September is Suicide Prevention Month, and Suicide Prevention Week begins Sept. 4. This is an excellent time to rethink our approach to and understanding of suicide.

Suicide prevention begins with awareness. That involves educating the community –and ourselves– about the prevalence of suicide and how to recognize warning signs. But that's just the beginning. To reduce the number of suicides and suicide attempts, we must remove the stigma. For people struggling with suicidality, that means encouraging them to seek the mental health assistance they need. For others, it may mean changing the way they think and talk about suicide and mental illness.

Let's start with the data.

According to the most current US data from the CDC, in 2020, suicide was

• the 12th leading cause of death overall
• the second leading cause of death among individuals between the ages of 10-14 and 25-34
• the third leading cause of death among those 15-24
• the fourth leading cause of death among those 35- 44
• twice as common as homicide: 45,979 suicides vs, 24,576 homicides

According to the American Foundation for Suicide Prevention (AFSP), in 2020

• White males accounted for 70% of suicide deaths.
• Firearms accounted for 53% of all suicide deaths, and 54% of firearm deaths were suicides.

With that as background, let's look at 10 things we need to understand about suicide.

How we think and talk about suicide matters.

1. Suicide is a public health issue. Johns Hopkins Public Health offers advice that, although designed for reporters, makes sense for everyone. Suicide is not a crime or a moral failing. It's a public health issue that needs to be discussed as openly as cancer or cardiovascular disease.
2. People die by, or from, suicide. You may have noticed that reporters say "die by" suicide. It's something mental health advocates have long pushed for, and for good reason. "Commit" connotes a crime rather than a health issue. One commits murder. You wouldn't say "committed heart failure" or "committed cancer." (NBC News offers a nice layperson's explanation of "died by.") Along those same lines, talking about "successful" or "unsuccessful" attempts suggests that suicide is some sort of an achievement. And yes, to some people, all this may sound like splitting hairs. But the way we talk about suicide shapes our attitudes about it individually and as a community. Changing our language can begin to change the way we think.
3. It's not selfish or lazy. Reasons behind suicide are quite complex. Often, people who die by suicide are going through extreme emotional pain. Desperation makes it difficult to consider different perspectives or see a way out of their situation. It's not the "easy" way out. In a moment of extreme pain, despair and desperation, it looks like the only way to end their suffering.
4. The stigma around suicide can be deadly. A 2020 study in Suicide and Life-Threatening Behavior found that "anticipated suicide stigma, and secrecy can contribute to suicidality among suicide attempt survivors." Stigma leads to shame and secrecy, which increases the possibility of a suicide survivor attempting suicide again. That's why it's so important to change our language and our thinking.

Suicide is not inevitable

5. No one is "destined" to die by suicide. Suicidality may occasionally occur within families. And some people are at greater risk of suicide than others. However, it's neither genetic nor inevitable.
6. Suicide is preventable. Most people who die by suicide have talked about it with someone prior to their death, either specifically or in terms of not wanting to keep living. Most people who contemplate suicide either talk about it or display some warning signs. Here are a few:

• A preoccupation with death, dying or violence.
• Feeling trapped and/or hopeless about a situation.
• Giving away their belongings or getting their affairs in order.
• Obtaining the means to take their own life, such as buying a gun or stockpiling pills.
• Withdrawal from friends, family and community
• Dramatic mood swings
• Impulsive, risky or reckless behavior

Talking is good. So is listening.

7. People who talk about suicide need to be taken seriously. A dangerous myth is that people who talk about suicide don't follow through. Most don't, but many do. You've probably heard, "They're just seeking attention." Well, that's not a bad thing: That attention could save their life. A drowning person shouting for help is trying to get attention, too.
8. It's ok to ask: Don't be afraid of raising the subject of suicide. There's a misconception that merely mentioning the topic could spur someone to harm themselves. In fact, someone struggling with suicidal thoughts is likely to welcome the opportunity to share what they are going through with a non-judgmental friend or acquaintance.

It's not as rare as some people think

9. Suicidal thoughts are common. For all the shame and stigma still associated with suicide, feeling suicidal is incredibly common. A 2020 Harris Poll found that 55% of those surveyed knew someone who has had suicidal thoughts or behaviors, and 24% indicated they had personally thought about or attempted suicide.

10. There's not a "suicidal type." Just because someone seems to have their act together doesn't mean they aren't at risk for suicide. Numbers vary, but according to the CDC, 53% of people who died by suicide did not have a known mental health condition.

At Total Brain, we believe removing the stigma and shame of suicide will encourage more people to seek out the help they need. Seeking help for suicidal feelings should be no more shameful than seeking help for a sinus infection.