Suicide Prevention with Mental Health First Aid

Mental wellness is for everyone.

Psychology isn’t only for the afflicted or differently abled. It is for anyone who wishes to feel happier and find fulfillment in life. The World Health Organization1 defines mental and emotional well-being in four capacities:

  1. Realize own potential
  2. Cope with the normal stresses of life
  3. Work productively and fruitfully
  4. Contribute to community

These behaviors compose mental health in the same way our nutrition, exercise, sleep, and defenses make up our physical health. Mental illnesses create obstacles in the pursuit of wellness. Often, treatment interventions involve managing obstacles and learning skills to live a fruitful life, whether or not a person manages a mental illness.

Information about mental health and well-being is more accessible than ever before, but many people are reluctant to admit they are unhappy or unwell. Negative stigma and misperceptions of mental health conditions leave people afraid to ask for help.

From a public health perspective, there are three degrees of suicide prevention: primary (understanding the cause), secondary (intervening in active suicidal behavior to limit injury), and tertiary (crisis intervention after a suicide attempt.)

Suicide is preventable.

Primary preventions aim at shrinking the factors that increase risk of crisis and expanding factors that help people learn, cope, and develop resilience. Expanding mental health education and resources is a primary prevention, as it normalizes psychological wellness and reduces negative stigma that prevents individuals from seeking help. Individual therapy is also a primary prevention, if sought early.

Many people are not aware that mental health resources are widely available. It is estimated that 90% of people who die by suicide were suffering from depression or a similar mental illness at the time of their death.


Five most common warning signs of Suicide Risk (From the National Association of School Psychologists)
  1. Suicide threats, both direct (“I am going to kill myself.” “I need life to stop.”) and indirect (“I need it to stop.” “I wish I could fall asleep and never wake up.”). Threats can be verbal or written, and they are often found in online postings.
  2. Giving away prized possessions.
  3. Preoccupation with death in conversation, writing, drawing, and social media.
  4. Emotional distress.
  5. Changes in behavior, appearance/hygiene, thoughts, and/or feelings. This can include someone who is typically sad who suddenly becomes extremely happy.

Always take warning signs seriously, and never promise to keep them secret. Parents, school personnel, and peers can recognize the warning signs and should take immediate action to keep the person safe.

Mental Health First Aid

The National Council for Behavioral Health3 has developed a series of 8-hour courses that teach people how to identify, understand, and respond to a mental health crisis. Mental Health First Aid provides an action plan for starting conversations about mental health and substance use problems. The core tenets of any mental health intervention are to connect, communicate, and care. The 5-Step plan, ALGEE, teaches what to do and how to do it.

Mental Health First Aid 5-Step Action Plan: ALGEE


Ask: Approach, assess, and assist the individual in sharing their thoughts and feelings. Ask them, “have you ever thought about hurting yourself or taking your own life?”

Listen: Listen with undivided attention. Allow silence. Do not deny how they are feeling, and do not evaluate or judge. Instead, acknowledge and let them know you understand.

Give: Give the individual your support and offer information that may help manage immediate obstacles.

Encourage: Encourage them to seek professional help and offer assistance.

Educate: Encourage education about mental health, self-help, and other therapeutic resources.

You can find a Mental Health First Aid certification course near you at www.mentalhealthfirstaid.org/take-a-course

Mental wellness is as important as physical wellness.

If you or someone you know are in crisis, call the toll-free National Suicide Prevention Lifeline (NSPL) at 1-800-273-TALK (8255), available to everyone, 24 hours a day, 7 days a week. The deaf and hard of hearing can contact the lifeline via TTY at 1-800-799-4889. Dial 911 in an emergency. Learn more at: https://suicidepreventionlifeline.org/


Additional Resources for Suicide Prevention


Centers for Disease Control and Prevention https://www.cdc.gov/features/preventingsuicide/index.html
National Action Alliance for Suicide Prevention http://actionallianceforsuicideprevention.org/




1. Mental health: a state of well-being. (2014). World Health Organization. Retrieved from http://www.who.int/features/factfiles/mental_health/en/
2. Kashdan, Todd B. (2014) Why Do People Kill Themselves? New Warning Signs. Psychology Today. Retrieved from https://www.psychologytoday.com/blog/curious/201405/why-do-people-kill-themselves-new-warning-signs
3. Mental Health First Aid. (2013) National Council for Behavioral Health. Retrieved from https://www.mentalhealthfirstaid.org/

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(Q&A with Dr. Michelle Murray, Ph.D.)