Between 2020 and 2021, suicide rates alarmingly increased.  According to the American Foundation for Suicide Prevention, the statistics are startling:

  • Suicide is the 11th leading cause of death in the U.S.
  • Suicide is the 2nd leading cause of death for individuals ages 20 to 34.
  • Suicide rates increased 37 percent between 2000 and 2018 and decreased 5 percent between 2018 and 2020. However, rates nearly returned to their peak in 2021. 
  • Each year, nearly 48,000 Americans die by suicide – that is 132 per day or 1 death ever 11 minutes.
  • The racial groups that have a disproportionately high rate of suicide are non-Hispanic, American Indian/Alaskan Native (28 percent) and non-Hispanic White people (17 percent).
  • Males make up about 80 percent of deaths by suicide.
  • People aged 85 or over have the highest rates of suicide (22 percent).
  • Firearms make up about half of all suicides. In states where there are stricter gun control laws, there tends to be a lower rate of suicide by firearm.
  • Black children and youth ages 10 to 24 saw the highest increase—36.6 percent—of all age and racial groups measured in 2021.
  • Based on the most recent Youth Risk Behaviors Survey from 2021, 10 percent of youth in grades 9 to 12 reported that they had made at least one suicide attempt in the past 12 months. 

What is causing suicide rates to rise?

The rise can be attributed to several reasons. States with more limited access to mental health services and were more affected by the coronavirus pandemic demonstrated higher rates. Substance use disorders are also believed to be contributing to the rising rates of suicide.

My colleagues and I are often asked why someone would commit suicide. The specific reason why someone would take their own life may never be known. However, there is a quote from Reducing Suicide: A National Imperative, by the Institute of Medicine, that I believe provides a good sense of what suicidal individuals experience.

It reads, “Suicide is ultimately a private act. It is difficult to put into words the suffering and agonized state of mind of those who kill themselves…A minority of those who kill themselves actually write suicide notes, and these only infrequently try to communicate the complex reasons for the act. Still, some consistent psychological themes emerge. Clearest of these is the presence of unendurable heartache, captured in the simple phrase, ‘I can’t stand the pain any longer.’”

Who is at risk?

While the causes are varied, the risk factors may be related to health or mental health conditions, environmental factors, or family history as well.

Health issues that increase suicide risk include

  • mental health conditions
  • serious or chronic health conditions, particularly chronic pain
  • traumatic brain injuries
  • recent suicide attempts or recent discharge from a psychiatric unit

Environmental factors that may increase risk include

  • access to lethal means
  • prolonged exposure to stress
  • stressful life events, such as a death, relationship break-up, or job loss
  • exposure to another person’s suicide

Historical risk factors include

  • a history of suicide attempts
  • a family history of suicide
  • experiencing childhood abuse, neglect, or trauma

Warning signs of suicide ideation

People who have considered taking their own lives often show signs. The individual may talk about any of the following:

  • feeling hopeless or trapped
  • experiencing unbearable pain
  • feeling like a burden
  • having no reason to live
  • feeling suicidal

There are some behaviors that are often red flags as well, including:

  • researching ways to kill oneself
  • increasing isolation
  • visiting or saying goodbye to people
  • giving away possessions
  • increased use of alcohol or drugs

Individuals may appear depressed, anxious, and/or be in an angry mood. Also of concern is someone who may have been depressed or anxious and is suddenly very happy. This may be a sign they have already made the decision to act.

How to help someone who may be suicidal

You can be the person to help someone who is struggling. If you suspect someone you know is suicidal, it is vital to be supportive and kind. Listen to the person, but know your limits, and help them get the support needed.

Do not leave the person alone if you are concerned the risk is imminent. Of note, there was a study of people who attempted suicide. They indicated that not much time passed between the time the decision was made to commit suicide and acting on it. About a quarter of those surveyed said 5 minutes or less, while another 47 percent said an hour or less. This tells us that while suicide is often something people think about, it seems that the ultimate decision is an impulsive one. 

Do not be afraid to ask them if they have thought about suicide. It is a myth that talking about suicide with someone may be viewed as encouragement. In fact, talking openly about it may help someone realize they have options.


If you are worried about an imminent risk call 9-1-1 immediately.

The Lifespan Psychiatry and Behavioral Health Access Center can connect individuals to a range of outpatient assessment and treatment resources. Call our access center at 401-606-0606.

There are also hotlines for people to call, including the National Suicide Prevention Hotline (dial 988 or chat and the Samaritans 401-272-4044 or 1-800-365-4044.

Lisa Shea, MD

Lisa Shea, MD

Dr. Lisa B. Shea is a psychiatrist at Lifespan Physician Group and director of quality in adult psychiatry at Lifespan. Her clinical interests include suicide prevention and women’s mental health.