Suicide Prevention

While almost everyone has contemplated suicide at one time or another, to actually kill oneself is a very rare event. 99.9% of Americans do not kill themselves. Yet, even one suicide is a tragedy that leaves in its wake a horrible devastation for those who loved the deceased. One of the tragedies of suicide, especially for healthy young individuals, is that the person has turned to a permanent solution to what is almost always a temporary problem. Suicidal crises are time-limited, thus timely intervention is essential. While one can argue that any individual has the right to kill him or herself, the decision to self-destruct is oftentimes made in a state of severe cognitive impairment and overwhelming emotions, arguing against the notion that the suicidal person is acting as a free and competent individual. Even though the decision to kill oneself is perhaps the most personal decision one can make, the effects of the suicide are almost always profoundly social in nature. What's at stake is not only the life of the individual student but the welfare of the surviving loved ones and the campus community at large.

Why Suicide?
We do not know enough about suicide to accurately predict a specific suicide or to absolutely prevent it. Fortunately, there is an emerging consensus on how suicide tends to occur. In its simplest form, the current explanation of suicide is that it occurs when the person is facing a situation that is perceived to be intolerably painful AND the person does not have the coping resources to face this painful situation AND the person believes that suicide is the only way to end the pain. On a more theoretical level, suicide can best be understood by considering three key factors: 1) predisposing factors, 2) current risk factors and 3) protective factors. Predisposing factors include genetic factors, previous psychiatric history, previous suicide attempts, history of suicide in the family of origin and history of abuse or trauma. Current risk factors include: 1) Current identifiable stressors, particularly related to loss of any kind, 2) presence of excruciating emotional pain, 3) current psychiatric disorder, particularly mood disorders, anxiety disorders and schizophrenia, 4) active substance abuse, 5) evidence of impaired impulse control, 6) social isolation and limited social support, 7) specific suicidal intent and planning, and 8) lethality of the plan and ready access to lethal means of carrying out these plans. Protective factors include deeply held religious beliefs, compelling reasons for living, the willingness to seek help and good social support. One common misconception about suicide is that external events alone cause a person to commit suicide. In reality, suicide occurs when the person is temporarily not able to think clearly due to being blinded by overwhelming pain. Just like we wouldn't allow a friend to drive a car when his thinking is clouded by too much alcohol, we mustn't allow someone who is temporarily disrupted by overwhelming pain to take his own life.

Warning Signs
Suicide very rarely occurs without prior warning. Suicidal behaviors can be viewed as a desperate cry for help. Recognizing these warning signs is the key to preventing suicide. Common triggers to a suicidal crisis include situations that lead a person to feel hopeless and worthless. Actual or threatened break-up with a loved one, rejection by family members and peers, or perceived failure in academic pursuits are examples of situations that might lead a person to turn to drastic self-destructive behaviors. Just because a person begins to feel better does not necessarily mean that the suicidal crisis is over. Sometimes a suicide can occur when the person's painful situation is improving.

There are many signs that can indicate increased risk for suicide. The following is a partial listing of such potential warning signs:

• Explicit statements expressing hopelessness, self-loathing and wish to die.
• Preoccupation with morbid topics, such as death and dying.
• Depressed and/or angry mood.
• Change in appetite and sleeping habits.
• Drug and alcohol abuse.
• Statements implying the person does not intend to be around in the future.
• Noticeable personality changes.
• Loss of interest in pleasurable activities.
• Suddenly becoming cheerful after a period of depression.
• Giving away prized personal possessions.
• Noticeable decrease in academic or job performance.
• Isolation and withdrawal from peers and family.
• Loss of enthusiasm about life.

What Can You Do?
Become aware of others around you. Take time to listen; the simple act of showing you care can make the difference between a person attempting suicide or seeking help. Learn to recognize the subtle clues and warning signs of the troubled individual. When you suspect someone is suicidal or otherwise in need of help, contact an expert who can provide practical, knowledgeable aid. If you suspect a suicide is very imminent or in progress, call 911.

One good rule of thumb is not to take on the responsibility of helping a suicidal person all by yourself, but instead to rally other resources that can help the troubled person. There is a good chance that the suicidal person can be helped through the temporary crisis, as long as help is provided promptly.

If you suspect that someone you know is suicidal, don't be afraid to talk about it. The clues you may be hearing or seeing can be subtle invitations for you to help. Most suicidal people have opposing feelings of wanting to die and at the same time wanting to live. Ask the person about his or her feelings and the changes that you have noticed. Let the person know that you want to help. Remember, suicidal crises are temporary: what seems to be unbearable pain can be survived and there are solutions other than suicide.