This Issue

Suicide: Out of the darkness

The tough road for those left behind

A preventable loss of life

Q & A

Need more information?

What puts a person at risk for suicide?

  • Depression or other mental health disorders

  • Substance abuse

  • Family history of mental disorder or substance abuse

  • Family violence, including physical or sexual abuse

  • Firearms in the home

  • Family history of suicide

  • Exposure to suicide of family members, peers or celebrities

  • Gender — occurs in almost four times as many males as females

  • Race — more common in American Indians and whites, but the number is increasing among blacks

  • Age — more common in people under the age of 24 and 65 and older

  • Incarceration

  • Previous attempts

Suicide is not a normal response to these risks and can often be prevented by appropriate treatment for the mental or substance abuse disorder.

What puts a person at risk for suicide?

Don’t keep it to yourself!
If you or someone you know is contemplating suicide,
make a call instead.
Telephone Number Organization Hours of Availability
800-273-TALK (8255) Nat’l Suicide Prevention Lifeline 24 hours a day
800-981-HELP (4357) Boston Emergency Service Team 24 hours a day
800-784-2433 Nat’l Suicide Prevention Lifeline 24 hours a day
617-247-0220 Samaritans 24 hours a day
877-870-HOPE (4673) Samaritans 24 hours a day
800-252-TEEN (8336) Samaritans – for teens 24 hours a day
866-508-HELP (4357) Massachusetts Suicide Prevention Lifeline 8 AM to 11 PM

Pay attention to the warning signs!
  • Threatening to hurt or kill oneself or talking about wanting to hurt or kill oneself

  • Looking for ways to kill oneself by seeking access to firearms, available pills or other means

  • Talking or writing about death, dying or suicide

  • Feeling hopeless

  • Feeling rage or uncontrolled anger or seeking revenge

  • Acting reckless or engaging in risky activities — seemingly without thinking

  • Feeling trapped — like there’s no way out

  • Increasing alcohol or drug use

  • Withdrawing from friends, family and society

  • Feeling anxious, agitated or unable to sleep or sleeping all the time

  • Experiencing dramatic mood changes

  • Giving away belongings or getting affairs in order

  • Seeing no reason for living or having no sense of purpose in life

Source: Substance Abuse and Mental Health Services Administration (SAMHSA).

Pay attention to the warning signs!

Don’t keep it to yourself!

What should you do if you think
someone is thinking of suicide?
  • Take the threat seriously

  • Let the person know you care

  • Ask questions

    Are you thinking about killing yourself?
    Do you think you might hurt yourself today?
    Have you thought of ways that you might hurt yourself?
    Do you have pills or weapons in the house?

  • Do not leave him or her alone

  • Remove potential tools for suicide

  • Tell him or her that you will get help

  • Call 911 or go to the nearest emergency room

  • Call 800-273-TALK — the National Suicide Prevention Lifeline

What should you do if you think
someone is thinking of suicide?

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Need more information?

It’s a call or click away …

American Foundation for Suicide Prevention • 888-333-AFSP (2377)

National Organization for People of
Color against Suicide • 202-549-6039

American Association of Suicidology • 202-237-2280

Suicide Prevention Action Network
(SPAN) USA • 202-449-3600

Centers for Disease Control and Prevention
800-232-4636 (CDC-INFO)

Questions & Answers

Xenia H. Johnson, M.D.
Director, Community Minority Affairs for Psychiatry
Cambridge Health Alliance
1. Is suicide a problem in the black community?

Yes. The rate of suicide deaths has been increasing in the black community since the 1990s. While depression is the major predictor of suicide universally, risk factors for depression are not the same from community to community. Factors such as income, education, employment, as well as fire arm possession and substance abuse put blacks at much higher risk of suicide.

2. What age groups are more susceptible to suicide?

Suicide is the number three killer of African American youth between the ages of 15 and 24 and more prevalent in black men over 65 than previously thought. While it is not clear why these age groups are most susceptible research has linked joblessness and social isolation to the high rates of suicide.

3. Why are women less likely to succeed in suicide attempts?

Suicide attempts are common among men and women, although females attempt suicide three times more often than males. A suicide attempt is different from suicide. Much of the time suicide is a solution to a problem, while an unsuccessful attempt is often a means to bring attention to a problem. Women are more open to sharing and tend to be more verbal than men. This serves as one of several factors reducing the lure of suicide as a solution for women. In addition, women have historically had an easier task of developing relationships and as a result are more able to access social resources like federal assistance and other opportunities for help.

4. What is the best course of action if you think someone is considering suicide?

The best course of action if you think someone is considering suicide is to first empathize and then help. Empathy is simply being nonjudgmentally understanding. A statement such as “It must be hard to keep going” or “You are handling a lot right now,” goes a long way to pulling someone who is alone with their troubles out of that dangerous lonely place and closer to getting help. Help should be with a counselor, their primary care doctor or the emergency room in situations where suicide is imminent.

5. What are the signs that a person is considering suicide?

The signs of suicide include isolation, loss of interest, loss of energy and loss of hope. A sudden change from distraught to enthusiastic behavior can deceptively appear hopeful. Instead, in a suicidal person it can be an indicator that the individual who is contemplating suicide has reached a decision to follow through with the act.

6. Why are some behaviors, such as alcohol or drug use, considered a “slow form” of suicide?

Suicide is the act of deliberate self-destruction. Practices such as alcohol or drug abuse are destructive habits that are self-imposed. While they are not often seen as means of suicide, over the course of days, months or years, these destructive practices can be understood as “slow forms” of death.

7. Is there a correlation between suicide and homicide?

Yes. There is a correlation between suicide and homicide. Suicide and homicide are both products of the absence of the value of life. The capacity to disregard life can equally lead to taking the life of yourself or someone else. For the black community it has historically been important to be supported in relation to others. Suicide and homicide occur as a result of lack of relation to others in healthy ways.

8. Why does suicide tend to be “contagious” or run in families?

Our first experience of managing painful situations often occurs in the context of family. This is where you learn how to cope. While we learn from those who overcome the most difficult struggles, we are also influenced by those who succumb to their struggles as well. In addition, depression in the black community is one cause of suicide and it runs in families.

9. What are the most common reasons that blacks commit suicide?

Blacks like others commit suicide most often related to mental illness. However, the misconceptions of mental illness in the black community hinder treatment and therefore hinder prevention of suicide.

10. Is suicide more frequent among isolated individuals?

Yes. Studies have shown that individuals in supportive and affirming communities display lower rates of suicide than those who are isolated. It is thought that routine contact with others lessens the chance for hopelessness and even enhances the efficacy of mental health treatment.