How to prevent suicide?


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Why would people kill themselves?

Recent studies have shown the correlation between suicide and serotonin deficiency in the brain. Moreover, the presence of significant stress has far-reaching consequences especially if such stressor, such as legal entanglements, results in profound hopelessness and depression. Frequently, when there is no immediate resolution to the problem, suicide becomes an attractive escape.

It then becomes obvious that suicide is not only a medical disorder but a psychosocial issue. It is more than just a manifestation of emotional distress. It is a complication of an unresolved state of affairs.

There is no question that suicide is devastating to everyone. I have seen loved ones grapple with the pain of the loss and shame associated with the manner of death. Pain and grief among relatives persist for months despite efforts to feel better though counseling and medication.

Can suicide then be prevented?

Suicide prevention is as much a science as it is an art. Although applying scientific psychotherapeutic techniques can be effective, the gentle art of dealing with the suicidal person makes all the difference.

Having stated these, if clues of suicidal behavior can be recognized early and sources of stress addressed immediately, then the risk of suicide can be reduced. The issue of early recognition and remedy therefore becomes crucial. The CARE approach can help loved ones cope.

What is the CARE Approach?

The CARE Approach is a practical four-step process that a person can use in dealing with a disorder such as suicidal behavior and depression. This approach emphasizes early recognition and intervention. The early process includes the following: 1) Check for signs of emotional illness 2) Anticipate complications 3) Remedy with early intervention and 4) Educate yourself about the illness.

Check for signs of emotional illness or distress

Suicide, like any medical disorder, does not happen instantly or “out of the blue.” Usually, it is preceded by emotional turmoil such as depression, agitation, significant anxiety, impulsivity, feelings of hopelessness and helplessness.

Look for outward sign that shows deviation from the person’s usual self. Observe any changes in functioning. Is the person less motivated to work? Does the person prefer to stay in bed and withdraw from friends and family members? Check also for any physiologic changes such as inability to sleep, eat, and concentrate.

Anticipate complications

Watch out for complications once you know that your loved one is in distress. Be aware of any changes such as suicidal and homicidal behavior and aggression. If not showing actual destructive behavior, ask for any thoughts of death or wanting to die or to kill.

Inquiring about the presence of suicidal or homicidal thought will not push your loved one to act destructively. In fact, your loved one might be encouraged to disclose more information and to express well-kept emotions.

Remedy with Early Intervention

Early intervention requires you to first accept or acknowledge that a problem exists and the urgent need to address it. Being in denial can only make matters worse. Denial interferes in recognizing on-going problem.

Assist in addressing your loved ones pressing issues. Offer to provide some financial support or to contact appropriate government agencies. For someone in legal trouble, suggest obtaining the advice of a good lawyer.

Be available and supportive. Reassure your loved ones that you will be in their side no matter what. Let them talk about their worries and travails. Provide a listening ear. Avoid arguments and criticisms. Show empathy.

Be alert for signs of destructive behavior such as wrist slashing, overdosing, verbalizing death, agitated behavior, writing or changing a will, and giving away properties. If your loved one is in distress, clarify if one has entertained destructive thoughts.

Call for help. Because suicidal and homicidal behavior requires immediate help, further delay is a not an option. Call mental health hotline, mental health services, or emergency rooms to seek guidance and to ask for the next step. Do not hesitate to call law enforcement agencies or mental health crisis team if your loved one refuses to get help.

Educate Yourself

Knowing about the illness, the dos and don’ts, and how to best cope is a powerful way of dealing with suicide or other destructive behavior. Furthermore, education helps you get rid of misconception, self-blame, guilt, and shame.

In summary, suicide, like cancer, has only one goal – death. It has caused agony, sleepless nights, and oceans of tears for those who are left behind. However, despite its deadly intentions, suicide is also a cry for help. Fortunately, simple steps such as the CARE approach make suicide surmountable.

Dr. Rayel, author of First Aid to Mental Illness, is a clinician, a forensic and geriatric expert, and a speaker. As an advocate of first aid for mental health, he has established seminars and workshops on the subject. He can be reached at


Suicide does not happen instantaneously. People who have become suicidal are usually suffering from an illness of the brain, such as clinical depression, bipolar depression, anxiety or schizophrenia.

This means that it can be treated, although many people think they can’t be helped. If depression is recognised and treated, suicidal thoughts can be eliminated and many suicides can be prevented.

Suicide is always a desperate choice made by a person who is feeling overwhelmed by distress. Helping that person survive the period of turmoil when other alternatives are not clear is the most important thing we can do.


• Loss of health, marriage, friend, job etc.
• Mental illness (eg depression, anxiety, schizophrenia)
• Family history of suicide
• Socio-economic disadvantage, low educational achievement or unemployment
• Legal problems
• Child abuse
• Access to means eg. Guns
• High stress
• Sexual preference

Please note that these are just potential factors that could bring on a depressive episode. Not everyone who has a mental illness is suicidal, nor do all child abuse victims have suicidal thoughts, these are just signs that people should keep an eye out for.


• Depression, sad, empty mood
• Chronic fatigue
• Changes in sleep and eating patterns
• Talking or joking about suicide
• Talks of hopelessness, helplessness or worthlessness
• Preoccupation with death
• Loss of interest in things previously enjoyed
• Saying goodbye to people
• Giving away possessions
• Self destructive behaviour (eg. Alcohol and drug abuse)
• Risk taking behaviour (eg. Reckless driving)
• Obsession with guns/knives

There may be other signs that someone is contemplating suicide. It is up to the people around them to notice anything unusual and to assess whether there is something to be concerned about. There is no formula for suicide.


Knowing what to do if you know a suicidal person can save their life. Keep in mind the following points.

1. Take it seriously - You can’t assume that because you feel something is not worth committing suicide about, that the person you are with feels the same way.

2. A cry for help – A suicidal person is ambivalent. Part of them wants to live, part wants to die. The process can be stopped, be alert for calls for help.

3. Help now – You need to do everything to reduce the person’s suffering, getting early intervention is always better now, rather than later.

4. Listen – Give the person an opportunity to talk. Make time for them. They are turning to you for help, so try not to argue, be supportive.

5. Ask them if they are contemplating suicide – People already have the idea, so bringing it up will show that you care for them, something they probably need. You’re giving them an opportunity to discharge their pent up feelings.

6. Don’t leave them alone – If the person has access to the means and is threatening, do not leave them alone. Discard anything that could be used in a suicide (eg. Guns).

7. Urge professional help – Professionals are trained to work with suicidal people.

8. No secrets – Making a pact not to tell anyone can have dire consequences. A suicidal person won’t be offended if you get help if it saves their life.


Knowing how NOT to react can also help. Whilst these are all normal reactions, try to avoid using them, don’t:

• Panic
• Preach to them
• Ignore them, they are calling for help!
• Criticise them, it’ll only add to their grief
• Blame them for feeling the way they do, it is usually a biological disease and nobody’s fault.
• Punish them
• Get angry
• Use a quick fix approach
• Be appalled
• Dramatise the situation

In order to save lives, it’s critical that we recognize the symptoms of these biological diseases that cause suicide. There is still a stigma associated with these illnesses, which can prevent people from getting help.

Your willingness to talk about depression and suicide with a friend, family member or co-worker can go a long way in reducing stigma. Education is the key to understanding the tragedy of suicide that, in many cases, can be prevented

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