Suicide prevention is one of the most important topics the public can discuss. It’s everyone’s business, and while this week saw individuals and organizations nationwide joining forces to broadcast the message that suicide can be prevented, it is vital that as many people as possible be reached so that they have the necessary tools and resources to support themselves and those around them.

The Los Angeles Department of Mental Health (DMH) reports that each year more than 41,000 Americans commit suicide, yet the tragic event can be prevented if only family and friends can recognize the signs. It is the 10th leading cause of death for Americans. Most people who are considering suicide show some warning signs or signals of their intentions. Recognizing the warning signs can mean the difference between life and death. It is also important to find the words to convey to a troubled soul. The DMH suggests you ask them directly if they are thinking about suicide, and although this approach can be a difficult proposition, being direct can provide an opportunity for the person to open up and discuss their distress.

Vital to ‘reach out’

It is equally important for the concerned party to “reach out” because they are not alone in this drama. If the concerned party becomes familiar with the resources available they can, in turn, let the troubled person know of their concern for wellbeing and desire to extend help.

The DMH reports that many people who contemplate suicide don’t want to die, therefore if counseling and/or treatment resources are introduced to them they often can get through the crisis. The Centers for Disease Control and Prevention (CDC) report that mental illness is the prime cause of more than 90 percent of suicides, with the most common form of mental illness being depression. Untreated mental illness (including depression, bipolar disorder, schizophrenia and others) is the cause for the vast majority of suicides.

Some people are genetically predisposed to depression, and thus they may not appear to be undergoing any negative life experiences, yet still become depressed and may die by their own decision. Many people hear about individuals who commit suicide who never exhibited any symptoms nor did they appear to have any serious personal problems. In these cases, according to the CDC, it is possible that the person had depression that occurred because of a genetic factor.

The negative contributors

It is rare that a person commits suicide because of a singular cause. Some people kill themselves because depression is triggered by several negative life experiences, and the person has never received treatment—or if they have, it was not effective—for their depression. Among the negative life experiences that can lead to suicide are:

—The death of a loved one;

—A divorce, separation or breakup of a relationship;

—A serious loss, such as loss of a job, house or money;

—A serious illness;

—A serious accident;

—Chronic physical pain;

—Intense emotional pain;

—Loss of hope;

—Being victimized (e.g. domestic violence,

rape, assault, etc.);

—A loved one being victimized (e.g. child

murder, child molestation, kidnapping);

—Physical, verbal and sexual abuse;

—Unresolved past abuse (of any kind).

It will always ‘get better’

Sometimes people feel “trapped” and believe things will “never get better.” Other times an individual believes they’ve been “taken advantage of” or they have difficulty or a specific inability to deal with a perceived “humiliating” situation. They may believe they are a failure (i.e. not living up to his/her high expectations or those of another).

Some depressed people believe they’ll never be “accepted” by family, friends, co-workers or society in general. Disappointments are part of life, but often the person contemplating suicide may lump all of their past “bad luck” into one huge period of despair and decide they can’t go on.

Substance abuse, of course, can go hand-in-hand with low self esteem, and any of the above causes may trigger depression which, if left unaddressed, can result in suicide.

The CDC reported two years ago that the rate of suicide is particularly high for persons ages 15 to 65 years (fourth leading cause of death), with one person taking their life every 12.3 minutes in the United States. Each day, about 117 Americans will take their life and 90 percent of all people who die by suicide will have had a diagnosable psychiatric disorder at the time of their death.

Depression is prime factor

Men reportedly commit suicide at a rate of 3.5 times for every woman who takes her life. However, three times as many women will attempt suicide. In 2014, a reported 494,000 people visited a hospital for injuries due to self-harm behavior, suggesting that about 12 people harm themselves (not necessarily intending to take their lives) for every reported death by suicide.

Again, according to the CDC, it is untreated depression—eventually transforming itself into “major” depression—that is the cause of more than 50 percent of suicides. Depression reportedly affects anywhere from five to eight percent of Americans 18 years and older in any given year. As well, more Americans suffer from depression than coronary heart disease, cancer and HIV/AIDS.

What may be most agonizing for experts in psychiatry is that between 80 and 90 percent of people with depression respond positively to treatment—with almost all patients gaining some relief from their symptoms—but not enough people know where to seek treatment and live daily within a dark abyss of despair.

Robin Kay, acting director of the DMH, says depression can be a ‘silent killer’ long before people take deadly action. It must first be “recognized.”

“[Treatment] begins with eliminating the stigma and discrimination associated with a mental diagnosis,” she said. “We must break stigma and discrimination barriers, while enhancing acceptance, tolerance and social inclusion.” She added that the best way to prevent suicide is through early detection, diagnosis and treatment of depression and other mental health conditions.

Onset of suicidal thoughts

What exactly is depression? Maybe you’ve noticed some changes in yourself lately. You may feel sad, hopeless or simply don’t get the joy out of activities that used to be fun. You worry more, have a loss of appetite, and have increasing trouble getting a good night’s sleep. Researchers at the Mayo Clinic have drawn a direct link between depression and the onset of suicidal thoughts, and have listed a number of key warning signs that the individual must confront and then seek help. Very often, the depressed person will make a “cry for help” to others either through their words or actions:

—Talking about suicide for example, making statements such as “I’m going to kill myself,” “I wish I were dead” or “I wish I hadn’t been born”;

—Getting the means to take your own life, such as buying a gun or stockpiling pills;

—Withdrawing from social contact and wanting to be left alone;

—Having mood swings, such as being emotionally “high” one day and being deeply discouraged the next day;

—Being preoccupied with death, dying or violence;

—Feeling trapped or hopeless about a situation;

—Increasing use of alcohol or drugs;

—Changing normal routine, including eating or sleeping patterns;

—Doing risky things such as using drugs or driving recklessly;

—Giving away belongings or getting “affairs” in order, when there is no logical explanation for doing this;

—Saying goodbye to people as if they won’t see you again;

—Developing personality changes or being severely anxious or agitated, particularly when experiencing some of the aforementioned warning signs.

The ‘protective factors’

People rarely communicate openly about suicide, which hinders effective prevention. Many people are uncomfortable with the topic of suicide. Too often, victims are blamed and their families and friends are left stigmatized. As a result, people suffering with depression and contemplating suicide won’t open up about their feelings which leaves an important health problem left hidden in secrecy.

Researchers at the CDC have identified various “protective factors” that are said to buffer individuals from suicidal thoughts and behavior, including:

—Skills in problem solving, conflict resolution, and non-violent ways of handling disputes;

—Effective clinical care for mental, physical, and substance abuse disorders;

—Easy access to various clinical interventions and support;

—Family and community support or “connectedness”;

—Cultural and religious beliefs that discourage suicide and support seeking help.

Guns are the primary method

Experts and laymen have long assumed that people who committed suicide will have ultimately succeeded—even if temporarily deterred. And because firearms are the primary method of suicide (51.5 percent) followed by suffocation (24.5 percent) and poisoning (16.1 percent), many of these experts in mental health say that not enough attention is being paid to restricting the means to do it—particularly access to guns.

“You can reduce the rate of suicide in the United States substantially, without attending to underlying mental health problems, if fewer people had guns in their homes and fewer people who are at risk of suicide had access to guns in their home,” said Matthew Miller, a director with Harvard Injury Control Research Center and a professor of health sciences at Northeastern University. He said that about 90 percent of people who try suicide and live ultimately never kill themselves. If people who died had not had easy access to lethal means, he noted, “most would still be alive.”

Veterans of combat in both the Afghanistan and Iraq wars have an alarming rate of suicide. The National Institute of Mental Health (NIMH) reported last year that the suicide rate among recent veterans was 50 percent higher for nonmilitary civilians. New analysis of these self-inflicted deaths were published in the February issue of the Annals of Epidemiology and included all 1.28 million veterans who served in active-duty units between 2001 and 2007 and left the military during that period. The analysis matched military records with the National Death Index—which collects data on every U.S. death—and tracked the veterans after service until the end of 2009, finding a total of 1,868 suicides. That figure reportedly equates to annual suicide rate of 2.95 per 100,000 veterans—roughly 50 percent higher than the rate among other civilians with similar demographic characteristics.

Our troubled veterans

One statistic has become a rallying cry in the nation’s capitol: 22 veterans take their lives every day. Men accounted for 83 percent of the veterans in the study and all but 124 of the suicides. A CNN report that aired in 2014 revealed that while veterans comprise about 10 percent of the U.S. population, they account for roughly one in five suicides. Male veterans were three times more likely than women to kill themselves. Female veterans, however, committed suicide at more than twice the rate of other women—a difference much bigger than the gap between male veterans and non-veterans.

These suicide rates are said to set these individuals apart from veterans of past generations. In the Vietnam era, for instance, suicide rates were elevated for veterans suffering from post-traumatic stress disorder, or those wounded in action. Experts believe that the elevated rate today could reflect differences in who served. During the draft, troops reportedly represented a wider cross-section of society, but the long wars after 9/11, according to the NIMH study, may have attracted more volunteers prone to risk-taking and impulsive behaviors.

The Pentagon is embarking on a more detailed study of veteran suicide. The Suicide Data Repository will reportedly link national death records to military and health data to help researchers learn more about veterans’ deployment history, education and other information.