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Who Attempts Suicide?

Suicide prevention: Who attempts suicide and why?

Consider this short blog to be my PSA for the holidays:

Depression is the number one risk factor for attempted suicide, followed closely by substance abuse. The big issue faced by mental health practitioners is identifying who is a suicide risk in advance so that help can be provided. A new study provides hope.

The Patient Health Questionnaire-9 (PHQ-9) is a nine question, patient-answered survey which is used for screening, diagnosing, monitoring and measuring the severity of depression. It's only one page and takes about five minutes to complete. Here’s the link.

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The PHQ-9 is used mainly by researchers though it is starting to trickle down to private practices across the country. A new study reveals that the answer to question 9 has an overwhelming correlation with suicide risk. The question is: "Thoughts that you would be better off dead or of hurting yourself in some way.

For those who answered question 9 "Nearly every day" vs "not at all" there was a ten-fold increased risk of attempted suicide; from 0.4 percent to 4 percent.

What does this mean to you as a lay person? Plenty. Those that talk about suicide or about being better off dead or wanting to hurt themselves are the ones who are most likely to do it. More than half of suicide victims sought medical help within the months prior to their death. Remember this: Most people who attempt suicide don’t want to die.

Suicide is caused by a complex interaction between depression, hopelessness and helplessness. Consider: You are severely depressed -- this can have a variety of causes (stress, a loss, substance abuse) and brain chemistry is usually involved. The depression becomes so bad there is no end or relief in sight (hopeless) and you feel powerless to make any changes (helpless). Then your mind starts ruminating, “I feel so bad, I’ll never get better and there is nothing I can do about it. I would actually be better off dead rather than living like this forever.”

The key to helping this person is to ask the simple question, “have you ever felt that you would be better off dead or about hurting yourself in some way?” If you get a “yes”, then professional help is needed immediately. If you don’t know a local mental health provider, or are unsure about what to do, call the National Suicide Prevention Lifeline: 1-800-273-8255.

Yes, I know it’s hard to ask, but I repeat, most suicidal people do not want to die. They just want the pain to stop and they want help, but don’t know how to get it.

During this busy holiday season we're all searching for the perfect gift for our loved ones. As cliché as it may sound, the greatest gift of all is time. If you know someone that you suspect is at risk; ask the question. You may save a life.

Dale Archer, M.D., is a clinical psychiatrist and author of The New York Times bestseller, Better Than Normal: How What Makes You Different Can Make You Exceptional.

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