Suicide deaths are among the most preventable deaths currently in the US. Suicide is the tenth leading cause, and in 2019, it was responsible for more than 47500 deaths based on the data from the Centers for Disease Control and Prevention (CDC). Suicide is the act of injuring oneself with the intent of death, whereas a suicide attempt is an act of harming oneself with the intent to die, but one does not die. From 1999 to 2019, the CDC reported that the suicide rate in the US has increased by 33%, with 2019 experiencing a slight decline. Notably, every age is affected, but people below the age of 34 are at an increased risk as suicide is the second leading cause of death. However, the highest rates of suicide are experienced among Alaska Natives and non-Hispanic Whites. Other populations at risk include workers, and lesbian, gay, bisexual, and transgender (LGBT) members, and veterans.
Causes of Suicide
People commit suicide for various reasons. The first is due to mental illnesses. Mental illnesses, particularly severe depression, are the leading cause of many suicide cases. Depression has severe impacts on someone’s emotions, and usually, patients feel hopeless. As a result of such feelings, people commit suicide. Other mental illnesses responsible for suicide include schizophrenia, eating disorders, bipolar disease, and borderline personality disease. Another cause is the traumatic stress people experience after some life events. For instance, rape, childhood sexual abuse, war trauma, domestic violence, and physical abuse cause traumatic stress. Approximately 23% of people who experienced physical assault and 22% experienced rape attempted suicide. The risk of committing suicide increases when an individual faces multiple trauma or is diagnosed with Post-Traumatic Stress Disorder; such people feel helpless and hopeless, leading to suicide.
Moreover, suicide can be caused by substance abuse. Research indicates that people who have already developed suicide thoughts are at a higher risk of committing suicide if they use alcohol and other drug substances. Drugs make these individuals more impulsive to be influenced by their urges. Indirectly, substance abuse can trigger other stressors like loss of job or end marriages which make people commit suicide. Notably, people with mental illnesses like depression are most likely to abuse these substances, impairing their judgment to commit suicide. Equally, other stressors like being imprisoned, failing academically, loss of social status, job loss, loss of family or friends after revealing one’s sexuality, ending a romantic relationship, bullying, and financial challenges can lead to suicide.
Chronic illnesses and pain can lead to suicide. In some cases, if an individual is suffering from a chronic disease and experiencing chronic pain with no hope for a cure, suicide becomes the only option to end the suffering. According to the American journal of preventive medicine, asthma, Parkinson’s disease, cancer, diabetes, HIV/AIDS, back pain, brain injury, epilepsy, congestive heart failure, heart conditions, and migraine are among the chronic diseases that patients experience high suicide deaths. Other causes of suicide are the feeling of being a burden to other people and being socially isolated. People who suffer from chronic illnesses or are disabled feel they are a burden to other people. These individuals may find it challenging to ask other people to accompany them to places or hospitals or getting help to pay for their bills. Furthermore, people may be socially isolated due to loss of friends, divorce, separation, retirement, or social anxieties, and such loneliness can make people commit suicide. Socially, stigma and discrimination are among the causes of suicide.
The first step in managing suicide is identifying vulnerable individuals, constantly checking for symptoms of suicide thoughts. Some of the symptoms include feelings of being hopeless, alone, or trapped. People may feel there is no need to live, exploring ways to harm oneself, sleeping too little or too much, mood swings, talking about suicide. Similarly, other symptoms are increasing the use of drugs, engaging in risky behaviors, giving out belongings, long-lasting sadness, and urges to attempt suicide. People who present these symptoms should be directly confronted and asked whether they are trying to attempt suicide and the manner they are planning to attempt suicide.
Equally, vulnerable individuals should not access objects that can be considered lethal. Such individuals should be monitored closely on any further change in behaviors, for instance, their eating behaviors and medication intake. There is a need to ensure these individuals seek help whenever they develop these thoughts and inform family and friends to offer additional support in managing suicide.
Suicide can be prevented in society; firstly, it can be controlled through social and economic supports. There is a need to increase household financial security and stabilizing housing policies to avoid stressors that can lead to suicide. Stressors like being homeless or financial challenges can trigger suicide. Increasing access to suicide care services can prevent suicides. There is a need for health insurance to cover mental health services and additional policies to ensure more people are protected. Equally, access to these services can be increased by addressing the shortage of caregivers in under-served communities. Secondly, the approach is by using evidence-based practices while giving suicide care services. Thirdly, suicide can be prevented through the creation of a protective environment. For the identified people at increased risk of committing suicide, access to lethal means to commit suicide should be denied. For individuals residing in institutions or others working in organizations, a change in culture and policies is recommended to ensure low rates of suicide are experienced in the organizations and institutions. Additionally, there is a need for more community policies that reduce alcohol consumption and substance abuse, especially for the population considered vulnerable.
Besides, increasing connectedness can prevent suicide. Vulnerable people can be encouraged to join community peer groups and be engaged in community activities like charity services or volunteering. Individuals who are considered vulnerable can be taught problem-solving skills. Many strategies can be implemented to teach these individuals, and among them are family relationship and parenting skill programs and the social-emotional learning approach. The community can identify and offer support to people vulnerable to suicide; this may be through the treatment of these individuals or those who have already attempted suicide. Additional programs like gatekeeping training and crisis intervention are also recommended.
Treatment for Suicide and Suicide Attempts
Various evidence-based approaches are now used in the US to treat suicide. First psychotherapeutic interventions are widely recommended. The interventions can be at a group or individual level, and the length of treatment varies based on the patient’s risk. The psychotherapeutic approach is a treatment that identifies thinking patterns and behaviors to motivate patients, reduce suicide rates and increase retention in therapy sessions. Psychotherapy includes cognitive behavioral therapy, dialectical therapy, improving mood, collaborative assessment, and family-based treatment. Cognitive Behavior Therapy for Suicide Prevention uses a relapse prevention and risk reduction approach where therapists identify all the risk factors and stressors that may cause suicide. A safety plan after this analysis is created, and psycho-education is similarly provided to clients. This plan has shown 50% success in reducing suicide re-attempts. Dialectical Behavior Therapy (DBT) is another approach used for most vulnerable individuals and struggles with emotional regulation and impulsivity. Some techniques are used for DBT like group skills training, therapist consultation, and telephone coaching.
Another evidence-based approach is Improving Mood-Promoting Access to Collaborative Treatment (IMPACT); this program targets the elderly in primary care through depression management and minimizing suicide ideas. This approach similarly supports personalized treatment. Collaborative Assessment and Management of Suicidality has no particular plan, but the doctor and the patient designed the treatment plan. Various techniques are used, and the patient determines what is working for them. Attachment-Based Family Therapy is another psychotherapeutic approach used for adolescents, particularly to address depressive symptoms, suicide ideas, and eliminating anxiety.
Psychiatric medications are another treatment alternative. The medications are primarily used to reduce self-violence and manage mental disorders. The common medications used include lithium, antidepressants, antipsychotics, and neuroleptics. Lithium is used to treat mental illnesses like bipolar and mood swings. Lithium is a mood stabilizer for these patients. Similarly, antidepressants can be administered, and there is evidence that they can minimize suicide behaviors among patients with emotional challenges. Other drugs like antipsychotics are used to manage mental illnesses which cause suicide.
In conclusion, this article has examined the causes, management, prevention, and treatment of suicide. Some of the reasons discussed include mental illnesses and trauma. The article has also identified ways suicide can be prevented in society. There is a need for vulnerable individuals to be engaged in community activities and their access to caregivers, including therapists, to be increased. Similarly, the two treatment alternatives include psychotherapeutic approaches that address behaviors and suicidal thoughts or psychiatric treatment using drugs that manage mood disorders and mental illnesses. Suicide has several negative impacts on society; hence there is a need to pay more attention to its management.