Suicide Risk in South Africa: What to Know, Spot & Support

This guide is intended to bring awareness to suicide risks, recognise warning signs, and offer support to those who may be at risk. It unpacks how to understand suicide in South Africa and what to know about suicide risk factors. Thereby enabling you to better spot suicide early warning signs and know how to provide support to someone who is suicidal. 

What suicide is, is the act of intentionally causing one’s own death. For most people this makes suicide an uncomfortable and difficult topic to discuss. However, to save lives it’s a very necessary discussion to destigmatise and create more dialogues around. Death by suicide is more common than most are aware. It’s estimated that at least one in five people will have suicidal thoughts at some point.

Suicide is rooted in a complicated mix of, for example, mental health challenges, trauma, interpersonal conflicts, stress and substance abuse. For a person lost to suicide, research has found that approximately 135 people around that person are adversely affected. This means suicide affects others and is consequently not an individual problem. As such, attempted suicide and death by suicide are regarded as a serious public health problem. Most people who die by suicide have attempted to kill themselves before. This means that there are often suicide risk factors and warning signs. Therefore, if these are spotted, there are ways to assist someone who is suicidal. 

How Common is Suicide?

According to the World Health Organisation (WHO), worldwide there are upwards of 720 000 people a year that die by suicide. Consequently, suicide accounts for 20.5% of deaths. Amongst 15–29-year-olds it’s the third leading cause of death behind road traffic injury and interpersonal violence. The majority of suicides occur in low and middle-income households. It’s estimated that for every death by suicide there are 25 attempted suicides. Statistically, across the globe, more men die from suicide than women. 

Suicide in South Africa

In South Africa the rate of suicide and attempted suicide rates are increasing year-on-year. The estimated suicide rate in South Africa is 23.5 people per 100 000, which per year is about 14 000 deaths. It has been found to be the second leading cause of deaths of 15–29-year-olds. Worldwide South Africa is ranked as having the 10^th highest suicide rate. And in Africa, South Africa has the third highest suicide rate.

Across all age groups, financial stress is a common suicide driver in South Africa. It’s exasperated by a continuously escalating cost of living. Additionally, it’s reported that those who experience socio-economic challenges are also more likely to suffer challenges with their mental health. This further increases risk of suicide and is especially worrying given that the ratio of people to psychologists in South Africa is 1: 100 000. 

Suicide Risk Factors

The reasons someone attempts to kill themselves is complicated. Usually, it is a combination of factors.

• Individual factors 
• Interpersonal factors 
• Societal factors 
• Cultural factors 

It’s important to bear in mind that while something may seem insignificant to one person, it could be a deciding factor for someone else. Oftentimes, someone who is suicidal has a greater sense of hopelessness and might see no better solution to their battle other than ending their life. 

Discussions about suicide are often peppered with stigmatism and suicide myths. Neither are helpful to the person who is struggling or to anyone attempting to assist them. Furthermore, stigma can compound the risk of suicide because it increases how isolated and alone someone feels. 

The Trusth behind 5 Suicide Myths

1. Talking increases suicide risk. Truth: Talking to someone won’t make them act on their suicidal feelings. 
2. Suicide happens without warning. Truth: Studies show that around 50% of people have shared their suicidal thoughts or behaviours with someone else. 
3. Suicide can’t be prevented. Truth: While it’s true that suicide is unpredictable this doesn’t mean that it’s not preventable. More often than not talking to someone else and getting support can save the person’s life. 
4. It’s an attention seeking tactic. Truth: Sharing suicidal thoughts is not an attention seeking tactic rather it’s an attempt to ask for help. Therefore, it needs to be treated seriously, without judgement and sensitively. 
5. Suicide is a selfish, cowardly or weak decision. Truth: Suicide is rooted in complicated factors like psychiatric illness, chronic pain or substance abuse. Often by the time someone attempts suicide they have experienced significant emotional and/or physical pain. Therefore, it’s difficult to consider any other way out and suicide is not a selfish, cowardly or weak decision. 

Factors that Influence Suicide Risk

The single most important risk factor for suicide is a prior attempt. However, this is not always helpful. The challenge with suicide risk factors is that sometimes they are subtle and easy to miss because they happen over an extended period of time.

10 Suicide Risk Factors to Be Aware of:

1. Previous suicide attempts. 
2. History of mental health conditions e.g.: depression, anxiety, bipolar, post-traumatic stress disorder (PTSD). 
3. Family history relating to suicide or suicide attempts. 
4. History of abuse or trauma . 
5. History of substance abuse or miss-use.
6. Prolonged or chronic pain, disability or terminal illness. 
7. Sudden stress or trauma e.g.: Job security, loss of a loved one or relationship.
8. Legal, disciplinary or financial issues. 
9. Ongoing exposure to bullying.
10. Access to harmful means e.g.: Gun, knives, pills. 

15 Possible Warning Signs for Suicide

These 15 suicide warning signs are divided into three groups: Emotional, Verbal and Action Markers. They are a guideline and should be used together with what you already know about the person. Always trust your instincts and if you feel like someone is struggling, reach out and see if they want to talk.

Possible warning signs vary: If you think that something is wrong, ask them privately and in a non-judgmental and empathetic manner.

3 Categories of Suicide Warning Signs

1. Emotional Markers.
2. Verbal Markers.
3. Action Markers.

1. Emotional Markers: Feelings

• Sudden mood-swings or moody in general.  
• Aggressive tendencies.  
• Sudden change of behaviour e.g.: Calm and cheerful after being depressed. 
• Withdrawing or self-isolating (with no medical purpose). 
• Disinterest in self-care/personal appearance. 

2. Verbal Markers: Phrases

• I want to kill myself.  
• I’m going to commit suicide.  
• Hints such as: I won’t be a bother/problem for you much longer or if something happens to me, I want you to know…  
• Describing strong feelings of guilt or shame.  
• Talking about feelings of hopelessness, emptiness or having no way out of a problem(s). 

3. Behavioural Markers: Actions

• Giving or throwing away of personal items that have held significant meaning or particular sentimental value.  
• Writing of notes that talk about suicide or leaving.  
• Changed sleeping patterns.  
• Reckless behaviour or general disregard for own safety.  
• Pre-occupation or focus on death.

What to Do if You’re Feeling Suicidal

Take hope, a suicide crisis is most often temporary which means it can be worked through. Start by promising yourself that you won’t do anything just yet. Set yourself a timeframe of, for example, 24-hours, a week or month, when you will reassess how you feeling. And then during this time seek some assistance. 

There are a number of ways you can get assistance if you are contemplating suicide, self-harm or have attempted suicide. Ideally, the first step to seeking assistance is to talk to someone you trust and feel comfortable with so that they can empathetically support you. However, this isn’t always possible. Luckily, there are many organisations that specialise in assisting and supporting those who reach out for help regardless of their circumstances. 

Where to Seek Help if You’re Feeling Suicidal

The South African Depression and Anxiety Group

SADAG has multiple support options All of which give you access to free counselling, crisis intervention, information and nationwide referrals. 

• Online resources
• Counsellors available daily between 8am to 8pm: 011 234 4837
• 24-hour Help Line: 0800 456 789
• 24-hour Suicide Crisis Helpline: 0800 567 567

Befrienders South Africa

• Bloemfontein Face-to-face: [email protected] or 051 444 5691
• Call for help within South Africa: 051 444 5000

Additional Suicide Helplines

• Cipla 24hr Mental Health Helpline: 0800 456 789 
• Adcock Ingram Depression and Anxiety Helpline: 0800 70 80 90
• Dr Reddy’s Help Line: 0800 21 22 23 
• South Africa Suicide Crisis Helpline: 0800 21 22 23 or 0800 12 13 14

Contact for Assistance with Emotional Distress, Personal Difficulties and Abuse

• Akeso Crisis Helpline: 0861 435 787
• ChaiFM Helpline: 0800 24 24 36
• ChildLine South Africa: 116 (free) or online counselling
• Lifeline: 0861 322 322
• Tears Foundation: 0800 083 277
• Careline 082 787 6452 or 082 822 7981 

Ask for help when problems and challenges seem overwhelming.

Does Medical Aid cover Suicide Attempts?

Prescribed Minimum Benefits (PMBs) are a defined set of health benefits which all medical schemes are legally required to cover regardless of a member’s medical scheme plan. There are 271 PMB medical conditions that falls within the Diagnosis Treatment Pairs (DTPs) published by the Council for Medical Schemes (CMS). We encourage you to explore your medical aid plan coverage along with the PMB to understand the extent of interventions for mental illnesses that medical aid schemes are mandated to cover. 

How to Help Someone with Suicidal Thoughts

When helping someone who is contemplating or attempted suicide, it’s important for you to remember that there are no secrets. This means that even if they want you to, don’t keep things a secret. You cannot keep someone safe by yourself – both of you need support and assistance to help them. 

Five Steps to Help a Person at Risk of Suicide

1. Talk to them: Be direct and ask if they have or are currently contemplating suicide or if they have self-harm plans. 
2. Be there: Listening without judgement or advice and just being there is critical. 
3. Help them with a safety plan: Don’t leave them alone and discuss how you can assist them to feel and be safer. For example, do they have any pills or harmful items you can remove from their immediate surroundings. 
4. Assist them to reach out to connect with professional help: There are resources such as suicide helplines, safe spaces and support groups that you can help them contact and get additional support from. 
5. Follow up: Even after they’re receiving support and/or treatment, it’s important for their mental health and wellbeing for you to follow up with them regularly. 

Keeping secrets isn’t helpful. You can’t keep someone safe by yourself.

There are a number of complicating factors when it comes to how to treat suicidal people. These need to be considered ahead of talking to someone, as it they could influence how to approach them. These five are ones that you need to think through ahead of approaching someone who is having suicidal thoughts. 

5 Factors When Considering What to Tell A Person who is Having Suicidal Thoughts

1. Cultural or social beliefs surrounding suicide. For example, suicide being a “noble” response to a personal dilemma. 
2. Stigma associated with seeking help with mental health and/or suicidal thoughts and/or attempted suicide. 
3. Consequence of seeking help. Such as to a job or family if the person is hospitalised.  
4. Lack of accessible health care facilities that cater for mental illness, substance abuse or have suicide watch / intervention. 
5. Lack of implemented health protocol (country, local or facility) that adequately addresses or acknowledges suicide risks. 

September is recognised as Suicide Prevention Month in South Africa. It’s a time to honour the lives lost to suicide and support those who have experienced suicidal thoughts. As well as acknowledge the individuals, families and communities affected by this tragedy.  

How to Understand Suicide: Shifting the Perspective

The Triennial (2024 – 2026) theme for World Suicide Prevention Day is centred around “Change the Narrative” – a call to action to “Start the Conversation.” This theme aims to raise awareness about the need to change how we talk about suicide and break down the stigma around suicide. Thereby shifting our perspective on this complex issue.  

Are you passionate about helping others? In these challenging times, stress and its impact are more evident than ever. Why not take the opportunity to make a real difference by enrolling at SACAP (The South African College of Applied Psychology)? SACAP graduates are already contributing positively to society, and you can too.  

SACAP has numerous accredited qualifications that include a range of degrees, diploma and higher certificates. Explore our diverse range of psychology courses, including the BPsych degree, which offers a globally recognised pathway to a master’s degree in psychology. SACAP has four campuses across South Africa in Cape Town, Durban, Johannesburg and Pretoria. For more information Click Here or Apply Online today.