September is National Suicide Prevention Month. Every year, September is designated as a time to remember people who have died by suicide, acknowledge the survivors they have left behind, and raise awareness about preventing suicides. At Cottonwood, in Tucson, Arizona, we provide treatment for people who are struggling with suicidal thoughts and support to their families. We want everyone to have the knowledge to be able to prevent suicides from occurring and support people who are struggling with suicidal ideation.

Warning Signs for Suicidal Ideation

Survivors sometimes indicate that there were no warning signs before they lost a loved one to suicide. In reality, most suicidal people do show signs, but the people who care about them don’t always recognize those signs as red flags for suicide:

• Talking or writing about:
  • Suicide or death
  • Being a burden to others
  • Being trapped
  • Feeling unbearable pain
  • Hopelessness
  • Revenge
• Seeming more aggravated, reckless, or having mood swings
• Using more alcohol or drugs than in the past
• Isolating from family, friends, and colleagues
• Showing changes in sleep or appetite
• Wrapping up loose ends by:
  • Giving away cherished possessions
  • Writing a will
  • Buying or reviewing terms of a life insurance policy
• Gathering the means to kill themselves (guns, ammo, medications, rope, blades, etc.)

At-Risk Populations

Anyone can experience suicidal thoughts, but some people are at increased risk:

• Adults over age 45, especially men over age 85
• Indigenous Americans and Alaskan Natives
• Veterans
• Teenagers
• LGBT+ people, especially youth
• People who have had previous attempts
• People who recently experienced a big loss
  • The end of an important relationship
  • Sudden death of an important person, especially if the person was lost to suicide
  • Loss of a job
  • Homelessness
  • Disability

How You Can Prevent Suicide

You can save a life by providing support to people who are experiencing suicidal ideation. One of the things people struggling with suicidal thoughts need most is connectedness to other people. There are five easy steps to help people who might be considering ending their life:

1. Ask – If you’re concerned that someone around you could be thinking about killing themselves, don’t be afraid to ask them. You might be the first person who has expressed concern and taken the time to listen to their response, and that is powerful.
2. Be there – This can mean a lot of things, but make sure you don’t make promises you cannot keep. If you say you’re going to physically stay with the person, be sure to do that. If you cannot stay with them in-person, help them find someone else who can. Also, let them share why they have been thinking of killing themselves.
3. Help keep them safe – This involves asking more detailed questions. Has the person already done anything to hurt themselves? Do they have a plan for how and when they might take their life? Do they have access to the items they would need to implement their plan? Are they willing to let you remove the items they would use to kill themselves?
4. Help them connect – Brainstorm with the person about supports they can access. This might include a combination of other family and friends, a therapist, and the National Suicide & Crisis Lifeline. If they cannot make a plan to stay safe, call 911 or drive them to the nearest emergency room.
5. Follow up – After you have connected the person with appropriate supports, don’t assume that they are cured. Check in later with a text, phone call, or visit. Try to spend time with them to ensure they feel connected.

Arizona-Specific Resources

When you’re attempting to connect people with supports related to suicide prevention, it is often best to link them to local resources. In Arizona, this could include a wide range of resources based on groups to which the person might belong. The National Suicide and Crisis Lifeline is also operated at a local level and serves anyone who is considering suicide, plus their loved ones and colleagues.

At Cottonwood, we treat patients with a wide range of mental health diagnoses, substance use disorders and process addictions. We often see people when they are in the darkest times of their lives. We provide hope for the future and reason to keep going.