Part 1: SEE

1. SEE – Recognizing Suicidality

Why is this important?

Facts and Figures (source: 113)

• On average, 5 people die by suicide every day in the Netherlands.
• Approximately 450,000 Dutch people think about suicide each year.
• Nearly half of Dutch lesbian, gay, and bisexual (LGB) adults and youth have had thoughts of suicide at some point. This is more than 5 times the rate of the general adult population. Recent international research confirms that over 40% of LGB youth struggle with suicidal thoughts. 8% of LGB adults have attempted suicide at some point, which is 4 times higher than in the general adult population.
• Transgender individuals die by suicide 3 to 4 times more often than non-transgender individuals. They also attempt suicide 5 to 10 times more often and think about suicide 7 times more often than non-transgender individuals. Recent international research confirms that over 80% of transgender individuals have thought about suicide at some point. More than 90% of transgender individuals who have attempted suicide did so before the age of 25. Suicidal thoughts often decrease when people gain access to proper transgender care.

Most LGBTQ+ individuals with suicidal thoughts indicate that these thoughts are related to their sexual orientation or gender identity. This is often due to negative reactions, bullying, violence, and minority stress. Additionally, young people tend to discuss this mainly among themselves and do not involve an adult, which can reinforce suicidal ideation among peers. Important protective factors include parental support, self-acceptance/self-worth, personal resilience, a sense of belonging, and a positive school or work environment.

Breaking the Taboo

• Many people do not openly talk about suicidal thoughts due to fear of stigma and shame. It is important to break this taboo because talking helps…
  • … to find recognition.
  • … to take the first steps toward help.
  • … to relieve emotional burden.
• Language use plays a crucial role when speaking about suicide: avoid terms like ‘committing suicide’ and instead use ‘died by suicide’ to reduce negative associations. See the following table for language adjustments that can help reduce negative associations.

Signs of Suicidality

People thinking about suicide often show indirect or direct signs.

Common Statements:

1. “I can’t go on like this.”
2. “I don’t want to live anymore.”
3. “You won’t have to deal with me anymore.”
4. “No one will miss me.”

Common Behaviors:

1. Appearing sad, lonely, or hopeless.
2. Excessive alcohol or drug use.
3. Not keeping appointments.
4. Talking about death or suicide.
5. Being irritable or aggressive.
6. Noticeable behavioral changes.

The signs can vary for everyone but stand out because they represent a change from a person’s usual behavior.

5 Risk Factors That Increase Suicidality:

1. Experiences of loss (e.g., job, relationship, coming-out struggles).
2. Previous suicide attempts.
3. Psychological problems or psychiatric disorders.
4. Losing a loved one to suicide.
5. Social isolation and lack of support.

Quiz: Misconceptions About Suicide (True or False)

• Myth: “Someone who dies by suicide necessarily wanted to die.”
  • False: Most people do not want to die but see no other way out.
• Myth: “Suicide attempts are just a cry for attention.”
  • False: Every attempt must be taken seriously; it is a sign of despair.
• Myth: “Suicide happens suddenly.”
  • False: There is often an invisible process with increasingly intense thoughts.