Suicide is the act of intentionally causing one's own death. Suicide is often carried out as a result of despair, the cause of which is frequently attributed to a mental disorder such as depression, bipolar disorder, schizophrenia, borderline personality disorder, alcoholism, or drug abuse. Stress factors such as financial difficulties or troubles with interpersonal relationships often play a role. Efforts to prevent suicide include limiting access to firearms, treating mental illness and drug misuse, and improving economic circumstances. Although crisis hotlines are common, there is little evidence for their effectiveness. The most commonly used method of suicide varies by country and is partly related to availability. Common methods include: hanging, pesticide poisoning, and firearms. Around 800,000 to a million people die by suicide every year, making it the 10th leading cause of death worldwide. Rates are higher in men than in women, with males three to four times more likely to kill themselves than females. There are an estimated 10 to 20 million non-fatal attempted suicides every year. Non-fatal suicide attempts may lead to injury and long term disabilities.