Suicide Prevention

There is often not a single cause of suicide. For many people, it is the result of multiple stressors and health issues. Learn the warning signs, and if you or someone you know may be at risk of suicide, get help immediately.

Many people who die by suicide show one or more warning signs, often through what they say or do. Here are some warning signs:

Talk: a person talks about feeling hopeless or trapped, feeling like a burden, having no reason to live

Behavior: change in behavior, increased drug or alcohol use, searching for suicide methods, withdrawing from people or activities, sleeping too much or too little, aggression

Mood: depressed, anxious, lose interest in doing things, irritable, humiliated, ashamed and agitated

• Stressful life events or crisis, such as job loss, relationship trouble and major life transition 
• Access to lethal means (including firearms and medications) 
• Social isolation
• Exposure to traumatic events
• Adverse childhood experiences
• Use and misuse of alcohol and other substances
• Mental health disorders and conditions, such as depression or anxiety 
• Chronic health conditions, including pain and traumatic brain injury
• Lack of access to behavioral health care
• Knowing someone who died by suicide, particularly a family member
• Significant dates, such as anniversaries of a loved ones’ death or birth 

Find out more about Risk Factors and Warning Signs

Risk factors vary across groups.

Here are some examples of how some factors can impact groups differently:

• Stress resulting from prejudice and discrimination (family rejection, bullying, violence) is a known risk factor for suicide attempts among lesbian, gay, bisexual and transgender youth.
• For men in the middle years of age, life stressors that challenge traditional male roles, such as unemployment and divorce, have been identified as risk factors.
• People experiencing poverty, especially in rural areas, are at risk due to increased life stressors and lack of access to effective and affordable behavioral health care.
• Older adults and youth who experience higher levels of social isolation.
• First responders (including EMS, fire, law enforcement, emergency dispatchers) and military veterans have stressors including exposure to traumatic events such as death by suicide, higher rates of post-traumatic stress, the stigma associated with seeking help and increased access to lethal means.

• Effective clinical care for mental, physical, and substance abuse disorders 
• Easy access to a variety of clinical interventions and support for help-seeking 
• Connectedness to individuals, family, community and social institutions
• Life skills (including problem-solving skills, coping skills and ability to adapt to change)
• Self-esteem and a sense of purpose or meaning in life
• Cultural, religious or personal beliefs that discourage suicide

Learn more about Risk and Protective Factors

Best practice is to have firearms:

• Unloaded.
• Locked in a secure location.
• Separated from ammunition, with the ammunition also locked up.

Safe storage of firearms in the home can help prevent injuries and deaths that involve a firearm. According to the 2018 Behavioral Risk Factor Surveillance Survey, 43% of all Vermont households store firearms in or around their home. Research shows that the presence of guns in the home increases the risk of dying by suicide. During a suicidal or mental health crisis, you have options for temporarily storing potentially dangerous things, like firearms or medicines.  

In Vermont:

• firearm injuries are most often accidental (61%). The remaining firearm injuries are homicide or assault (16%) or intentional self-harm (13%).
• most firearm deaths are due to suicide (91%). Homicides account for 9% of firearm deaths.

Talk with your children about gun safety. Be sure that they know to stay away from guns in a friend’s home or elsewhere, and to tell you if they see or find a gun.

Talk with the parents of your children’s friends. Find out if they have guns in their homes. If they do, ask that they keep them unloaded, locked up, and out of children’s reach.

Additional Firearm Safety Resources

• The Harvard School of Public Health's Means Matter: Suicide, Guns, and Public Health (link is external)page
• Suicide Prevention Resource Center's Reduce Access to Means of Suicide (link is external)page 
• CALM: Counseling on Access to Lethal Means Training for Clinicians (link is external)

The way we talk about suicide matters. Asking someone if they are thinking of suicide will not plant the idea in their mind. Listening to someone can help save a life. For help on talking to someone about suicide, contact the National Suicide Prevention Lifeline (link is external, , visit their website or contact one of the other resources listed at the top of this page. 

Media reporting on suicide can have a positive or negative effect on the community, especially after a suicide death. For best practices on responsible reporting on suicide, visit Reporting on Suicide. This resource includes guidance on coverage of suicide. 

Wondering how to talk to others about suicide after a death in your community? See guidance from the National Suicide Prevention Resource Center

Organizations throughout Vermont are working to reduce the number of deaths by suicide, increase the number of people seeking help for suicide, and improve the health care people get when they have thoughts of suicide. 

We are working to raise awareness about the importance of mental health in society. It is okay to talk about your mental health, and it is okay to ask others how they are doing. We need to eliminate the stigma around talking about mental health. 

Projects in Vermont include:

• CDC Comprehensive Suicide Prevention grant: Vermont has received a five-year grant from the Centers for Disease Control and Prevention (CDC) to support the implementation and evaluation of the state’s comprehensive public health approach to suicide prevention in Vermont. The State of Vermont will use the federal grant to build on existing partnerships and programs to implement and evaluate a data-driven public health approach to suicide prevention in Vermont. The grant will bolster collective efforts on the integration between healthcare and mental health, and work to ensure all Vermonters have access to the supports they need. For more information, contact Nick Nichols, Suicide Prevention Program Coordinator.  
   
• Zero Suicide in Vermont Health Care: When health care systems are developed and designed to support and care for people struggling with suicidality and other mental health challenges, we can have an impact on the number of deaths by suicide. The State of Vermont has adopted the Zero Suicide framework to support anyone seeking health and mental health care. The Zero Suicide initiative has partnered with a number of health and behavioral health care organizations focused on implementing the Zero Suicide framework into their work. To learn more, see the Zero Suicide in Vermont brochure(link is external). 
   
• Prevention programs like Youth Thrive(link is external), UMatter (link is external)and Project Aware work to strengthen the mental health of Vermont youth.
   
• Mental Health First Aid (link is external) is a program that teaches people how to understand and respond to someone in distress.
   
• Grand Isle Connecting Rural Communities: Connecting Rural Communities is a collaboration of the Center for Health and Learning, the Indian Education Program of Franklin County Abenaki Title VI Parent Advisory Committee, and the Northwestern Counseling and Support Services. This collaboration is designed to better understand what is influencing suicide and develop strategies to improve suicide prevention efforts and access to behavioral health and health care. The project will work to improve connections between the community and providers in Grand Isle County, with a focus on culturally competent engagement with members of the Abenaki Nation of Missisquoi.
   
• Expanding Vermont Lifeline Crisis Centers: The National Suicide Prevention Lifeline is a national network of local crisis centers that provides free and confidential emotional support to people in suicidal crisis or emotional distress 24 hours a day, 7 days a week. The National Lifeline is dependent on local in-state call response infrastructure. Vermont currently ranks at the very bottom of in-state response for National Lifeline calls, at a 0% response rate. Vermont callers are routed out-of-state, resulting in potential delays and barriers to appropriate referrals. Vermont was awarded a two-year grant to expand the state's capacity and has set a target to increase in-state call response to 70% by 2021 (approximately 1,672 calls) by investing in local response agencies.
   
• Emergency Department Surveillance of Nonfatal Suicide-Related Outcomes grant: Vermont was awarded a 3-year grant from the Centers for Disease Control and Prevention (CDC) to improve timeliness of surveillance of suicide-related outcomes. The Emergency Department Surveillance of Nonfatal Suicide-Related Outcomes grant (link is external)will use timely emergency department data to monitor and detect clusters of suicide ideations, attempts and intentional self-harm. This grant has two goals, to increase the timeliness of aggregate reporting of nonfatal suicide-related outcomes using case definitions developed by CDC, and to share surveillance findings with key suicide prevention stakeholders throughout the state. 
   
• National Violent Death Reporting Systems grant: Vermont was awarded a 3-year grant from the Centers for Disease Control and Prevention (CDC) to collect and disseminate surveillance data on violent deaths, which includes suicides, homicides and deaths from legal intervention. The National Violent Death Reporting Systems grant (link is external) collects information from death certificates, medical examiner reports, law enforcement reports and toxicology reports into one anonymous database. The Vermont Violent Death Reporting System will use data to prevent violent deaths through informing decision-makers and program planners, educating communities and evaluating the impact of prevention programs and strategies. 

Data collection and analysis inform all suicide prevention efforts in Vermont. Understanding the trends in data about suicidal thinking, attempts and deaths helps Vermont experts focus on populations that are at high risk. 

Visit our Injury Data page for all data briefs and reports about suicide and self-harm injury in Vermont.

Vermont population data for suicide risk:

• LGBT high school students are significantly more likely to make a suicide plan or attempt than their peers (2019 HS YRBS: plan 36% vs. 9%; attempt 19% vs. 4%).
• LGBT adults are three times more likely to have seriously considered suicide in the past year compared to non-LGBT adults (2018 BRFSS: 12% vs. 4%).
• High school students of color are significantly more likely to make a suicide plan or attempt than their peers (2019 HS YRBS: plan 17% vs. 13%; attempt 10% vs. 6%).
• Female high school students are significantly more likely than males to make a suicide plan or attempt (2019 HS YRBS: plan 17% vs. 10%; attempt 8% vs. 5%).
• Females are two times more likely to visit the hospital for intentional self-harm compared to males (2020 VUHDDS: 214.3 vs. 109.5 per 100,000).
• Adults with a disability are five times more likely to report having seriously considered suicide in the past year (2018 BRFSS: 10% vs. 2%).
• Males are three times more likely to die by suicide compared to females (2020 rate: 29.3 vs. 7.1 per 100,000).

Performance Scorecard

See our performance measure scorecard for details about suicide prevention efforts. The scorecards reflect how we are doing in our efforts to promote mental health and reduce self-harm and suicide death. 

• % of adolescents in grades 9-12 who made a suicide plan in the past year
• % of LGBT adolescents in grades 9-12 who made a suicide plan in the past year
• % of adolescents of color in grades 9-12 who made a suicide plan in the past year
• Emergency department visits for self-harm rate per 100,000 Vermonters
• Firearm-related death rate per 100,000 Vermonters
• Rate of suicide deaths per 100,000 Vermonters
• Rate of suicide deaths per 100,000 male Vermonters age 65 and older 

The Health Department collects data from various sources that help inform what we know about suicide in Vermont. Vermont has data on youth suicide risk factors from the Youth Risk Behavior Survey, adult risk factors from the Behavioral Risk Factor Surveillance Survey, hospital visits for intentional self-harm and suicide-related outcomes from the Vermont Utilization Hospital Discharge Data System, detailed case reviews from the National Violent Death Reporting Systemlink is external and emergency medical services data from the Statewide Incident Reporting Network.

Vermont

• Vermont Suicide Prevention Resource Center
• Vermont Department of Mental Health

National

• National Suicide Prevention Resource Center
• Centers for Disease Control and Prevention- Suicide Prevention
• National Institute of Mental Health
• American Foundation for Suicide Prevention

The Vermont Department of Mental Health and the Vermont Department of Health support multiple evidence-based suicide prevention programs to help increase public awareness, train providers, develop treatment networks within schools and communities, and increase prevention outreach. Through continued collaboration with our partners, we can work to reduce the burden of intentional self-harm and suicide within Vermont’s communities. 

If you have any questions about suicide prevention programs or resources, please contact Nick Nichols, Vermont Department of Health Suicide Prevention Program Coordinator.