Absolutely. Suicide is the 8th leading cause of death for all Americans and the 3rd leading cause of death for adolescents and young adults. You are far more likely to die from suicide than from homicide (and much more likely to die from domestic homicide that from terrorism). The overall suicide rate in the United States is about 11.3 per 100,000 per year. Having a mood disorder dramatically elevates your risk of suicide. Most people who kill themselves suffer from a mood disorder. Up to 10 to 15 percent of people with mood disorders will kill themselves over their lifetime.

The vast majority of people who attempt suicide give warning signs to relatives and health-care providers. Many visit a health-care provider within a month of their attempt. Hopelessness, pervasive gloominess, or outright statements that they would be better off dead should all trigger more detailed questioning. Remember that most people who attend suicide are ambivalent; the job of health-care providers and loved ones is to ally ourselves with the part of the person who wants to live.

The most important thing is to talk candidly and openly about suicidal thoughts and feelings. Some family members fear that if they talk about suicide, they will plant ideas in a loved one's head. There is no evidence to support this, but plenty of evidence to support the opposite: that taboos on the frank discussion of suicidal thoughts and feelings can prevent someone from getting help. If you suspect someone is suicidal, try to talk to them about their feelings of sadness and hopelessness. Ask them if they feel that they would be better off dead. Ask if they have a specific plan. Have they taken additional steps such as writing a will or giving away their possessions? How lethal and realistic is the plan? If a person has a suicidal plan or serious suicidal thoughts, in most cases they should be evaluated as soon as possible by a mental health professional.

Definitely. Perhaps the most important thing is to determine whether the person needs emergent psychiatric evaluation. If the person is able to, develop a plan of action, if writing if necessary, to take in the event that the person's suicidal thoughts become overpowering. If necessary, have someone be with the person to keep an eye on them at least until the crisis passes. Removing any fire arms from the house is critical. Avoiding exposure to alcohol or other drugs is also important. If necessary, remove any large supplies of medications, especially lethal ones such as Tylenol, from the person's home. Be available to listen to the person and let them know that you support them. Many suicide attempts are probably cries for help.

Absolutely. Gunshot wounds remain the most common cause of completed suicide among men and women. If you attend suicide with a gun, you will have a higher probability of killing yourself than with any other means. Over 80 percent of all fatal gunshot wounds in the United States are from suicide. Furthermore, in one large study (Wintemute, 1991), purchasing a handgun led to a 57-fold increase in the suicide rate versus the general population (644/ 100,000 versus 11.3 per 100,000). This suicide risk remained elevated 5 years after the purchase. The means of suicide matters: guns do kill people.

Yes. Risk factors include age (suicide rates tend to increase with age), gender (men are more likely to complete suicide; females are more likely to attempt), prior attempt, mood disorder diagnosis, access to firearms, active alcohol or substance abuse, and divorce. Native Americans have the highest suicide rate of any Americans, but the white suicide rate is about double that of the African-American rate. Bipolar disorder, especially rapid cycling, and eating disorders have particularly high rates of suicide. Some professions (policemen, physicians, and dentists) have higher than average suicide rates; suicide is the leading cause of death of physicians under 40.

The United States suicide rate is comparable with other countries. Some European countries such as Switzerland have suicide rates double that of the United States. China's suicide rate is triple that of the United States. China is also the only country in the world in which the female suicide rate is higher than the male suicide rate.