Suicide is the second most common cause of death in individuals aged 10 to 34 and the tenth most common cause of death throughout the United States.¹ It’s a harrowing and anxiety-provoking subject, but one that is crucial to talk about despite any discomfort. In 2020, there were almost 46,000 deaths and 1.2 million suicide attempts in the United States.³⁰ Every eleven minutes, an American dies by suicide; every 40 seconds, someone will die by their own hand globally. Approximately 130 Americans die by suicide every day. If you are suffering, it’s essential to know that you are not alone.
We have compiled some facts about rates of suicide in different populations, risk factors for suicidal actions, and information on warning signs and resources to help you. Whether you are helping a loved one or helping yourself, we want to provide you with the best possible information to help you stay safe.
If you are currently experiencing thoughts of suicide, please reach out to a friend or loved one, a text or phone crisis line (text HOME to 741741 or call 1-800-273-8255), or your local emergency department.
We differentiate between sexual minority (non-heterosexual) and transgender and nonbinary identities because the two groups have poignant differences in both social understandings and risk factors. However, many statistics and studies lump the two together to look at the LGBT+ community as a whole.
One-quarter of 12- to 14-year-olds who die by suicide are LGBT+, whereas only 8% of 25- to 29-year-olds are LGBT+.¹² This problem directly affects young non-heterosexual people at dramatically higher rates than straight people. Non-heterosexual youth are four times more likely to attempt suicide than heterosexual youth.¹ These attempts are almost five times more likely to need treatment from a medical professional as a result of poisoning, injury, or overdose.¹³
Social support is critical for non-heterosexual youth. When LGBT+ youth are sent to conversion therapy – a program designed to change the patient’s sexual orientation to heterosexual and their gender identity to the one they were assigned at birth – suicide rates skyrocket. 27% of LGBT+ youth who attempted suicide in 2020 had been sent to conversion therapy.³
While conversion therapy is an extreme example of social rejection, 75% of LGBT+ youth reported experiencing discrimination based on their sexual orientation or gender identity in 2021. LGBT+ youth who come from highly unsupportive families are 8.4 times as likely to have attempted suicide as LGBT+ peers who reported no or low levels of family rejection. Yet, only one in three LGBT+ youth reported feeling comfortable and supported in their home.³
Transgender and nonbinary people
In 2020, more than half of transgender and nonbinary youth considered suicide.³ This number has increased from 2015, where 48.5% of transgender and nonbinary people experienced suicidal ideation over the year.¹⁴ About 40% of transgender and nonbinary people have attempted suicide at least once in their lives, with 92% of people reporting their first attempt occurring before age 25.
98% of respondents to a 2015 survey who experienced four or more instances of discrimination and violence in a year experienced suicidal ideation.¹⁵ This is particularly concerning with rates of violence against transgender people rising and legal protections dropping at historic rates.¹⁷ Transgender people are four times more likely than cisgender people to experience violent crimes, including rape, sexual assault, and aggravated or simple assault.¹⁶
Rates of suicide ideation and attempts in transgender people drop dramatically with consistent community support. This can take the form of:
- Legal recognition (gender markers on ID, legal name changes)
- Interpersonal recognition (people around them consistently using the correct name and pronouns)
- Medical recognition (access to medical support like hormone replacement therapy and gender-affirming surgeries)
Transgender and nonbinary people who receive social support at home are half as likely to attempt suicide as those who do not.¹⁸ When given gender-affirming care, including hormone replacement therapy and puberty blockers, rates of severe depression dropped by 60% and suicidality by 73% in transgender and nonbinary youth.²⁷
Suicide is an epidemic amongst all Indigenous communities but is especially prevalent in the United States. In fact, Indigenous youth in the United States are 2.5 times more likely to attempt suicide than non-Indigenous youth, who are already at high risk of attempting or committing suicide. Since 1999, rates of suicide have increased by 71% and 139% for Indigenous men and women, respectively.⁵
In the Navajo Nation, which is over 3,000 square miles larger than West Virginia, residents are 67 times more likely than a white American to lack access to adequate plumbing. Between 30 and 40% of residents do not have running water or a toilet. Across the country, approximately one in ten Indigenous Americans do not have this same access to water.⁶ The intensity of this poverty is undoubtedly a risk factor for increased suicidal ideation.
Cultural disconnection, alienation, and pressure to assimilate also contribute to higher rates of suicide amongst Indigenous Americans. Multiple forms of discrimination, whether it’s based on sexual orientation, gender identity, or race, increase the risk of a non-heterosexual person attempting suicide. The more forms of discrimination faced, the higher the risk. The Trevor Project’s 2021 National Survey on LGBT+ Youth Mental Health found that while 12% of white LGBT+ youth surveyed attempted suicide in 2020, 31% of Indigenous LGBT+ youth attempted as well.³
The veteran suicide rate has increased since 2001 alongside the general nonveteran population but decreased in 2019, albeit very slightly. In 2018, the highest year, the rate of suicide among veterans was 32.0 per 100,000, compared with 17.2 per 100,000 nonveterans.⁸ This average American suicide rate has increased over time, but veteran suicide attempt and mortality rates have risen faster than civilian rates since 2005.⁷ Currently, a veteran is 1.5 times more likely to commit suicide than a civilian.⁸
Approximately 30,000 active-duty personnel and veterans of war post-9/11 have died by suicide. This is more than three times the number of service members killed in war operations.¹⁹ However, this number is lower than the average rate of suicide attempts pre-World War II.
While some veterans have PTSD from their service, not all will attempt suicide. Other risk factors to consider are:
- High exposure to trauma
- Military culture and training
- Continued access to guns and knowledge of operation
- Difficulty reintegrating into civilian life
- Traumatic brain injuries
The average cultural disinterest in American wars post-9/11 also plays a role in veteran suicide rates, particularly when coupled with the length of the war and damaging veteran stereotypes.¹⁹
It’s easy to automatically associate suicide with depression (or major depressive disorder). This is extremely common, but it’s not the only mental illness associated with higher rates of suicide.
Severe mental illnesses (SMIs) are mental illnesses that significantly strain a person’s ability to function. Specifically, these are bipolar disorders and psychotic disorders. Both bipolar disorder types I and II have an increased risk of suicide attempts and deaths during depressed and mixed states, between 10 and 30 times higher than the general population.²⁶
Any psychotic disorder brings an increased risk of suicide attempts and death. Psychotic disorders, which are mental illnesses characterized by abnormal thinking, delusions, or hallucinations, include:
- Schizophreniform Disorder
- Brief Psychotic Disorder
- Schizoaffective Disorder
- Delusional Disorder
Suicide is the primary method of death for patients with psychosis. About half of all patients experiencing psychosis also experience suicidal thoughts, and between 2.7% and 4.5% of those die by suicide.²³
People struggling with eating disorders are also much more likely to experience suicidal thoughts or attempts. Those with anorexia are 18 times more likely to die by suicide, while people with bulimia or binge-eating disorder are seven times more likely to die by suicide. About one-quarter to one-third of people with any eating disorder have experienced suicidal thoughts or attempted at least once.²⁴
When it comes to depression, the condition we most associate with suicidality, only half of Americans experiencing an episode of major depression receives treatment. Of those who do, between 80 and 90% find a resolution in their depression symptoms. 8.4% of adults in the United States reported experiencing depression at least once in their lives in 2020. ²⁸
Substance abuse increases the risk of suicide and the risk of suicide mortality. One study found that even people who only smoked cigarettes were twice as likely as the general population to die from suicide, ranging up to 11.2 times more likely to die for those with multiple tobacco, alcohol, and drug use disorders.²⁵ This may be because many substances lower inhibitions, meaning you are more likely to go through with a fleeting thought of suicide rather than being able to sit with it and let the feeling pass.
In December 2021, the US Surgeon General released a special health advisory on the youth mental health crisis. In recent years, surveys on youth mental health have shown increases in both depressive symptoms and suicidal ideation. Between 2009 and 2019, overall feelings of sadness and helplessness (primary symptoms of depression) increased by 40%. Active suicidal ideation and plan creation increased in students by 44%, and the rate of students seriously attempting suicide has risen by 36% in the same time period.¹⁰ Between 2007 and 2018, suicide rates among people aged 10-24 increased by 57%.¹⁰
The rate of suicide in the young has expanded into people between the ages of 25 and 34. Suicide used to be the third most common method of death but has increased to the second most common in recent years.¹
Those in middle age (ages 45 to 64) have historically been the most likely to die by suicide, but in 2020, those numbers changed significantly. Those over the age of 75 were the most likely to die by suicide at a rate of around 2 in 10,000 people, a figure that has only continued to climb.³⁰ The second most likely age group to commit suicide in 2020 was people aged 25 to 34.³⁰
There’s a notable gender gap in suicide rates. Women are more likely to experience depression (at about twice the rate) and are three times more likely to attempt suicide than men. However, men are 3.88 times more likely to complete and die by suicide.³⁰ This seems to be because men use more lethal methods – i.e., firearms – when they attempt, whereas poisoning and overdoses are the most common method of suicide for women.²⁹ As of 2021, men represent an overwhelming 79% of all suicide deaths in the United States. Middle-aged white men, in particular, are incredibly likely to attempt suicide, accounting for almost 70% of suicide deaths in the United States in 2020.
This is not to say that these so-called “unsuccessful” suicide attempts are anything to scoff at. For every 25 people attempting, there is one death by suicide. The biggest predictor of a suicide attempt is a history of trying, so it’s critical that those who are suicidal are taken as seriously as they deserve.
Other key risk factors
Suicide is complicated. There’s no one reason that it happens, but an amalgamation of risk factors increases the likelihood of an attempt. Aside from age, gender, race, previous attempts, and a history of trauma or previous suicide attempts, other major risk factors include:
- Recent loss of loved one
- Access to guns in the home (more than half of all suicide deaths in 2020 were from firearms)³⁰
- Recent release from incarceration
- Chronic pain
- Family violence and a family history of suicide attempts
- Personal history of suicide attempts
There are no formal definitions for what is and what isn’t a suicidal thought in clinical settings. It depends completely on the individual and is surprisingly common in response to intense distress. However, researchers have identified two distinct types of suicidal thoughts: passive and active ideation.
Passive ideation is thoughts or feelings of wanting not to exist or die but without a concrete plan to commit suicide. If you are experiencing passive suicidal ideation, you may think that people in your life would be better off without you or that you’d like to go to sleep and not have to wake up. Others dream about fatal accidents or are reckless with their medications or eating and drinking habits. It’s not always studied, as some healthcare professionals and researchers think that the overall desire for death isn’t a great predictor for attempts.²⁰ However, passive ideation can quickly transform into active suicidal ideation.
Active suicidal ideation is what therapists call creating a plan with the intent to die. The thoughts have escalated beyond wishes into preoccupations, regularly thinking about how you might commit suicide. This is what most people think of when you mention “suicidal thoughts or feelings.” Active suicidal ideation can sometimes feel uncontrollable or unstoppable and can quickly lead to suicide attempts.
Suicidal thoughts and feelings tend to be short-lived but emotionally intense. They most often present in a “waxing and waning” manner, where they fluctuate dramatically over the course of a day, week, or month. Individual moments of suicidal ideation can also vary in intensity, length, and character.²⁰
While the signs vary between individuals, there are some general red flags. Some serious warning signs that someone may be at risk of attempting suicide include:
- Talking about wanting to die, kill themselves, or not exist
- Looking for ways to kill themselves, such as stockpiling medication or searching online for a gun
- Displaying extreme mood swings, particularly going from very sad to calm or happy
- Talking about feeling extreme guilt or shame
- Talking about being a burden to others
- Increasing alcohol and drug use
- Acting anxious or agitated
- Behaving recklessly or taking unnecessary risks
- Changing eating or sleeping habits
- Withdrawing or isolating themselves
- Giving away prized possessions
- Seems preoccupied with death or dying, even in the abstract
All suicidal thoughts are something to discuss with a professional. No matter the risk factors, the biggest indicator of a suicide attempt are active suicidal thoughts and a coherent plan.
Many who suffer from suicidal thoughts hesitate to talk with a professional about it. Mental health professionals are required to report if you may hurt yourself or others, so someone who is actively suicidal may be hesitant to bring it up with their therapist or psychiatrist out of fear of involuntary commitment to a mental health facility. You may not want to bring it up because you don’t want help or think you need it. However, honesty is important to ensure you get the care you need.
A therapist or licensed medical health professional will first run a risk assessment to see if you are in imminent danger of hurting yourself or others. This determines how they move forward and if they think reporting the behavior is necessary.
If you are concerned that someone you love is experiencing suicidal thoughts, you can ask for the same level of information to help figure out what resources they need. The order of escalation, from most mild to most severe, is:
- Thoughts of wanting to die or thinking one would be better off dead (passive suicidal ideation)
- Thoughts of actually harming or killing oneself
- A desire to kill oneself
- A plan for killing oneself
- Steps a person has taken to prepare for suicide
- Ready access to the means of suicide
Therapists will also often ask about reasons you have not to end your life, such as family, pets, or aspirations. Someone with a high level of danger may need hospitalization; someone on the lower end of the spectrum may not be in an emergency, but may need a safety plan in case thoughts escalate.²¹
Asking someone if they feel suicidal won’t make them more likely to act on it, even when asked frequently.¹¹ Don’t be afraid to sit down with them and be straightforward. Though they might avoid eye contact, refuse to give direct answers, or deny it altogether, stay with them.
Risk factors for suicidal thoughts and behaviors last long-term, but suicidal thoughts themselves tend to have rapid onsets and last short amounts of time through large bursts of emotion. If they can get through this moment, be it five minutes, half an hour, or several hours, you can help get them out of a crisis.
There are multiple support networks available for those experiencing a crisis or are experiencing active suicidal ideation. The most important thing these networks do is provide a safe place to listen and provide support, helping them get through the difficult moment. Some crisis support lines include:
If you aren’t sure how to help but know things are serious, or if you or a loved one are going to act on a suicide plan, please go to your local emergency department or urgent care center. They will be able to identify the best form of treatment for you.
Therapy is the first (and arguably most important) way someone experiencing suicidal thoughts and feelings can get help long-term. No matter the risk factor, comorbid condition, or reason for your suicidal ideation, a therapist, psychologist, licensed social worker, or other mental health professional is trained for years to be able to help you.
Cost can be prohibitive to getting help, particularly if economic conditions have driven you or your loved ones’ suicidal ideation. Online therapies such as BetterHelp are just as effective as in-person therapy but cost less per session without insurance. Suppose you don’t have consistent internet access or aren’t interested in online therapy. In that case, many in-person clinics have sliding scales, where they can adjust the cost of your session depending on your income, and some community mental health centers or student psychologists can get your copay down to $0.
National Suicide Prevention Hotline
Call 1-800-273-8255 or chat online.
Crisis Text Line
Text HOME to 741741.
For LGBT+ young people under 25. Call 1-866-488-7386 or text START to 678678.
The LGBT National Hotline
The line is available from 1:00 PM to 9:00 PM Pacific Time on weekdays and 9 AM to 2 PM on Saturdays. Call 1-888-843-4564 or email help@LGBThotline.org.
Facilitates justice-oriented community aid for transgender people. The line is available from 7:00 AM to 1:00 AM Pacific Time. Call 1-877-565-8860.
Veterans Crisis Line
Free, confidential VA health care responders. Call 1-800-273-8255 and press 1 or text 838255.
- American Psychiatric Association
- American Psychological Association
- National Association of Social Workers
- Substance Abuse and Mental Health Services Treatment Locator
- Veterans Affairs
- National Queer and Trans Therapists of Color Network
- The American Indian and Alaska Native Society of Indian Psychologists
- Mental Health America
Foundations and resources
- Wounded Warrior Project for veterans
- American Association of Suicidology
- Safety plan templates
- The Jason Foundation for suicidal youth
- The Jed Foundation for suicidal youth
- Action Alliance
- National Organization for People of Color Against Suicide
- Suicide Prevention Resource Center
- Help a Friend in Need pamphlet from the Jed Foundation on helping through social media
- Youth Mental Health First
It may seem cheesy, but remember: It gets better.
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