Pearlman & Associates

655 Craig Road
St. Louis, MO 63141

Monday – Saturday

Suicide: Risk Factors, Warning Signs, Protective Factors, and Resources

CDC says that, “In 2019, 12 million American adults seriously thought about suicide, 3.5 million made a plan, and 1.4 million attempted suicide”. According to the American Psychiatric Association, suicide is, “The 10th leading cause of death in the United States and the second leading cause of death (after accidents) for people aged 10 to 34”. Additionally, they report that in 2019, 47K+ people died by suicide in the United States. In 2020, NPR went into depth about a study conducted by the CDC, reporting that in 2020, around 46K people died by suicide. Despite the pandemic leading to mass isolation, this means that there was a decline in suicide in 2020. Though there was a small decline in suicide, 46K people still died. One person dying by suicide is too much. This is a gargantuan issue.

The American Psychiatric Association lists several risk factors, warning signs, and protective factors. Before listing these factors and signs, it is important to define these.

Retrieved from The Suicide Prevention Resource Center

“Risk factors are characteristics that make it more likely that an individual will consider, attempt or die by suicide. Warning signs indicate an immediate risk of suicide. Protective factors are characteristics that make it less likely that individuals will consider, attempt or die by suicide.”

Retrieved from the American Psychiatric Association (

Risk Factors:

  • Previous suicide attempt(s)
  • A history of suicide in the family
  • Substance misuse
  • Mood disorders (depression, bipolar disorder)
  • Access to lethal means (e.g., keeping firearms in the home)
  • Losses and other events (for example, the breakup of a relationship or a death, academic failures, legal difficulties, financial difficulties, bullying)
  • History of trauma or abuse
  • Chronic physical illness, including chronic pain
  • Exposure to the suicidal behavior of others

Warning Signs:

  • Often talking or writing about death, dying or suicide
  • Making comments about being hopeless, helpless or worthless
  • Expressions of having no reason for living; no sense of purpose in life; saying things like “It would be better if I wasn’t here” or “I want out.”
  • Increased alcohol and/or drug misuse
  • Withdrawal from friends, family and community
  • Reckless behavior or more risky activities, seemingly without thinking
  • Dramatic mood changes
  • Talking about feeling trapped or being a burden to others

Protective Factors:

  • Contacts with providers (e.g., follow-up phone call from health care professional)
  • Effective mental health care; easy access to a variety of clinical interventions
  • Strong connections to individuals, family, community and social institutions
  • Problem-solving and conflict resolution skills

What can we do? First, don’t be afraid to have “the talk”. Asking someone if they are suicidal and having those thoughts does not plant those thoughts or harm them in any way. The National Alliance on Mental Illness (NAMI) has an incredibly insightful article on how to have the conversation:

The National Institute of Mental Health (NIH) talks about the 5 Action Steps for Helping Someone in Emotional Pain.

  1. Ask. See above paragraph.
  2. Keep Them Safe
  3. Be There
  4. Connect. Contact information for resources can be found at the end of this article.
  5. Keep in touch. Stay connected.


National Suicide Prevention Lifeline: 1-800-273-TALK (1-800-273-8255)

24/7 Crisis Counselor – Text HOME to 741741

Dr. Lena Pearlman & Associates is a St Louis mental health therapy practice in Creve Coeur, Missouri. The practice has a team of mental health therapists who provide therapy and counseling services to kids, teens, adults, couples, and families. Dr. Lena Pearlman & Associates specializes in stress, anxiety, depression, relationships, and other mental health related issues and concerns.

The practice can be reached by phone at: 314-942-1147, by email at: or on the web at: The office is located at: 655 Craig Road, Suite 300, St. Louis, MO 63141.

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