Contributors to Risk of Suicide

There have been 725,001 suicides across the world this year. Two happened while I wrote the first sentence! This statistic does not include those who were determined to die by overdose on substances which is roughly 600,000 per year. When someone commits suicide they often suffer from depression, substance use disorder, anxiety, and/or Post-traumatic Stress Disorder (PTSD). Personality disorders, eating disorders, and psychosis also contribute to suicide risk. Women with PTSD are at a 7 times greater risk than other women for committing suicide and the risk for committing suicide is far greater for men with PTSD. Depression, followed by substance use disorders, puts people at the greatest risk for suicide, with the combination of depression with substance use being especially risky. When PTSD and depression co-occur, PTSD adds even greater risk for suicide attempts and completions.

What can we do to reduce risk for suicide? We can do our best to prevent children from ever having their first depressive episode, because once a person experiences a major depressive episode they are at a greater risk for further depressive episodes. Rigorous prevention would involve teaching children social-emotional learning skills at a young age, training parents in autonomy supportive communication, creating trust betweens parents and schools, and working with Hollywood and other media to send healthy messages to children. College students and other young adults should have access to classes that teach them how to be happy like this one.

We also need to provide better access to mental health services. Currently, there are shortages of child and adolescent psychiatrists, school psychologists, and clinical child psychologists. The surgeon general has lamented about how children often do not have access to psychological services. All too often, hospitals and school districts have very few psychologists on staff and they are often expected to focus almost exclusively on psychological assessment, rather than psychotherapy, family therapy, and group therapy.

We also need better pay for psychologists and therapists and support for those who enter the field. Psychologists (with a PhD or PsyD) often spend as many years training as specialized medical doctors, but receive less than half the pay. This suggests that as a society we do not value mental health. Although psychiatrists get paid much more and are highly skilled in interviewing, they are no longer given adequate time or training to provide psychotherapy, rather their practice becomes almost exclusively focused on administering medication. Although medication is often an important part of treatment, people at-risk of suicide need psychotherapy and/or other forms of intervention that help them to develop new ways of thinking, spiritual growth, and/or stronger positive social networks.

Don't make the mistake of thinking that someone is not at-risk for suicide because they appear to have a great life. Robin Williams, Chelsie Kryst (lawyer, Miss America, Extra host), and Kurt Cobain are examples of people that had great success and an ability to light up the room. There are even instances in which people commit suicide after it seems like their life is getting better and their mood is improving. If you want to save lives from suicide, be willing to go the extra mile to be there for people in your life and help them through their darkest times. You cannot save everyone by yourself, but we can all help more people if we collectivley work on awareness and advocate for policies that make high quality prevention and help more readily available. We also need to advocate for sobriety, less social media and advertisements for alcohol consumption, and modeling healthy lifestyles on television and social media.

References and Links

Bertolote JM, Fleischmann A. Suicide and psychiatric diagnosis: a worldwide perspective. World Psychiatry. 2002 Oct;1(3):181-5. PMID: 16946849

Froiland, J. M. (2018). Promoting gratitude and positive feelings about learning among young adults.? Journal of Adult Development ,? 25 (4), 251-258.

Fox, V., Dalman, C., Dal, H., Hollander, A. C., Kirkbride, J. B., & Pitman, A. (2021). Suicide risk in people with post-traumatic stress disorder: A cohort study of 3.1 million people in Sweden.? Journal of affective disorders ,? 279 , 609-616 .

Wilcox HC, Storr CL, Breslau N. Posttraumatic stress disorder and suicide attempts in a community sample of urban american young adults. Arch Gen Psychiatry. 2009 Mar;66(3):305-11. doi: 10.1001/archgenpsychiatry.2008.557.

About the Author

Dr. Froiland has published 70 scientific articles and book chapters in the fields of psychology, psychiatry, engineering, and human development. See Google Scholar and Research Gate

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