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Ask 'the question' to save a life

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John Westefeld, guest columnist

In 2014, the most recent data we have, there were 42,773 suicides in the United States. That is 117 per day, or one every 12 minutes.

Of these, 33,113 were males and about 50 percent were carried out using firearms. Suicide is the second leading cause of death among people ages 15-24 in the U.S. In 2014 there were 407 suicides in Iowa.

Suicide impacts almost everyone — eventually. If you live long enough you will very likely know someone who attempts or completes suicide. One of my close friends chose to end their life when I was young, and a member of my extended family made multiple attempts. These experiences had a profound impact on me early in my life, and motivated me to want to become a psychologist, study and try to help suicidal people, and keep the topic of suicide and suicide prevention in front of the public.

It is challenging to predict suicide. The person themselves can be ambivalent about ending their own life. However, a number of important risk factors have been identified, and with World Suicide Prevention Day being Sept. 10, this is a very appropriate time to review these risk factors.

The risk factors can vary a great deal from individual to individual; sometimes there may appear to be no risk factors at all.

That said, the most important risk factors for suicide tend to be: depression; increased use of alcohol/drugs; becoming withdrawn; having attempted suicide previously; feelings of hopelessness and helplessness; being exposed to someone else’s suicide; low self concept; experiencing violence/victimization/trauma; having a specific plan for ending one’s life; talking about suicide explicitly or implicitly; and very high levels of stress.

There are a number of things we can do to try and address the issue of suicide. First, we can conduct suicide prevention workshops for churches, schools, colleges, community organizations, business and industry and other groups. Second, we can reach out to someone if we are concerned they may be suicidal.

If you are concerned about someone, do not be afraid to ask them what many suicidologists call “the question”. There are a variety of ways to ask this question. What I have found most effective is to say, “Have you been feeling so badly lately that you have thought about harming yourself?” or words to that effect. Most people will respond to this question honestly, and suicidal people will almost always appreciate you asking. They want permission to talk about their pain.

There is a perception by some that by asking about suicide, it may give the person the idea to attempt. And while I suppose almost anything is possible, the evidence is very strong that you are much more likely to prevent a suicide than cause one by reaching out if you are concerned someone is suicidal.

If you learn the person is suicidal, provide them with hope and support, monitor them, consult with a mental health professional and encourage them to seek treatment. Many suicidal people will initially resist, but with continued encouragement, most will eventually seek the help that they need. The key is not to give up.

There are many excellent resources, I want to mention two that I believe to be especially relevant and useful. The most important one is the National Suicide Prevention Lifeline, which is available 24 hours a day, seven days a week. Their phone number is (800) 273-TALK (8255). Another excellent resource is the website of the American Association of Suicidology.

Though suicide is an overwhelming and very complex issue, there are steps we can take to try and lower the suicide rate. These include prevention; training and education — especially about risk factors; a willingness to reach out if concerned that someone may be suicidal; and treatment. By taking these steps we can create a world where more people like my friend — and so many others — will be able to live out their lives — and their dreams — in meaningful ways.

• John S. Westefeld is a Psychologist and Suicidologist who lives in Iowa City.

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