Suicide Prevention: Warning Signs and Keys to Prevention
Scientific evidence on suicide prevention.
Posted Sep 27, 2017
According to the National Alliance on Mental Illness (NAMI), more than 41,000 Americans die by suicide each year and suicide is the second leading cause of death among individuals ages 10 to 24. The Journal of the American Medical Association (JAMA) reports that mood disorders (e.g. depression) are associated with approximately 60 percent of suicide attempts and additional factors include the availability of lethal means (e.g., guns), alcohol and drug abuse, and help-seeking behaviors (Mann et al., 2005). Research indicates that suicide is rare and it is difficult to accurately predict (APA, 2017). One of the most useful ways of preventing suicide is knowing the warning signs and then seeking appropriate treatment.
The American Psychological Association notes the following warning signs of suicide:
- Talking About Dying: any mention of dying, disappearing, jumping, shooting oneself, or other types of self-harm.
- Recent Loss: through death, divorce, separation, broken relationship, self-confidence, self-esteem, loss of interest in friends, hobbies, or activities previously enjoyed.
- Change in Personality: sad, withdrawn, irritable, anxious, tired, indecisive, apathetic.
- Change in Behavior: can't concentrate on school, work, or routine tasks.
- Change in Sleep Patterns: insomnia, often with early waking or oversleeping, or nightmares.
- Change in Eating Habits: loss of appetite and weight, or overeating.
- Fear of losing control: acting erratically, harming self, or others.
- Low self esteem: feeling worthless, shame, overwhelming guilt, self-hatred, "everyone would be better off without me."
- No hope for the future: believing things will never get better, or that nothing will ever change.
Suicide is preventable and can be treated. However, we know that ethnic minorities often avoid mental health treatment due to stigma and other attitudes related to cultural norms about seeking help (Turner et al., 2016). For example, data from SAMHSA shows that the use of psychiatric treatment is most common for whites (7.8 percent) and less common for ethnic minorities (4.7 percent African American, 3.8 percent Hispanic, 2.5 percent Asian American). In an article I co-authored (Turner et al., 2016), we discussed how multiple factors contribute to treatment initiation for ethnic minorities, including lack of providers of color, preference for spiritual or religious leaders, and fear of being stigmatized.
There is a significant amount of research on suicide prevention. Key domains of suicide prevention may include: awareness and public education, improved diagnosis and treatment of mental illness, the use of gatekeepers such as clergy, parents, and teachers to identify individuals at-risk and refer them for treatment, improved screening in primary care settings such as hospitals, and providing access to appropriate treatment (Mann et al., 2005). Furthermore, some research shows that identifying as being somewhat spiritual and attending religious services is associated with decreased odds of engaging in suicidal attempts (Rasic et al., 2009). Given the protective nature of spirituality, it is important for clinicians and therapists to inquire about these beliefs and practices as a prevention method.
If you or someone you know is in an emergency, call The National Suicide Prevention Lifeline at (800) 273-TALK (8255) or call 911 immediately.
You can also use the online chat through the National Suicide Prevention website http://chat.suicidepreventionlifeline.org/GetHelp/LifelineChat.aspx
Copyright 2017 Erlanger A. Turner, Ph.D.
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American Psychological Association (2017). Teen suicide is preventable. Retrieved September 26, 2017 from http://www.apa.org/research/action/suicide.aspx
Mann, J. J., Apter, A., Bertolote, J., Beautrais, A., Currier, D., Haas, A., ... & Mehlum, L. (2005). Suicide prevention strategies: a systematic review. JAMA, 294(16), 2064-2074.
Rasic, D. T., Belik, S. L., Elias, B., Katz, L. Y., Enns, M., Sareen, J., & Team, S. C. S. P. (2009). Spirituality, religion and suicidal behavior in a nationally representative sample. Journal of Affective Disorders, 114(1), 32-40.
Turner, E.A., Cheng, H., Llamas, J., Tran, A. T., Hill, K.,*Fretts, J.M., & Mercado, A. (2016). Factors impacting the current trends in the use of outpatient psychiatric treatment among diverse ethnic groups. Current Psychiatry Reviews, 12, 2, 199-220.