I take it as part of my duty to educate others about suicide, the signs, and symptoms and how you can help a person who is thinking about ending their life.
Why am I writing about this now? There have recently been two community deaths that I have become aware of through family and friends. One of these was an adolescent and one was an adult. In each case, the community is in shock. The parents of the adolescent said their son was happy and showed no signs of distress. The article announcing the death of the adult reported what a wonderful educator this man had been and how much he gave to his students and the community in which he lived. What happened in the lives of these two individuals that were so bad that the only solution they could find was death? Their families may never know the complete story.
Suicide has risen 35% since 1999 (National Alliance on Mental Illness [NAMI], 2021) and is now the 10th leading cause of death (Centers for Disease Control and Prevention [CDC], 2020). In trying to help others, there are several terms you need to understand to determine the level of suicidality of a person in crisis.
Suicidal ideation means the person is thinking about suicide. There are some people who live with suicidal thoughts all the time but have no intention of acting upon them. Other people have begun to formulate a plan for how they will act upon their suicidal thoughts. This is called suicidal intent. The most critical level is when a person has suicidal thoughts, intent and the means to follow through with the plan. This is an emergency situation. If you determine that a person has this highest level of suicidal ideation they need immediate help. Call 911 or take them to the nearest Emergency Room.
Parasuicide happens when a person self-harms or inflicts a wound that does not end up in suicide. This could be in the form of cutting or a non-lethal drug overdose. This is often considered a cry for help and may lead to an actual suicide. Copy-cat suicides can occur after the death of a person in the community or a celebrity figure. It is very important for news media to control the way the event is shared with the public because if the death is glamorized then there can be vulnerable people who see suicide as a way to emulate the celebrity and get attention (Vitelli, 2016).
Suicide risk factors
One of the primary parts of taking care of patients is to perform a complete head-to-toe assessment. This includes asking questions about a person’s emotional well-being. One of the concerns that my nursing students have voiced in the clinical setting is fear that if they ask a patient about suicidal thinking it will put the thought into that person’s head. This is a myth. I always explain to my students that this is not possible. In fact, in most cases, a person who is having suicidal thoughts will feel a sense of relief to be asked and offered support. Asking a patient if they are feeling suicidal should be part of every nursing assessment. There are certain factors that may contribute to a person having a higher risk for suicidal tendencies. These include:
- A family history of suicide – this may play into the way a person reacts to stressors. They may see it as “Well, my father completed suicide and he was not weak, so I will follow in his shoes.”
- Substance use – the use of substances can increase the mood swings that can cause suicidal ideation.
- Intoxication – According to NAMI (2021), one in three people who are successful in suicide are intoxicated at the time of their death.
- Access to firearms – the top three means of suicide are firearms, suffocation (hanging), and poisoning (CDC, 2020).
- A serious or chronic medical illness or mental illness – 46% who die by suicide have been diagnosed with a mental illness (NAMI, 2021)
- Gender – 78% are male. Women are more likely to attempt suicide, but men are 4x more likely to die (NAMI, 2021) due to the use of more deadly means, most often firearms.
- A history of trauma or abuse
- Prolonged stress
- A recent tragedy or loss – elderly people, age 85 and older, have the highest suicide rate. Loss of independence (giving up a driver’s license), death of spouse and/or friends, health/memory issues, financial stressors, and loneliness are top reasons (Mendoza, 2020).