Breathe Through It:
Suicide Prevention

The behaviors listed below may be signs that someone is thinking about suicide. • Talking about wanting to die or wanting to kill themselves • Talking about feeling empty, hopeless, or having no reason to live • Making a plan or looking for a way to kill themselves, such as searching for lethal methods online, stockpiling pills, or buying a gun • Talking about great guilt or shame • Talking about feeling trapped or feeling that there are no solutions • Feeling unbearable pain (emotional pain or physical pain) • Talking about being a burden to others • Using alcohol or drugs more often • Acting anxious or agitated • Withdrawing from family and friends • Changing eating and/or sleeping habits • Showing rage or talking about seeking revenge • Taking great risks that could lead to death, such as driving extremely fast • Talking or thinking about death often • Displaying extreme mood swings, suddenly changing from very sad to very calm or happy • Giving away important possessions • Saying goodbye to friends and family • Putting affairs in order, making a will If these warning signs apply to you or someone you know, get help as soon as possible, particularly if the behavior is new or has increased recently. Help is available by calling or texting 988.

Suicide does not discriminate. People of all genders, ages, and ethnicities can be at risk. Suicidal behavior is complex, and there is no single cause. Many different factors contribute to someone making a suicide attempt. But people most at risk tend to share specific characteristics. The main risk factors for suicide are: • Depression, other mental disorders, or substance abuse disorder • Certain medical conditions • Chronic pain • A prior suicide attempt • Family history of a mental disorder or substance abuse • Family history of suicide • Family violence, including physical or sexual abuse • Having guns or other firearms in the home • Having recently been released from prison or jail • Being exposed to others' suicidal behavior, such as that of family members, peers, or celebrities Many people have some of these risk factors but do not attempt suicide. It is important to note that suicide is not a normal response to stress. Suicidal thoughts or actions are a sign of extreme distress, not a harmless bid for attention, and should not be ignored. View additional information on suicide prevention.(https://www.adamhscc.org/?splash=https%3a%2f%2fwww.nimh.nih.gov%2fhealth%2ftopics%2fsuicide-prevention%2findex.shtml&____isexternal=true)

Here are five steps you can take to #BeThe1To help someone in emotional pain: 1. Ask: “Are you thinking about killing yourself?” It’s not an easy question, but studies show that asking at-risk individuals if they are suicidal does not increase suicides or suicidal thoughts. 2. Keep Them Safe: Reducing a suicidal person’s access to highly lethal items or places is an important part of suicide prevention. While this is not always easy, asking if the at-risk person has a plan and removing or disabling the lethal means can make a difference. 3. Be There: Listen carefully and learn what the individual is thinking and feeling. Research suggests acknowledging and talking about suicide may reduce rather than increase suicidal thoughts. 4. Help Them Connect: Save the National Suicide Prevention Lifeline number 988 and the Crisis Text Line’s number (741741) in your phone, so it’s there when you need it. You can also help make a connection with a trusted individual like a family member, friend, spiritual advisor, or mental health professional. 5. Stay Connected: Staying in touch after a crisis or after being discharged from care can make a difference. Studies have shown the number of suicide deaths goes down when someone follows up with the at-risk person. Download the Action Steps Flyer(https://www.adamhscc.org/?splash=https%3a%2f%2fwww.nimh.nih.gov%2fhealth%2fpublications%2f5-action-steps-for-helping-someone-in-emotional-pain%2f&____isexternal=true)

Protective factors are characteristics that help to adapt to different levels of hardship. Studies show protective factors act as a buffer against suicidal thoughts and attempts. Here are some examples of protective factors: • Strong family support and relationships • Community and social support • Religious and spiritual engagement • Personal factors like positive self-esteem and emotional wellbeing • Factors like stable housing, income and employment

Take time to learn more or become certified. We offer FREE suicide prevention training called Question, Persuade, and Refer (QPR), which teaches three simple steps that anyone can learn to help save a life from suicide. Just as people trained in CPR and the Heimlich Maneuver help save thousands of lives each year, people trained in QPR learn how to recognize the warning signs of a suicide crisis and how to question, persuade, and refer someone to help.

• In 2023, there were 49,316 deaths by suicide, making it the 11th leading cause of death overall in the US. • Recent data reveals an alarming increase in suicide rates among Black and African American youth. In 2023, the Centers for Disease Control and Prevention (CDC) reported that suicide rates among Black adolescents have continued to rise, with a 30% increase in suicide rates for Black children ages 10 to 14 from 2018 to 2023. • This troubling trend was further highlighted by a 2024 study published in the Journal of the American Medical Association, which found that Black adolescents are twice as likely to die by suicide compared to their white counterparts. Additionally, the National Institute of Mental Health reports that, in 2024, suicide remains a leading cause of death for Black youth ages 10 to 19.

How we report on suicide matters. Please read these ten tips (https://www.adamhscc.org/?splash=https%3a%2f%2fwww.datocms-assets.com%2f12810%2f1577098744-13763toptennotesreportingonsuicideflyerm1.pdf&____isexternal=true)on how you can more safely report on suicide. Here are some additional recommendations for reporting.(https://www.adamhscc.org/?splash=https%3a%2f%2fwww.datocms-assets.com%2f12810%2f1577098761-recommendations.pdf&____isexternal=true)

Here are a few resources for parents: • Life is better with you here (https://lifeisbetterwithyouhere.org/resources/) • We offer Youth Mental Health First Aid (https://www.legaciesempowered.org/mental-health-first-aid)training for parents, caregivers and other adults who work with youth ages 12-18 to recognize and help young people facing mental health and/or substance use issues. • Resources for parents from The Kids Mental Health Foundation (https://www.kidsmentalhealthfoundation.org/mental-health-resources/parents-and-caregivers)

• 988 Lifeline (https://suicidepreventionlifeline.org/) • The Black Mental Health Corporation (https://therapyforblackmen.org) • American Association of Suicidology (https://afsp.org/) • American Foundation for Suicide Prevention (https://supporting.afsp.org/home) • Center for Black Women's Wellness (https://www.cbww.org) • Cornerstone of Hope: A Center for Grieving Children, Teens and Adults (https://cornerstoneofhope.org/) • Cuyahoga County Suicide Postvention Response Team (https://www.adamhscc.org/home/showpublisheddocument/100/637310196887600000) • Depression and Bipolar Wellness Alliance (https://www.dbwacleveland.org/) • FrontLine Service (https://www.frontlineservice.org/) • Interactive Screening for College Students (https://afsp.org/interactive-screening-program) • LifeAct (https://lifeact.org/) • Mental Health America (https://www.mhanational.org/) • Mental Health and Suicide Prevention Glossary (https://suicidepreventionlifeline.org/learn/glossary/) • NAMI Greater Cleveland (https://namigreatercleveland.org/) • National Action Alliance for Suicide Prevention ( https://theactionalliance.org/) • National Institute of Mental Health (https://www.nimh.nih.gov/index.shtml) • National Queer and Trans Therapists of Color Network (https://nqttcn.com/en/) • Ohio Department Behavioral Health (DBH) (https://dbh.ohio.gov) • Ohio Suicide Prevention Foundation (https://www.ohiospf.org/) • Seize the Awkward(https://seizetheawkward.org) • Substance Abuse and Mental Health Services Administration (SAMHSA) (https://www.samhsa.gov/find-help/suicide-prevention) • Therapy for Black Men (https://therapyforblackmen.org) • The Trevor Project (https://www.thetrevorproject.org/) • Veterans Crisis Line (https://www.veteranscrisisline.net)