The Science of Protective Factors in Suicide Prevention

Yesterday, I received a message that stopped me in my tracks. Y, a former client who had come to me two years ago during a severe suicidal crisis, sent me a photo from her university graduation ceremony.

“Stephanie, Stephanie, Stephanie” she wrote

“I wanted you to see what protective factors look like in real life, and to say I get it now”

Attached was a picture of her surrounded by family, friends, and mentors, the very support network we had worked together to build and strengthen when she couldn’t see a reason to continue living.

Y’s transformation wasn’t magic, it was science and hardwork.

Over the past decade of practice in São Paulo, I’ve witnessed countless individuals move from vulnerability to resilience by strengthening what we call protective factors.

These aren’t just feel-good concepts; they’re measurable, evidence-based attributes that can literally save lives by creating buffers against suicidal thoughts and behaviours.

How protective factors go well beyond risk reduction

For decades, suicide prevention focused primarily on reducing risk factors, by treating depression, removing means of self-harm, managing crises as they arose. While these approaches remain absolutely essential, prevention is most effective when we simultaneously build strengths rather than just these addressing deficits.

In my perspective, protective factors work by strengthening the brain’s natural resilience systems.

When Y managed to develop strong social support, learn effective coping skills, and created reasons for living, her brain developed more robust stress management capabilities and maintained better emotional regulation even during difficult periods.

This didn’t eliminate pain nor her challenges, but it provided a well built foundation for working through difficulties without reaching suicidal desperation.

Family Connections

Her social support consisted of various adults who were consistently present in her life, and were all willing to help create a protective environment that ultimately played a part in saving Y’s life. 

Brazilian culture’s emphasis on family loyalty and extended networks provides natural protective advantages when these relationships are healthy and supportive. The concept of família, family extends well beyond nuclear family to include godparents, close family friends, grandparents, teachers, and community elders who can provide additional layers of support and connection.

The Power of Belonging

Another important protective factor for Y was her peer connections, research consistently shows that meaningful peer relationships serve as powerful protective factors.  It’s not a case of quantity but the quality of connection and the sense of belonging these relationships bring.

Self-Esteem and Self-Efficacy: The Foundation of Resilience

Research shows that individuals with healthy self-esteem and strong self-efficacy, the belief that they can handle challenges and influence outcomes in their lives, show significantly lower rates of suicidal ideation and behavior.

However, building genuine self-esteem requires more than positive self-talk; it requires competence-building experiences and realistic self-assessment.

Personal protective factors, the internal shields against despair

Effective Coping Skills: The Toolbox for Life

One of the most modifiable and powerful protective factors is the development of effective coping skills, by building what I call a coping toolbox, which is a collection of strategies individuals can use to manage stress, regulate emotions, and solve problems without becoming overwhelmed.

These are a few:

Emotional regulation techniques such as deep breathing, mindfulness, progressive muscle relaxation.

Cognitive coping such as realistic thinking, problem-solving, perspective-taking.

Behavioral coping such as physical exercise, creative expression, social connection.

Asking about spiritual coping because this is Brazil, where personal faith and religion is very much part of the culture.

The Anchor Points

This is one of the most powerful protective factors I assess and strengthen in clinical work, through finding the reasons for living. These are the people, or experiences, or goals, or values that give life meaning and create motivation to persist through despair.

These are a few:

Responsibility to family members, especially children or dependent relatives

Relationships with pets or other beings that depend on them

Future goals and aspirations they want to achieve

Religious or spiritual beliefs about the sanctity of life

To sum up

Regular practice of protective behaviors, like maintaining social connections, using coping skills, and engaging in meaningful activities, thus creating stronger neural pathways for healthy stress management.

And Remember that Protective Factors often have cumulative effects, which means that the more protective factors someone has, the more resilient they become.