Preventing Suicide

Suicide is one of the most horrible events that can happen.  It’s devastating to the people left behind and very sad that an irrevocable step was taken by a human being.  And you never know when it could happen.

From the National Institute of Mental Health

Suicide is a major, preventable public health problem. In 2007, it was the tenth leading cause of death in the U.S., accounting for 34,598 deaths. The overall rate was 11.3 suicide deaths per 100,000 people. An estimated 11 attempted suicides occur per every suicide death.

Risk factors include:

  • Depression, other mental disorders or a substance-abuse disorder.  Often the substance-abuse disorder goes hand in hand with a mental disorder.  90 percent of the people who die by suicide have these two risk factors.
  • Previous suicide attempt
  • Family history of mental disorders or substance abuse
  • Family history of suicide
  • Family violence, including physical or sexual abuse
  • Firearms in the home (the method used in more than half of suicides).
  • Incarceration
  • Exposure to the suicidal behavior of others, such as family members, peers, or media figures.

Suicide or suicidal behaviors, however, are not normal responses to stress; just because someone may have one or two of these risk factors doesn’t mean they are going to kill themselves.

Almost four times as many men as women commit suicide, with males using firearms 56% of the time while women use poisoning 40% of the time.

In 2007, suicide was the third leading cause of death for young people ages 15 to 24.  Most likely, suicide is due to existential issues: young people going from being a kid to an adult, or not having the maturity to deal with romantic, work, and transitional situations.  Some illnesses like schizophrenia tend to show up in the early 20s. And as with the general population, young people are more likely to use firearms, suffocation and poisoning over other suicide methods.

Older Americans are disproportionally likely to commit suicide.  The national average in the general population is 11.3 per 100,000 people.  Those who are 65 or older average 14.3 per 100,000 people.

When people call me who believe someone is just crying for attention, I tell them not to think that way. Most suicide attempts are expressions of extreme distress, not harmless bids for attention.  If a person who appears in any way suicidal, and you’re going to make an error, err in the direction of getting that person hospitalized immediately.

A type of psychotherapy I’ve talked about numerous times and is a major contributor to my perspective on helping people is cognitive therapy.  All kinds of studies have shown cognitive therapy has reduced the rate of repeated suicide attempts by 50 percent during a follow-up year.  Cognitive therapy helps suicide attempters consider alternative actions than self-harm.

If you think someone is suicidal – do not leave them alone.  Get them help immediately.  Call 911 or put them in the car and take them off to the psychiatric ward at a hospital. Eliminate any access to any tool than may be used in a suicide, like drugs, knives, guns, or rope…

One of the most horrifying things that happened to me as a psychotherapist was helping a particular married couple.  A colleague of mine was counselling the wife, and I was counselling the husband.  He was distressed for many reasons.  I learned he had a gun and I made a deal with him to get rid of it.  His wife confirmed he had done so.  He began to feel better and terminated our therapy sessions.  Sometimes when people start to feel better, it means they have put a suicide plan into place, and about three months later in front of his wife, he pulled out a new small caliber pistol and shot himself.  Ultimately, these things are uncontrollable unless you’re physically there and can call for help.

So while we can know the signs of what risk factors to look for, knowing what’s going on in the recesses of someone’s mind is tough.  But if suicidal behaviors are being demonstrated, get nervous and do something about it.  Don’t stand by thinking, “I don’t want anybody to be mad at me.”