Suicide prevention: data, warning signs and how to help

September is internationally recognized as suicide prevention month, with initiatives aimed at expanding the discussion on mental health. In Brazil, the Setembro Amarelo® (Yellow September) campaign, organized by the Brazilian Association of Psychiatry (ABP) in partnership with the Federal Council of Medicine, is considered the largest awareness initiative on the topic in the world. 

In 2024, the chosen theme was “If you need it, ask for help!”, highlighting the importance of access to appropriate support. The movement is also connected to World Suicide Prevention Day, on September 10th, which brings attention to a concerning fact: more than 720,000 people die by suicide each year worldwide, according to the World Health Organization (WHO). 

Suicide: global and national overview

The World Health Organization (WHO) estimates that more than 720,000 people die by suicide annually, with more than 20 attempts for every life lost. The phenomenon affects all age groups but can be prevented through evidence-based interventions (1). Among children and adolescents aged 5 to 19, the impact is especially relevant: suicide is among the leading causes of death in this age group, totaling about 52,000 annual deaths worldwide (2). 

In Brazil, in 2021 there were 15,507 registered suicide deaths, of which 77.8% occurred among men. Mortality is particularly high among adolescents and young adults: suicide ranks as the 11th cause of death among children aged 5–14, 3rd among those aged 15–19, and 4th among young people aged 20–29 (Epidemiological Bulletin, 2024). Internationally, the United States reported more than 49,000 deaths in 2023, according to the Centers for Disease Control and Prevention (4), showing the persistence of high levels in other countries as well. 

Beyond mortality rates, mental disorders must also be considered. Depression, for example, affects around 16 million Brazilians and is present in about 10% of the adult population (IBGE), making it one of the main factors associated with suicide. 

What is suicide prevention and why does it matter?

Suicide represents one of the major global public health challenges, accounting for about 1 in every 100 deaths worldwide (1). Although complex, it is largely preventable when early detection, adequate treatment, and multisectoral strategies are in place. 

Suicide prevention goes beyond individual clinical care. It includes strengthening support networks, reducing social and behavioral risk factors, and expanding access to mental health services. Awareness campaigns and training of professionals are also central tools in this process. 

Yellow September: why the Suicide Prevention Awareness Campaign matters

Public campaigns play an essential role in reducing stigma, promoting safe information, and connecting people with health services. In Brazil, Setembro Amarelo® was launched in 2013 by the Brazilian Association of Psychiatry (ABP) in partnership with the Federal Council of Medicine (CFM). The initiative includes training sessions, discussion groups, and the dissemination of support hotlines, while also guiding media and influencers to communicate responsibly—avoiding method descriptions and always including help resources (5, 6). 

Mental disorders are present in 96.8% of suicide cases, according to the ABP, which reinforces the need to address the issue without stigma and with an evidence-based approach. In 2024, marking 11 years, the campaign adopted the theme “If you need it, ask for help!”, reinforcing that seeking help is an act of courage that can save lives (7). 

The movement is also connected to World Suicide Prevention Day, celebrated every September 10th since 2003, a date symbolizing the importance of strengthening discussions on mental health worldwide. 

Risk factors and warning signs

For each death by suicide, there are many more attempts and self-harm cases. Studies show that for every death, there are dozens of emergency visits due to self-inflicted injuries and hundreds of people with serious suicidal thoughts, underscoring the importance of early detection and crisis care (1,8,9). 

The risk of suicide is about 50 times higher in patients admitted to hospitals after an act of self-harm, whether suicidal or not. 

Effective prevention depends on understanding the main risk factors (1, 10): 

• Previous suicide attempt: considered the strongest isolated predictor of future suicide;
• Mental disorders: depression, bipolar disorder, schizophrenia, dysthymia, and substance abuse are present in about 90–95% of suicide cases;
• Other factors: easy access to lethal means (firearms, pesticides), recent stressful events (job loss, grief, economic crises), social isolation, discrimination due to sexual orientation or gender identity, and medical comorbidities such as chronic pain and epilepsy. 

The Brazilian Ministry of Health also highlights warning signs that may indicate imminent risk: talking about death (“I’m going to disappear,” “I can’t take it anymore”), social withdrawal, saying goodbye, sudden changes in mood or appearance, and neglect of self-care (3). 

Recognizing these signs is not an exact science, but careful observation and dialogue can be decisive in prevention. 

Who is at greater risk?

Studies indicate consistent patterns of risk, such as (3): 

• Sex: most suicide deaths occur among men. Women show more ideation and attempts, but with lower lethality;
• Age: adolescents and young adults concentrate a higher proportion of deaths from external causes, with suicide ranking high among causes of mortality; 
• Social determinants: unemployment, financial difficulties, violence, grief, and access to lethal means (such as firearms and pesticides) increase the risk. WHO recommends interventions in lethal means as a cost-effective measure; 
• Previous attempt: considered the strongest single risk factor for suicide death, reinforcing the need for active follow-up after any self-harm episode (11). 

Which groups and contexts deserve attention?

• Adolescents and young people (15–29 years): suicide ranks high as a cause of death; school programs promoting socio-emotional skills and anti-bullying initiatives reduce risk (3). 
• Men: higher lethality, use of more lethal means, and lower engagement with services; male-focused engagement strategies, such as extended service hours and specific campaigns, are recommended (3). 
• People with previous attempts or mental disorders: require safety planning, removal of lethal means, and active follow-up after emergency service discharge (11, 12). 
• Social determinants: unemployment, debt, domestic violence, and access to weapons or toxic substances increase risk, requiring public policy interventions in these areas. 

Depression: prevalence, impact, and relationship with suicide

Depression is one of the most common mental disorders worldwide and a major risk factor for suicide. WHO estimates that about 280 million people live with depression, approximately 3.8% of the global population and 5% of adults, being more frequent among women. In the same period, more than 700,000 people die by suicide annually (1). 

In Brazil, the National Health Survey (PNS/IBGE) shows that self-reported depression rose from 7.6% to 10.2% between 2013 and 2019, representing about 16.3 million adults diagnosed by a health professional. Slightly more than half received medical assistance in the past year, highlighting challenges in access and continuity of care (13, 14). 

The Ministry of Health estimates that lifetime prevalence of depression is around 15.5% (3). 

WHO highlights that depression is one of the leading causes of disability. However, effective treatments exist, both pharmacological and psychotherapeutic, which should be expanded within health systems. 

Depression and mental health in adolescence

Adolescence is a stage of major physical, emotional, and social changes, which can make young people more vulnerable to mental disorders, including depression. Biological factors, such as hormonal changes, genetics, and family history, combine with environmental factors such as school pressure, bullying, family conflicts, social isolation, and exposure to traumatic situations. 

Excessive use of social media and constant comparison with others can also contribute to feelings of inadequacy and persistent sadness (1, 14). 

How to identify and treat depression in young people

Signs of depression include persistent sadness, loss of interest in activities, irritability, changes in sleep and appetite, difficulty concentrating, and feelings of worthlessness or guilt. Treatment involves a multidisciplinary approach: psychotherapy (such as cognitive-behavioral therapy), medical follow-up, and, in some cases, medication prescribed by a qualified professional. 

Early detection is essential, and family members and teachers play an important role in identifying warning signs (1, 11). 

The role of pharmacogenetic testing in depression treatment

Pharmacogenetic testing has proven to be a fundamental tool in the treatment of depression, as it helps understand how individual genetic variations influence medication response. Antidepressants often show variable efficacy and may cause undesirable side effects in some patients.  

Pharmacogenetic analysis allows identification of variants in genes related to the metabolism and action of these drugs, offering valuable information for choosing the most appropriate medication and correct dosage for each person. 

Thus, pharmacogenetic testing helps reduce the trial-and-error time in antidepressant prescription, increasing chances of positive response and reducing the risk of adverse reactions. This personalized approach promotes greater treatment adherence and improved quality of life for the patient. Furthermore, it represents an important step toward precision medicine in mental health, enabling safer, more effective, and individualized therapies. 

What works in suicide prevention

The World Health Organization proposes the action package known as LIVE LIFE, which integrates suicide prevention measures, such as (15): 

• Limiting access to lethal means, such as gun control, bridge barriers, and pesticide restriction;
• Ensuring responsible media coverage, avoiding method details, sensationalist headlines, and stigmatizing language;
• Developing socio-emotional skills in adolescents;
• Identifying, assessing, treating, and following up with people in distress (1).

In Brazil, the strategy is implemented through the Psychosocial Care Network (RAPS), involving Primary Health Care Units, Psychosocial Care Centers (CAPS), emergency care, and epidemiological surveillance (SIM and Sinan), to support focused actions. The Ministry of Health emphasizes the need for multisectoral responses, linking health, education, social assistance, and public security. 

In addition, the country relies on CVV – Centro de Valorização da Vida, a free national service available 24/7 via phone 188, chat, and email, which provides millions of annual consultations with trained volunteers. 

How to Take Care of Your Mental Health Daily

Maintaining mental health depends on habits and pillars that promote emotional, social, and physical balance. 

Key pillars include: adequate sleep, balanced nutrition, regular physical activity, healthy social relationships, stress management, and leisure time. Caring for the mind is just as important as caring for the body (1). 

Practical Tips for Self-Care: 

• Set aside time for rest and hobbies;
• Exercise regularly;
• Maintain a consistent sleep routine;
• Keep in touch with friends and family;
• Practice breathing techniques, meditation, or mindfulness;
• Seek professional help whenever you feel emotionally overwhelmed. 

How to Help Someone Experiencing Suicidal Thoughts

When noticing warning signs, such as mentions of death or hopelessness, it is important to: 

• Do: listen without judgment, offer support, encourage seeking professional help, remove lethal means if possible;
• Avoid: minimizing the person’s feelings, moralizing about suicide, using sensationalist language, or insisting on “quick fixes” (1, 11). 

Listening attentively, validating feelings, and showing that the person is not alone are fundamental actions. Empathy helps reduce feelings of isolation and builds trust, making it easier for the person to seek appropriate help. Open-ended questions calmly posed encourage expression without fear of judgment. 

Available Support Services

In Brazil, there are public and private psychological support services, such as: 

• CVV – Centro de Valorização da Vida: available 24/7 via phone (188), chat, and email;
• Basic Health Units (UBS) and Psychosocial Care Centers (CAPS): providing follow-up and treatment;
• Telehealth platforms and state/municipal suicide prevention lines offered by health authorities;
• State and municipal suicide prevention and emotional support hotlines. 

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References 

1. World Health Organization. Suicide: key facts. Geneva: World Health Organization; 2021. Disponível em: https://www.who.int/news-room/fact-sheets/detail/suicide

2. Kim, S., Park, J., Lee, H. et al. Global public concern of childhood and adolescence suicide: a new perspective and new strategies for suicide prevention in the post-pandemic era. World J Pediatr 20, 872–900 (2024). https://doi.org/10.1007/s12519-024-00828-9

3. Boletim Epidemiológico do Ministério da Saúde, Volume 55, N.º 4, de 6 de fevereiro de 2024. Disponível em: https://www.gov.br/saude/pt-br/centrais-de-conteudo/publicacoes/boletins/epidemiologicos/edicoes/2024/boletim-epidemiologico-volume-55-no-04.pdf/%40%40download/file

4. Center for Disease Control and Prevention. Suicide Data and Statistics. 2025. Disponível em: https://www.cdc.gov/suicide/facts/data.html

5. Organização Pan Americana de Saúde – Pandemia de COVID-19 aumenta fatores de risco para suicídio. 2020. Disponível https://www.paho.org/pt/noticias/10-9-2020-pandemia-covid-19-aumenta-fatores-risco-para-suicidio?

6. World Health Organization. WHO Global Health Estimates. Disponível em:
https://www.who.int/teams/mental-health-and-substance-use/data-research/suicide-data

7. Setembro Amarelo: 11 anos de conscientização na prevenção ao suicídio. Conselho Federal de Medicina. 2024. Disponível em: https://portal.cfm.org.br/noticias/setembro-amarelo-11-anos-de-conscientizacao-na-prevencao-ao-suicidio.

8. Hawton, K., Bergen, H., Cooper, J., Turnbull, P., Waters, K., Ness, J., Kapur, N., 2015. Suicide following self-harm: findings from the multicentre study of self-harm in England, 2000–2012. J. Affect. Disord. 175, 147–151.

9. Lin, C.Y., Bickley, H., Clements, C., Webb, R.T., Gunnell, D., Hsu, C.Y., Chang, S.S., Kapur, N., 2019. Spatial patterning and correlates of self-harm in Manchester, England. Epidemiol. Psychiatr. Sci. 29, e72.

10. Organização Pan Americana de Saúde – Pandemia de COVID-19 aumenta fatores de risco para suicídio. 2020. Disponível https://www.paho.org/pt/noticias/10-9-2020-pandemia-covid-19-aumenta-fatores-risco-para-suicidio?

11. International Association for Suicide Prevention. Global Suicide Statistics. Disponível em https://www.iasp.info/wspd/references/

12. World Health Organization, 2022. ICD-11 for mortality and morbidity statistics (Version: 02/2022). https://icd.who.int/browse11/l-m/en#!/

13. Brito VCA, Bello-Corassa R, Stopa SR, Sardinha LMV, Dahl CM, Viana MC. Prevalência de depressão autorreferida no Brasil: Pesquisa Nacional de Saúde 2019 e 2013. Epidemiol. Serv. Saúde 31 (spe1) 202208 Jul 2022 https://doi.org/10.1590/SS2237-9622202200006.especial

14. Insttuto Brasileiro de Geografia e Estatístico. IBGE: pelo menos uma doença crônica afetou 52% dos adultos em 2019. 2020. Disponível em: https://agenciabrasil.ebc.com.br/saude/noticia/2020-11/ibge-pelo-menos-uma-doenca-cronica-afetou-52-dos-adultos-em-2019

15. LIVE LIFE: An Implementation Guide for Suicide Prevention in Countries. Diponível em: https://www.who.int/initiatives/live-life-initiative-for-suicide-prevention