May 2019 By


Suicide is the act of ending one's own life. From a historical perspective, for thousands of years, the concept of suicide has been debated philosophically and from religious viewpoints. This debate continues to this day on social, legal, and political levels.[1][2][3] From a medical and psychiatric perspective, suicide attempts are a major cause of disability for patients, and completed suicide attempts present a significant challenge to the patient's healthcare providers and can be devastating for family members.


The average incidence of suicide in most psychiatric illnesses is about 10% and eating disorders is >10%. Suicide affects all socioeconomic levels and all professions.[4]

Suicide contagion is of significant public health concern. There is strong evidence that vulnerable youth are especially susceptible to the influence of reports and portrayals of suicide in the mass media.[5] More recently, this became an issue of discussion when Netflix released 13 Reasons Why, a show about a teenager who completed suicide. Debate has continued about the role that media plays in the portrayal of suicide and the negative effects that result from it. (See: Scientific American: 13 Reasons Why and Suicide Contagion)

One approach to reducing the harmful effects of media portrayals is to educate journalists and media programmers about ways to present suicide so that imitation will be minimized and help-seeking encouraged.

Media reporting

The role of the media in suicide prevention is often underestimated. The media plays an important role and have an important responsibility reporting suicide. Various media guidelines exist for the reporting of suicides.[6]

Copycat suicides

Copycat suicides, also known as the Werther effect, is the phenomenon of an individual copying suicidal behaviour that they have in the media.[7][8] In Canada, the Aboriginal population recently dealt with a series of youth suicides on reserves, some of which could also be attributed to suicide contagion.[9]

Suicide prevention can be implemented on an individual, local, and systemic levels.[10]

Blue lights

There is some research that suggests the installation of blue lights may reduce the incidence of suicide.[11]


It is difficult to research the exact effect of suicide hotlines and distress helplines, but most of the research suggests it is effective in reducing the crisis state of callers. Anecdotally, of course, phone line counsellors are able to recall specific situations where callers had lethal means (e.g. - a gun) while on the phone, and stopped the attempt by talking to the caller. Helplines continue to play a supportive role on the population level.[12]


High lethality suicide attempts include deaths by jumping from lethal heights, or in front of high speed objects, such as trains or in the subways. Current studies have demonstrated that installing barriers reduced the incidence of deaths at the location, but more importantly, did not result in an increase in suicide by other means.[13] This means that the installation of barriers actually led to an overall decrease in suicide attempts. Work is being done around the world to install more barriers, including at the famous Golden Gate Bridge.

Restricting access

Other high lethality means of suicide include firearms and toxins like pesticides. Worldwide, pesticides account for an estimated one-third of the world's suicides. In the United States, suicide by firearms.

Treatment of suicide includes medications, psychotherapy, and/or hospitalization. Medications that have bee providing to reduce the risk of suicide include lithium and clozapine.

Suicide varies on a cultural level, both in terms of stigma, means of suicide, and incidence.

United States

Suicide risk assessment remains a daunting and elusive task that mental health professionals face. One of the main challenges in risk-stratifying individuals is that almost half of completed suicide attempts are by individuals who are considered low risk.


Individuals for high risk of suicide include those recently discharged from a psychiatric hospital.[14]


The role of machine learning and artificial intelligence in predicting suicide risk is currently being investigated.[15]

Impact on others

Suicide attempts can often have a ripple effect on other individuals, including those who witness it, and family members. Subway operators who are involved in a suicide death can often report higher rates of absenteeism, as well as develop other psychiatric conditions.[16]