Pennsylvania Physician Ebook Continuing Education

Table 1. Myths and Facts about Suicide

Myth

Fact

Suicide only affects individuals with a mental health condition.

Many individuals with mental illness are not affected by suicidal thoughts and not all people who attempt or die by suicide have mental illness. Relationship problems and other life stressors such as criminal/legal matters, persecution, eviction/loss of home, death of a loved one, a devastating or debilitating illness, trauma, sexual abuse, rejection, and recent or impending crises are also associated with suicidal thoughts and attempts. Active suicidal ideation is often short-term and situation-specific. Studies have shown that approximately 54% of individuals who have died by suicide did not have a diagnosable mental health disorder. And for those with mental illness, the proper treatment can help reduce symptoms. Warning signs—verbally or behaviorally—precede most suicides. Many individuals who are suicidal may only show warning signs to those closest to them. These loved ones may not recognize what is going on, which may seem like the suicide was sudden or without warning. Therefore, it’s essential to learn and understand the warning signs of suicide. Typically, people do not die by suicide because they do not want to live—people die by suicide because they want to end their suffering. These individuals are suffering so deeply that they feel helpless and hopeless. Individuals who experience suicidal ideations do not do so by choice. They are not simply “thinking of themselves,” but rather they are going through a severe mental health symptom due to either mental illness or a difficult life situation.

Once an individual is suicidal, he or she will always remain suicidal.

Most suicides happen suddenly without warning.

People who die by suicide are selfish and take the easy way out.

Talking about suicide will lead to and encourage suicide. There is a widespread stigma associated with suicide, and as a result, many people are afraid to speak about it. Talking about suicide reduces the stigma and allows individuals to seek help, rethink their opinions, and share their story with others. We all need to talk more about suicide. 6 Note. From Fuller, K. (2020, September 30). 5 Common myths about suicide debunked. National Alliance on Mental Illness. https://www.nami.org/Blogs/NAMI-Blog/September- 2020/5-Common-Myths-About-Suicide-Debunked 6

United States Suicide Data The American Foundation for Suicide Prevention (AFSP) similarly proposes that suicide is underreported, and there are challenges in collecting accurate data regarding the number of individuals who die by suicide each year. 8 The National Violent Death Reporting System (NVDRS) is a state-based surveillance system that gathers more than 600 unique data elements from death certificates, coroner/medical examiner reports, law enforcement reports, and toxicology reports. 9 The AFSP estimates that 47,511 Americans die from suicide each year, making it the tenth leading cause of death in the U.S. This amounts to 130 suicides per day. 8 Suicide is the second leading cause of death in ages 10-24; the third leading cause of death in ages 35-44; and the fourth leading cause of death in ages 45-54. Over seven times as many people died by suicide in 2019 than in alcohol-related motor vehicle accidents. 10

White, middle-aged males die by suicide at a greater rate than any other population. Males are 3.63 times more often to die by suicide than women. Females are 1.66 times more likely to attempt suicide. 8 The number of people who think about or attempt suicide is even higher. In 2019, 12 million American adults seriously thought about suicide, 3.5 million planned a suicide attempt, and 1.4 million attempted suicides. 8,11 The most common means of suicide in the United States is a firearm, followed by suffocation and poisoning. In 2019, up to 50% of suicides involved a firearm, 28% involved suffocation, and 13% involved poisoning. 12 Approximately 75% of firearm deaths were suicides, and 50% of all suicides were caused by firearms. 10 In men and women, firearms are the most common means of suicide. Firearms are the most common method of suicide used by men of all ages, and this is especially true among men aged 65 years and older. 12

Suicide Risk Factors

Most suicides occur with individuals experiencing depression, substance use disorders, and psychosis. 13 Although research has identified that multiple factors can increase one’s risk for suicide, no studies show that one factor or a set of factors is predictive of suicide. Factors that are positively associated with suicide risk include specific demographics, psychiatric illness and comorbidity, suicide-specific symptoms and attitudes, family history, personality disorder/traits, substance use/ abuse, severe medical illness, life stressors, suicidal behavior, psychological vulnerability, and access to weapons. 5 Table 2 briefly outlines these risk factors.

Table 2. Risk Factors for Suicide

Individual

Relationship

Community

Societal

• Previous attempts. • Mental illness, particularly clinical depression. • Social isolation

• Adverse childhood

• Local epidemics of suicide. • Barriers to accessing

• Easy access to lethal methods (firearms, medications). • Stigma associated with mental illness or help-seeking. • Unsafe media portrayals of suicide.

experiences, such as child abuse or neglect.

• Bullying. • Family history of suicide. • Relationship problems, such as a break-up, violence, or loss. • Sexual violence.

mental health treatment.

• Criminal problems. • Financial problems.

• Cultural and religious

beliefs, such as the belief that suicide is a noble resolution of a personal problem.

• Impulsive or aggressive tendencies. • Job problems or loss (relational, social, work, or financial). • Serious illness. • Substance use disorder. Note. Adapted from U.S. Centers for Disease Control. 14

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