What are risk factors for suicide?
The biggest risk factor is mental illness. There also are other static dangers for suicide including:
- marital status
However, the greatest variable, and the one that we can impact are, dynamic risk factors like treatment of mental illness and access to care.
What types of mental illness may lead to suicide?
The perception is that individuals who suffer from major depressive disorder are the ones who commit suicide. That's not entirely true. There are statistics out there, and I would tend to agree, that substance abuse disorders are even higher risks than major depression. In general, when looking at populations of people, substance abuse is an illness we need to pay close attention to.
Are there certain groups that are higher risk than others?
Certainly people who have been exposed to trauma of any kind are at greater risk. That has been studied extensively in the military veteran population. Overall statistics suggests adolescents and individuals who are older (over the age of 65) have an increased chance to take their own life.
We see many times in the press about younger people committing suicide, but there's not much media attention on the 70 or 80-year-old in a nursing home who die by suicide. The reality is, elderly women and men are at a much higher risk than, at least, middle-aged people.
According to the CDC, men are more likely to die by suicide than women, but women are more likely to attempt suicide.
Also, certain demographic subgroups are at higher risk, per the CDC. Certainly elderly Caucasian males are the highest risk group.
What are warning signs of suicidal behavior?
Behavioral warning signs that may indicate an individual is thinking about suicide include, but are not limited to:
- depression or other mental illnesses
- showing despondence (loos of hope)
- withdrawing/disconnecting from relationships
- acting like they don't care
- giving away items
- saying things that indicate a finite view
- the absence of talking about the future
What treatment options are available?
The most studied treatment that reduces the risk of suicide is medication of major depressive disorder. However, that it is an incomplete way of looking at treatment options. The patients who have the best outcomes with major depressive disorder and other mental illnesses benefit from, not only the medication, but also psychotherapy and determining ways to connect them interpersonally within the healthcare system. All of those treatment methods are very important.
What can we do if a loved one expresses suicidal thoughts?
The most important thing one can do is get them access to immediate care. It's akin to someone saying, "I've got chest pain." We understand then to seek medical attention or get someone to a hospital. When teaching medical students and residents, I reinforce the idea that the brain is like any other organ. If it is repeatedly stressed, it often fails.
Early intervention is key. People tend to deny their family member or loved one is sick. We need to take these things more seriously and intervene as much as possible. Family and friends should make sure their loved one stays connected, whether it be through community, family, or church - these are positive factors that affect people's risk and are actions everyone can take fairly consistently that will help.
Tips for coping with the loss of a loved one to suicide
First and foremost is to manage the guilt. Everyone feels incredibly guilty when a loved one takes their own life. We wonder what we did and how we played a part. It helps to work with family and friends from a standpoint of understanding that suicide is a result of an illness. It was not under the control of the family.
It is important to grieve for that person, just like anyone else who dies; however, it helps with the guilt to separate the act from themselves. The suicide was a product of mental illness and abhorrent thinking.
Where can people get help?
- The National Suicide Prevention Lifeline at 1-800-273-TALK (8255) is available 24 hours a day, 7 days a week for people in crisis.
- If an individual or a family member is at immediate risk, my recommendation is to call 911.
- Individuals in crisis can also seek help at an emergency room. Every ER has some sort of access to assessment, and that's another avenue where patients can seek help through the healthcare system.
- The Jason Foundation, which partners with several HCA hospitals across the country, provides programs and resources that educates and equips individuals with tools to help students, educators and communities recognize "warning signs" and react responsibly.
The key is recognizing the signs and seeking immediate help.