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Help me I am glad you are reading this, because if you are, it means that at least some part of you believes there is a chance you can be helped. I hope you can spare a couple more minutes to read to the end of this page. If you can't, please at least read Surviving today before you go back to looking at ways to kill yourself.

I know what it is like to feel there is no hope left. To feel like there is nothing worth living for. To not be able to face the rest of your life. I know because I felt it myself, and I am truly sorry you are in that place. It probably means you are past caring about anybody or anything, and don't believe it's possible to change how you feel right now.

Think for a minute. Have you always felt like you do right now? The chances are, there were times in your life where you did not. Which means something in your life changed to get you where you are now. But that also means that something can change to get you away from you are now. Seriously - life is changing all the time - yours included. Surely there were other times you felt really low and something happened to make you feel brighter?

People think about committing suicide as a solution to a problem they see no solution to. But here's the thing - even if you don't think there is a solution to your problems right now, that does not mean it does not exist. It just means that you can't see it right now.The evidence.


There is a huge body of evidence to show that most problems that lead people to suicide can be resolved or effectively treated. Even if you have previously sought treatment and it hasn't worked, that doesn't mean there isn't a treatment that will work (see Addressing the problem). Sometimes a few different things need to be tried before the right treatment is found.

You should also bear in mind that the crisis that leads people to contemplate suicide is nearly always temporary, and that in time, people see that their problems were not as big as they first thought. That's all good news.

I'd like to ask you a question. Given a choice, would you choose to feel like you do right now, or would you choose to feel happy?

Of course, we all want to be happy. Who wants a life of misery? But here's the thing. We control how we feel (feelings are derived from our thoughts and emotions). So if you feel on the verge of killing yourself right now, and, given a free choice, you'd choose to be happy - have you ever wondered - who's doing the choosing? 'Cos it can't be the sane part of you that just wants to be happy...The script

We all have a part of us that seems to take over our lives. That voice inside. Richard Wilkins, founder of the Ministry of Inspiration, calls it our script. It is the sum total of our life experience to date. Everything that has happened to us, that we have heard, seen, felt - and how we have interpreted those experiences.

Many people have a script that says "I'm not good enough", that started in their childhood. Some "I'm not attractive". Some "nobody will ever love me", "I'll always be broke", "I'll never find a partner" or "I'll never be happy". And that script is POWERFUL. This second it has you by the scruff of your neck. It has been running your life for a long, long time. And you can't change it - your script is your script. However, what you can do is to recognise it for what it is - a script, written in your past. You can, and I really mean, you can - however fragile and on the edge you might be right now - start to ignore the old script, and start writing a new script, a better one, for the rest of your life.

Well, you are either now interested, or still reading but in that suicidal haze that says "I'm reading, but nothing I read will make any difference". I can understand that. It can be hard to believe anything anybody writes will change anything when you get to the edge of life. So if you don't want to read further, at least briefly look at Surviving today.What's the point in living?

In my dark days, and less dark days, there was one thing that I thought about often - what is the point in living? I just wanted to find an answer to that simple question! Maybe if I had a reason for that I'd decide I wouldn't need to kill myself after all. I suspect it might be a question that you have thought about too.

I actually researched that very question for this site, and found an interesting array of answers from philosophers, psychotherapists, religions and social commentators, including:Many religions state the meaning of life is to serve god and obey his commandments.Instinctism states that every action is driven by a need to attract the opposite sex, thereby fulfilling the basic need of reproduction and thereby the continuance of the human race.Some say life doesn't have its own meaning, just the meaning you ascribe to it. And when people are asked what is important to them, the answers generally come down to three things: love, learning and being happy.

To read more about meanings of life, click here.

My own view, is that there are three or four things that drive us, not necessarily all at the same time. Firstly, physical connection. We have genetic programming to reproduce, and that drives a lot of our behaviour, whether that be making ourselves more attractive to potential partners, or what we have to do to stay with them. When we aren't having physical connection, we are driven by what's required to get it. If we don't have one, it can make us sad, frustrated, or drive us to focus on other things so we are distracted from not having it.

For those that have children, especially younger ones, providing for children can be a really powerful reason to stay alive. Once they grow older this reason can start to reduce though – the kids don’t need the parents anymore, and the parents need to find some other reason for living.

Next is emotional connection. Sex and intimacy are not enough any more. We search for deep emotional connection, which some might describe as love. Like when a parent loves a young child unconditionally. The child does not need to be clever, funny, rich or good at sport. They are loved for who they are. As we go through life, we spend so much energy doing things to be loved, whether that is by parents, partners, children or friends. But deep down, we just want to be loved and accepted for who we are - the bad and the good. But these days it seems people find it ever harder to express love, and/or if they get it coming their way, how to receive it. It's no wonder we live in a fucked up world.....

However, love alone isn't enough to keep us going - as Don Henley sung, "sometimes love just ain't enough". So the other thing we need is to make a difference to the world. We need to do something beyond ourselves for the good of our fellow human beings. Why, I don't know. Maybe it is simply genetic programming about making sure our race survives. And whilst we might not be able to control who loves us, or getting physical connection, this is one area we can take charge of our own destiny. Which begs the difficult question - "what do I have to do to make a difference"?What makes a difference?

For me, it was always something more than whatever I did (read My story). If you donated $10 to provide food or water to a starving person in a developing country, that would make a real difference to them. A huge difference. Maybe the difference between living and dying. Would that be enough reason for you to stay alive?

What about if you stayed alive to help a friend or family member, through some sort of personal crisis. And with your help and support that person went on to make the lives of 20 other people better. Would that be enough? Maybe if you hadn't helped, it never would have happened?

Maybe in staying alive you have a business that makes loads of money and helps find a cure to a disease that improves the lives of thousands of people. Or maybe you are the doctor that helps find that cure? Is that enough?

Or maybe by not killing yourself, you save a number of people you know the sort of unbelievable heartache that is 100 times worse that whatever you are feeling now? Is that alone enough reason? You might be thinking that those near to you will come to terms with what you are about to do; that your pain is much worse than theirs will be. But the legacy you leave those people is not only the grief of your death, but guilt for the rest of their lives that they couldn't help you feel better. They will feel responsible. Or else hurt, confused, angry or remorseful.

Make no mistake. Suicide will have a devastating effect on those around you, and the effects will stay with them the rest of their lives. If in your mind you belittle this impact (as I did), you are fooling yourself. And to test it, just ask someone close to you how they'd feel if you got knocked over by a bus.

Or maybe, like me, you find some small way to help just a few people feel happier in their lives. Even if it is just one person. Is that a life worth living? I'd say yes. And trust me, in a life we can all make a difference to at least one other person. Whatever you are suffering from. Whatever it is in your life that makes you desperate enough to find this site. I promise you. I absolutely promise you - YOU CAN MAKE A DIFFERENCE. Much harder is for you to realise how much difference you can make, and probably already do.You are not alone

So I write this on new year's eve 2009. In the next month, and every month thereafter, over 16 million people will do a Google search on the word suicide. Yes, 16 million, so trust me, you are not alone feeling like you do. In the next 12 months the World Health Organisation (see Suicide statistics) estimates well over 20 million people will actually try and commit suicide. Over 1 million will succeed. A good chunk of the others will end up in hospital, in pain. Possibly with permanent health issues. Like brain damage.

I don't judge anyone who considers ending their life, tries to do it, or succeeds. It saddens me that economically the world has come so far, yet emotionally we have gone so far in reverse. Over the last 50 years the suicide rate has increased more than 50%1. So what difference would it make to the world if 20 million people per annum, spent just half the time they were going to spend planning their death, on doing something to help someone else? Even something small to a friend or member of their family? That would be huge. What difference would it make if 20 million less people tried to kill themselves - what impact would that have on those that know them? Massive. As Margaret Mead said:

"Never doubt that a small group of thoughtful citizens can change the world. Indeed, it is the only thing that ever has."

So I'm sad that we live in a world that drives so many people to consider they want to leave it. The reason I created this website is that it scares me how many people injure themselves trying to commit suicide. It scares me that after these people wake up in hospital, the majority2 will say they weren't that intent on killing themselves. I'm happy that by not succeeding in killing myself, I have a chance to help you. And maybe you will pass on that favour and help someone else.

A life with no love, and no making a difference, is going to be a struggle. We need at least one, and ideally both. And they both cost nothing. So here's my plea - that rather than trying to kill yourself, you read the rest of this section of the website. Try and find something that will make a difference to you. Just one thing, and commit to doing it. If you've tried already - try again. If you've tried again. Try harder. There's always time to look at the methods of suicide later...

What's behind suicide? In researching this website, I came across some interesting studies and comments about what drives people to suicide. I thought it might be helpful to share this information so people can understand better what might be lying behind how they are feeling.

Research in the UK and in the US seems consistent in identifying the principal factors that contribute to someone committing suicide. According to the American Association of Suicidology1, major depression is the psychiatric diagnosis most commonly associated with suicide. The risk of suicide in people with major depression is about 20 times that of the general population. About two thirds of people who complete suicide are depressed at the time of their deaths. That's a very high percentage.

The risk of someone suffering from an untreated major depressive disorder trying to commit suicide is around 1 in 5 (20%). However, the suicide risk among treated patients is around 1 in 1,000 (0.1%). That would point to treatment for depression substantially reducing the risk of suicide, so maybe there is hope for feeling better. See Help me.

Research studies2,3,4 would point to the following being major factors triggering people to attempt to kill themselves. Note that more than 90 percent of people who die by suicide have the top two risk factors:Depression (especially if exhibiting extreme hopelessness, lack of interest in activities that were previously pleasurable, heightened anxiety and/or panic attacks) and other mental disordersAn alcohol or substance-abuse disorder (often in combination with other mental disorders)Relationship difficulties (either with an existing partner, or due to divorce, being widowed or a relationship break-up)Prior suicide attempt (one study5 indicated that anyone who has previously attempted suicide is 100 times more likely to make a successful attempt compared to the suicide rate of the general population)Family history of mental disorder or substance abuseFamily history of suicide, or exposure to the suicidal behaviour of family members, peers, or media figuresFamily violence, including physical or sexual abuse (especially for young people)Firearms in the home, the method used in more than half of US suicidesBeing in prisonUnemploymentIssues with studies (a major problem for those at university/college)Financial problemsLegal problemsSocial deprivationSocial isolation

However, suicide and suicidal behaviour are not normal responses to the factors mentioned above; many people have these risk factors, but are not suicidal. Research also shows that the risk for suicide is associated with changes in brain chemicals called neurotransmitters, including serotonin. Decreased levels of serotonin have been found in people with depression, impulsive disorders, a history of suicide attempts, and in the brains of suicide victims.

Depression, like other mental illnesses, is probably caused by a combination of biological, environmental, and social factors, but the exact causes are not yet known. For years, scientists thought that low levels of certain neurotransmitters (such as serotonin, dopamine, or norepinephrine) in the brain caused depression.

However, scientists now believe that the interplay of factors leading to depression is much more complex. Genetic causes have been suggested from family studies that have shown that between 20 and 50 percent of children and adolescents with depression have a family history of depression, and that children of depressed parents are more than three times as likely as children with non-depressed parents to experience a depressive disorder6.

In some people, there can be underlying physical reasons for severe depression. For instance, those diagnosed with a terminal illness, or those living with a long term physical disability, especially if accompanied by pain that is never likely to go away. It can be much harder to treat depression for people in this category, as the underlying causes are physical issues that cannot be cured. That isn't to say though that even people such as this can't find a motivating reason for living. See Help me.

For more information on the factors that lead to someone feeling suicidal, see Risk factors for suicide.

Things to considerIf one is intent on committing suicide, there are a few practical matters that need to be considered before making that attempt. This section aims to briefly outline those in a factual way, with no comment or opinion.Be sure, be really, really sure, that there is no other way to get over the pain you are experiencing, other than suicide. You are recommended to read the section Help me.Consider the likely responses of those you leave behind i.e. how family and friends will react to the news of your choice to end your life, what impact it will have on them; what impact it may have on your work, business, clients. According to the US Suicide & Crisis Centre, each suicide intimately affects at least six other people, so consider carefully the impact on them. Read more in Help me.

Be wary if what is driving you to consider suicide is sending a message to others (which it is in many cases, often on a sub-conscious level). Your actions might be driven from anger, hurt or revenge, rather than a true desire to end your life.Select a method of suicide. There is plenty of information on this website, and recommended further reading. Consider carefully how painful the selected method is, and whether your desire to die exceeds the likely pain, and risk of a failed attempt.Prepare the means. Most suicide methods require some preparation.If required, find someone to assist getting the means for the selected method, or help with the method itself. This may be particularly relevant for the infirm or terminally ill, and working out who can assist without judging you is key. Take great care that any assistance will not run foul of euthanasia laws in your country, as assisting people in their own suicide is generally illegal. See the law sections under Euthanasia & assisted suicide for more information.Decide who you tell. Many people will not tell anyone for fear of being judged, or attempts to be talked out of it. It could be argued that if being talked out of it is a fear, then that is a reason for telling someone, as the chances are you have some doubts that it is the right thing to do.Have an up to date will. For anyone in the UK who has not yet written a will, or needs to replace their current will, quality, reasonably priced do-it-yourself wills (that can also be reviewed by a lawyer) are available online at www.desktoplawyer.co.uk, and in the US from www.mylawyer.com.Create a living will. This could be handy in the event your attempt is not successful and significant physical or mental damage results. A living will sets out your wishes regarding healthcare and how you would like to be treated in the event you are seriously ill and unable to make or communicate your own choices. See websites above for how to create one.Financial affairs. It makes sense to have all your financial affairs in order. It is also extremely helpful to whoever will be left to deal with your financial affairs, generally the executors of your will, to have a letter detailing bank accounts, life insurance policies, pension funds and details of any other assets that may be subject of your will.Funeral. Consider whether you wish to be buried, cremated, or leave your body to be donated to medical science. Put this instruction in your will. Try and make sure someone else knows.Follow the three day rule. If you are ready to commit suicide, like really, really ready, wait three days, or better still a week, until you actually go through with it. If you are going to be dead for the rest of time, what's another few days wait? It may be that in a few days your enthusiasm to go through with it might not be the same, which will suggest that maybe suicide is not the only answer, but possibly something could change in your life circumstances, or how you view/feel about your life, that will change your decision. After all, something changed to get you to this place - maybe it will change again? Read Help me.

Many suicides and attempted suicides are done on impulse, but this suggests that the same people would not have tried to kill themselves either days before, or days after, had they thought about their actions for longer. Suicide is a permanent condition. It is not a decision that should be rushed.

Suicide Welcome to Lost All Hope. I’m sorry you are here reading this, but glad you have come across a site that is filled with information and resources designed to help people thinking of committing suicide.

People who are depressed and thinking of committing suicide often feel alone, isolated, hopeless; that the world will be a better place without them, and no-one will miss them. Well, you are not alone, because there are around 20 million attempted suicides every year (see Suicide statistics). Probably around 160m every year who have serious thoughts of committing suicide. So there are many, many people feeling just like you do now.

And whilst this might not make you feel better, perhaps be reassured that out of those 160m who think about committing suicide, only 0.6% of them actually do. So for 99.4% of people, their feelings of desperation reduce enough for them not to try and kill themselves. However you feel right now, a bit more reading before committing suicide can’t do any harm, so I would really urge to read Help me, especially Surviving today.

Possibly like you, for a number of years, I frequently spent time trawling the internet researching ways of killing myself. Feel free to read My story. I thought I had the means all sorted out. My will and financial affairs were in order. All I needed was something to push me over the edge. One day that thing happened. I really expected my suicide attempt to work. I was very disappointed when it didn’t.Painless suicide

Years later I put together this site. In doing so I researched suicide forums, books, blogs, newsgroups and websites. I am no longer surprised I failed. Because the more I read, the more I see how many ways there are to screw up killing yourself. The research would point to painless suicide being the problem. People that hang themselves, shoot themselves, throw themselves off the top of a building or cliff, don’t seem to engage in so much chat about how to do it.

The people who discuss suicide the most, think about it for the longest time, attempt suicide the most, yet fail suicide most often, are those looking for peaceful and painless methods to go. This site was designed to help people thinking of killing themselves. That help might consist of informing of the dangers of particular methods. And there are, many dangers, in many methods. They aren’t on this site to dishearten you, or overwhelm you with information, it is just the facts. A successful, painless suicide takes a lot of research and preparation. And, if you read as much information as I have, you will realise it does take effort.

The help on this site might also consist of more practical advice, like that contained in Help me and Addressing the problem. Please have a good look around. My own experience was that it took a lot of trial, error and persistence to find something that made a difference to me. But that doesn’t mean that help is not possible.

I understand that people visiting this site feel hopeless. I really do know how that feels. And in that place it is hard to believe anything will ever get better. I was always prone to cutting myself off from people. If I did speak to people, I never told them how I felt. Not how I really, really felt. Who could possibly want to put up with someone who felt so miserable and hopeless?

I read in my research that speaking to someone was very powerful, and noticed there are all these suicide helplines. Who really wants to speak to some helpline when you want to kill yourself? What good will that do? Nine years later I learnt how much difference speaking to someone can make. Do not underestimate the power of truly expressing how you feel. It can be massive. It can be hard, but for reasons I can’t explain, really beneficial.

So, if you can reach out to someone, and somehow express what you really, really feel – do it. If you can’t reach out to a friend, then almost every country has some sort of suicide helpline. Speak to somebody. If speaking makes no difference then you have only lost the time it takes to make a phone call. Links to the main suicide helplines are below, and further information on these and other helplines is in Links.

Befrienders Worldwide (operating in 39 countries): www.befrienders.org

National Suicide Prevention Lifeline (USA): www.suicidepreventionlifeline.org 1-800-273-8255

The Samaritans (UK): www.samaritans.org 08457 90 90 90

Lifeline (Australia): www.lifeline.org.au


Surviving today Assume, just for a second, you have a car. If it breaks down, what do you do? Normally, take it to someone to get it fixed. You wouldn't pour acid on it, blow it up, drive it over a cliff. It's just broken, and broken things can be repaired. You are no different to a car. You have a problem. The issue is you either don't believe it can be repaired, or don't know how. Both can be addressed.

On www.metanoia.org, Martha Ainsworth uses a slightly different analogy, and talks about suicide being driven by a person getting to a place where their pain exceeds their ability cope with the pain. I think this is also true, and the trick is to either reduce the pain, increase the coping resources, or ideally both.

So, you are on the brink, you have no hope, but for some strange reason you are still reading. Is there anything that can make you feel less shit than you do right now? I hope so...Follow the three day rule. If you are ready to commit suicide, like really, really ready, wait three days, or better still a week, until you actually go through with it. If you are going to be dead for the rest of time, what's another few days wait? It may be that in a few days your enthusiasm to go through with it might not be the same, which will suggest that maybe suicide is not the only answer, and possibly something could change in your life circumstances, or how you view/feel about your life, that will change your decision.

Many suicides and attempted suicides are done on impulse, but this suggests that the same people would not have tried to kill themselves either days before, or days after, had they thought about their actions for longer. Suicide is a permanent solution to an often temporary problem. It is not a decision that should be rushed.Speak to someone. Now. People who are suicidal are very often feeling lonely, isolated, depressed, hopeless. I understand that in that place you may not want to speak to anyone. I certainly didn't. After all, what difference can they make? Or maybe you are too embarrassed or ashamed to talk to anyone about how you are feeling, especially someone that knows you? I certainly was.

But I'll say this. However much you might not want to speak to someone, do it anyway. If you are going to spend the rest of time dead, what difference making a phone call now? Speaking to someone, and discussing how you feel, is possibly the single most powerful thing you can do right now. You don't have to speak to someone that knows you. Whatever the time of day, the organisations below have trained people available who will listen to you, without judgement. If you can't face speaking to someone, see further down this page for chat forums:

UK: www.samaritans.org 08457 90 90 90 (Republic of Ireland 1850 60 90 90)

US: www.suicidepreventionlifeline.org 1-800-273-8255

Australia: www.lifeline.org.au

Worldwide www.befrienders.org (phone numbers dependent on country of residence)

Or call a minster or rabbi. If you are already having psychotherapy, you should tell your psychotherapist.

If you have a friend or a family member you can trust to listen to you, without being angry or judgemental, consider using them as well as, or instead of, the above. Just chatting to someone who cares can make all the difference. Really, it can. Even just going round to a friend or family member whose company you enjoy can make a huge difference.

It is also highly advisable to tell your doctor, as they should be able to point you towards some form of treatment (and see Addressing the problem).

If you don't want to speak to a real person, another option might be going to the Depression Understood chat room (see Chat), which should be an environment where you can share how you feel, and be supported by others who will understand exactly what you are going through. It is open 24/7, and some people might feel more comfortable communicating by chat than to a person.Realise that statistics show the vast majority of people who are suicidal do not go through with it. You are not alone. And the odds of you getting though this and feeling better again are in your favour. So even if you think there is no hope, the statistics would point to there being lots of hope. Most people who are suicidal go on to lead a much longer life.Think, very, very carefully, about the pain of killing yourself. Many people mistakenly assume that suicide is painless, and thus it will be less painful than the pain of life they are enduring. In many cases though, suicide is not painless, and is positively very painful. Look through this site to see the possible dangers of whatever method you are considering.

To read more about longer term initiatives to help you feel better, read the section Addressing the problem.

You might also want to have a look round the Mentanoia website which also has helpful advice and guidance.


Addressing the problem According to the American Association for Suicidology (AAS)1, nearly everyone at some time in their life thinks about suicide. Almost everyone decides to live because they come to realise that the crisis is temporary. However, people in the midst of a crisis often perceive their dilemma as inescapable and feel an utter loss of control. Frequently, they:Can't stop the painCan't think clearlyCan't make decisionsCan't see any way outCan't sleep eat or workCan't get out of the depressionCan't make the sadness go awayCan't see the possibility of changeCan't see themselves as worthwhileCan't get someone's attentionCan't seem to get control

The AAS estimates that about two thirds of people who commit suicide are depressed at the time of their death. Not a big surprise. Perhaps what is a surprise is that the treatment of depression is effective 60% to 80% of the time. The risk of someone suffering from an untreated major depressive disorder trying to commit suicide is around 1 in 5 (20%). However, the suicide risk among treated patients is around 1 in a 1,000 (0.1%).

You'd think that if treatment was that effective, a lot less people would try and kill themselves. However, according the World Health Organization, less than 25% of individuals with depression receive adequate treatment. Unfortunately believing your condition is "incurable" is often part of the hopelessness that accompanies serious depression. But what you believe is different to the facts. So the clear message is here:

Depression IS treatable, and in gaining effective treatment the chances of feeling suicidal go down significantly.

Of course, depression is not the only reason people commit suicide. It might be for any variety of reasons - see What's behind suicide? for more information. But whatever your reason is, there is a high probability there is some form of effective treatment for it, so please keep reading.Suicide and medical conditions

Even if you are reading this and suffering from a serious medical condition, that might not have a cure, I'd urge you to read on. I don't pretend to know what it is like living life in permanent physical pain. I can understand anyone in severe pain wanting to consider ending their lives. But you must be reading this for a reason. You must be open to hope. Even people in physical pain or with a disability can still find reason to live. To you, I would urge you watch the Jonny Kennedy and Christopher Reeve movies (see Watch this), and read Still Me by Christopher Reeve (see Books & DVDs). For people in pain have done incredible and inspiring things with their lives, and maybe you will find inspiration in their stories.Loss of hope

The thing that struck me about suicidal people is the loss of hope. That anything can be done that will make a difference to the rest of their life. Many people arriving at this website might have been on anti-depressants and/or had some form of therapy. But just because they have not worked does not mean there is nothing that can work. There is a good chance that there are other things you can try. As Thomas Edison, inventor of the light bulb, said, when asked about whether he had any success yet in inventing the light bulb:

"Results? Why man, I have gotten lots of results! If I find 10,000 ways something won't work, I haven't failed. I am not discouraged, because every wrong attempt discarded is often a step forward...."

Or as the inventor of pasteurisation, Louis Pasteur said:

"Let me tell you the secret that has led me to my goal: my strength lies solely in my tenacity."

Or, Mary Pickford (know as one of the pioneers of Hollywood, and founder of United Artists and the Academy of Motion Picture Arts and Sciences, that awards the Oscars):

"If you have made mistakes, there is always another chance for you. You may have a fresh start any moment you choose, for this thing we call "failure" is not the falling down, but the staying down."

So whatever you have tried so far, whatever has not worked, is a step in the direction of finding something that will work. Remember that.

Things to try are listed and linked below. Please read through them all. Consider trying more than one, as there is no limit on initiatives that might make you feel better. But try something.Watch thisTherapyE-therapyPsychiatryMedicationHypnotherapyPersonal development coursesCounsellingLife coachingMeditation & relaxationYogaSupport groupsExercise & hobbiesReligionCommunity/charityNutritional supplementsChatBooks & information

There are links to numerous other websites and organisations that may be of help in Links.

Suicide statistics The first thing you should be aware of if you are trying to kill yourself is, the odds are against you. Yes, I'll say that again - the odds are against you. According to a report released by the American Association of Suicidology1, there are 25 attempts at suicide for every one success.

In young people (aged 15 - 24), the odds are between 100 and 200 to 1 against. The elderly seem a lot more successful at 4:1.

Women are three times more likely to make an unsuccessful attempt than a man, yet will attempt suicide two to three times more often. However, this does depend on their age, as younger women make many more attempts than men, whereas women older than 50 make slightly less attempts than men2.

According to the 2008 National Survey on Drug Use and Health3, in the US there were 8.3m adults who had serious thoughts of committing suicide, and 2.3m who had actually made plans to commit to suicide. Of those, 1.1m actually attempted suicide, but only just over 33,000 succeeded. Which would make the ratio of failure to success 33 to 1.

According the World Health Organisation4, in the year 2000, there were approximately 1m suicides globally. However, another study5 for the WHO states that the suicide figures from some countries may be underreported by between 20% and 100%, so the death toll could well be higher. Worldwide, suicide rates have increased by 60% over the last 50 years, and the increase has been particularly marked in developing countries.

The WHO estimates that globally there are at least 20 suicide attempts for every success, meaning that there are least 20m, yes, 20million, attempted suicides every year - and rising.

In a study done in Oxford UK6, 864 people that attempted suicide (and survived) were asked to rate, on a scale of 1 to 30, how intent they were on killing themselves (where 30 was totally intent, and 1 was hardly at all). The results are below:
Rating of suicidal intent % of respondents
Low (0-6) 36.9%
Moderate (7-12) 33.9%
High (13-20 25.0%
Very High (21+) 4.2%

The message here is that two thirds of people that try to kill themselves are not that intent on succeeding. Maybe there's a part of them that wanted to end it, and a part didn't, and due to some event that tipped them over the edge, they tried to commit suicide.

So what are the messages here? Firstly, you are not alone. Suicide is a major problem. We are living in a society where more and more people are considering suicide. Second, note that anyone thinking of trying to kill themselves is much more likely to screw it up than succeeding. The odds globally are at least 20 to 1 against, and in the US quite possibly 33 to 1 against or higher. And many of those unsuccessful attempts end up with people having nasty short or long term health implications. And third, many people who actually try and commit suicide say after the event they weren't that intent on doing it. Many people attempt suicide on impulse, and then end up living with serious health implications.

So anyone thinking of suicide should first read Help me. It is not the only option. If you are still intent on attempting to take your own life, be sure to read the dangers of whatever method you are considering, and think it over again. The pain you are currently going through might be nothing compared to pain you are about to put yourself through trying to kill yourself.

Inspirational quotes Harriet Beecher Stowe When you get into a tight place and everything goes against you, till it seems as though you could not hang on a minute longer, never give up then, for that is just the place and time that the tide will turn.Sir Winston Churchill

Never give in. Never. Never. Never. Never.

If you're going through hell, keep going.

The pessimist sees difficulty in every opportunity. The optimist sees the opportunity in every difficulty.Japanese proverb

Fall seven times, stand up eight.Mary Pickford

If you have made mistakes, there is always another chance for you. You may have a fresh start any moment you choose, for this thing we call "failure" is not the falling down, but the staying down.Thomas Edison

Many of life's failures are people who did not realize how close they were to success when they gave up.

Genius is one percent inspiration and ninety-nine percent perspiration.

Results? Why, man, I have gotten lots of results! If I find 10,000 ways something won't work, I haven't failed. I am not discouraged, because every wrong attempt discarded is often a step forward....Christopher Reeve

Once you choose hope, anything's possible.Nelson Mandela

It always seems impossible until it's done.

The greatest glory in living lies in not never falling, but in rising every time we fall.William Dempster Hoard

Happiness doesn't depend on what we have, but it does depend on how we feel toward what we have. We can be happy with little and miserable with much.Zig Ziglar

Failure is an event, never a person.Dolly Parton

If you want the rainbow, then you've gotta put up with the rain.Jane Addams

Nothing could be worse than the fear that one had given up too soon, and left one unexpended effort that might have saved the world.Marian Wright Edelman

You're not obligated to win. You're obligated to keep trying to do the best you can every day.Mary Kay Ash

Aerodynamically the bumblebee shouldn't be able to fly, but the bumblebee doesn't know that so it goes on flying anyway.John Quincy Adams

Patience and perseverance have a magical effect before which difficulties disappear and obstacles vanish.Herodotus

Some give up their designs when they have almost reached the goal; while others, on the contrary, obtain a victory by exerting, at the last moment, more vigorous efforts than ever before.Franklin D Roosevelt

When you come to the end of your rope, tie a knot and hang on.Dale Carnegie

Most of the important things in the world have been accomplished by people who have kept on trying when there seemed to be no hope at all.Barack Obama

Hope is what led a band of colonists to rise up against an empire; what led the greatest of generations to free a continent and heal a nation; what led young women and young men to sit at lunch counters and brave fire hoses and march through Selma and Montgomery for freedom's cause. Hope is what led me here today - with a father from Kenya, a mother from Kansas; and a story that could only happen in the United States of America. Hope is the bedrock of this nation; the belief that our destiny will not be written for us, but by us; by all those men and women who are not content to settle for the world as it is; who have courage to remake the world as it should be.Don Quixote

Sanity may be madness but the maddest of all is to see life as it is and not as it should be.Henri Nouwen

All the great spiritual leaders in history were people of hope. Abraham, Moses, Ruth, Mary, Jesus, Rumi, Gandhi, and Dorothy Day all lived with a promise in their hearts that guided them toward the future without the need to know exactly what it would look like. Let's live with hope.Mohandas K Gandhi

You must not lose faith in humanity. Humanity is an ocean; if a few drops of the ocean are dirty, the ocean does not become dirty.Robert Fulghum

I believe that imagination is stronger than knowledge - myth is more potent than history - dreams are more powerful than facts - hope always triumphs over experience - laughter is the cure for grief - love is stronger than death.Theodore Roosevelt

It is not the critic who counts: not the man who points out how the strong man stumbles or where the doer of deeds could have done better. The credit belongs to the man who is actually in the arena, whose face is marred by dust and sweat and blood, who strives valiantly, who errs and comes up short again and again, because there is no effort without error or shortcoming, but who knows the great enthusiasms, the great devotions, who spends himself for a worthy cause; who, at the best, knows, in the end, the triumph of high achievement, and who, at the worst, if he fails, at least he fails while daring greatly, so that his place shall never be with those cold and timid souls who knew neither victory nor defeat. (Speech at the Sorbonne, Paris, April 23, 1910)Will Smith (from The Legend of Bagger Vance)

The game cannot be won, only played.William Shakespeare

There is neither good or bad, but thinking makes it so.Aldous Huxley

Experience is not what happens to a man, it's what he does with what happens to him.Lao Tzu

The journey of a thousand miles must begin with a single step.Katherine Paterson

Peace is not won by those who fiercely guard their differences, but by those who, with open minds and hearts, seek out connections.Peyton Conway March

There is a wonderful law of nature that the three things we crave most in life - happiness, freedom and peace of mind - are always attained by giving them to someone else.Stephen Covey

To touch the soul of another human being is to walk on holy ground.J. Willard Marriott

Good timber does not grow with ease, the stronger the wind, the stronger the trees.Oliver Goldsmith

Our greatest glory consists not in never failing, but in rising every time we fall.Dr. Martin Luther King, Jr.

If it falls your lot to be a street sweeper, sweep streets like Michelangelo painted pictures, sweep streets like Beethoven composed music, sweep streets like Leontyne Price sings before the Metropolitan Opera. Sweep streets like Shakespeare wrote poetry. Sweep streets so well that all the hosts of heaven and earth will have to pause and say: Here lived a great street sweeper who swept his job well. If you can't be a pine at the top of the hill, be a shrub in the valley. Be the best little shrub on the side of the hill.

Be a bush if you can't be a tree. If you can't be a highway, just be a trail. If you can't be a sun, be a star. For it isn't by size that you win or fail. Be the best of whatever you are.Marianne Williamson (but often attributed to speech made by Nelson Mandela)

Our deepest fear is not that we are inadequate. Our deepest fear is that we are powerful beyond measure. It is our light, not our darkness that most frightens us. We ask ourselves, Who am I to be brilliant, gorgeous, talented, fabulous? Actually, who are you not to be? You are a child of God. Your playing small does not serve the world. There is nothing enlightened about shrinking so that other people won't feel insecure around you. We are all meant to shine, as children do. We were born to make manifest the glory of God that is within us. It's not just in some of us; it's in everyone. And as we let our own light shine, we unconsciously give other people permission to do the same. As we are liberated from our own fear, our presence automatically liberates others.A Ballade of Suicide

The gallows in my garden, people say,
Is new and neat and adequately tall;
I tie the noose on in a knowing way
As one that knots his necktie for a ball;
But just as all the neighbours on the wall
Are drawing a long breath to shout "Hurray!"
The strangest whim has seized me... After all
I think I will not hang myself to-day.

To-morrow is the time I get my pay
My uncle's sword is hanging in the hall
I see a little cloud all pink and grey
Perhaps the rector's mother will NOT call
I fancy that I heard from Mr. Gall
That mushrooms could be cooked another way
I never read the works of Juvenal
I think I will not hang myself to-day.

The world will have another washing-day;
The decadents decay; the pedants pall;
And H.G. Wells has found that children play,
And Bernard Shaw discovered that they squall;
Rationalists are growing rational
And through thick woods one finds a stream astray,
So secret that the very sky seems small
I think I will not hang myself to-day.

ENVOI

Prince, I can hear the trumpet of Germinal,
The tumbrils toiling up the terrible way;
Even to-day your royal head may fall
I think I will not hang myself to-day.

By G.K. Chesterton

Life events & circumstancesThese are the things that are most likely to push someone over the edge from considering suicide, to actually trying it. The table below is from a study1 in Oxford (UK), where suicide survivors were asked what factor was causing them current distress and/or contributed to them making their attempt. It is interesting to note the variations between men and women:
Problem Both sexes Men Women
Other family member 42.1% 35.7% 45.6%
Partner 40.8% 39.6% 41.5%
Alcohol 33.9% 45.9% 27.4%
Employment/studies 25.7% 31.1% 22.8%
Financial 23.5% 30.0% 20.0%
Social isolation 18.6% 21.4% 17.1%
Housing 17.8% 22.2% 15.4%
Friends 10.6% 7.6% 12.2%
Bereavement 10.0% 9.5% 10.3%
Childhood sexual abuse 8.2% 3.8% 10.6%
Physical health 8.1% 8.1% 8.1%
Drugs 7.9% 13.2% 5.0%

In a different study2, of 4,391 self harmers in Oxford, 80.6% reported multiple life problems, the most common being the relationship with spouse or partner. Females, but not males, with high suicidal intent, had more problems than those with low intent. Patients with high intent more frequently experienced psychiatric and social isolation problems than those with low intent. Females with high intent more frequently reported bereavement or loss and eating problems.

The study in Oxford is by no means a definitive list though. The American Association of Suicidology (AAS) published a factsheet3 on the risk factors for suicide, and had the items below as things that can increase the short term risk of suicide:Recently divorced or separated with feelings of victimization or rageCurrent self-harm behaviourRecent suicide attemptExcessive or increased use of substances (alcohol or drugs)Psychological pain (acute distress in response to loss, defeat, rejection, etc.)Recent discharge from psychiatric hospitalizationAnger, rage, seeking revengeAggressive behaviourWithdrawal from usual activities, supports, interests, school or work; isolation (e.g. lives alone)Anhedonia (inability to experience pleasure from normally pleasurable life events such as eating, exercise, social interaction or sexual activities)Anxiety, panicAgitationInsomniaPersistent nightmaresSuspiciousness, paranoia (ideas of persecution)Severe feelings of confusion or disorganizationCommand hallucinations urging suicideIntense affect states (e.g. desperation, intolerable aloneness, self-hate)Dramatic mood changesHopelessness, poor problem-solving, cognitive constriction (thinking in black and white terms, not able to see gray areas or alternatives), rumination, few reasons for living, inability to imagine possibly positive future eventsPerceived burdensomenessRecent diagnosis of terminal conditionFeeling trapped, like there is no way out (other than death)Sense of purposelessness or loss of meaning; no reasons for livingNegative or mixed attitude toward help-receivingNegative or mixed attitude by potential caregiver to individualRecklessness or excessive risk-taking behaviour, especially if out of character or seemingly without thinking of consequences, tendency toward impulsivity

It should also be noted that according to the AAS, owning a firearm, or having easy access to one, increases the short term suicide risk for those living in the US. Clearly, for people that are suicidal and not thinking clearly, having the means for an effective suicide to hand makes it that much easier.

The AAS also mention the following heighten the risk in the short term of a suicide attempt:Any real or anticipated event causing, or threatening: shame, guilt, despair, humiliation, unacceptable loss of face or status, or legal problems (loss of freedom), financial problems, feelings of rejection/abandonmentRecent exposure to another's suicide (of friend or acquaintance, or of celebrity through media)

Top 10 Common Methods of Suicide + Get Help If You Can + Thank You Westlaw

The unfortunate and depressing issue of suicide has become a staggering piece of harsh reality in today's world. In the US, ranking 46th in the world of rates per capita, we experience 11,000 self-inflicted deaths per year, and the UK: 7,000. This has become a serious issue for many countries whether the factors be family issues, health issues, money problems, or relationship failures. The ways in which people decide to shuffle this mortal coil are numerous and varying. Ten of the most often seen are as follows.

10. Drowning

How it's Done: Maybe a relationship tremor has caused you to rethink your life here on the planet, and the weight of it all has made you decide to drown yourself. Sometimes, driving or even convincing yourself to walk into a large body or water will do it, otherwise many perish in as little water as a slightly-filled bathtub.

Results From Failure: Oxygen deprivation can cause severe and permanent brain damage.

9. Electric Shock

How it's Done: Sometimes the thought of continuing to live in a world inundated with problems and insurmountable issues results on one wanting to die by electric shock. Something as simple as jamming a utensil in a wall outlet, to the more notable dunking an appliance in an occupied bathtub, can result in death by electric shock.

Results From Failure: Deep burns from 500-1000 volts, ventricular fibrillation at 110-220 volts, and severe neurological damage.

8. Exsanguination

How it's Done: Frequently the most obvious way to rapidly harm one's self yet pass on relatively slowly, is to slit the wrists or the carotid, radial, ulnar, or femoral artery. Using a sharp implement is the easiest way to go. Razors or knives are popular. Contrary to popular belief, the effective method for this is not to cross the wrist, but to draw the blade up the forearm (as is evident in the photograph above). This is the same way Japanese perform Jigai (women) and Seppuku (men), although their's is often for more spiritual purposes.

Results From Failure: Extreme loss of blood causing the heart to dramatically slow eventually depriving the brain of oxygen. Also, most often, deep scars and tissue damage.

7. Jumping

How it's Done: Pondering the emptiness in one's life can be a painful experience. Yet, when it all seems so overwhelming, you might decide to plummet from a significant height to your own death. Leaping from a building to the pavement below is quite lethal, and popular. However, romantics may choose to use a cliff over jagged rocks. Or bridges.

Results From Failure: Shattered femurs from impacting with water up to severe bodily harm from impacting with any solid surface.

6. Suffocation

How it's Done: You've decided that your life is in disarray and you can no longer stand the pressure. One way to end it all is to encase your head in a plastic bag and asphyxiate yourself. Or, if you're really ready to go, nitrogen or helium directly inhaled is useful.

Results From Failure: Turning back at the last minute before passing out can result in serious and long-lasting to permanent brain damage.

5. Carbon Monoxide Inhalation

How it's Done: It's all so difficult and the full weight of the world is seemingly square upon your shoulders. You've decided to go to the great beyond and you are going to lock yourself in a car, in a closed garage with the engine running and go to sleep. Or, if you have any appliance that puts of CO, that'll do.

Results From Failure: CO molecules irreversibly attach themselves to human hemoglobin and the result is often fatal even if one backs out.

4. Poisoning

How it's Done: Romeo and Juliet had it down when, once seeing the other presumably dead, the other fatally poisons himself. Taking a substance internally not meant to be done so can be considered poisoning: cleaners, industrial fluids, diazepam, cyanide, and the like.

Results From Failure: The toxic levels of poison required to kill one's self are generally non-reversible. However, hospital staff can attempt it and often make one vomit or something similar. Lasting effects can include internal organ damage

3. Hanging

How it's Done: It's all over. Nothing in life seems to make it worth living any more. You can acquire a length of rope and construct yourself a noose, which is, by the way, considered a deadly weapon if tied correctly. Once built, wrap one end securely around something high: a rafter or a ceiling fan, and leap, head fastened within the loop, from a chair. Or, if you're short of rope, anything strong enough to support your weight from your neck can be employed.

Results From Failure: Brain damage from lack of oxygen, Often, failure to actually break your own neck may only yield strangulation and you can be saved, but damaged. Also, permanent rope burns or implement scarring can occur.

2. Drug / Alcohol Overdose

How it's Done: The pressure and stress of daily routines has beaten you down for the final time. Within your medicine cabinet lies the answer to your extermination: prescription and over-the-counter meds. A huge mouthful can do you right in. Or, to speed along the process, couple your target pills with a few swigs of alcohol. Many of our favorite musicians have chosen this route. Even alcohol alone, in extreme excess can kill you.

Results From Failure: Severe to permanent organ failure if successful removal isn't achieved, as well as impaired judgment. Often, clinical assistance is necessary if attempt is repeated.

1. Gun Shot

How it's Done: One of the most often achieved forms of suicide is by gun shot. Generally a head shot is desired since its results are 99 percent effective, however a chest shot can be equally as devastating.

Results From Failure: Sometimes the blast isn't enough to kill. In this case, severe to permanent bodily damage can occur as well as blood loss, organ and tissue damage, and brain damage.

Support

Suicide is never a solution. There is no problem so great that it can not be resolved with time and care. This list is meant not as an instruction guide, but a description of the most common forms of suicide. The following is a list of sites you can visit to get help if you are feeling beyond help. Please remember, no matter how bad things get, someone, somewhere is able to listen to you and help you through.

Suicide Awareness Voices of Education
National Suicide Prevention Lifeline
The Samaritans UK

World News Headlines:

A major health problem that can stop tragic death is suicide. Wikipedia states that more than one million people commit suicide every year. According to the World Health Organization, the thirteenth leading cause of death is suicide. Although it is known to occur in different age groups and backgrounds, certain groups of individuals are more susceptible to it according to research. For example people with mental illnesses, family history or past history of suicide attempts are more vulnerable to suicide.
According to experts males are more like to commit suicide rather than females, however attempts are more common in females.
This health problem might not be universally preventable but loved ones can recognize some warnings or signs in there loved ones. 75% of suicide victims show warning signs that they are having suicidal thoughts. Many people who believe that a loved one wants to committing suicide are afraid to bring it up with their loved ones because they don’t want influence them negatively. They even believe that talking about suicide motivates the suicidal individual. That is not true. In fact talking about it help them a great deal.
However to help them you need recognize the suicide warning signs, here are some of the signs:
1) Obsession with death
Individuals with suicidal thoughts are constantly thinking and talking about death. It is not necessary that they will be talking about it 24/7, but will mention it on and off. Some even write stories or poems about death.

2) Seeking dangerous means to kill themselves
Individuals considering suicide would be looking for dangerous items like guns, knives, pills or other harmful objects. They will also have self-destructive behavior which would lead to increased alcoholism or drug abuse. Some might start taking unnecessary risks because they have a death wish.

3) Individuals will talk about suicide
Individuals with suicidal thoughts would talk about suicide or death. They would say things like “I am better off dead” or “I wish I hadn’t been born”

4) Suicidal individuals are deeply depressed so they have no optimism about the future
Suicidal individuals are extremely negative and will appear hopeless and helpless about everything in their lives. They will not believe any words of encouragement.

5) Suicidal individuals are full of self-loathing
Suicidal individuals hate themselves and have great feelings of shame, guilt and worthlessness. They believe that their existence is burdening society and that the world would be better place without them.

6) Dramatic mood swings and personality change
A person who is having suicidal thoughts will have a big personality change. They have no sense of self-worth so they will change dramatically, personality wise. In addition, they will experience uncontrollable mood swings that will swing from depression to eerie calmness.

7) Increased social isolation
Some suicidal individuals start withdrawing from friends and family. If they have a job, they quit it is because they don’t feel the need for it.

8) Setting their affairs in order and saying farewell
Some suicidal individuals even set their affairs in order before committing suicide. For example they write their wills and give out treasured possessions to their loved ones. They make unexpected calls or visit family members and friends.

The things mentioned above are a few things that you might spot in suicidal individuals. In conclusion, do note that reasons for committing suicide vary among people so some individuals might not even show the listed signs. Therefore you need to approach the person you suspect and talk with him or her honestly. Be there for them and encourage them to get professional help at all costs.

Methods of Suicide Among Persons Aged 10--19 Years --- United States, 1992--2001

In 2001, suicide was the third leading cause of death among persons aged 10--19 years (1). The most common method of suicide in this age group was by firearm (49%), followed by suffocation (mostly hanging) (38%) and poisoning (7%) (1). During 1992--2001, although the overall suicide rate among persons aged 10--19 years declined from 6.2 to 4.6 per 100,000 population (1), methods of suicide changed substantially. To characterize trends in suicide methods among persons in this age group, CDC analyzed data for persons living in the United States during 1992--2001. This report summarizes the results of that analysis, which indicated a substantial decline in suicides by firearm and an increase in suicides by suffocation in persons aged 10--14 and 15--19 years. Beginning in 1997, among persons aged 10--14 years, suffocation surpassed firearms as the most common suicide method. The decline in firearm suicides combined with the increase in suicides by suffocation suggests that changes have occurred in suicidal behavior among youths during the preceding decade. Public health officials should develop intervention strategies that address the challenges posed by these changes, including programs that integrate monitoring systems, etiologic research, and comprehensive prevention activities.

Annual data on suicides occurring in the United States during 1992--2001 (2) were obtained by using CDC's Web-based Injury Statistics Query and Reporting System (WISQARS™) (1) and examined by age group (i.e., persons aged 10--14 and 15--19 years) and method (e.g., firearm, suffocation, and poisoning) for each year and the 10-year period. To analyze these data, codes were used from the International Classification of Diseases, Ninth Revision (ICD-9) and the International Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10), which was implemented in 1999. Although coding of mortality data changed in 1999, the two revisions have near 100% agreement on classification of suicides by firearm, suffocation, and poisoning (3); thus, the suicide method was defined consistently during the period analyzed.

For each method of suicide, annual suicide rates (per 100,000 population) were calculated by age group and overall. Because firearms and suffocation were the two most common methods of suicide among persons aged 10--19 years, accounting for approximately 90% of suicide deaths in this age group, trends for these two methods (Figures 1 and 2) were formally evaluated by using negative binomial rate regression to account for overdispersion in the data. Supplemental information on suicides by poisoning (the third most common method) and suicide by all other methods (e.g., jumping from a height) is provided for illustration purposes. Annual ratios of suffocation suicides to firearm suicides were examined as an additional means of assessing changes in the relative magnitude of these methods over time (Table).

Among persons aged 10--14 years, the rate of firearm suicide decreased from 0.9 per 100,000 population in 1992 to 0.4 in 2001, whereas the rate of suffocation suicide increased from 0.5 in 1992 to 0.8 in 2001. Rate regression analyses indicated that, during the study period, firearm suicide rates decreased an average of approximately 8.8% annually (p<0.0001), and suffocation suicide rates increased approximately 5.1% annually (p<0.0001). Among persons aged 15--19 years, the firearm suicide rate declined from 7.3 in 1992 to 4.1 in 2001; the suffocation suicide rate increased from 1.9 to 2.7. Rate regression analyses indicated that, during the study period, the average annual decrease in firearm suicide rates for this age group was approximately 6.8% (p<0.0001), and the average annual increase in suffocation suicide rates was approximately 3.7% (p<0.0001). Poisoning suicide rates also decreased in both age groups, at an average annual rate of 13.4% among persons aged 10--14 years (Figure 1) and 8.0% among persons aged 15--19 years (Figure 2). Because of the small number of suicides by poisoning, these decreases have had minimal impact on changes in the overall profile of suicide methods of youths.

Among persons aged 10--14 years, suffocation suicides began occurring with increasing frequency relative to firearm suicides in the early- to mid-1990s, eclipsing (i.e., ratio >1.0) firearm suicides by the late 1990s (Table). In 2001, a total of 1.8 suffocation suicides occurred for every firearm suicide among youths aged 10--14 years. Among youths aged 15--19 years, an increase in the frequency of suffocation suicides relative to firearm suicides began in the mid-1990s; however, in 2001, firearms remained the most common method of suicide in this age group, with a ratio of 0.7 suffocation suicides for every firearm suicide.

Reported by: KM Lubell, PhD, MH Swahn, PhD, AE Crosby, MD, Div of Violence Prevention; SR Kegler, PhD, Office of Statistics and Programming, National Center for Injury Prevention and Control, CDC. Editorial Note:

The findings in this report indicate that the overall suicide rate for persons aged 10--19 years in the United States declined during 1992--2001 and that substantial changes occurred in the types of suicide methods used among those persons aged 10--14 and 15--19 years. Rates of suicide using firearms and poisoning decreased, whereas suicides by suffocation increased. By the end of the period, suffocation had surpassed firearms to become the most common method of suicide death among persons aged 10--14 years.

The reasons for the changes in suicide methods are not fully understood. Increases in suffocation suicides and concomitant decreases in firearm suicides suggest that persons aged 10--19 years are choosing different kinds of suicide methods than in the past. Data regarding how persons choose among various methods of suicide suggest that some persons without ready access to highly lethal methods might choose not to engage in a suicidal act or, if they do engage in suicidal behavior, are more likely to survive their injuries (4). However, certain subsets of suicidal persons might substitute other methods (5). Substitution of methods depends on both the availability of alternatives and their acceptability. Because the means for suffocation (e.g., hanging) are widely available, the escalating use of suffocation as a method of suicide among persons aged 10--19 years implies that the acceptability of suicide by suffocation has increased substantially in this age group.

The findings in this report are subject to at least two limitations. First, because U.S. mortality data include a limited number of variables, direct testing of whether method substitution is occurring is not possible; however, no sizeable demographic changes in the composition of youth suicide decedents have been documented that might explain the changes in methods (1). Second, official mortality data for suicide are known to reflect some degree of undercount; however, such undercounts do not appear to affect conclusions about trends over time (6).

The findings in this report demonstrate that rapid shifts in youth suicidal behavior can occur, underscoring the need for early effective suicide-prevention efforts that focus on suicidal thoughts and pressures. Moreover, statistical simulations comparing the impacts of different types of suicide-prevention approaches suggest that widely implemented population-based strategies will have a greater effect in reducing overall suicide rates than the more traditional strategies that concentrate on persons at high risk (7). One of the most common population-based strategies focuses on restricting access to highly lethal means (e.g., bridge barriers and bubble-packaging for over-the-counter medications) to diminish the likelihood of death from self-inflicted injuries (8). However, the private nature of suffocation, its widespread availability, and its high lethality suggest that population-based prevention efforts addressing access to lethal means also must confront the underlying reasons for suicidality to avoid the potential for method substitution.

Suicide is a multifaceted problem for which several risk factors exist, including societal beliefs regarding the acceptability of suicidal behavior, social isolation and community disintegration, stressful life events, mental illness, and substance abuse (9). When such factors combine with widespread availability of lethal means, higher rates of suicide tend to result (8). The actual effectiveness of existing population-based prevention approaches in reducing the number of suicide deaths is unclear. In addition to improving data-collection methods, public health officials should emphasize the need to evaluate the effectiveness of current suicide-prevention activities and examine how effective strategies can be implemented in diverse communities. CDC supports various efforts to evaluate suicide-prevention programs for youth. Additional information is available at http://www.cdc.gov/ncipc.

Links Befrienders Worldwide

Emotional support by phone or email for people when they are suicidal. With 31,000 volunteers in almost 40 countries, the centers aim to alleviate misery, loneliness, despair and depression by listening to anyone who feels they have nowhere else to turn.

www.befrienders.org

National Suicide Prevention Lifeline (USA)
A 24-hour hotline available to anyone in suicidal crisis or emotional distress.

www.suicidepreventionlifeline.org 1-800-273-8255

The Samaritans (UK)

A 24 hour helpline offering confidential non-judgemental emotional support for people who are experiencing feelings of distress or despair, including those which could lead to suicide.

www.samaritans.org 08457 90 90 90 (or Republic of Ireland 1850 60 90 90)

Lifeline (Australia)

Offers access to a range of national and local services that support mental health, wellbeing and suicide prevention, including a 24 hour telephone counselling service.

www.lifeline.org.au 13 11 14

American Association of Suicidology

Provides statistics on suicide, information for those considering suicide, links to support groups, state based crisis centres and other useful resources.

www.suicidology.org

Papyrus (UK)

Resources (including a helpline) and support for those dealing with suicide, depression or emotional distress - particularly teenagers and young adults.

www.papyrus-uk.org

CALM - Campaign Against Living Miserably

Provides support and information to men affected by depression and stress.

www.thecalmzone.net

Depression Understood

Offers many ways in which like-minded people can communicate with each other and offer peer support to one another. Also contains articles on depression, anxiety, bipolar disorder, obsessive compulsive disorder, post traumatic stress disorder and many other health issues.

www.depression-understood.org

Depression Alliance (UK)

Works to relieve and prevent depression by providing information and support services (including links to support groups). A website full of information, advice and resources.

www.depressionalliance.org

Depression and Bipolar Support Alliance (USA)

Aims to improve the lives of those with mood disorders. Has links to support groups across the USA.

www.dbsalliance.org

Metanoia

An excellent website that aims to break down barriers that keep people with problems from getting the help they need. It has valuable information for those feeling suicidal or depressed, and links to resources and websites that may be of help.

www.metanoia.org

MIND (UK)

Nationwide support services for sufferers of mental health problems as well as comprehensive information on different types of mental health problems.

www.mind.org.uk

SANE (UK)

Provides emotional support and information to people experiencing mental illness, their family and carers.

www.sane.org.uk

Rethink (UK)

Offers expert advice and information to people with severe mental illness and other mental health problems and those that care for them, plus UK-wide support groups and other services.

www.rethink.org

Maytree (London, UK)

A sanctuary for the suicidal. Accommodation in a non-medical setting offering time, space and respite for those in a suicidal crisis and in danger of taking their own lives.

www.maytree.org.uk

The US National Institute of Mental Health (NIMH)

A mine of information available from their publications page, with particularly comprehensive information about depression.

www.nimh.nih.gov/health/publications/index.shtml

Mental Health America

Useful links to a number of resources to assist finding therapists and support groups.

www.mentalhealthamerica.net/go/help

SAMSHA

The US Department of Health and Human Services, Substance Abuse and Mental Health Services Administration. It provides information about mental health via a toll-free telephone number (800-789-2647), their website, and more than 600 publications.

The National Mental Health Information Center was developed for users of mental health services and their families, the general public, policy makers, providers, and the media.

Information Center staff members are skilled at listening and responding to questions from the public and professionals. The staff quickly direct callers to Federal, State, and local organizations dedicated to treating and preventing mental illness. The Information Center also has information on Federal grants, conferences, and other events.

Website home: http://mentalhealth.samhsa.gov/

Locator for mental health services: http://mentalhealth.samhsa.gov/databases/

Drug and alcohol abuse treatment programs locator: http://dasis3.samhsa.gov/

Survive

A webpage with information for people coming into contact with someone who is suicidal.

http://survive.org.uk/suicide.html

Compassion & Choices

An organisation that uses the power of choice and comfort to restore hope to individuals and their loved ones at the end of life. Professional staff and trained volunteers help thousands of clients each year by listening without judgment to their fears and guiding their search for a peaceful, humane death. Clients are offered help with advance directives, local service referrals, and pain and symptom management. Information on self-determined dying is provided when appropriate as is emotional support.

www.compassionandchoices.org

Exit International

An end of life choices information & advocacy non-profit organisation. Information on assisted suicide, links to the Peaceful Pill Handbook to carry out an assisted suicide, and information about regular meetings and workshops in Australia, Canada, the US, UK and NZ which provide advice to the terminally ill on the best ways of achieving suicide.

www.exitinternational.net

Dignitas

Euthanasia clinic in Switzerland.

www.dignitas.ch

Final Exit

Information site on euthanasia and book on how to do carry it out.

www.finalexit.org

The Peaceful Pill Handbook

Book on how to carry out a voluntary euthanasia.

www.peacefulpillhandbook.com

Suicide.com

Site of Melody Clark offering information, and help for the severely depressed & suicidal, also has links to numerous other resources.

www.suicide.com



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