Suicide is the act of intentionally causing one's own death. Mental disorders (including depression, bipolar disorder, autism spectrum disorder, schizophrenia, personality disorders, anxiety disorders), physical disorders (such as chronic fatigue syndrome) and substance disorder (including alcohol use disorder) are risk factors. Some suicides are impulsive acts due to stress (such as from financial or academic difficulties), relationship problems (such as breakups), or harassment/bullying. Those who have previously attempted suicide are at a higher risk for future attempts.
Factors that affect the risk of suicide include mental disorders, drug misuse, psychological states, cultural family and social situations, genetics, experiences of trauma or loss. Mental disorders and substance misuse frequently co-exist. Other risk factors include having previously attempted suicide, the ready availability of a means to take one's life, a family history of suicide, or the presence of traumatic brain injury. For example, suicide rates have been found to be greater in households with firearms than those without them.
Socio-economic problems such as unemployment, poverty, homelessness, and discrimination may trigger suicidal thoughts. Suicide might be rarer in societies with high social and cohesion and moral objections against suicide. About 15-40% of people leave a suicidal note. War veterans have a higher risk of suicide due to higher rates of mental illness, such as post traumatic stress disorder, and physical health problems related to war. Genetic appears to account for between 38% and 55% of suicidal behaviors.
Most research does not distinguish between risk factor that lead to thinking about suicide and risk factors that lead to suicide attempts. Risks for suicide attempt rather than just thoughts of suicide include a high pain tolerance and a reduced fear of death.
A previous history of suicide attempts is the most accurate predictor of suicide. Approximately 20% of suicides have a previous attempt, and of those who have attempted suicide, 1% die by suicide within a year and more then 5% die by suicide within 10 years. Acts of self-harm are not usually suicide attempts and most who self-harm are not at high risk of suicide. Some who self-harm, however, do still end their life by suicide, and risk for self-harm and suicide may overlap.
Suicide prevention is a term for the collective efforts to reduce the incidence of suicide through prevention measures. Protective factors for suicide include support, and access to therapy. About 60% of people with suicidal thoughts do not seek help. Reasons for not doing so include low perceived need, and wanting to deal with the problem alone. Despite these high rates, there are few established treatments available for suicidal behavior.
Reducing access to certain methods, such as firearms or toxins such as opioids and pesticides, can reduce risk of suicide by that method. This may be in part because suicide is often an impulsive decision, with up to 70% of near-fatal suicide attempts made after less than one hour of deliberation- thus, reducing access to easily-accessible methods of suicide may make impulsive attempts less likely to succeed. Other measures include reducing access to charcoal (for burning) and adding barriers on bridges and subway platforms. Treatment of drug and alcohol addiction, depression, and those who have attempted suicide in the past, may also be effective. Some have proposed reducing access to alcohol as a preventing strategy (such as reducing the number of bars).
In young adults who have recently thought about suicide, cognitive behavior therapy appears to improve outcomes. School-based programs that increase mental-health literacy and train staff have shown mixed results on suicide rates. Economic development through its ability to reduce poverty may be able to decrease suicide rates. Efforts to increase social connection, especially in elderly males, may be effective. In people who have attempted suicide, following up on them might prevent repeat attempts. Although crisis hotlines are common, there is little evidence to support or refute their effectiveness. Preventing childhood trauma provides an opportunity for suicide prevention. The World Suicide Prevention Day is observed annually on September 10 with the support of the International Association for Suicide Prevention and the World Health Organization.