Every year, over 800,00 people die from suicide. Perhaps more shockingly, for every successful attempt there are more than 20 attempts. In 2018, 6,507 of them were in the U.K. Death by suicide rose by 10.9% in this year, and it is one of the leading causes of death for young people.
Suicide is not only emotionally traumatic for those close to the victim, but is also hugely expensive, with each one estimated to cost the U.K. economy £1.67 million pounds.
This article will examine various methods of suicide prevention which have been shown to be effective.
Causes and Risk Factors
In order to understand how suicide can be prevented, it is important to know which factors can precipitate its risk. Some researchers have stated that the three main causes of suicide are:
- Mental illness
- Societal pressure
- Interpersonal conflicts
It is important to note that these factors are not mutually exclusive, and there are broad concepts with various sub-categories.
Societal Pressure
With regards to societal pressure, one study which examined 20 notes written by people who attempted, and were successful in committing suicide, found that a common theme throughout all of the notes was a sense of being a “burden” on their community and loved ones.
This is pertinent for prevention as it is important to note that many potential suicide victims may not be committing it just to end their own pain; they may truly believe that they are doing the kindest thing to those around them.
Tailored Approaches to Prevention
Tailoring the approach of suicide prevention to various sub-sections of society has been shown to be effective.
One study of New York teenagers found that screening for:
- mood changes
- depression
- suicidal ideation
- substance misuse
could be used in order to assess whether or not the subject needed to be recommended for mental health assessment and subsequent intervention, if it is deemed necessary.
Cultural Factors and Media Influence
It is important to note cultural acceptance of suicide has also been shown to be a risk factor, which could explain why suicide figures are higher in certain ethnic groups than others. Whilst these beliefs can be challenged, often they are very entrenched in said culture.
It has been shown that media reports about suicide can influence vulnerable people to imitate it, especially if they identify with the deceased person.
One way of reducing people’s perceived acceptance of suicide as an appropriate action is to make sure that the media reports on it responsibly. This includes:
- being careful to not spread misinformation, such as the false claim that suicides spike at Christmas
- including the treatability of any underlying mental health conditions the victim may have been suffering from
Regulating Means of Suicide
Regulating certain items which can be used for suicide has also shown to be effective. This can include:
- selling analgesics in smaller packets
- controlling the sale of toxic chemicals such as pesticides which are commonly used in some countries
Other preventative measures can include:
- erecting barriers in sites popular for jumping
- detoxifying domestic gas
- introducing catalytic converters in cars
Gun control has also been shown to reduce suicide risk in some high-risk individuals.
Mental Illness and Suicide
It is stated that mental illness is the main key predictor for suicidal ideation, although this is a blanket term which can refer to many individual illnesses of which some have a higher incidence of suicidal behaviour.
In the U.K, affective disorders rank highest in diagnoses of suicide victims:
- Affective disorders (43%)
- Schizophrenia (19%)
- Personality disorder (9%)
- Alcohol dependence (6%)
- Drug dependence (4%)
This means that suicidal behaviours are not isolated incidents, but can instead be symptomatic of an illness.
Treatment and Intervention
Whilst reducing items associated with suicide can help in suicide prevention, it is more efficacious to treat the underlying mental health condition which can cause it.
Effective treatments include:
- Cognitive Behavioural Therapy (CBT): has been shown to reduce suicidal behaviour in adults and teenagers.
- Dialectic Behavioural Therapy (DBT): has also shown to reduce this risk in suicidal adolescents.
- Pharmacological interventions:
- Clozapine can benefit psychotic patients.
- Lithium can aid patients with mood disorders.
- Ketamine has also been suggested as a potential fast-acting treatment.
Anti-depressants have also been shown to reduce the risk of suicide in depressed patients, although it is important to note that some studies have claimed that they can increase this risk.
Patients who are comfortable with the use of the internet have also been shown to benefit from sharing their experiences with online communities.
The Role of Healthcare Professionals
It is estimated that 83% of suicidal patients contacted a doctor in the previous year.
As such, it is highly important that doctors are:
- trained in how to spot symptoms of depression and other indicators for suicide risk, such as self-harm
- using the most recent screening procedures for this risk
- aware of scenarios which heighten the risk of suicide, such as recent discharge from in-patient treatment
Conclusion
Because of the myriad factors which can increase suicide risk, there is no “one size fits all” approach to preventing it.
Instead, triangulation of various psychological, sociological, and pharmalogical methods, tailored to the subject’s individual needs, should be the most effective method in suicide prevention.