Suicidal thoughts and actions

People who are suicidal go through a lot of different emotional and behavioral changes that are connected to actually committing suicide. Suicidality is like a spectrum that goes from just having some thoughts about death and the idea of suicide to actually attempting it. In between, there are all sorts of behaviors and feelings, including really wanting to end it all and planning how to do it. It's vital to remember that not every thought about suicide means someone is in real or immediate danger.

About suicidality and suicide worldwide

A report from the World Health Organization (WHO) in 2023 says that nearly a million people die from suicide each year. It's the 15th leading cause of death in the Western world. The global suicide rate sits at 10.7 per 100,000 people each year, making up about 1.4% of all deaths. Even though the worldwide suicide rate has been going down over the last few decades, the progress isn't fast enough, and we need to do more.

In Israel, suicide is also one of the top causes of death. Over the past decade (up to 2022), hospitals have recorded an average of 6,300 suicide attempts each year in their emergency departments. This includes around 2,600 attempts by men and about 3,700 by women yearly. During this time, there have been about 405 recorded suicides each year, with roughly 319 being men and 86 women. Fortunately, the last decade has seen a slight drop in suicide rates across most age groups.

In other words, the distress that someone who's suicidal is feeling shows that they think there's no way out, no solutions, and that nothing can help them. At that moment, if you know someone who's going through this and notice their struggles, you can actually make a difference in their mindset, ease their pain, and help improve how they feel. You can do this by asking questions and showing genuine interest and empathy, which lets them know there's someone who sees them, listens to them, and can help them through their suffering. Experience shows that, in most cases, people are open to offers of help, so it’s vital to reach out and offer support as soon as you recognize the need.

Suicidal risk assessment

It is important to become familiar with the risk factors and warning signs of suicidal risks. It is also important to determine whether the person is considered to be at risk for suicide. Awareness of this can facilitate identification and response to intention or risk.

Suicide is not a certainty; it can be avoided

Suicide attempts can be prevented if suitable assistance is received. You need to be able to identify risks in order to immediately intervene, but in many cases, expressing interest and establishing a caring human connection can inspire hope and help cope with a suicidal crisis while also receiving help.

It is important to remember that although two common myths of suicide may cause harm instead of help:

1. The myth that says that “anyone who wants to commit suicide will eventually commit suicide”. This myth is, as its name implies, just a myth. Factually, the opposite is true: early identification of intent, honest and open discussion regarding suicidal thoughts and therapy—can save lives even in cases of intense mental distress and actual suicidal intent.
2. Another myth is “Don’t speak about suicide to avoid putting ideas into one’s head." Here too, the opposite is true: direct questions about suicidal thoughts or intent can break the walls of silence and help the person share, vent, and feel cared for—easing his distress. It is important to know that approximately 80% of people who committed suicide discussed it first with their relatives. For this reason, it is important to not delay a conversation when suicidal ideation is suspected. For this sensitive discussion, one needs to prepare in advance, find a quiet, private location, and not promise confidentiality if the person is at risk.

So, what can be done? There are several ways that can help prevent suicide, including:

• Open, honest conversation with the suicidal person about suicide and getting help.
• Contacting professionals to provide counseling and professional therapy.
• Preventing access to lethal means (weapons, knives, high windows).
• Supervising the suicidal person until the danger has passed.

Read more about suicide prevention

Written in collaboration with the National Suicide Prevention Program.

Written with the assistance of: Dr. Shira Barzilai, clinical psychologist, senior lecturer in the Community Mental Health Faculty, the University of Haifa, and Nadav Horovitz, clinical psychologist