Suicide Awareness

May marks Mental Health Awareness Month. As a group that provides psychiatric services in Columbus, Ohio, we dedicate this time to bringing attention to mental health and the importance of access to effective healthcare. It is a crucial time for focusing on educating the public to aid in eliminating stigma, extending support, and advocating for policy changes that will prioritize the well-being of those impacted by mental illness. Speaking openly about mental illness can help reduce misconceptions and encourages those that are struggling to reach out for the help that they need. One extremely important topic that continues to require more awareness is suicide. Suicide is defined as self-inflicted death with evidence of intention of ending one’s own life (Naguy, Elbadry, Salem, 2020). Suicidal ideation refers to the thoughts about and planning for suicide. Suicidal ideation occurs at different levels, beginning with general thoughts of suicide with little to no plan, which can then progress to detailed plans with intent to carry out or act on the plans. Suicidal ideation serves as an important risk factor for future suicide attempts. (Harmer, Lee, Rizvi, Saadabadi, 2024).

 

 

Trends in Mental Health Data

According to the Centers for Disease Control and Prevention, suicide was the eleventh leading cause of death in the United States in 2021, claiming the lives of more than 48,000 individuals. Suicide was the second leading cause for individuals aged 10-24 and 25-34. SAMHSA’s recent data reports that in 2022, more than 13 million adults had serious thoughts of suicide, 3.8 million made plans for suicide, and over 1.5 million made suicide attempts.

 

Risk Factors and Mental Health Concerns

There are many factors that can contribute to suicidal ideation and subsequent suicide attempts. There are consistent findings that show that suicide risk might have genetic contributions. A family history of suicide increases an individual’s risk for suicidal behavior (Zai, Vincenzo, Strauss, et al, 2012). According to Edwin Schneidman, suicide is caused by “psyche ache” which is defined as psychological pain that is deemed unbearable or intolerable by the person experiencing it. It is thought that unresolved “psych ache” can contribute to suicidal ideation and attempts. There are also several clinical diagnoses that increase an individual’s risk for suicidal ideation/attempts, some of which include Depression, Anxiety, Bipolar Disorder, Schizophrenia, TBI, PTSD.

  • Depression: Depression (major depressive disorder) is a common and serious mental disorder that negatively affects how you feel, think, act, and perceive the world. A diagnosis of depression requires that symptoms occur for most of the day, nearly every day, for more than two weeks, along with a clear change in day-to-day functioning (Psychiatry.org)
  • Anxiety: Anxiety refers to anticipation of a future concern and is more associated with muscle tension and avoidance behavior. Anxiety disorders can cause people to try to avoid situations that trigger or worsen their symptoms. Job performance, schoolwork and personal relationships can be affected (Psychiatry.org)
  • Bipolar Disorder: Bipolar disorders are mental health conditions characterized by periodic, intense emotional states affecting a person’s mood, energy, and ability to function. Mood episodes are categorized as manic/hypomanic episodes when the predominant mood is intensely happy or
    irritable, or depressive episodes when there is an intensely sad mood or the ability to experience joy or pleasure disappears (Psychiatry.org)
  • Schizophrenia: a chronic brain disorder, symptoms can include delusions, hallucinations, disorganized speech, trouble with thinking and lack of motivation (Psychiatry.org)
  • PTSD: psychiatric disorder that can occur in people who have experienced or witnessed a traumatic event, series of events or set of circumstances (Psychiatry.org)
  • TBI: a nondegenerative, non-congenital insult to the brain from an external mechanical force, possibly leading to permanent or temporary impairment of cognitive, physical, and psychosocial functions, with an associated diminished or altered state of consciousness

 

Suicidality is a multi-faceted issue and there is no single cause. Suicide is more likely to happen “during periods of socioeconomic, family, and individual crisis situations (e.g., death of a loved one, loss of employment, etc.)” (Soreff, Attia, 2017), but increasing awareness of the contributing factors, warning signs and protective factors can help those suffering recognize that there are options and resources that can help.

 

Understanding Warnings Signs of Suicide

There are a number of feelings, actions, and behaviors that can be indicative of thoughts of suicide. Below are some common warnings signs that a person is at risk of suicide and can help to identify when professional help is necessary.

  • Talking about death
  • Feeling hopeless, worthless, trapped, burdensome, etc.
  • Feeling unbearable pain
  • Gradual negative thoughts and feelings
  • Changes in recent behavior or mood
  • Withdrawing from friends and family
  • Increased substance use (alcohol, drugs)
  • Giving away possessions
  • Dangerous or reckless behavior
  • Eating or sleeping more or less
  • Chronic Pain

 

Protective Factors and Suicide Reduction

Similar to the risk factors for suicide, there are a range of factors that can be preventative against suicide.
One of the most important protective factors for individuals struggling with thoughts of suicide is access
to effective health care. There are many barriers to effective health care in the United States including
transportation, insufficient insurance coverage, healthcare staffing shortage, stigma, employment, and
patient language barriers. Overcoming these barriers and ensuring that effective care is available to
individuals at risk for suicide is a crucial component of suicide prevention.
Other protective factors include, but are not limited to:

  • Family, Friends, Pets
  • Culture, Religion
  • Community (Connectedness)
  • Coping and problem-solving skills

 

 

Resources for Patients

If you or someone you know is struggling with thoughts of suicide, there are resources available to help
you cope.

❖ Call or text the 988 Suicide and Crisis Lifeline. This resource provides 24-hour support to anyone
in emotional distress or a mental health crisis

❖ Find a therapist or support group. Linkage with psychosocial interventions can help individuals to
learn coping skills and reduce the risk of suicide

❖ Medication: Many people that are at risk of suicide struggle with psychiatric illnesses and might
benefit from medication management. Consider an evaluation with a psychiatrist or a
psychiatric nurse practitioner. Here is a link to our new patient request form,
https://forms.myupdox.com/#/form/105743

❖ Use your support network

❖ Make a safety plan: a safety plan consists of warning signs, coping strategies, social contacts,
family members, friends, or professionals that might be able to help, and steps to make the
environment safe. Having this prepared in the case of a crisis is crucial in preventing suicidal
behavior.

 

Naguy A, Elbadry H, Salem H. Suicide: A Précis! J Family Med Prim Care. 2020 Aug 25;9(8):4009-4015. doi:
10.4103/jfmpc.jfmpc_12_20. PMID: 33110803; PMCID: PMC7586562.
Schneidman ES. Suicide as psychache. J Nerv Ment Di. 1993;181:145-147.
Soreff SM, Basit H, Attia FN. Suicide Risk. 2023 May 29. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing;
2024 Jan–. PMID: 28723011.
U.S. Department of Health and Human Services. (n.d.). Suicide. National Institute of Mental Health.
https://www.nimh.nih.gov/health/statistics/suicide
Zai CC, de Luca V, Strauss J, et al. Genetic Factors and Suicidal Behavior. In: Dwivedi Y, editor. The Neurobiological Basis of
Suicide. Boca Raton (FL): CRC Press/Taylor & Francis; 2012. Chapter 11.