As seen in Psychology Today.

Suicide is a difficult topic to discuss earnestly. It can be particularly difficult for college students, especially if they are in a new environment, far from home, and without a nearby network of friends and family. While one can easily cite statistics highlighting the growing number of suicides in the United States and call attention to the fact that it is now the second leading cause of death among college students, the actual process of reaching out to someone who may be contemplating suicide either due to a mental health crisis or other factors is more difficult. As September is National Suicide Prevention Month, it seems more than appropriate to discuss how one can help prevent a suicide on campus.

People who are struggling with thoughts of suicide oftentimes do not solicit help from others. They may be ashamed of their thoughts, they may feel as though they must bear the burden alone, or they may believe that no one cares enough to help. In some cases, they may be struggling with a severe persistent mental illness like schizophrenia, bipolar disorder, dysthymia (also known as persistent depressive disorder), or unipolar depression (also known as major depressive disorder) and may not want others to know about their diagnosis due to social stigmas surrounding mental illness. As the Boston Globe recently noted, there may be cultural issues among college students of various backgrounds that can make these stigmas even more difficult to overcome.

Any person who is experiencing depression of this magnitude should not feel judged or maligned. More importantly, they should not feel as though seeking treatment is a flaw in their character. It would be like looking down on someone suffering from an infection for seeking antibiotics. This is how one ought to think of depression and all mental disorders—not as flaws, but akin to diseases that can and should be treated by medical professionals. In a more ideal world, there would be no stigma about depression and other mental illnesses, meaning more people would be comfortable seeking out help and discussing mental health problems.

How to Reach Out

However, we do not live in an ideal world. Consequently, one must take the initiative when it comes to reaching out to someone who may be considering suicide whether it is due to a mental illness or not. While many schools may have programs in place to screen students who are potentially at risk or to check on students who have either attempted suicide in the past or been identified as being at risk, these programs are often inadequate, even at top-tier universities. As schools work to make improvements and to expand access to preventative measures, students need to take a proactive approach by intervening when they sense a friend or roommate may be contemplating suicide.

This is by no means a walk in the park. In many cases, you may be confronted with denial, accused of betrayal or having ulterior motives, or met with silence. For college students who hope to engage a roommate who appears to be at risk, the experience can be even more difficult. On the one hand, there may be cultural hurdles to openly discussing issues like mental illness and suicide. On the other, being someone’s roommate does not always mean that you are someone’s friend, and you may encounter emotional barriers that make it difficult to broach the subject. However, you will not know how any individual will respond until you offer to help.

While there is no single guide that can fully prepare you for the experience, there are steps that you can take to prepare yourself. Anyone who is either having thoughts of suicide or knows someone who appears to be at risk can call the National Suicide Prevention Lifeline at 1-800-273-8255 or go to their website here. For college students who are concerned about a friend, roommate, or acquaintance on campus who appears to be struggling with thoughts about suicide, there are typically resources available through the school even in states where these services are not required (an overview of state laws can be found here). This includes crisis hotlines, crisis intervention resources, and access to mental health programs. Additionally, some students and faculty members may have received training through gatekeeper programs, which teach individuals how to identify warning signs of suicide risk and how to get those who are at risk the help they need. If you would like to enroll in a gatekeeper program, the following website offers several options, many of which are web-based.

For more immediate emergencies in which you believe that someone is in imminent danger of hurting themselves due to a mental illness such as schizophrenia or bipolar disorder, you should offer to take them to a hospital. Once there, you should stay with them to ensure that they are admitted by doctors successfully and be prepared to speak with doctors. (For more information about the admissions process, please see my previous post, Mental Health and Psychiatric Hospitals, which is the third installment of my four-part guide addressed to friends and family of individuals with severe and persistent mental illness.)

If they refuse to go or indicate that they will imminently harm themselves or others, you may have to call the police or campus security and request they be involuntarily committed. Although the final decision to have someone committed against their will is ultimately the decision of the psychiatrist evaluating them, your words and experiences can have a significant impact on their assessment. Consequently, it is not a decision that you should take lightly. It is an absolute last resort when there are no other options.

When it comes to suicide prevention, being proactive saves lives.

Suicide Facts:

  • Between 1999 and 2017, the suicide rate in the United States rose by approximately one-third—from 10.5 per 100,000 Americans to 14.0.
  • This trend has accelerated in recent years, with the number of suicides between 1999 and 2006 increasing by around 1 percent per year; the number of suicides between 2006 and 2017 increased by closer to 2 percent.
  • Rates are increasing for both men and women in all age groups between 10 and 74.
  • Suicide is the 10th leading cause of death in the United States.
  • A 2017 survey found that 3 percent of Americans over the age of 18 seriously thought about suicide.
  • A 2018 survey found that 14 percent of college students seriously thought about suicide.
  • Among college students, suicide is the second leading cause of death after unintentional injury.
  • 47,173 Americans took their own lives in 2017.
  • The American Foundation for Suicide Prevention claims that there were as many as 4 million suicide attempts in 2017.

Dr. Ahmad reports no conflict of interest. He is not a speaker, advisor, or consultant and has no financial or commercial relationship with any biopharmaceutical entity whose product/device may have been mentioned in this article.

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