If you could go back in time and talk to yourself in your darkest moment, what would you say?

World Suicide Prevention Day is Sept. 10, and the emphases are "Changing the Narrative on Suicide" and "Start the Conversation."

In this spirit, I would like to review some basic information about suicide, in hopes that people can learn more about the warning signs, and what to do if concerned that someone might potentially be suicidal.

The latest data we have are from 2022. Data provided by the Centers for Disease Control and Prevention indicate that there were 49,476 completed suicides in the United States -- that is 136 per day, or six per hour. In Iowa there were 590 completed suicides during 2022. Nationwide, 55% of completed suicides involved a firearm.

In order to deal with this issue, we need to be familiar with suicide warning signs. In my experience these can vary. In addition, there are occasional situations where there are no warning signs. When signs do manifest they often include hopelessness and helplessness, depression, lack of social support, substance abuse, a history of experiencing violence and victimization, exposure to another person's suicide, low self-worth, and having attempted in the past.

In my experience, hopelessness is an especially important warning sign.

If you are worried about someone being suicidal, it is important to talk with them, and ask them if they are suicidal. There are many ways of asking this question. For me, a good way to word this is, "Have you been feeling so badly lately that you have thought about hurting yourself?" Asking this question often provides an opportunity for the person to talk about their pain. It can potentially provide a lifeline. And while almost anything is possible in the complex world of suicidology, you are more likely to save someone's life than cause their suicide by bringing up your concern and reaching out to them.

It is also important that you support the person in an ongoing way, monitor them for risk, and encourage them to seek treatment. Many times people will initially resist treatment. However, with continued emotional support and encouragement, many people eventually will seek the help that they need. It is also important to prevent access to firearms. As noted above, firearms account for 55% of suicides. Firearm restriction, in my opinion, is a very pivotal component of suicide prevention.

An especially important resource is the phone number 988, the Suicide and Crisis Lifeline. Implemented in July 2022 this service can also be texted. In the first year of operation nearly 5 million contacts were answered. People experiencing distress can use this number, and so can people concerned about someone else.

Suicide remains a difficult issue to understand. Even with decades of research across multiple disciplines, it is difficult to predict suicide, even for mental health professionals, family, and close friends. However, there are hopeful signs. As described on the Department of Health and Human Services website, the Biden-Harris administration has released a 2024 National Strategy for Suicide Prevention. This plan focuses on many issues related to suicide, including prevention strategies, crisis intervention, and supporting survivors of suicide loss.

With initiation of this 2024 strategic plan, and with all of us learning about suicide warning signs and what to do if concerned about someone, I hope the suicide rate can be lowered.