Resources for Those in Crisis
If you or someone you know is in crisis,
we urge you to seek help now.
Suicide is NOT the answer.
When You Fear Someone May Take Their Life
Most suicidal individuals give some warning of their intentions. The most effective way to prevent a friend or loved one from taking his or her life is to recognize the factors that put people at risk for suicide, take warning signs seriously and know how to respond.
Know the Facts
More than 90 percent of people who kill themselves are suffering from one or more psychiatric disorders, in particular:
- Major depression (especially when combined with alcohol and/or drug abuse)
- Bipolar depression
- Alcohol abuse and dependence
- Drug abuse and dependence
- Post Traumatic Stress Disorder (PTSD)
- Eating disorders
- Personality disorders
Depression and the other mental disorders that may lead to suicide are - in most cases - both recognizable and treatable. Remember, depression can be lethal.
The core symptoms of major depression are a "down" or depressed mood most of the day or a loss of interest or pleasure in activities that were previously enjoyed for at least two weeks, as well as:
- Changes in sleeping patterns
- Change in appetite or weight
- Intense anxiety, agitation, restlessness or being slowed down
- Fatigue or loss of energy
- Decreased concentration, indecisiveness or poorer memory
- Feelings of hopelessness, worthlessness, self-reproach or excessive or inappropriate guilt
- Recurrent thoughts of death or suicide
PAST SUICIDE ATTEMPTS
Between 25 and 50 percent of people who kill themselves had previously attempted suicide. Those who have made suicide attempts are at higher risk for actually taking their own lives.
Availability of means
Recognize the Imminent Dangers
- In the presence of depression and other risk factors, ready access to guns and other weapons, medications or other methods of self-harm increases suicide risk.
The signs that most directly warn of suicide include:
- Threatening to hurt or kill oneself
- Looking for ways to kill oneself (weapons, pills or other means)
- Talking or writing about death, dying or suicide
- Has made plans or preparations for a potentially serious attempt
Other warning signs include expressions or other indications of certain intense feelings. In addition to depression, these warning signs include:
- Intense anxiety, usually exhibited as psychic
- pain or internal tension, as well as panic attacks
- Feeling desperate or trapped -- like there's no way out
- Feeling hopeless
- Feeling there's no reason or purpose to live
- Rage or anger
Certain behaviors can also serve as warning signs, particularly when they are not characteristic of the person's normal behavior. These include:
Take it Seriously
- Acting reckless or engaging in risky activities
- Engaging in violent or self-destructive behavior
- Increasing alcohol or drug use
- Withdrawing from friends or family
Be Willing to Listen
- Fifty to 75 percent of all suicides give some warning of their intentions to a friend or family member.
- Imminent signs must be taken seriously.
Seek Professional Help
- Start by telling the person you are concerned and give him/her examples.
- If he/she is depressed, don't be afraid to ask whether he/she is considering suicide, or if he/she has a particular plan or method in mind.
- Ask if they have a therapist and are taking medication.
- Do not attempt to argue someone out of suicide. Rather, let the person know you care, that he/she is not alone, that suicidal feelings are temporary and that depression can be treated. Avoid the temptation to say, "You have so much to live for," or "Your suicide will hurt your family."
In an Acute Crisis
- Be actively involved in encouraging the person to see a physician or mental health professional immediately.
- Individuals contemplating suicide often don't believe they can be helped, so you may have to do more.
- Help the person find a knowledgeable mental health professional or a reputable treatment facility, and take them to the treatment.
Follow-up on Treatment
- If a friend or loved one is threatening, talking about or making plans for suicide, these are signs of an acute crisis.
- Do not leave the person alone.
- Remove from the vicinity any firearms, drugs or sharp objects that could be used for suicide.
- Take the person to an emergency room or walk-in clinic at a psychiatric hospital.
- If a psychiatric facility is unavailable, go to your nearest hospital or clinic.
- If the above options are unavailable, call 911 or the National Suicide Prevention Lifeline at 1-800-273-TALK (8255).
- Suicidal individuals are often hesitant to seek help and may need your continuing support to pursue treatment after an initial contact.
- If medication is prescribed, make sure your friend or loved one is taking it exactly as prescribed. Be aware of possible side effects and be sure to notify the physician if the person seems to be getting worse. Usually, alternative medications can be prescribed.
- Frequently the first medication doesn't work. It takes time and persistence to find the right medication(s) and therapist for the individual person.
From the American Foundation for Suicide Prevention.
Bullying is a form of youth violence. Although definitions of bullying vary, most agree that bullying includes:
- Attack or intimidation with the intention to cause fear, distress, or harm that is either physical (hitting, punching), verbal (name calling, teasing), or psychological/relational (rumors, social exclusion);
- A real or perceived imbalance of power between the bully and the victim; and
- Repeated attacks or intimidation between the same children over time.
Bullying can occur in person or through technology (electronic aggression, or cyberbullying). Electronic aggression is bullying that occurs through e-mail, a chat room, instant messaging, a website, text messaging, or videos or pictures posted on websites or sent through cell phones.
A young person can be a bully, a victim, or both (bully-victim).
Why is bullying a public
Bullying is widespread in the United States.
- In a 2009 nationwide survey, about 20% of high school students reported being bullied on school property in the 12 months preceding the survey.
- During the 2007-2008 school year, 25% of public schools reported that bullying occurred among students on a daily or weekly basis. A higher percentage of middle schools reported daily or weekly occurrences of bullying compared to primary and high schools.
- In 2007, about 4% of 12- to 18-year-old students reported having been cyberbullied during the school year.
How does bullying affect health?
Bullying can result in physical injury, social and emotional distress, and even death. Victimized youth are at increased risk for mental health problems such as depression and anxiety, psychosomatic complaints such as headaches, and poor school adjustment. Youth who bully others are at increased risk for substance use, academic problems, and violence later in adolescence and adulthood. Compared to youth who only bully, or who are only victims, bully-victims suffer the most serious consequences and are at greater risk for both mental health and behavior problems.
Who is at risk for bullying?
A number of factors can increase the risk of a youth engaging in or experiencing bullying.5 However, the presence of these factors does not always mean that a young person will become a bully or a victim.
Some of the factors associated with a higher likelihood of engaging in bullying behavior include:
- Impulsivity (poor self-control)
- Harsh parenting by caregivers
- Attitudes accepting of violence
Some of the factors associated with a higher likelihood of victimization include:
- Friendship difficulties
- Poor self-esteem
- Quiet, passive manner with lack of assertiveness
How can we prevent bullying?
The ultimate goal is to stop bullying before it starts. Research on preventing and addressing bullying is still developing. School-based bullying prevention programs are widely implemented, but infrequently evaluated. Based on a review of the limited research on school-based bullying prevention, the following program elements are promising:
- Improving supervision of students
- Using school rules and behavior management techniques in the classroom and throughout the school to detect and address bullying, providing consequences for bullying
- Having a whole school anti-bullying policy, and enforcing that policy consistently
- Promoting cooperation among different professionals and between school staff and parents
How does CDC approach bullying prevention?
CDC uses a 4-step approach to address public health problems like bullying.
Step 1: Define and monitor the problem
Before we can prevent bullying, we need to know how big the problem is, where it is, and whom it affects. CDC learns about a problem by gathering and studying data. These data are critical because they help decision makers send resources where they are needed most.
Step 2: Identify risk and protective factors
It is not enough to know that bullying is affecting a certain group of people in a certain area. We also need to know why. CDC conducts and supports research to answer this question. We can then develop programs to reduce or eliminate risk factors.
Step 3: Develop and test prevention strategies
Using information gathered in research, CDC develops and and tests strategies to prevent bullying.
Step 4: Assure widespread adoption
In this final step, CDC shares the best prevention strategies. CDC may also provide funding or technical help so communities can adopt these strategies.
Where can I learn more?
National Bullying Prevention Center
Bullying Information Center
- Farrington, D. P. & Ttofi, M. M. School-based programs to reduce bullying and victimization. Systematic review for The Campbell Collaboration Crime and Justice Group; 2010. Available from URL: http://www.ncjrs.gov/pdffiles1/nij/grants/229377.pdf
- David-Ferdon, C., Hertz, M. F. Electronic media and youth violence: A CDC issue brief for researchers. Atlanta, GA: Centers for Disease Control and Prevention; 2009. Available from URL: http://www.cdc.gov/violenceprevention/pdf/Electronic_Aggression_Researcher_Brief-a.pdf
- Eaton, D. K. et al. (2010). Youth risk behavior surveillance – United States 2009. Morbidity and Mortality Weekly Report, 59 (SS-5), 1-142. Available from URL: http://www.cdc.gov/mmwr/pdf/ss/ss5905.pdf
- Robers, S., Zhang, J., & Truman, J. Indicators of School Crime and Safety, 2010 (NCES 2011-002/NCJ 230812). National Center for Education Statistics, U.S. Department of Education, and Bureau of Justice Statistics, Office of Justice Programs, U.S. Department of Justice. Washington, DC; 2010. Available from URL: http://nces.ed.gov/pubs2011/2011002.pdf
- Smokowski, P. R., & Kopasz, K. H. Bullying in school: An overview of types, effects, family characteristics, and intervention strategies. Children and Schools, 27, 101-109; 2005.
Listed below are other online resources:
Suicide Awareness Voices of Education
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