Should We Ask About Suicide?

If you are experiencing suicidal thoughts, contact the National Suicide Prevention Lifeline, crisis textline, or BC Crisis Centre (local). If you need non-emergency mental health help, contact the NAMI Helpine.

A meta-analysis published this week investigated whether asking participants in research studies about suicide or exposing them to suicide-related content increased their distress, thoughts about suicide, or suicide attempts. Importantly, the paper found no increase in thoughts about suicide or suicide attempts in participants asked about suicide compared to those who were not asked, and in fact noted a small reduction in these participants – especially adolescents.

When We Don’t Ask

The authors cited older work wherein 36% of doctors believed asking about suicide increased risk for suicidal behaviour, and 23% didn’t ask about suicide for fear of this risk. This fear lead to the shocking statistic that between 54-76% of patients screened for mental illness were never asked about suicide.

The general dialogue about mental illness and suicide encourages suicidal individuals to disclose their suicidal thoughts in order to receive adequate support, but popular attitudes toward and fear of suicide contribute to a massive stigma against disclosing such information. Thus, most suicidal individuals never disclose their suicidal intent or receive treatment in the months leading up to an attempt. It is important, then, that gatekeepers to suicide prevention resources take the first step in asking people about suicide.

Gatekeepers to Suicide Prevention

“Gatekeeper” refers to any individual in the position to recognize signs of suicide and refer suicidal individuals to appropriate resources. This can be a teacher, parent, doctor, counsellor, or peer. In the effective intervention program Question, Persuade, Refer, gatekeepers are trained to ask these individuals clearly and directly whether they are thinking about killing themselves. The gatekeeper’s role, then, is to persuade the suicidal individual to seek emergency care for their symptoms and refer them to appropriate mental health centres, community counselling centres, or other resources.

Suicide Research

Aside from directly intervening one-to-one with suicidal individuals, the meta-analysis provides evidence for the safety of suicide research. Research is key to understanding motivations for wanting to die, factors that contribute to suicidal ideation and attempts, and effective interventions for suicidal behaviour. Some key players in the quest for suicide-related knowledge are the American Association for Suicidology and the Canadian Association for Suicide Prevention.

If you are experiencing suicidal thoughts, contact the National Suicide Prevention Lifeline, crisis textline, or BC Crisis Centre (local). If you need non-emergency mental health help, contact the NAMI Helpine.

Caroline A. Blades, Werner G.K. Stritzke, Andrew C. Page, Julia D. Brown , The benefits and risks of asking research participants about suicide: A meta-analysis of the impact of exposure to suicide-related content. Cpr (2018),

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