  • Key leaders and influencers in your community or system
  • Relevant settings (e.g., schools, nursing homes, community-based organizations)
  • Others with an interest in suicide prevention (especially those with lived experience)
  • It takes teamwork, open dialogue, and compromise to build partnerships. Clearly establishing partner roles and responsibilities in the effort can create positive relationships and avoid duplication.

Safe and Effective Messaging and Reporting

How we communicate about suicide—both in the media and in prevention messages— makes a difference.

Messages and images about suicide can:

  • Encourage hope or discourage people from seeking help
  • Celebrate life or romanticize death
  • Help people understand that suicide is preventable and mental illnesses are treatable or reinforce inaccurate beliefs that nothing can be done about these problems

Reporting on Suicide

The news media should report on suicide in a way that is accurate and doesn't negatively impact people at risk. See the Recommendations for Reporting on Suicide website.

Developing Suicide Prevention Messages

The National Action Alliance Framework for Successful Messaging website can help people working in suicide prevention and mental health promotion ensure that all of their messages about suicide are strategic, safe, positive, and make use of relevant guidelines and best practices.
Source: www.sprc.org/keys-success/safe-messaging-reporting

Culturally Competent Approaches

Your suicide prevention efforts will more likely be effective if they are based on the values, needs, and strengths of the groups you are trying to reach. Suicide prevention efforts should be respectful and responsive to groups’ beliefs, practices, and cultural and linguistic needs and preferences. Factors to consider include not only race and ethnicity, but also age, education, gender identity, physical and mental health, occupation, religion, and other characteristics.

Actions to consider:

  • Research and understand the cultural context of the community targeted by your program.
  • Ensure that your team includes a diverse representation of members from your target population throughout the planning, implementation, and evaluation processes.
  • Tailor information and resources to respectfully address your target population’s values, beliefs, culture, and language. Use alternative formats (e.g., audiotape, large print, storytelling) whenever appropriate.
  • Create an open dialogue with group members to allow cultural considerations to be communicated, such as preferences regarding personal space, geography, familiarity, and terminology (i.e., words that should be used or avoided).

See the sections of our website on Populations and Settings to learn more about suicide prevention and particular groups.

Evidence-Based Prevention

Practicing evidence-based prevention means using the best available research and data throughout the process of planning and implementing your suicide prevention efforts.

Evidence-based prevention includes:

  • Engaging in evidence-based practice (sometimes called evidence-based public health)
  • Selecting or developing evidence-based programs

Engaging in Evidence-Based Practice

Evidence-based practice has been defined as "the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of communities and populations in the domain of health protection, disease prevention, health maintenance and improvement (health promotion)."1

Examples include:2

  • Making decisions based on best available scientific evidence
  • Using data and information systems systematically
  • Applying program-planning frameworks
  • Engaging the community in decision making
  • Conducting sound evaluation
  • Disseminating what is learned

These processes and activities are a part of SPRC's strategic planning approach to suicide prevention, which recognizes that suicide prevention efforts are more likely to succeed if they are guided by the best evidence available.

Using Evidence to Select or Develop Programs

One of the key steps in strategic planning is to make decisions about the programs and practices that will be a part of your comprehensive approach to suicide prevention.

Selecting Programs

Good sources of information regarding evidence-based programs are registries (lists of programs that have been evaluated) and literature reviews (articles that summarize findings from different studies).

See these pages of our website for information and resources:

  • Resources and Programs: Includes a searchable list of suicide prevention programs, including programs with evidence of effectiveness (see box).

Finding Programs and Practices: Provides links to registries and other program listings, and tips on how to use the

SPRC's Designation: "Programs with Evidence of Effectiveness"

Some programs in SPRC’s Resources and Programs page are designated as “programs with evidence of effectiveness.” These are programs that have been evaluated and found to result in at least one positive outcome related to suicide prevention.

Programs labeled as evidence-based may have stronger or weaker evidence. At SPRC, we use the phrase "programs with evidence of effectiveness" to refer to programs with any level of evidence. See each listing for the source of the program, specific outcomes reviewed, and evidence ratings.

SPRC’s sources for programs with evidence of effectiveness:

  • Many programs are from the National Registry of Evidence-Based Programs and Practices (NREPP), sponsored by Substance Abuse and Mental Health Services Administration (SAMHSA).
  • A few programs are legacy programs from the SPRC/AFSP Evidence-Based Practices Project (EBPP), which stopped conducting evidence-based reviews in 2005 when SAMSHA began reviewing suicide-related interventions for NREPP.
  • In the future, SPRC will add programs with evidence from other sources, such as other registries, literature reviews, and meta-analyses. SPRC does not conduct reviews of individual programs.

Things to keep in mind about evidence-based programs:

  • For suicide prevention, relevant outcomes are reductions in suicidal thoughts and behaviors or changes in suicide-related risk and protective factors. Short-term outcomes, such as post-training increases in knowledge, suggest that a program might be effective, but are not conclusive.
  • Make sure you look for programs that have evidence related to the desired outcomes and priority populations in your strategic plan.
  • The program's theory of change should also be clear: why would you expect the program to lead to your desired outcomes? (To learn more, see these resources on logic models, or diagrams often used to answer this question.)
  • Read the fine print! The criteria used to designate programs as “evidence-based” vary across registries and reviews.
  • No registry or review includes a complete listing of all possible programs, so consult multiple sources.

Adapting or Developing a Program

Even if you can’t find an evidence-based program that meets your needs, your efforts can still be informed by evidence.

When adapting a suicide prevention program or developing a new one, make sure that it:

  • Is grounded in a thorough understanding of local problems and assets
  • Targets known, research-based risk and protective factors for suicide
  • Is guided by research-based theories (e.g., behavior change theories)
  • Has a clear theory of change documented in a logic model or conceptual model that shows how the program will achieve its intended results
  • Draws from research on related programs and their effectiveness

Cultural Considerations

Using culturally competent approaches is another important key to success. One challenge is that many evidence-based programs for suicide prevention have not been assessed in diverse populations, so their effectiveness with these populations is not known. When implementing an evidence-based program that was done with a population different from the one your program will be targeting, consider doing a small pilot test first.

Practice-based evidence (PBE) is a term sometimes used to refer to practices that are embedded in local cultures and are accepted as effective by the community. Practitioners of PBE models draw upon cultural knowledge to develop programs that are respectful of and responsive to local definitions of wellness. In some cases, PBE also refers to a participatory, "ground up" approach to designing programs, as opposed to a "top-down" process in which programs are developed by academic researchers and then disseminated to local communities. To the extent possible, PBE programs should be evaluated, so that they can add to the evidence base for suicide prevention. For more information, see Emerging Evidence in Culture-Centered Practices in NREPP's Learning Center.

Our Settings section provides information and resources for conducting suicide prevention activities in various settings. For information on practices that are culturally appropriate for American Indian/Alaska Native settings, see our Promising Prevention Practices page


1. Jenicek, M. (1997). Epidemiology, evidence-based medicine, and evidence-based public health. Journal of Epidemiology, 7, 187-197. Retrieved from: https://www.jstage.jst.go.jp/article/jea1991/7/4/7_4_187/_pdf

2. Brownson, R. C., Fielding, J. E., & Maylahn, C. M. (2009). Evidence-based public health: A fundamental concept for public health practice. Annual Review of Public Health, 30(1), 175–201.
Source: www.sprc.org/keys-success/evidence-based-prevention


Suicide prevention efforts should be conducted in multiple settings. This section will help you learn more about suicide prevention in particular settings.

Cost of suicide

The costs of suicidal behaviors—and the savings that can result from preventing these behaviors—can help convince policymakers and other stakeholders that suicide prevention is an investment that will save dollars as well as lives. For example, the recent study Suicide and Suicidal Attempts in the United States: Costs and Policy Implications revealed the following:1

  • The average cost of one suicide was $1,329,553.
  • More than 97 percent of this cost was due to lost productivity. The remaining 3 percent were costs associated with medical treatment.
  • The total cost of suicides and suicide attempts was $93.5 billion.
  • Every $1.00 spent on psychotherapeutic interventions and interventions that strengthened linkages among different care providers saved $2.50 in the cost of suicides.

Source: www.sprc.org/about-suicide/costs

Resources & Programs

Resources (e.g., articles, tools, fact sheets, reports) developed by SPRC and other suicide prevention organizations and experts

Programs and Practices (e.g., education, screening, treatment, environmental change), including former BPR listings

  • Programs with evidence of effectiveness are indicated by the icon . To learn more about programs with this designation, see Evidence-Based Prevention.
  • Check the box on the left to display only programs with evidence of effectiveness.
  • For information about other program registries and lists, visit our Finding Programs and Practices page.

Adolescent Coping with Depression (CWD-A)

CWD-A is a cognitive behavioral treatment adapted to the needs of depressed adolescents that teaches an array of skills and strategies for problem solving and coping.

Complicated Grief Treatment (CGT)

CGT is a semi-structured, manualized treatment for adults experiencing complicated grief that is administered by a licensed and trained therapist.

Making the connection: Suicidal thoughts and behaviors and academic grades

Data from the 2015 National Youth Risk Behavior Survey indicates that students that student with a high grade point average were much less likely to feel sad or hopeless nearly every day for at least 2 weeks in a row, seriously consider attempting suicide, make a plan to attempt suicide and actually attempt suicide. School health professionals, officials and other stakeholders can use this information to target suicide prevention activities to assist students at risk.
Source: www.sprc.org/resources-programs

Training and Events

SPRC provides in-person trainings, online courses and learning labs, as well as an archive of webinars.

Use the Events and Training Type filter on the left to find:

Assessing and Managing Suicide Risk (AMSR) Training: upcoming 1-day, in-person workshops delivered by AMSR leaders. See our AMSR page for more information.

Self-paced Online Courses that are open to anyone and free-of charge. Go to Online Training Courses for more information.

Virtual Learning Labs with interactive modules on a variety of topics.

Webinars sponsored by SPRC, SAMHSA and our partners.

ICF and SAMHSA-required grantee webinars for logged in users.

Annual SAMHSA GLS grantee meeting information and materials.

Displaying 128 results. Refine results using the filters on the left.


Assessing and Managing Suicide Risk Workshop: Georgetown, KY

October 17, 2017

State: Delaware

AMSR is a one-day training workshop for behavioral health professionals. The 6.5-hour training program is based on the latest research and designed...


Assessing and Managing Suicide Risk Workshop: Dublin, GA

September 28, 2017

State: Georgia

AMSR is a one-day training workshop for behavioral health professionals. The 6.5-hour training program is based on the latest research and designed...


Assessing and Managing Suicide Risk Workshop: Clairsville, OH

September 26, 2017

State: Ohio

AMSR is a one-day training workshop for behavioral health professionals. The 6.5-hour training program is based on the latest research and designed...


Suicide Surveillance Strategies for American Indian and Alaska Native Communities

August 29, 2017

SPRC’s Tribal Suicide Surveillance Project has completed a yearlong inquiry, which began in spring 2016, of key informants and tribal Garret Lee...


ICF Garrett Lee Smith (GLS) National Outcomes Evaluation Grante Close Out Webinar for Campus Cohort 8

August 3, 2017

This webinar provides and overview of the cohort level data and review the remaining evaluation requirements.


Action Alliance Webinar: Developing Successful and Positive Suicide Prevention Messaging

July 13, 2017

Research shows that certain types of messaging about suicide deaths can increase risk among vulnerable individuals. Conversely, positive and safe...


Voluntary Medical Leave for Students Experiencing Mental Health Difficulties at College Title II Clarifications: Principles for Developing a Leave of Absence Policy

June 13, 2017

Many colleges struggle to understand how to enable their mental health leave of absence policies to meet the expectations inherent in the Americans...


Pre-application Webinar: Cooperative Agreements to Implement Zero Suicide in Health Systems

June 2, 2017

This webinar provides information for those interested in applying for a cooperative agreement through the Zero Suicide grant program. For more...


Campus Sustainability Training Series #4 Secure Funding & Resources

May 22, 2017

This virtual workshop series will provide Campus GLS grantees with the knowledge, skills, and tools to continue their suicide prevention efforts...


Zero Suicide Webinar: Data-Driven Quality Improvement in Zero Suicide

May 2, 2017

In a Zero Suicide approach, a data-driven quality improvement approach involves assessing two main categories: fidelity to the essential systems,...


Campus Sustainability Training Series #3 Building Momentum and Fostering Leadership

April 24, 2017

This virtual workshop series will provide Campus GLS grantees with the knowledge, skills, and tools to continue their suicide prevention efforts...


Action Alliance Webinar: Community-Based Approaches to Suicide Prevention: New Resources and Future Directions

April 12, 2017

Suicide remains one of the 10 leading causes of death in the U.S. claiming more 44,000 lives in 2015 alone and causing tremendous pain and loss to...


Campus Sustainability Training Series #2 Cultivate Partnerships

February 27, 2017

This virtual workshop series will provide Campus GLS grantees with the knowledge, skills, and tools to continue their suicide prevention efforts...


Action Alliance Webinar: Faith.Hope.Life:The Role of Faith Communities in Suicide Prevention

February 23, 2017

Faith communities of all traditions have an important part to play in fostering mental health and helping prevent suicide. Faith leaders are on the "...


Lifeline at the State Level: State Communication Reports

February 9, 2017

"If knowledge is power, let’s spread it as widely as possible.” This presentation will provide an in-depth breakdown of a new resource for State...
Source: www.sprc.org/events-trainings

How Emergency Departments Can Help Prevent Suicide among At-Risk Patients: Five Brief Interventions

This nine-minute video describes the unique role that emergency department (ED) professionals can play in preventing suicide by providing five brief interventions prior to discharge. It outlines the following interventions and provides tools to support their implementation:

  • Brief Patient Education: Help the patient understand their condition and treatment options and facilitate adherence to the follow-up plan. For more information, see page 9 of the ED Guide.
  • Safety Planning: Work with the patient to develop a list of coping strategies and resources that they can use before or during a suicidal crisis. See page 10 of the ED Guide.
  • Lethal Means Counseling: Assess the patient’s access to firearms, prescription and over-the-counter medications, and other lethal means and discuss ways to limit access until they are no longer suicidal. See page 12 of the ED Guide.
  • Rapid Referral: Schedule a follow-up outpatient mental health appointment for the patient that ideally occurs within 24 hours of discharge. See page 13 of the ED Guide.
  • Caring Contacts: Follow up with the discharged patient via postcards, letters, e-mail or text messages, or phone calls. See page 14 of the ED Guide.

To learn more about preventing suicide in ED patients, access the full and quick versions of our consensus guide and take our online course.
Source: www.sprc.org/resources-programs/how-emergency-departments-can-help-prevent-suicide-among-risk-patients-five-brief

Topics and Terms

This page offers definitions of terms commonly used in suicide prevention. Many of these terms are also used in other public health and behavioral health contexts, where they may be defined somewhat differently.


A comprehensive evaluation, usually performed by a clinician, to confirm suspected suicide risk in a patient, estimate the immediate danger, and decide on a course of treatment. Also see Screening. To learn more, read SPRC's Suicide Screening and Assessment.


Characterized by a high level of risk for suicide and/or a low level of protection against suicide risk factors. An individual displaying warning signs of suicide would also be considered at risk. Note that most members of any at-risk group will not display warning signs, attempt suicide, or die by suicide. Also see Warning signs, Risk factor, and Protective factor.

Behavioral health

Emotional and mental health, and individual actions that affect wellness. Behavioral health problems include substance abuse and addiction, serious psychological distress and mental disorders, and suicidal behaviors. “The term is also used to describe the service systems encompassing the promotion of emotional health; the prevention of mental and substance use disorders, substance use, and related problems; treatments and services for mental and substance use disorders; and recovery support.” [SAMHSA (2011). Leading change: A plan for SAMHSA’s roles and actions 2011–2014. HHS Publication (SMA) 11-4629. Rockville, MD: Substance Abuse and Mental Health Services Administration.]


“A group of suicides or suicide attempts, or both, that occurs closer together in time and space than would normally be expected in a given community.” [Centers for Disease Control and Prevention. (1988). Recommendations for a community plan for the prevention and containment of suicide clusters. Morbidity and Mortality Weekly Report, August 19, 1988, 37(S-6), 1-12]. Some researchers divide clusters into (1) “mass clusters,” in which “suicides occur closer in time than would be expected by chance following media coverage,” and (2) “point clusters,” which “involve suicides or episodes of suicidal behavior localized in both time and geographic space, often occurring within a small community or institutional setting.” [Niedzwiedz, C., Haw, C., Hawton, K., and Platt, S. (2014). The definition and epidemiology of clusters of suicidal behavior: A systematic review. Suicide and Life-Threatening Behavior, 44(5), 569-581.] Also see Contagion.


“The degree to which a person or group is socially close, interrelated, or shares resources with other persons or groups. This definition encompasses the nature and quality of connections both within and between multiple levels of the social ecology, including connectedness between individuals, connectedness of individuals and their families to community organizations, and connectedness among community organizations and social institutions.” [Centers for Disease Control and Prevention. (n.d.). Strategic direction for the prevention of suicidal behavior: Promoting individual, family, and community connectedness to prevent suicidal behavior. Atlanta, GA: Centers for Disease Control and Prevention.


Suicide risk associated with the knowledge of another person’s suicidal behavior, either first-hand or through the media. Suicides that may be at least partially caused by contagion are sometimes called “copycat suicides.” Contagion can contribute to a suicide cluster. Also see Cluster.

Copycat suicide/Contagion

Evidence-based practices

Suicide prevention activities that have been found effective by rigorous scientific evaluation. See Evidence-Based Prevention page.

Gatekeeper training

Programs that teach individuals who routinely have personal contact with many others in their community (i.e., “gatekeepers”) to recognize and respond to people at potential risk of suicide. To learn more, take SPRC's online course, Choosing and Implementing a Suicide Prevention Gatekeeper Training Program.


Seeking care or assistance for emotional distress, a mental health condition, or suicidal thoughts.

Indicated intervention

An activity that targets individuals who exhibit symptoms or have been identified by screening or assessment as being at risk for suicidal behavior. For example, safety planning for people who have reported thinking about suicide is an indicated intervention. Also see Selective intervention and Universal intervention.


An activity or set of activities designed to decrease risk factors or increase protective factors. Also see Universal intervention, Selective intervention, and Indicated intervention. To learn more, take SPRC's online course, A Strategic Planning Approach to Suicide Prevention.

Lethal means

Methods of suicide with especially high fatality rates (e.g., firearms, jumping from bridges or tall buildings). Also see Means.

Lethal means restriction

See Means restriction.

Lived experience

"Knowledge gained from having lived through a suicide attempt or suicidal crisis." [National Action Alliance for Suicide Prevention Suicide Attempt Survivors Task Force. (2014). The way forward: Pathways to hope, recovery, and wellness with insights from lived experience. Washington, D.C.: National Action Alliance for Suicide Prevention.]


Objects, instruments, and methods used by people in suicide attempts (e.g., firearms, poisons, suffocation, jumping from buildings or bridges).

Means restriction

“Techniques, policies, and procedures designed to reduce access or availability to means and methods of deliberate self-harm.” [U.S. Department of Health and Human Services and the National Action Alliance for Suicide Prevention. (2012). 2012 National strategy for suicide prevention: Goals and objectives for action. Washington, D.C.: U.S. Department of Health and Human Services.]

Non-suicidal self-injury (NSSI)

Injury inflicted by a person on himself or herself deliberately, but without intent to die.


Activities following a suicide to help alleviate the suffering and emotional distress of the survivors, and prevent additional trauma and contagion. See also Suicide loss survivor and Contagion.


Activities implemented prior to the onset of an adverse health outcome (e.g., dying by suicide) and designed to reduce the potential that the adverse health outcome will take place.

Protective factor

An attribute, characteristic, or environmental exposure that decreases the likelihood of a person’s developing a disease or injury (e.g., attempting or dying by suicide) given a specific level of risk. For example, depression elevates a person’s risk of suicide, but a depressed person with good social connections and coping skills is less likely to attempt or die by suicide than a person with the same level of depression who lacks social connections and coping skills. Social connections and coping skills are protective factors, buffering the suicide risk associated with depression and thus helping to protect against suicide. Also see Risk factor (below).

Risk factor

“Any attribute, characteristic, or exposure of an individual that increases the likelihood of developing a disease or injury” (e.g., attempting or dying by suicide). [World Health Organization. (n.d.). Retrieved from http://www.who.int/topics/risk_factors/en/ ]. Risk factors do not necessarily cause a disease or injury, but can contribute to negative health outcomes like suicide or suicide attempts in combination with other risk factors. For example, depression, access to firearms, and substance abuse disorders (individually and in combination) increase the likelihood of attempting or dying by suicide, although most people with these risk factors do not attempt suicide. Risk factors should not be confused with warning signs. Also see Protective factor and Warning signs.

Safe messaging

Media or personal communications about suicide or related issues that do not increase the risk of suicidal behavior in vulnerable people, and that may increase help-seeking behavior and support for suicide prevention efforts. To learn more, go to the National Action Alliance Framework for Successful Messaging and Recommendations for Reporting on Suicide.


A procedure in which a standardized tool, instrument, or protocol is used to identify individuals who may be at risk for suicide. Also see Assessment. To learn more, read SPRC's Suicide Screening and Assessment.

Selective intervention

Activities targeting a group whose members are generally at higher than average risk for an adverse health condition (e.g., suicidal behaviors) regardless of whether individual members of the group display symptoms or have been screened for the condition. For example, suicide prevention interventions targeted at victims of intimate partner violence is a selective intervention because intimate partner violence is associated with increased risk of suicidal behaviors. Also see Indicated intervention and Universal intervention.

Suicidal behaviors

Suicide, suicide attempts, suicidal ideation, and planning/preparation done with the intent of attempting or dying by suicide.

Suicidal crisis

A suicide attempt or an incident in which an emotionally distraught person seriously considers or plans to imminently attempt to take his or her own life.

Suicidal ideation

“Thoughts of engaging in suicide-related behavior.” [Crosby, A.E., Ortega, L., Melanson, C. (2011). Self-directed violence surveillance: Uniform definitions and recommended data elements. Version 1.0. Atlanta, GA: Centers for Disease Control and Prevention, National Center for Injury Prevention and Control.]


“Death caused by self-directed injurious behavior with any intent to die as a result of the behavior.” [Crosby, A.E., Ortega, L., and Melanson, C. (2011). Self-directed violence surveillance: Uniform definitions and recommended data elements. Version 1.0. Atlanta, GA: Centers for Disease Control and Prevention, National Center for Injury Prevention and Control.]

Suicide assessment

Suicide attempt

“A nonfatal, self-directed, potentially injurious behavior with any intent to die as a result of the behavior. A suicide attempt may or may not result in injury.” [Crosby, A.E., Ortega, L., Melanson, C. (2011). Self-directed violence surveillance: Uniform definitions and recommended data elements. Version 1.0. Atlanta, GA: Centers for Disease Control and Prevention, National Center for Injury Prevention and Control.]

Suicide attempt survivor

A person who has attempted suicide, but did not die. Also see Suicide loss survivor (below)

Suicide loss survivor

A person who has lost a family member, friend, classmate, or colleague to suicide. Sometimes called “suicide survivor,” although the term “suicide loss survivor” is often favored to avoid confusion with "suicide attempt survivor."

Suicide plan

An individual’s thinking about a suicide attempt that includes elements such as a timeframe, method, and place.

Suicide screening

See Screening

Suicide survivor

See Suicide loss survivor.

Universal intervention

An activity designed to prevent negative health outcomes (e.g., suicide attempts and suicides) in an entire population regardless of the risk status of members of that population. For example, a middle school life skills curriculum that includes coping and help-seeking skills is a universal intervention, since it would be directed at all the students in that middle school regardless of their level of risk for suicide. Also see Indicated intervention and Selective intervention.

Warning signs

Behaviors and symptoms that may indicate that a person is at immediate or serious risk for suicide or a suicide attempt. To learn more, visit our Warning Signs for Suicide page.
Source: www.sprc.org/about-suicide/topics-terms

CALIFORNIA: Study Shows Transgender Students Are at Significant Risk for Suicidal Thoughts

Source: www.sprc.org/news/california-study-shows-transgender-students-are-significant-risk-suicidal-thoughts

Oregon Health Authority Training Communities to Recognize and Respond to Signs of Suicide Risk

Resources are provided here with the goal of establishing a network of adults and youth in every community who can recognize and respond to youth exhibiting signs of suicide risk and can assist them in getting professional help.


  • Learn about Applied Suicide Intervention Skills Training (ASIST)
  • Living Works Applied Suicide Intervention Skills Training (ASIST) website
  • ASIST Best Practice Registry


  • QPR Institute: Question, Persuade, Respond Prevention Training
  • QPR Best Practice Registry
  • ColumbiaCare
  • ColumbiaCare Services Center for Suicide Prevention


RESPONSE Program - A comprehensive high-school based youth suicide prevention program


Oregon's Kognito program offers courses available for free to all educators and staff in the first 100 high schools in Oregon that sign up and have implemented the RESPONSE program. The courses are provided through the Oregon Public Health Division, with funding from the Substance Abuse and Mental Health Services Administration.

Kognito At-Risk for High School Educators on the National Registry of Evidence-Based Programs and Practices. Learn to identify and refer students in mental distress

At-Risk for High School Educators Best Practice Registry

Step In, Speak Up!: Supporting LGBTQ Students Best Practice Registry listing. Training for high school educators to support LGBTQ students
Source: www.oregon.gov/oha/PH/PREVENTIONWELLNESS/SAFELIVING/SUICIDEPREVENTION/Pages/SuicideInterventionTrainings.aspx

Online SPRC Courses

Suicide Prevention Resource Center`s self-paced online courses will help improve your knowledge and skills in suicide prevention. They are especially for clinicians and other service providers, educators, health professionals, public officials, and community-based coalitions who are responsible for developing and implementing effective suicide prevention programs and policies.


All courses are free of charge
and open to anyone.

You must register first. If you have already
registered, please log in to go to any course.

Learn more about Continuing Education credits for these courses

SPRC`s current list of self-paced online courses:

Source: training.sprc.org/

State Contact: Meghan Crane, (971) 673-1023, Meghan.crane@state.or.us The 2016-2023 Youth Suicide Intervention and Prevention Plan
Source: www.oregon.gov/oha/PH/PREVENTIONWELLNESS/SAFELIVING/SUICIDEPREVENTION/Documents/discussionguide.pdf

Warning signs of suicide include: (National Institutes of Mental Health)

Observable signs of serious depression:

  • Persistent sad, anxious, or “empty” mood
  • Feelings of hopelessness, pessimism
  • Feelings of guilt, worthlessness, helplessness
  • Perceived burdensomeness
  • Loss of interest/pleasure in activities that were once enjoyable
  • Social withdrawal and self-isolation
  • Decreased energy, fatigue, being “slowed down”
  • Difficulty concentrating, remembering, making decisions
  • Insomnia, early-morning awakening, or oversleeping
  • Appetite and/or weight loss or overeating and weight gain
  • Thoughts of death or suicide; suicide attempts
  • Restlessness, irritability
  • Persistent physical symptoms that do not respond to treatment, such as headaches, digestive disorders, and chronic pain
  • Increased alcohol and/or other drug use
  • Recent impulsiveness and taking unnecessary risks
  • Unexpected rage or anger
  • Threatening suicide directly or expressing a strong wish to die (e.g., “I can't go on any longer")
  • Making a plan:
  • Giving away prized possessions
    • o Sudden or impulsive purchase of a firearm

      o Obtaining other means of killing oneself such as poisons or medications


What We Can All do to Help

According to the American Foundation for Suicide Prevention (AFSP): “Most suicides give some warning of their intentions. The most effective way to prevent a friend or loved one from taking their life is to recognize when someone is at risk, take the warning signs seriously and know how to respond. The depression and emotional crises that so often precede suicides are -- in most cases -- both recognizable and treatable.” Here are some tips they offer if you are concerned someone is planning suicide:

Take It Seriously

• 75% of all suicides give some warning of their intentions to a friend or family member.

• All suicide threats and attempts must be taken seriously.

Be Willing to Listen

• Take the initiative to ask what is troubling them and persist to overcome any reluctance to talk about it.

• If professional help is indicated, the person you care about is more apt to follow such a recommendation if you have listened to him or her.

• If your friend or loved one is depressed, don't be afraid to ask whether he or she is considering suicide, or even if they have a particular plan or method in mind.

• Do not attempt to argue anyone out of suicide. Rather, let the person know you care and understand, that he or she is not alone, that suicidal feelings are temporary, that depression can be treated and that problems can be solved. Avoid the temptation to say, "You have so much to live for," or "Your suicide will hurt your family."

Seek Professional Help

• Be actively involved in encouraging the person to see a physician or mental health professional immediately. Individuals contemplating suicide often don't believe they can be helped, so you may have to do more. For example, a suicidal college student resisted seeing a psychiatrist until his roommate offered to accompany him on the visit. A 17-year-old accompanied her younger sister to a psychiatrist because her parents refused to become involved.

• You can make a difference by helping the person in need of help find a knowledgeable mental health professional or reputable treatment facility.

In an Acute Crisis

• Take your friend or loved one to an ER or walk-in clinic at a psychiatric hospital.

• Do not leave them alone until help is available.

• Remove from the vicinity any firearms, drugs or sharp objects that could be used in a suicide attempt.

• Hospitalization may be indicated and may be necessary at least until the crisis abates.

• If a psychiatric facility is unavailable, go to your nearest hospital or clinic.

• If the above options are unavailable, call your local emergency number or the National Suicide Prevention Lifeline at 1-800-273-TALK or text "SOS" to the Crisis Text Line 741741

Follow-up on Treatment

• Suicidal patients are often hesitant to seek help and may run away or avoid it after an initial contact unless there is support for their continuing.

• If medication is prescribed, take an active role to make sure they are taking the medication and be sure to notify the physician about any unexpected side effects.

Often, alternative medications can be prescribed.

National Resources
Source: www.oregon.gov/oha/PH/PREVENTIONWELLNESS/SAFELIVING/SUICIDEPREVENTION/Documents/discussionguide.pdf

National Resources

  • National Suicide Prevention Lifeline 1-800-273-TALK http://www.suicidepreventionlifeline.org/
  • Active Minds on Campus 202-332-9595 http://www.activemindsoncampus.org/
  • American Foundation for Suicide Prevention (AFSP) 1-888-333-2377 http://www.afsp.org/
  • American Association of Suicidology (AAS) 202-237-2280 http://www.suicidology.org
  • Girls and Boys Town Crisis 1-800-448-3000
  • Center for Suicide Information (Canada) 403-245-3900 http://www.suicideinfo.ca/
  • Crisis and Information hotline 1-800-560-5535
  • Emergency Shelter 1-800-560-5535
  • Friends for Survival 916-392-0664 www.friendsforsurvival.org/
  • The Jed Foundation 212-647-7544 http://www.jedfoundation.org/
  • National Institutes of Mental Health (NIMH) 1-866-615-6464 http://www.nimh.nih.gov/health/topics/suicide-prevention/
  • National Alliance for the Mentally Ill (NAMI ) 1-800-950-6264 http://www.nami.org
  • National Mental Health Association (NMHA) 1-800-969-6642 http://www.nmha.org
  • National Runaway Hotline 1-800-231-6946
  • National Runaway Switchboards 1-800-621-4000
  • National Youth Hopeline 1-800-442-4673
  • PBS Weblab - Living With Suicide: Shared Experiences and Voices of Loss http://www.pbs.org/weblab/living/
  • School-based Youth Suicide Prevention Guide http://theguide.fmhi.usf.edu/
  • Spanish Crisis Line 1-800-942-6908 Spanish Crisis Line
  • Substance Abuse and Mental Health Services Administration's (SAMHSA)
  • National Mental Health Information Center 1-800-789-2647 http://mentalhealth.samhsa.gov/suicideprevention/
  • Suicide Prevention Action Network (SPAN) 202-449-3600 http://www.spanusa.org
  • Suicide Awareness Voices of Education (SAVE) 952-946-7998 http://www.save.org/
  • Suicide.org http://www.suicide.org/
  • Suicide Prevention Resource Center 1-877-438-7772 http://www.sprc.org/
  • Survivors of Suicide http://www.survivorsofsuicide.com/
  • Yellow Ribbon Suicide Prevention Project 303-429-3530 http://www.yellowribbon.org
  • Portions of the discussion guide were adapted from Daughter of Suicide study guide, D

State Resources

  • Oregon Partnership Helpline 1-800-923-HELP http://www.orpartnership.org/
  • Youth Suicide Prevention Program 971-673-1023 http://www.oregon.gov/DHS/ph/ipe/ysp/index.shtml

Local Resources

  • HOST 503-588-5825 Local Crisis Hotline
  • Lutheran Community Services 503-472-4020 Counseling Services
  • NAMI – Yamhill County 472-3823 (Shirley Kimball)
  • Rainbow Family Services 503-472-2240 Counseling Services
  • Yamhill County 434-7523 http://www.co.yamhill.or.us/hhs/index.asp0
  • Yamhill County Family and Youth Programs 503-434-7462 Counseling Services
  • Yamhill County Suicide Prevention Coalition – QPR Gatekeeper training 503-434-7404 For information on joining the coalition or to request a QPR gatekeeper training (also available in Spanish)
  • Youth Outreach 503-538-8023 Youth “Host” Homes

Source: www.oregon.gov/oha/PH/PREVENTIONWELLNESS/SAFELIVING/SUICIDEPREVENTION/Documents/discussionguide.pdf

Suicide: risk factors and warning signs

Source: www.currypilot.com/opinion/5600516-151/suicide-risk-factors-and-warning-signs?referrer=home&referrer=list

Are you a gatekeeper brochure Alaska

Source: dhss.alaska.gov/SuicidePrevention/Documents/pdfs_sspc/Gatekeeper.pdf

Print when I get a new color cartridge

Source: www.pinterest.com/jmullerlyons/suicide-prevention/


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