Warning Signs of Suicide

1. Interpersonal Theory of
Suicide
Thomas Joiner, 2009

2. Two Elements of Suicide
THOMAS JOINER: INTERPERSONAL THEORY OF SUICIDE
Desire to
die by
Suicide
Acquired
Ability to
Enact
Lethal
Self-

3. Desire to
die by
Suicide
Perceived
Burdensom
eness
Low
belongingn
ess/social
isolation

4. Desire to
die by
Suicide
Perceived
Burdensom
eness
Low
belongingn
ess/social
isolation
AcquireD
Ability to
Enact
Lethal
Self-
injury

5. Suicide RISK
Factors

6. Risk Factors
INDIVIDUAL:
• Previous suicide attempt
• Mental illness
• Social isolation
• Criminal problems
• Financial problems
• Impulsive / aggressive
tendencies
• Job problems or loss
• Legal problems
• Serious illness
• Substance use disorder
RELATIONSHIPS
• Adverse childhood experiences
(abuse and neglect)
• Bullying
• Family history of suicide
• Relationship problems:break-up,
violence, or loss
• Sexual violence

7. Risk Factors
COMMUNITY
• Barriers to health care
• Cultural and religious
beliefs such as a belief
that suicide is noble
resolution of a personal
problem
• Suicide cluster in the
community
SOCIETAL
• Stigma on mental illness or
help-seeking behavior
• Easy access to lethal
means among people at
risk (e.g. firearms,
medications)
• Unsafe media portrayals of
suicide

8. Pain isn't always obvious.

9. Suicide
First Aid
Protocol

10. Learning
Agenda
What we'll discuss
in this session:
Explain the process of
Suicide First Aid – Suicide
Protocols
Identify suicide warnings
signs

11. Pain isn’t always obvious, but most
suicidal people show some signs
that they are thinking about suicide.
The signs may appear in
conversations, through their actions,
or in social media posts. If you
observe one or more of these
warning signs, especially if the
behavior is new, has increased, or
seems related to a painful event,
KNOW
THE SIGNS

12. Ideation
Substance abuse
Purposelessness
Anxiety
Trapped
Hopelessness
Withdrawal
Anger
Recklessness
Mood changes

13. A dramatic change in mood, behaviour or appearance
• Expressing, in words or actions, hopelessness, worthlessness,
guilt, shame, or having no reason to live or no purpose in life;
• Withdrawing from friends, family or society;
• Expressing, in words or actions, loss of interest in things that
were previously of interest;
• Sudden or dramatic increase in depressed mood;
• Describing themselves as a burden to others or stating that
others would be better off without them.

14. Someone who is suicidal may threaten to kill themselves, or say
that they wish to die, verbally or in writing. This may be very
direct, but is sometimes subtle. Watch for:
• Looking for a way to kill themselves (e.g. seeking access to pills or
poisons, weapons or other means), including seeking information
about possible suicide methods (e.g. would 100 mg of this kill
me?);
• Unexpected jokes about death or suicide;
• Expressing, in words or actions, that they feel trapped, like there
is no way out, or that suicide is the only solution to their
problems;
• Expressing, in words or actions, the desire or hope that they will
die (including praying that God may take their life).

15. People may show one or many of these signs whereas some may
show signs not on this list (such as rage, anger, seeking revenge,
anxiety, agitation, sleep disturbance, starting or increasing
tobacco, alcohol or drug use; significant change in the level of
religious interest or preoccupation with afterlife or any dramatic
change in behaviour, mood, appearance).
If you have seen some of these warning signs and you suspect that
the person may be suicidal, you should ask them directly.
Are you having thoughts of suicide? Are you thinking of killing
yourself?