Suicide rates rose notably across the United States from 1999 to 2016. In 2016, 45,000 Americans took their own life, marking suicide the 10th leading cause of death in the U.S., according to the national health protection agency.
Recent unique prevalence of suicide in mass media, especially last month with the passing of designer Kate Spade and chef Anthony Bourdain, raised the national recognition that we, as a country, are doing something wrong.
Johns Hopkins University researchers Alan Berman and Daniel Reidenberg urge us to change the direction of suicide prevention, as we have been hyper-focusing on preventing suicide yet somehow suicide rates in the U.S. have increased.
In spite of tireless efforts, antidepressants prescribed, and the implementation of countless integrated prevention programs, we haven’t gotten to the bottom of what suicide prevention should look like.
Talking About Suicide Openly
Antidepressants alone don’t seem to work, so yes, we must talk more openly about suicide. And no, not just by covering celebrity suicides in the media.
Despite some case-by-case objective successes of antidepressants, the growing population of depressed and suicide-prone individuals suggests that there is weak evidence advocating for the sole use of antidepressants for suicide prevention.
This isn’t to say that antidepressants should be vetoed entirely, but rather that they should not be prescribed to depressed patients before a risk analysis has been made or before other treatments have been attempted.
Additionally, many people are afraid to ask the friends they are concerned about whether they may be considering suicide because they fear this would incite suicide. However, several studies are suggesting otherwise.
The more we talk about suicide; the more people will recognize warning signs. In many cases, there are few warning signs, and sometimes even people closest to suicide victims claim they “never saw it coming.”
Preventing Suicide
The national health protection agency released a package of policies to help the states prevent suicide, including creating protective environments, teaching coping and problem-solving skills, and identifying and supporting people at risk.
The package cites cognitive behavioral therapy (CBT) – a form of psychotherapy that improves quality of life by helping change unhelpful or unhealthy emotions, behaviors, and thoughts via verbal communication – as an effective therapeutic approach to prevent suicide re-attempts. CBT has had promising effects on individuals suffering from anxiety and depression. This implies that talking about suicide openly could significantly diminish the casualties.
A 2005 study found that 10-session outpatient CBT for suicide prevention (CBT-SP) reduced the likelihood of a suicide re-attempt by 50 percent for adults who have received previous treatment at emergency departments for suicide attempts. Specifically, 120 adults who have attempted suicide in the past were monitored for 18 months following their attempt. Out of the monitored adults who received CBT-SP, 13 participants (24.1 percent) made at least one future suicide attempt. From the people who received traditional care, 23 participants (41.6 percent) made at least one future attempt.
A 2009 study on a CBT-SP treatment model administered the therapy on adolescents who had recently attempted suicide within 90 days with the goal of reducing risk factors, bring new coping mechanisms to light, and averting suicidal behavior.
At the end of the study, 86 percent of participants reported that they would recommend this type of therapy to a friend in need of such treatment. Over a quarter (27.6 percent) said they felt the most relief from taking medication as well as receiving therapy. Only 6.4 percent said most of their improvement was because of medication.
Patients kept coming back to the CBT-SP method of treatment and grew more motivated to help themselves as they moved forward with the process. This could mean that simply talking about suicide could prevent someone from taking their own life. The less we fear and stigmatize depression, the faster we can decrease suicide rates.
