Reducing Suicide Risk

Reducing Suicide Risk

Suma Chand, PhD

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Suma Chand, PhD, is a Professor and Director of the Cognitive Behavior Therapy (CBT) Program in the Department of Psychiatry and Behavioral Neuroscience, St Louis University School of Medicine.  She is involved in the training of Psychiatry residents and fellows in CBT and as a SLUCare Provider runs CBT clinics for adults and older adults offering individual and group CBT. Dr. Chand's clinical and research interests are in the areas of CBT for adults and older adults with anxiety and depressive disorders, sleep related problems and maladaptive perfectionism. She also writes blog posts on mental health topics. Dr. Chand is a member of the  Public Education Committee of the Anxiety and Depression Association of America and serves on the Board of Directors for the National Social Anxiety Center.

Reducing Suicide Risk

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The recent suicides of Kate Spade and Anthony Bourdain has placed the spot light on the growing problem of suicide. It has triggered conversations on the topic and caused many people to question why such successful and seemingly happy people who had everything going for them would take their own lives. Suicide is a heart-breaking problem that is growing and needs to be addressed in as many ways as is possible. Understanding the risk factors, knowing the warning signs and what to do about them, is a crucial step. The more the awareness the greater the impact on suicide prevention.

Risk Factors for Suicide

Psychiatric illnesses have been diagnosed in 90% or more of individuals who die by suicide. Among the mental health conditions depression is the most potent in elevating risk for suicide. Suicidal ideation becomes more active when the severity of the depression is higher and compounded when the individual experiences a major stressful life event and other risk factors are also present. Other mental health conditions that are associated with suicide in hierarchical order include drug abuse, bipolar disorder, schizophrenia and personality disorders like borderline personality disorder.

Serious or chronic health conditions such as cancer, end stage renal disease, HIV/AIDS and chronic pain. Individuals with such illnesses often have co-morbid depression as well.

History of suicide attempts is a potent predictor of suicide especially in the first year following discharge from hospital for an attempt.

Prolonged stress, which can manifest in the form of bullying, harassment or relationship problems can also be a precursor for suicidal behavior.

Psychological risk factors include:

  • Hopelessness has been found to be very closely linked to suicidal behavior. Higher levels of hopelessness are associated with increasingly acute suicide ideation.
  • Suicidal ideation has been found to be closely associated with suicide attempts, especially as they become more intentional and involve thinking about ways in which to end their lives.
  • Impulsivity operates in some individuals and increases suicide risk indirectly. In such instances, their impulsive behaviors exacerbate their distress levels and triggers the suicide related risk factors, like excessive drug or alcohol use.
  • Problem solving deficits have been reported by suicide attempters. They report that they made the attempt because they could not see a way out of their life situation. Research has also demonstrated that suicide attempters experience an inability to generate solutions and a negative attitude towards the ability to solve problems.
  • Lack of social connectedness and subjective perception of not belonging has been associated with suicide and attempts.
  • A person’s perceptions that he or she is a burden to others has also been identified as being predictive of suicide, especially in older adults and people with chronic pain.

Access to lethal means including fire arms and drugs.

Stressful and negative life events such as divorce, conflict, death of a loved one, financial problems, job loss or being diagnosed with a troubling illness. When the risk factors converge with the triggering negative life event a suicidal crisis or act is triggered.

Protective factors - read about it here:

https://save.org/about-suicide/warning-signs-risk-factors-protective-factors/

Warning signs – read about it here:

https://save.org/about-suicide/warning-signs-risk-factors-protective-factors/

How Can You Help Someone Who is at Risk for Suicide?

Talking about suicide to someone who you think may be at risk for suicide can be uncomfortable. Sometimes people are afraid that talking about it may trigger the act. This is far from true. Talking and gently asking a loved one who is depressed if they have thoughts about suicide will allow them to talk openly about what they are going through and move them towards getting the help they need. Allow them to express their feelings and listen with interest, patience and understanding. Be supportive and non-judgmental while offering hope that there are options available that could be helpful. Safety is of prime importance so remove access to any lethal means of self-harm such as firearms, pills, alcohol, drugs or rope. Individuals who are in suicidal crisis need to get professional help at the earliest so it is important that the suicidal individual is actively encouraged to see a mental health professional as soon as possible.

People who are in a suicidal crisis are in a state of mind where they feel hopeless and stuck with no solution except for suicide. Their thinking tends to become narrowed with thoughts that are negative and distorted dominating. Their problems solving abilities are impacted. In the case of individuals who are in a suicidal crisis the first step would be to make sure that they get professional help so that they are helped to move towards emotional stability even as they stay safe. This may require hospitalization. The underlying disorder would need to be treated while the event that acted as the precipitant is also addressed. The goals of treatment are to help the person to move towards an emotional state of stability where he can then work on building healthy coping skills. Treatment would involve medical treatment as well as psychotherapy.

Cognitive behavior therapy for suicide prevention is a form of psychotherapy that has been found to be effective for suicide prevention. It helps suicidal individuals understand their suicidal mind set and develop skills that will allow them to cope more effectively with suicide triggering situations and prevent the recurrence of a suicidal crises.

Being well informed about suicide is crucial in the battle to prevent the needless loss of precious lives.

For immediate help if you are in a crisis, call the toll-free National Suicide Prevention Lifeline at 1-800-273-TALK (8255), which is available 24 hours a day, 7 days a week. All calls are confidential." Other helpful resources include: https://www.speakingofsuicide.com/resources and https://suicidepreventionlifeline.org/how-we-can-all-prevent-suicide/ to learn more about suicide.

View Suma's accompanying webinar "Reducing Suicide Risk."

Suma Chand, PhD

headshot

Suma Chand, PhD, is a Professor and Director of the Cognitive Behavior Therapy (CBT) Program in the Department of Psychiatry and Behavioral Neuroscience, St Louis University School of Medicine.  She is involved in the training of Psychiatry residents and fellows in CBT and as a SLUCare Provider runs CBT clinics for adults and older adults offering individual and group CBT. Dr. Chand's clinical and research interests are in the areas of CBT for adults and older adults with anxiety and depressive disorders, sleep related problems and maladaptive perfectionism. She also writes blog posts on mental health topics. Dr. Chand is a member of the  Public Education Committee of the Anxiety and Depression Association of America and serves on the Board of Directors for the National Social Anxiety Center.

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