Suicide is a tragic public health problem that impacts millions of people worldwide. It is an often neglected issue surrounded by stigma, myths, and taboos.
Preventing suicide can be a challenge, due to its high prevalence and the difficulty in predicting a person’s risk for attempting suicide. Therefore, multimodal approaches covering multiple levels of intervention and activities are needed.
Risk factors
There is no single cause of suicide, but a combination of factors at the individual, relationship, community and societal levels can increase risk. Knowing what risks and warning signs are can help us identify those who need extra support.
While a number of mental health conditions increase the risk of suicide, it’s not uncommon for people to feel the desire to kill themselves without having any specific risk factor. It is a complex and multifaceted experience, and thoughts of suicide are different from person to person over their lifetime.
While many risk factors can be treated or managed, some can’t be changed. These include permanent and non-modifiable risk factors, as well as predisposing risk factors that can be altered with certain interventions, such as mood stabilizing medications for bipolar disorder or increased social support in a community.
Protective factors
There are several factors that may help prevent suicide. These include good problem-solving abilities, strong connections with people, and access to mental health and healthcare services.
In addition, certain types of social and religious beliefs discourage suicide, and some areas have limited access to highly lethal means of suicide. Family and genetic history are also associated with suicidal behavior.
Young people who have problems with their mental health are at risk for attempting or even committing suicide, but they can learn to overcome these challenges. They can also get help and support from their friends, families, and communities.
Many of these protective factors can be strengthened through education, training, and therapy. They can also be reinforced through community programs that focus on self-esteem and coping skills. These programs can also encourage volunteer opportunities and mentorship, which can increase a person’s confidence and purpose in life.
Stigma
Stigma is when someone treats you in a negative way because of a mental health condition. This can make it harder to get treatment and recovery.
It can also make people feel isolated. This can lead to depression and poorer quality of life.
Fortunately, stigma can be overcome. It takes time to change beliefs and attitudes, but if you’re feeling the effects of stigma, talk to someone you trust and find support.
The most important thing is to start talking openly about your illness and the support you need. This will help others understand the challenges you face and may prevent them from stigmatizing you.
Goffman’s theory of stigma is still very relevant today. He introduced the idea of social marking of deviance and two levels of stigma: discredited and discreditable.
Treatment
Treatment options include mobile crisis teams, walk-in crisis clinics, hospital-based psychiatric emergency services, peer-based suicide prevention programs, and other services designed to help individuals with suicidal thoughts or behaviors. Some of these services also provide follow-up care.
A randomized trial of suicide prevention in an emergency department population found that patients who receive intensive crisis stabilization and pharmacological intervention before discharge from the hospital have lower rates of subsequent suicide attempts and deaths from suicide (ED-SAFE study). The use of rapidly acting anti-anxiety medications (e.g., clonazepam) for anxiety reduction is one promising approach.
Depression, bipolar disorder, schizophrenia, and alcohol abuse are common psychiatric disorders in patients with suicidal thoughts and/or attempts. Behavioral interventions can help people with these mental health problems learn new ways to manage their feelings and thoughts, reduce their distress, and strengthen relationships with others. They may also provide tools to replace thoughts of suicide with healthy alternatives such as positive coping strategies and problem-solving.