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Unfortunately, suicidal thoughts and ideation are more common than most people think. Suicidal ideations are also more common than completed suicide. Most persons who commit suicide have an active psychiatric disorder at the time of a completed suicide. Some patients diagnosed with a mental health disorder are inconsistent with medication adherence, maintaining visits with their therapist, or completely non-compliant with treatment.

Individuals that are inconsistent with treatment typically utilize family physicians and other primary care practitioners for their mental health needs rather than by psychiatrists, psychologists, or other mental health professionals. It is important that that patients received treatment from practitioners that can properly recognize and identify the signs and symptoms of the psychiatric disorder. Skilled mental health professionals can isolate the symptoms related to the disorder, making proper identification possible from other issues and illnesses (particularly alcohol abuse and major depression) that are associated with suicide. Although most patients with suicidal ideation do not ultimately commit suicide, the extent of suicidal ideation must be determined, including the presence of a suicide plan and the patient’s means to commit suicide.

Suicidal thoughts and ideations can be attributed to a combination of individual, relationship, community, and societal factors, placing them at risk of suicide. Risk factors are those characteristics associated with suicide—they might not be direct causes.

Risk Factors for Suicide Include:

  • Familial history of suicide
  • Alcohol and other substance use disorders
  • Untreated mental health disorder or concerns
  • Previous suicide attempts
  • Barriers to accessing mental health treatment
  • Recent significant loss, i.e., spouse, parent, sibling, etc.
  • History of mental disorders, particularly clinical depression
  • History of trauma or abuse
  • Major physical illnesses
  • Impulsive or aggressive tendencies
  • Job or financial loss
  • Lack of familial or social supports
  • Easy access to lethal methods
  • Lack of access to appropriate mental health services
  • Local epidemics of suicide
  • Intense feelings of hopelessness or helplessness
  • Isolation

Warning Signs for Suicide Include:

  • Talking about being a burden to everyone
  • Making statements about not “wanting to go on”, or wishing they were dead
  • Expresses significant mental or physical illness without a reason to live
  • Sleeping too little or too much
  • Acting anxious or agitated; behaving recklessly
  • Increased use of alcohol or other substances
  • Withdrawing or isolating themselves
  • Self-isolating

Protective Factors for Suicide Include:

  • Familial, social, or community support (a combination of all three is preferable)
  • Easy access to a variety of clinical interventions and support for help seeking
  • Mental and medical health support
  • Medication adherence (if medications are being prescribed)
  • Skills in problem solving, conflict resolution, and nonviolent ways of handling disputes
  • Appropriate treatment for alcohol or substance abuse if there are abuse concerns

Emotional pain and distress is not always obvious, but most suicidal people show some signs that they are thinking about suicide. Although, there will be some people that try to mask their feelings from others, there are typically warning signs. Once signs become visible we need to be vigilant and responsible enough to step in or speak up. Take the time to learn what to do now, so you’re ready to be there for a friend or loved one when it matters most.