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Can authority urge person to commit suicide?

Can authority urge person to commit suicide?


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I'm interested in the influence of authority. I would like to know if it is possible for authority to urge someone to commit suicide.

By urge, I mean not using any negative force, so affected person feels that suicide is 'right thing to do', and doesn't feel (consciously) forced to do it.


I believe that this has been proven by history and is also happening in the present world. During World War 2, there were (1)kamikaze pilots. In today's world, there are (2)suicide bombers.

(1) Kamikaze - This was a direct order to Japanese pilots from their authorities to kill themselves and take out as many of the enemy as they could.

(2) Suicide bombing - This too is a direct order from religious authorities.

It can also be argued that culture is an "authority". Culture is passed down from elders who are authority figures. In Japan, there was Seppuku. Samurai who were captured would disembowel themselves, because their culture dictated that this was the honorable thing to do.

I hope I understood your question correctly and was able to answer it.


Absolutely! First and foremost most people commit suicide on their own authority. I discovered that suicide can seem convincingly rational and sound. Suicides are with ease driven by the thoughts and feelings that it is the best that can happen to ones loved ones and society if you die, solves all their problems, good riddance. So yes, it is fully possible to give strong enough incentive over time if it is the subjects whole environment that pushes the same self image onto the person, that image should include diffuse feelings of being a problem, not quite living up to standards anywhere(shifting goalposts on what the standards are) making the subject aware of it causing disappointment repeatedly.


Contents

Medical professionals advise that people who have expressed plans to kill themselves be encouraged to seek medical attention immediately. This is especially relevant if the means (weapons, drugs, or other methods) are available, or if the patient has crafted a detailed plan for executing the suicide. Mental health professionals suggest that people who know a person whom they suspect to be suicidal can assist him or her by asking directly if the person has contemplated committing suicide and made specific arrangements, has set a date, etc. Posing such a question does not render a previously non-suicidal person suicidal [How to reference and link to summary or text] . According to this advice, the person questioning should seek to be understanding and sympathetic above all else since a suicidal person will often already feel ashamed or guilty about contemplating suicide so care should be taken not to exacerbate that guilt.

Mental health professionals suggest that an affirmative response to these questions should motivate the immediate seeking of medical attention, either from that person's doctor, or, if unavailable, the emergency room of the nearest hospital.

If the prior interventions fail, mental health professionals suggest involving law enforcement officers. While the police do not always have the authority to stop the suicide attempt itself, in some countries including some jurisdictions in the US, killing oneself is illegal.

In most cases law enforcement does have the authority to have people involuntarily committed to mental health wards. Usually a court order is required, but if an officer feels the person is in immediate danger he/she can order an involuntary commitment without waiting for a court order. Such commitments are for a limited period, such as 72 hours – which is intended to be enough time for a doctor to see the person and make an evaluation. After this initial period, a hearing is held in which a judge can decide to order the person released or can extend the treatment time. Afterwards, the court is kept informed of the person's condition and can release the person when they feel the time is right to do so. Legal punishment for suicide attempts is extremely rare [How to reference and link to summary or text] .


Overview of Durkheim's Text

The text of Suicide offered an examination of how suicide rates at the time differed across religions. Specifically, Durkheim analyzed differences between Protestants and Catholics. He found a lower rate of suicide among Catholics and theorized that this was due to stronger forms of social control and cohesion among them than among Protestants.

Demographics of Suicide: Study Findings

Additionally, Durkheim found that suicide was less common among women than men, more common among single people than among those who are romantically partnered, and less common among those who have children.

Further, he found that soldiers commit suicide more often than civilians and that curiously, rates of suicide are higher during peacetime than they are during wars.

Correlation Vs. Causation: Suicide's Driving Forces

Based on his gleanings from the data, Durkheim argued that suicide can be a result not only of psychological or emotional factors but of social factors as well. Durkheim reasoned that social integration, in particular, is a factor.

The more socially integrated a person is—that is, the more he or she is connected to society, possessing a feeling of general belonging and a sense that life makes sense within the social context—the less likely he or she is to commit suicide. As social integration decreases, people are more likely to commit suicide.

Durkheim's Typology of Suicide

Durkheim developed a theoretical typology of suicide to explain the differing effects of social factors and how they might lead to suicide:


Moral philosophy and suicide

There are two main moral issues regarding suicide: first, whether suicide is morally permissible, and if so, in what circumstances and second, whether a person who knows that someone is contemplating or attempting suicide has an obligation to intervene and if so, how strong that obligation is. With respect to the first issue, it is difficult to resist the conclusion that suicide is not wrong in itself. To characterize suicide as murder of one's self is incorrect. Even if people who commit suicide deprive the community of some good, there is no general duty to provide good services to others. Theological objections to suicide are not persuasive. And suicide could be rational. For example, if one's scheme of values is to maximize the overall value of experience, and if at some point in the future negative value outweighs positive value, suicide would be rationally indicated. With respect to intervention, different considerations apply to persons involved with someone contemplating or attempting suicide, professionals, and the general public. Those who are involved have their own lives to live and need not alter them even when another person's life is at stake. Professionals should not become paternalistic authorities who keep subjects alive against their will and miserable for indefinite periods. The general public has only a weak duty to save strangers from suicide.


Who Can Make the Request?

A short-term emergency detention, such as detention immediately following a suicide attempt, can generally be requested by anyone who has witnessed the situation that you are in, including friends, family, or the police. Even though almost anyone can initiate the process, most states do require either medical evaluation or court approval in order to ensure that you meet that particular state's criteria.  

The allowed duration of emergency detentions vary from state to state but are most often limited to 24–48 hours before a civil commitment proceeding must be initiated.  

Some states have longer detention periods that can range from four to 10 days.  


Contents

There are risks and disadvantages to both over-estimation and under-estimation of suicide risk. Over-sensitivity to risk can have undesirable consequences, including inappropriate deprivation of patients' rights and squandering of scarce clinical resources. On the other hand, underestimating suicidality as a result of a dismissive attitude or lack of clinical skill jeopardizes patient safety and risks clinician liability. [10] Some people may worry that asking about suicidal intentions will make suicide more likely. In reality, regarding that the enquiries are made sympathetically, it does not. [11] [12] Key areas to be assessed include the person's predisposition to suicidal behavior identifiable precipitant or stressors such as job loss, recent death of a loved one and change of residence [13] [ full citation needed ] the patient's symptomatic presentation presence of hopelessness nature of suicidal thinking previous suicidal behavior impulsivity and self-control and protective factors.

Suicide risk assessment should distinguish between acute and chronic risk. Acute risk might be raised because of recent changes in the person's circumstances or mental state, while chronic risk is determined by a diagnosis of a mental illness, and social and demographic factors. Bryan and Rudd (2006) suggest a model in which risk is categorized into one of four categories: Baseline, Acute, Chronic high risk, and Chronic high risk with acute exacerbation. [10] Risk level can be described semantically (in words) e.g. as Nonexistent, Mild, Moderate, Severe, or Extreme, and the clinical response can be determined accordingly. Others urge use of numbers to describe level of relative or (preferably) absolute risk of completed suicide. [6]

SSI/MSSI Edit

The Scale for Suicide Ideation (SSI) was developed in 1979 by Aaron T. Beck, Maria Kovacs, and Arlene Weissman to quantify intensity in suicide ideators. It was developed for use by clinicians during semi-structured interviews. The scale contained 19 items rated on a scale from 0 to 2, allowing scores between 0 and 38. The items could be grouped into three categories: "Active Suicidal Desire, Preparation, and Passive Suicidal Desire." Initial findings showed promising reliability and validity. [14]

The Modified Scale for Suicide Ideation (MSSI) was developed by Miller et al., using 13 items from the SSI and 5 new items. The modifications increased both reliability and validity. The scale was also changed to range from 0 to 3, yielding a total score ranging from 0 to 54. Joiner found two factors, Suicidal Desire and Ideation, and Resolved Plans and Preparation. The MSSI was also shown to have higher discrimination between groups of suicide ideators and attempters than the BDI, BHS, PSI, and SPS. [15]

SIS Edit

The Suicide Intent Scale (SIS) was developed in order to assess the severity of suicide attempts. The scale consists of 15 questions which are scaled from 0-2, which take into account both the logistics of the suicide attempt as well as the intent. The scale has high reliability and validity. Completed suicides ranked higher in the severity of the logistics than attempted suicides (it was impossible to measure intent for the completed suicides), and those with multiple attempts had higher scores than those who only attempted suicide once. [16]

SABCS Edit

The Suicidal Affect Behavior Cognition Scale (SABCS) is a six-item self-report measure based on both suicide and psychological theory, developed to assess current suicidality for clinical, screening, and research purposes. Substantial empirical evidence was found, from four independent studies, confirming the importance of assessing suicidal affect, behaviors, and cognition as a single suicidal construct. The SABCS was the first suicide risk measure to be developed through both classical test theory (CTT) and item response theory (IRT) psychometric approaches and to show significant improvements over a highly endorsed comparison measure. The SABCS was shown to have higher internal reliability, and to be a better predictor of both future suicidal behaviors and total suicidality over an existing standard. [17] [18]

Suicide Behaviors Questionnaire Edit

The Suicide Behaviors Questionnaire (SBQ) is a self-report measure developed by Linehan in 1981. In 1988 it was transformed from a long questionnaire to a short four questions that can be completed in about 5 minutes. Answers are on a Likert scale that ranges in size for each question, based on data from the original questionnaire. It is designed for adults and results tend to correlate with other measures, such as the SSI. It is popular because it is easy to use as a screening tool, but at only four questions, fails to provide detailed information. [19]

Life Orientation Inventory Edit

The Life Orientation Inventory (LOI) is a self-report measure that comes in both a 30 question and 110 question form. Both forms use a 4-point Likert scale to answer items, which are divided into six sub-scales on the longer form: self-esteem vulnerability, over-investment, overdetermined misery, affective domination, alienation, and suicide tenability. This scale has strong reliability and validity, and has been shown to be able to differentiate between control, depressed, possibly suicidal, and highly suicidal individuals. It also contains 3 validity indices, similar to the MMPI. However, while useful, this inventory is now out of print. [19]

Reasons For Living Inventory Edit

The Reasons For Living Inventory (RFL) is theoretically based, and measures the probability of suicide based on the theory that some factors may mitigate suicidal thoughts. It was developed in 1983 by Linehan et al. and contains 48 items answered on a Likert scale from 1 to 6. The measure is divided into six subscales: survival and coping beliefs, responsibility to family, child concerns, fear of suicide, fear of social disproval, and moral objections. Scores are reported as an average for the total and each sub-scale. The scale is shown to be fairly reliable and valid, but is still mostly seen in research as compared to clinical use. Other variations of the scale include the College Students Reasons for Living Inventory, and the Brief Reasons for Living Inventory. The college students reasons for living inventory replaced the responsibility to family sub-scale with a responsibility to family and friends sub-scale and that replaced the child concerns sub-scale with a college/future concerns sub-scale. The Brief Reasons for Living Inventory uses only 12 of the items from the RFL. [19] [20] Prolonged stress releases hormones that damage over time the hippocampus. The hippocampus is responsible for storing memories according to context (spatial, emotional and social) as well as activating memories according to context. When the hippocampus is damaged, events will be perceived in the wrong context, or memories with the wrong context might be activated.

Nurses Global Assessment of Suicide Risk Edit

The Nurses Global Assessment of Suicide Risk (NGASR) was developed by Cutcliffe and Barker in 2004 to help novice practitioners with assessment of suicide risk, beyond the option of the current lengthy checklists currently available. It is based on 15 items, with some such as "Evidence of a plan to commit suicide" given a weighting of 3, while others, such as "History of psychosis" are weighted with a 1, giving a maximum total score of 25. Scores of 5 or less are considered low level of risk, 6-8 are intermediate level of risk, 9-11 are high level of risk, and 12 or more are very high level of risk. Each item is supported theoretically by studies that have shown a connection between the item and suicide. However, the validity and reliability of the test as a whole have not yet been empirically tested. [21]

Within the United States, the suicide rate is 11.3 suicides per 100,000 people within the general population. [22]

Age Edit

In the United States, the peak age for suicide is early adulthood, with a smaller peak of incidence in the elderly. [23] On the other hand, there is no second peak in suicide in black men or women, and a much more muted and earlier-peaking rise in suicide amongst non-Hispanic women than their male counterparts. [23] Older white males are the leading demographic group for suicide within the United States, at 47 deaths per 100,000 individuals for non-Hispanic white men over age 85. For Americans aged 65 and older, the rate is 14.3 per 100,000. Suicide rates are also elevated among teens. For every 100,000 individuals within an age group there are 0.9 suicides in ages 10–14, 6.9 among ages 15–19, and 12.7 among ages 20–24. [22]

Sex Edit

China and São Tomé and Príncipe are the only countries in the world where suicide is more common among women than among men. [24] [ full citation needed ]

In the United States, suicide is around 4.5 times more common in men than in women. [25] U.S. men are 5 times as likely to commit suicide within the 15- to 19-year-old demographic, and 6 times as likely as women to commit suicide within the 20- to 24-year-old demographic. [22] Gelder, Mayou and Geddes reported that women are more likely to commit suicide by taking overdose of drugs than men. [11] Transgender individuals are at particularly high risk. [10] Prolonged stress lasting 3 to 5 years, such clinical depression co-morbid with other conditions, can be a major factor in these cases. [ citation needed ]

Ethnicity and culture Edit

In the United States white persons and Native Americans have the highest suicide rates, Black persons have intermediate rates, and Hispanic persons have the lowest rates of suicide. However, Native American males in the 15-24 age group have a dramatically higher suicide rate than any other group. [25] A similar pattern is seen in Australia, where Aboriginal people, especially young Aboriginal men, have a much higher rate of suicide than white Australians, a difference which is attributed to social marginalization, trans-generational trauma, and high rates of alcoholism. [26] A link may be identified between depression and stress, and suicide.

Sexual orientation Edit

There is evidence of elevated suicide risk among gay and lesbian people. Lesbians are more likely to attempt suicide than gay men and heterosexual men and women however, gay men are more likely to succeed. [10]

The literature on this subject consistently shows that a family history of committed suicide in first-degree relatives, adverse childhood experiences (parental loss and emotional, physical and sexual abuse), and adverse life situations (unemployment, isolation and acute psychosocial stressors) are associated with suicide risk. [27]

Recent life events can act as precipitants. Significant interpersonal loss and family instability, such as bereavement, poor relationship with family, domestic partner violence, separation, and divorce have all been identified as risk factors. Financial stress, unemployment, and a drop in socioeconomic status can also be triggers for a suicidal crisis. This is also the case for a range of acute and chronic health problems, such as pain syndromes, or diagnoses of conditions like HIV or cancer. [10] [23] : 18,25,41–42

Certain clinical mental state features are predictive of suicide. An affective state of hopelessness, in other words a sense that nothing will ever get better, is a powerful predictive feature. [10] High risk is also associated with a state of severe anger and hostility, or with agitation, anxiety, fearfulness, or apprehension. [23] : 17,38 [28] Research domain criteria symptom burdens, particularly the positive and negative valence domains, are associated with time varying risk of suicide. [29] Specific psychotic symptoms, such as grandiose delusions, delusions of thought insertion and mind reading are thought to indicate a higher likelihood of suicidal behavior. [3] Command hallucinations are often considered indicative of suicide risk, but the empirical evidence for this is equivocal. [28] [30] Another psychiatric illness that is a high risk of suicide is schizophrenia. The risk is particularly higher in younger patients who have insight into the serious effect the illness is likely to have on their lives. [11]

The primary and necessary mental state Federico Sanchez called idiozimia (from idios "self" and zimia "loss"), followed by suicidal thoughts, hopelessness, loss of will power, hippocampal damage due to stress hormones, and finally either the activation of a suicidal belief system, or in the case of panic or anxiety attacks the switching over to an anger attack, are the converging reasons for a suicide to occur. [31]

Suicidal ideation refers to the thoughts that a person has about suicide. Assessment of suicidal ideation includes assessment of the extent of preoccupation with thoughts of suicide (for example continuous or specific thoughts), specific plans, and the person's reasons and motivation to attempt suicide. [28]

Planning Edit

Assessment of suicide risk includes an assessment of the degree of planning, the potential or perceived lethality of the suicide method that the person is considering, and whether the person has access to the means to carry out these plans (such as access to a firearm). A suicide plan may include the following elements: timing, availability of method, setting, and actions made towards carrying out the plan (such as obtaining medicines, poisons, rope or a weapon), choosing and inspecting a setting, and rehearsing the plan. The more detailed and specific the suicide plan, the greater the level of risk. The presence of a suicide note generally suggests more premeditation and greater suicidal intent. The assessment would always include an exploration of the timing and content of any suicide note and a discussion of its meaning with the person who wrote it. [23] : 46 [28]

Motivation to die Edit

Suicide risk assessment includes an assessment of the person's reasons for wanting to commit suicide. Some are due to overwhelming emotions or others can have a deep philosophical belief. The causes are highly varied.

Other motivations for suicide Edit

Suicide is not motivated only by a wish to die. Other motivations for suicide include being motivated to end the suffering psychologically and a person suffering from a terminal illness may intend to commit suicide as a means of managing physical pain and/or their way of dealing with possible future atrophy or death. [32]

Reasons to live Edit

Balanced against reasons to die are the suicidal person's reasons to live, and an assessment would include an enquiry into the person's reasons for living and plans for the future. [23] : 44

There are people who commit suicide the first time they have suicidal thoughts and there are many who have suicidal thoughts and never commit suicide. [31]

All major mental disorders carry an increased risk of suicide. [33] However, 90% of suicides can be traced to depression, linked either to manic-depression (bipolar), major depression (unipolar), schizophrenia or personality disorders, particularly borderline personality disorder. Comorbity of mental disorders increases suicide risk, especially anxiety or panic attacks. [31]

Anorexia nervosa has a particularly strong association with suicide: the rate of suicide is forty times greater than the general population. [33] The lifetime risk of suicide was 18% in one study, and in another study 27% of all deaths related to anorexia nervosa were due to suicide. [34]

The long-term suicide rate for people with schizophrenia was estimated to be between 10 and 22% based upon longitudinal studies that extrapolated 10 years of illness for lifetime, but a more recent meta-analysis has estimated that 4.9% of schizophrenics will commit suicide during their lifetimes, usually near the illness onset. [35] [36] Risk factors for suicide among people with schizophrenia include a history of previous suicide attempts, the degree of illness severity, comorbid depression or post-psychotic depression, social isolation, and male gender. The risk is higher for the paranoid subtype of schizophrenia, and is highest in the time immediately after discharge from hospital. [30]

While the lifetime suicide risk for mood disorders in general is around 1%, long-term follow-up studies of people who have been hospitalized for severe depression show a suicide risk of up to 13%. [10] People with severe depression are 20 times more likely and people with bipolar disorder are 15 times more likely to die from suicide than members of the general population. [37] Depressed people with agitation, severe insomnia, anxiety symptoms, and co-morbid anxiety disorders are particularly at-risk. [38] Antidepressants have been linked with suicide as Healy (2009) stated that people on antidepressant have the tendency to commit suicide after 10–14 days of commencement of antidepressant.

People with a diagnosis of a personality disorder, particularly borderline, antisocial or narcissistic personality disorders, are at a high risk of suicide. In this group, elevated suicide risk is associated with younger age, comorbid drug addiction and major mood disorders, a history of childhood sexual abuse, impulsive and antisocial personality traits, and recent reduction of psychiatric care, such as recent discharge from hospital. While some people with personality disorders may make manipulative or contingent suicide threats, the threat is likely to be non-contingent when the person is silent, passive, withdrawn, hopeless, and making few demands. [39]

A history of excessive alcohol use is common among people who commit suicide, and alcohol intoxication at the time of the suicide attempt is a common pattern. [23] : 48 Meta analytic research conducted in 2015 indicates that a person with co-occurring alcohol use disorder and major depression is more likely to ideate, attempt, and complete suicide than those with individual disorders. [40]


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Edwin Shneidman, Authority on Suicide, Dies at 91

Edwin S. Shneidman, a psychologist who gave new direction to the study of suicide and was a founder of the nation’s first comprehensive suicide prevention center, died Friday at his home in Los Angeles. He was 91.

His death was confirmed by his son David.

Until Dr. Shneidman took up the study of suicide shortly after World War II, the subject had received little sustained attention from researchers or clinicians. But as a researcher, theoretician, lecturer and author, he helped establish the study of suicide as an interdisciplinary field and devised many concepts now widely accepted.

With Norman L. Farberow, Dr. Shneidman founded the Los Angeles Suicide Prevention Center in the 1950s. The center, where he was co-director, offered research, training and suicide prevention services and became the prototype for such centers in the United States and abroad.

In a career that spanned more than four decades, Dr. Shneidman was also the chief of the first national suicide prevention program, at the National Institute of Mental Health founded the American Association of Suicidology and was the first professor of thanatology (the study of death) at the University of California, Los Angeles.

In his early work, he and Dr. Farberow carried out a large suicide study that contradicted some widely held beliefs. For example, although it had long been thought that people had to be insane to take their own lives, they found that only 15 percent of suicides were psychotic.

They also developed the idea that most people who became acutely suicidal were in that state for a relatively brief period, and emphasized a need for active intervention.

They set up a telephone service to invite suicidal people to come in for an assessment and a referral for treatment. But, overwhelmed by the response, they had difficulty making referrals, and so they began offering treatment themselves.

Dr. Robert E. Litman, who was chief psychiatrist at the center, said Dr. Shneidman and Dr. Farberow had pioneered an approach in which trained nonprofessionals took calls from troubled people.

In an account in “The Enigma of Suicide,” by George Howe Colt, the author quotes Dr. Litman as recalling: “People were calling us and literally saying, ‘I’m just about to make a suicide attempt. Do I have to take these pills or jump off a building before I can talk to you? Or could I shortcut it and come in directly?’ ”

Staff members made house calls, escorted suicidal people to the hospital, tracked down estranged spouses and even traced telephone calls. One day, Mr. Colt wrote, a client ran out of the offices onto the roof, with staff members in hot pursuit they grabbed her before she could jump.

Three decades after the center was founded, the suicide rate in Los Angeles had been cut in half, Dr. Litman said in an interview.

Dr. Shneidman and his colleagues devised the “psychological autopsy,” a method used to help a coroner determine whether a death had been caused by suicide or accident when the circumstances were ambiguous. Staff members would interview friends and relatives of the deceased, study diaries and other documents, and try to reconstruct the person’s state of mind.

Their best-known case was that of Marilyn Monroe, who died of an overdose of barbiturates in 1962. After learning that she had twice previously tried to commit suicide and had been deeply depressed before she finally succeeded, they called the death a “probable suicide.” The coroner’s report agreed.

Dr. Shneidman left the Los Angeles center in 1966 to become the first chief of the Center for the Study of Suicide Prevention at the National Institute of Mental Health in Bethesda, Md., where he encouraged suicide prevention efforts in 40 states.

By March 1969, the number of suicide prevention centers in the United States had risen to 119 from 44 in July 1967, according to the American Association of Suicidology. There are now about 140 suicide prevention and crisis centers accredited by the association, and many more unaccredited ones.

Dr. Shneidman joined the U.C.L.A. faculty as professor of medical psychology in 1970 and became professor of thanatology in 1975. In addition to research and teaching, he counseled dying patients and their survivors. He retired in 1988 but continued to write and mentor researchers in his field.

Edwin Shneidman was born on May 13, 1918, in York, Pa. He received bachelor’s and master’s degrees at U.C.L.A. and earned a Ph.D. in psychology in 1948 at the University of Southern California.

In addition to his son David, of Seattle, he is survived by three other sons — Jon, of Fort Bragg, N.C. Paul, of Gibbsboro, N.J. and Robert, of Portland, Ore. — and six grandchildren. His wife of 56 years, Jeanne, died in 2001.

Among other books, Dr. Shneidman was the author of “Deaths of Man” (1973) “Voices of Death” (1980) “Definition of Suicide” (1985), which was considered a major theoretical treatment “Suicide as Psychache” (1993) and “The Suicidal Mind” (1996). His most recent book was “A Commonsense Book of Death: Reflections at Ninety of a Lifelong Thanatologist” (2008).

“Dying is the one thing — perhaps the only thing — in life that you don’t have to do,” he once wrote. “Stick around long enough and it will be done for you.”


7 million people have committed suicide due to mental illnesses such as depression. Most importantly, 90% of people with depression are unaware that they have it. This is a serious condition but fortunately, it can be treated as well. But for that, you need to be aware of the symptoms of depression

Suicide
Suicide is a problem that is near and dear to some of us and it can be a very troubling issue. If you are having thoughts of suicide, self-harm, or painful emotions that can result in damaging outbursts, please consult the hotline posted in the OP or dial one of these numberbelow for help! Remember, no medical advice is allowed in our posts and that includes psychiatric advice (asking for medical treatments of psychological diseases).

Worldwide suicide hotlines
United States

1-800-784-2433 (1-800-SUICIDE)
National Suicide Prevention Lifeline: 1-800-273-TALK (8255)
Texting: Text ANSWER to 839863
Spanish: 1-800-SUICIDA
1-800-273-8255
www.suicide.org/suicide-hotlines.html
www.crisiscallcenter.org/crisisservices.html

Trans Lifeline US: (877) 565-8860
CAN: (877) 330-6366 http://www.translifeline.org/

Kids Help Line (Under 18): 1-800-668-6868
Alberta: 1-866-594-0533
British Columbia: 1-888-353-2273
Manitoba: 1-888-322-3019
New Brunswick: 1-800-667-5005
Newfoundland & Labrador: 1-888-737-4668
Northwest Territories: 1-800-661-0844 7pm-11pm everyday
Nova Scotia: 1-888-429-8167
Nunavut: (867) 982-0123
Ontario: 1 800 452 0688
Prince Edward Island: 1-800-218-2885 (Bilingual)
Quebec: 1-866-277-3553 or 418-683-4588
Saskatchewan: (306) 933-6200
For more numbers in all areas please see: http://suicideprevention.ca/thinking-about-suicide/find-a-crisis-centre/

Trans Lifeline

United Kingom 08457 90 90 90 (24hrs)
0800 58 58 58 (open 5pm to midnight nationwide)
0808 802 58 58 (Open 5pm to midnight London)

Text 07725909090 (24hs)
07537 404717 (5pm to midnight)
[email protected]
www.samaritans.org
http://www.supportline.org.uk/problems/suicide.php
CALM - online chatting for those in the UK.
ChildLine (Free for any #, does not show up on billing) 0800-11-11
childline.org.uk

Suicide Call Back Service: 1300 659 467
Community Action for the Prevention of Suicide (CAPS): 1800 008 255
http://www.beyondblue.org.au/get-support/national-help-lines-and-websites
Lifeline: 13 11 14
Kids Help Line (ages 15-25): 1800 55 1800

EU Standard Emotional Support Number 116 123 - Free and available in much of Europe, http://ec.europa.eu/digital-agenda/en/about-116-helplines
Belgium 02 649 95 55

Brazil
Crisis Line - Phone Number: 188

Croatia (+385) 1 3793 000

Czech Republic 116 111 (Linka Bezpečí, for children and youth), 116 123 (Linka první psychické pomoci, for general adult population)

Deutschland 0800 1110 111

France 01 40 09 15 22

Greece 1018 or 801 801 99 99

Iceland 1717

India 91-44-2464005 0
022-27546669

Iran 1480 (6am to 9pm everyday)

Ireland ROI - local rate: 1850 60 90 90
ROI - minicom: 1850 60 90 91

Israel 1201

Italia 800 86 00 22

Japan 03-3264-4343
3 5286 9090

Korea LifeLine 1588-9191
Suicide Prevention Hotline 1577-0199
http://www.lifeline.or.kr/

Mexico Saptel 01-800-472-7835

Netherlands https://www.113.nl/ 0900-0113 zelfmoord preventie, suicide prevention. https://www.omgaanmetdepressie.nl/hulpinstanties overview website of services, including 113.

New Zealand 0800 543 354 Outside Auckland
09 5222 999 Inside Auckland

Norway 815 33 300

Serbia 011 7777 000 0800 300 303

South Africa LifeLine 0861 322 322
Suicide Crisis Line 0800 567 567

Suomi/Finland 010 195 202 available 9am-7am weekdays and 3pm-7am weekends
112, the regular emergency line, may be used at other times

Sverige/Sweden 0771 22 00 60

Switzerland 143

Turkey 182

Lithuania 8 800 28888

Uruguay Landlines 0800 84 83 (7pm to 11 pm)
(FREE) 2400 84 83 (24/7)
Cell phone lines 095 738 483 *8483

If there are other hotlines people wish to add, please include them on this post. Additionally, we would like to add a reminder that we do not allow personal anecdotes in r/psychology. Please keep the discussion on the topic of the study. Thank you!

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5 Common Myths About Suicide Debunked

Suicide affects all people. Within the past year, about 41,000 individuals died by suicide, 1.3 million adults have attempted suicide, 2.7 million adults have had a plan to attempt suicide and 9.3 million adults have had suicidal thoughts.

Unfortunately, our society often paints suicide the way they would a prison sentence&mdasha permanent situation that brands an individual. However, suicidal ideation is not a brand or a label, it is a sign that an individual is suffering deeply and must seek treatment. And it is falsehoods like these that can prevent people from getting the help they need to get better.

Debunking the common myths associated with suicide can help society realize the importance of helping others seek treatment and show individuals the importance of addressing their mental health challenges.

Here are some of the most common myths and facts about suicide.

Fact: Many individuals with mental illness are not affected by suicidal thoughts and not all people who attempt or die by suicide have mental illness. Relationship problems and other life stressors such as criminal/legal matters, persecution, eviction/loss of home, death of a loved one, a devastating or debilitating illness, trauma, sexual abuse, rejection, and recent or impending crises are also associated with suicidal thoughts and attempts.

Fact: Active suicidal ideation is often short-term and situation-specific. Studies have shown that approximately 54% of individuals who have died by suicide did not have a diagnosable mental health disorder. And for those with mental illness, the proper treatment can help to reduce symptoms.

The act of suicide is often an attempt to control deep, painful emotions and thoughts an individual is experiencing. Once these thoughts dissipate, so will the suicidal ideation. While suicidal thoughts can return, they are not permanent. An individual with suicidal thoughts and attempts can live a long, successful life.

Fact: Warning signs&mdashverbally or behaviorally&mdashprecede most suicides. Therefore, it&rsquos important to learn and understand the warnings signs associated with suicide. Many individuals who are suicidal may only show warning signs to those closest to them. These loved ones may not recognize what&rsquos going on, which is how it may seem like the suicide was sudden or without warning.

Fact: Typically, people do not die by suicide because they do not want to live&mdashpeople die by suicide because they want to end their suffering. These individuals are suffering so deeply that they feel helpless and hopeless. Individuals who experience suicidal ideations do not do so by choice. They are not simply, &ldquothinking of themselves,&rdquo but rather they are going through a very serious mental health symptom due to either mental illness or a difficult life situation.

Fact: There is a widespread stigma associated with suicide and as a result, many people are afraid to speak about it. Talking about suicide not only reduces the stigma, but also allows individuals to seek help, rethink their opinions and share their story with others. We all need to talk more about suicide.

Debunking these common myths about suicide can hopefully allow individuals to look at suicide from a different angle&mdashone of understanding and compassion for an individual who is internally struggling. Maybe they are struggling with a mental illness or maybe they are under extreme pressure and do not have healthy coping skills or a strong support system.

As a society, we should not be afraid to speak up about suicide, to speak up about mental illness or to seek out treatment for an individual who is in need. Eliminating the stigma starts by understanding why suicide occurs and advocating for mental health awareness within our communities. There are suicide hotlines, mental health support groups, online community resources and many mental health professionals who can help any individual who is struggling with unhealthy thoughts and emotions.

Kristen Fuller M.D. is a family medicine physician with a passion for mental health. She spends her days writing content for a well-known mental health and eating disorder treatment facility, treating patients in the Emergency Room and managing an outdoor women's blog. To read more of Dr. Fuller's work visit her Psychology Today blog and her outdoor blog, GoldenStateofMinds.


We&rsquore always accepting submissions to the NAMI Blog! We feature the latest research, stories of recovery, ways to end stigma and strategies for living well with mental illness. Most importantly: We feature your voices.


Moral philosophy and suicide

There are two main moral issues regarding suicide: first, whether suicide is morally permissible, and if so, in what circumstances and second, whether a person who knows that someone is contemplating or attempting suicide has an obligation to intervene and if so, how strong that obligation is. With respect to the first issue, it is difficult to resist the conclusion that suicide is not wrong in itself. To characterize suicide as murder of one's self is incorrect. Even if people who commit suicide deprive the community of some good, there is no general duty to provide good services to others. Theological objections to suicide are not persuasive. And suicide could be rational. For example, if one's scheme of values is to maximize the overall value of experience, and if at some point in the future negative value outweighs positive value, suicide would be rationally indicated. With respect to intervention, different considerations apply to persons involved with someone contemplating or attempting suicide, professionals, and the general public. Those who are involved have their own lives to live and need not alter them even when another person's life is at stake. Professionals should not become paternalistic authorities who keep subjects alive against their will and miserable for indefinite periods. The general public has only a weak duty to save strangers from suicide.


Contents

Medical professionals advise that people who have expressed plans to kill themselves be encouraged to seek medical attention immediately. This is especially relevant if the means (weapons, drugs, or other methods) are available, or if the patient has crafted a detailed plan for executing the suicide. Mental health professionals suggest that people who know a person whom they suspect to be suicidal can assist him or her by asking directly if the person has contemplated committing suicide and made specific arrangements, has set a date, etc. Posing such a question does not render a previously non-suicidal person suicidal [How to reference and link to summary or text] . According to this advice, the person questioning should seek to be understanding and sympathetic above all else since a suicidal person will often already feel ashamed or guilty about contemplating suicide so care should be taken not to exacerbate that guilt.

Mental health professionals suggest that an affirmative response to these questions should motivate the immediate seeking of medical attention, either from that person's doctor, or, if unavailable, the emergency room of the nearest hospital.

If the prior interventions fail, mental health professionals suggest involving law enforcement officers. While the police do not always have the authority to stop the suicide attempt itself, in some countries including some jurisdictions in the US, killing oneself is illegal.

In most cases law enforcement does have the authority to have people involuntarily committed to mental health wards. Usually a court order is required, but if an officer feels the person is in immediate danger he/she can order an involuntary commitment without waiting for a court order. Such commitments are for a limited period, such as 72 hours – which is intended to be enough time for a doctor to see the person and make an evaluation. After this initial period, a hearing is held in which a judge can decide to order the person released or can extend the treatment time. Afterwards, the court is kept informed of the person's condition and can release the person when they feel the time is right to do so. Legal punishment for suicide attempts is extremely rare [How to reference and link to summary or text] .


5 Common Myths About Suicide Debunked

Suicide affects all people. Within the past year, about 41,000 individuals died by suicide, 1.3 million adults have attempted suicide, 2.7 million adults have had a plan to attempt suicide and 9.3 million adults have had suicidal thoughts.

Unfortunately, our society often paints suicide the way they would a prison sentence&mdasha permanent situation that brands an individual. However, suicidal ideation is not a brand or a label, it is a sign that an individual is suffering deeply and must seek treatment. And it is falsehoods like these that can prevent people from getting the help they need to get better.

Debunking the common myths associated with suicide can help society realize the importance of helping others seek treatment and show individuals the importance of addressing their mental health challenges.

Here are some of the most common myths and facts about suicide.

Fact: Many individuals with mental illness are not affected by suicidal thoughts and not all people who attempt or die by suicide have mental illness. Relationship problems and other life stressors such as criminal/legal matters, persecution, eviction/loss of home, death of a loved one, a devastating or debilitating illness, trauma, sexual abuse, rejection, and recent or impending crises are also associated with suicidal thoughts and attempts.

Fact: Active suicidal ideation is often short-term and situation-specific. Studies have shown that approximately 54% of individuals who have died by suicide did not have a diagnosable mental health disorder. And for those with mental illness, the proper treatment can help to reduce symptoms.

The act of suicide is often an attempt to control deep, painful emotions and thoughts an individual is experiencing. Once these thoughts dissipate, so will the suicidal ideation. While suicidal thoughts can return, they are not permanent. An individual with suicidal thoughts and attempts can live a long, successful life.

Fact: Warning signs&mdashverbally or behaviorally&mdashprecede most suicides. Therefore, it&rsquos important to learn and understand the warnings signs associated with suicide. Many individuals who are suicidal may only show warning signs to those closest to them. These loved ones may not recognize what&rsquos going on, which is how it may seem like the suicide was sudden or without warning.

Fact: Typically, people do not die by suicide because they do not want to live&mdashpeople die by suicide because they want to end their suffering. These individuals are suffering so deeply that they feel helpless and hopeless. Individuals who experience suicidal ideations do not do so by choice. They are not simply, &ldquothinking of themselves,&rdquo but rather they are going through a very serious mental health symptom due to either mental illness or a difficult life situation.

Fact: There is a widespread stigma associated with suicide and as a result, many people are afraid to speak about it. Talking about suicide not only reduces the stigma, but also allows individuals to seek help, rethink their opinions and share their story with others. We all need to talk more about suicide.

Debunking these common myths about suicide can hopefully allow individuals to look at suicide from a different angle&mdashone of understanding and compassion for an individual who is internally struggling. Maybe they are struggling with a mental illness or maybe they are under extreme pressure and do not have healthy coping skills or a strong support system.

As a society, we should not be afraid to speak up about suicide, to speak up about mental illness or to seek out treatment for an individual who is in need. Eliminating the stigma starts by understanding why suicide occurs and advocating for mental health awareness within our communities. There are suicide hotlines, mental health support groups, online community resources and many mental health professionals who can help any individual who is struggling with unhealthy thoughts and emotions.

Kristen Fuller M.D. is a family medicine physician with a passion for mental health. She spends her days writing content for a well-known mental health and eating disorder treatment facility, treating patients in the Emergency Room and managing an outdoor women's blog. To read more of Dr. Fuller's work visit her Psychology Today blog and her outdoor blog, GoldenStateofMinds.


We&rsquore always accepting submissions to the NAMI Blog! We feature the latest research, stories of recovery, ways to end stigma and strategies for living well with mental illness. Most importantly: We feature your voices.


7 million people have committed suicide due to mental illnesses such as depression. Most importantly, 90% of people with depression are unaware that they have it. This is a serious condition but fortunately, it can be treated as well. But for that, you need to be aware of the symptoms of depression

Suicide
Suicide is a problem that is near and dear to some of us and it can be a very troubling issue. If you are having thoughts of suicide, self-harm, or painful emotions that can result in damaging outbursts, please consult the hotline posted in the OP or dial one of these numberbelow for help! Remember, no medical advice is allowed in our posts and that includes psychiatric advice (asking for medical treatments of psychological diseases).

Worldwide suicide hotlines
United States

1-800-784-2433 (1-800-SUICIDE)
National Suicide Prevention Lifeline: 1-800-273-TALK (8255)
Texting: Text ANSWER to 839863
Spanish: 1-800-SUICIDA
1-800-273-8255
www.suicide.org/suicide-hotlines.html
www.crisiscallcenter.org/crisisservices.html

Trans Lifeline US: (877) 565-8860
CAN: (877) 330-6366 http://www.translifeline.org/

Kids Help Line (Under 18): 1-800-668-6868
Alberta: 1-866-594-0533
British Columbia: 1-888-353-2273
Manitoba: 1-888-322-3019
New Brunswick: 1-800-667-5005
Newfoundland & Labrador: 1-888-737-4668
Northwest Territories: 1-800-661-0844 7pm-11pm everyday
Nova Scotia: 1-888-429-8167
Nunavut: (867) 982-0123
Ontario: 1 800 452 0688
Prince Edward Island: 1-800-218-2885 (Bilingual)
Quebec: 1-866-277-3553 or 418-683-4588
Saskatchewan: (306) 933-6200
For more numbers in all areas please see: http://suicideprevention.ca/thinking-about-suicide/find-a-crisis-centre/

Trans Lifeline

United Kingom 08457 90 90 90 (24hrs)
0800 58 58 58 (open 5pm to midnight nationwide)
0808 802 58 58 (Open 5pm to midnight London)

Text 07725909090 (24hs)
07537 404717 (5pm to midnight)
[email protected]
www.samaritans.org
http://www.supportline.org.uk/problems/suicide.php
CALM - online chatting for those in the UK.
ChildLine (Free for any #, does not show up on billing) 0800-11-11
childline.org.uk

Suicide Call Back Service: 1300 659 467
Community Action for the Prevention of Suicide (CAPS): 1800 008 255
http://www.beyondblue.org.au/get-support/national-help-lines-and-websites
Lifeline: 13 11 14
Kids Help Line (ages 15-25): 1800 55 1800

EU Standard Emotional Support Number 116 123 - Free and available in much of Europe, http://ec.europa.eu/digital-agenda/en/about-116-helplines
Belgium 02 649 95 55

Brazil
Crisis Line - Phone Number: 188

Croatia (+385) 1 3793 000

Czech Republic 116 111 (Linka Bezpečí, for children and youth), 116 123 (Linka první psychické pomoci, for general adult population)

Deutschland 0800 1110 111

France 01 40 09 15 22

Greece 1018 or 801 801 99 99

Iceland 1717

India 91-44-2464005 0
022-27546669

Iran 1480 (6am to 9pm everyday)

Ireland ROI - local rate: 1850 60 90 90
ROI - minicom: 1850 60 90 91

Israel 1201

Italia 800 86 00 22

Japan 03-3264-4343
3 5286 9090

Korea LifeLine 1588-9191
Suicide Prevention Hotline 1577-0199
http://www.lifeline.or.kr/

Mexico Saptel 01-800-472-7835

Netherlands https://www.113.nl/ 0900-0113 zelfmoord preventie, suicide prevention. https://www.omgaanmetdepressie.nl/hulpinstanties overview website of services, including 113.

New Zealand 0800 543 354 Outside Auckland
09 5222 999 Inside Auckland

Norway 815 33 300

Serbia 011 7777 000 0800 300 303

South Africa LifeLine 0861 322 322
Suicide Crisis Line 0800 567 567

Suomi/Finland 010 195 202 available 9am-7am weekdays and 3pm-7am weekends
112, the regular emergency line, may be used at other times

Sverige/Sweden 0771 22 00 60

Switzerland 143

Turkey 182

Lithuania 8 800 28888

Uruguay Landlines 0800 84 83 (7pm to 11 pm)
(FREE) 2400 84 83 (24/7)
Cell phone lines 095 738 483 *8483

If there are other hotlines people wish to add, please include them on this post. Additionally, we would like to add a reminder that we do not allow personal anecdotes in r/psychology. Please keep the discussion on the topic of the study. Thank you!

I am a bot, and this action was performed automatically. Please contact the moderators of this subreddit if you have any questions or concerns.


Contents

There are risks and disadvantages to both over-estimation and under-estimation of suicide risk. Over-sensitivity to risk can have undesirable consequences, including inappropriate deprivation of patients' rights and squandering of scarce clinical resources. On the other hand, underestimating suicidality as a result of a dismissive attitude or lack of clinical skill jeopardizes patient safety and risks clinician liability. [10] Some people may worry that asking about suicidal intentions will make suicide more likely. In reality, regarding that the enquiries are made sympathetically, it does not. [11] [12] Key areas to be assessed include the person's predisposition to suicidal behavior identifiable precipitant or stressors such as job loss, recent death of a loved one and change of residence [13] [ full citation needed ] the patient's symptomatic presentation presence of hopelessness nature of suicidal thinking previous suicidal behavior impulsivity and self-control and protective factors.

Suicide risk assessment should distinguish between acute and chronic risk. Acute risk might be raised because of recent changes in the person's circumstances or mental state, while chronic risk is determined by a diagnosis of a mental illness, and social and demographic factors. Bryan and Rudd (2006) suggest a model in which risk is categorized into one of four categories: Baseline, Acute, Chronic high risk, and Chronic high risk with acute exacerbation. [10] Risk level can be described semantically (in words) e.g. as Nonexistent, Mild, Moderate, Severe, or Extreme, and the clinical response can be determined accordingly. Others urge use of numbers to describe level of relative or (preferably) absolute risk of completed suicide. [6]

SSI/MSSI Edit

The Scale for Suicide Ideation (SSI) was developed in 1979 by Aaron T. Beck, Maria Kovacs, and Arlene Weissman to quantify intensity in suicide ideators. It was developed for use by clinicians during semi-structured interviews. The scale contained 19 items rated on a scale from 0 to 2, allowing scores between 0 and 38. The items could be grouped into three categories: "Active Suicidal Desire, Preparation, and Passive Suicidal Desire." Initial findings showed promising reliability and validity. [14]

The Modified Scale for Suicide Ideation (MSSI) was developed by Miller et al., using 13 items from the SSI and 5 new items. The modifications increased both reliability and validity. The scale was also changed to range from 0 to 3, yielding a total score ranging from 0 to 54. Joiner found two factors, Suicidal Desire and Ideation, and Resolved Plans and Preparation. The MSSI was also shown to have higher discrimination between groups of suicide ideators and attempters than the BDI, BHS, PSI, and SPS. [15]

SIS Edit

The Suicide Intent Scale (SIS) was developed in order to assess the severity of suicide attempts. The scale consists of 15 questions which are scaled from 0-2, which take into account both the logistics of the suicide attempt as well as the intent. The scale has high reliability and validity. Completed suicides ranked higher in the severity of the logistics than attempted suicides (it was impossible to measure intent for the completed suicides), and those with multiple attempts had higher scores than those who only attempted suicide once. [16]

SABCS Edit

The Suicidal Affect Behavior Cognition Scale (SABCS) is a six-item self-report measure based on both suicide and psychological theory, developed to assess current suicidality for clinical, screening, and research purposes. Substantial empirical evidence was found, from four independent studies, confirming the importance of assessing suicidal affect, behaviors, and cognition as a single suicidal construct. The SABCS was the first suicide risk measure to be developed through both classical test theory (CTT) and item response theory (IRT) psychometric approaches and to show significant improvements over a highly endorsed comparison measure. The SABCS was shown to have higher internal reliability, and to be a better predictor of both future suicidal behaviors and total suicidality over an existing standard. [17] [18]

Suicide Behaviors Questionnaire Edit

The Suicide Behaviors Questionnaire (SBQ) is a self-report measure developed by Linehan in 1981. In 1988 it was transformed from a long questionnaire to a short four questions that can be completed in about 5 minutes. Answers are on a Likert scale that ranges in size for each question, based on data from the original questionnaire. It is designed for adults and results tend to correlate with other measures, such as the SSI. It is popular because it is easy to use as a screening tool, but at only four questions, fails to provide detailed information. [19]

Life Orientation Inventory Edit

The Life Orientation Inventory (LOI) is a self-report measure that comes in both a 30 question and 110 question form. Both forms use a 4-point Likert scale to answer items, which are divided into six sub-scales on the longer form: self-esteem vulnerability, over-investment, overdetermined misery, affective domination, alienation, and suicide tenability. This scale has strong reliability and validity, and has been shown to be able to differentiate between control, depressed, possibly suicidal, and highly suicidal individuals. It also contains 3 validity indices, similar to the MMPI. However, while useful, this inventory is now out of print. [19]

Reasons For Living Inventory Edit

The Reasons For Living Inventory (RFL) is theoretically based, and measures the probability of suicide based on the theory that some factors may mitigate suicidal thoughts. It was developed in 1983 by Linehan et al. and contains 48 items answered on a Likert scale from 1 to 6. The measure is divided into six subscales: survival and coping beliefs, responsibility to family, child concerns, fear of suicide, fear of social disproval, and moral objections. Scores are reported as an average for the total and each sub-scale. The scale is shown to be fairly reliable and valid, but is still mostly seen in research as compared to clinical use. Other variations of the scale include the College Students Reasons for Living Inventory, and the Brief Reasons for Living Inventory. The college students reasons for living inventory replaced the responsibility to family sub-scale with a responsibility to family and friends sub-scale and that replaced the child concerns sub-scale with a college/future concerns sub-scale. The Brief Reasons for Living Inventory uses only 12 of the items from the RFL. [19] [20] Prolonged stress releases hormones that damage over time the hippocampus. The hippocampus is responsible for storing memories according to context (spatial, emotional and social) as well as activating memories according to context. When the hippocampus is damaged, events will be perceived in the wrong context, or memories with the wrong context might be activated.

Nurses Global Assessment of Suicide Risk Edit

The Nurses Global Assessment of Suicide Risk (NGASR) was developed by Cutcliffe and Barker in 2004 to help novice practitioners with assessment of suicide risk, beyond the option of the current lengthy checklists currently available. It is based on 15 items, with some such as "Evidence of a plan to commit suicide" given a weighting of 3, while others, such as "History of psychosis" are weighted with a 1, giving a maximum total score of 25. Scores of 5 or less are considered low level of risk, 6-8 are intermediate level of risk, 9-11 are high level of risk, and 12 or more are very high level of risk. Each item is supported theoretically by studies that have shown a connection between the item and suicide. However, the validity and reliability of the test as a whole have not yet been empirically tested. [21]

Within the United States, the suicide rate is 11.3 suicides per 100,000 people within the general population. [22]

Age Edit

In the United States, the peak age for suicide is early adulthood, with a smaller peak of incidence in the elderly. [23] On the other hand, there is no second peak in suicide in black men or women, and a much more muted and earlier-peaking rise in suicide amongst non-Hispanic women than their male counterparts. [23] Older white males are the leading demographic group for suicide within the United States, at 47 deaths per 100,000 individuals for non-Hispanic white men over age 85. For Americans aged 65 and older, the rate is 14.3 per 100,000. Suicide rates are also elevated among teens. For every 100,000 individuals within an age group there are 0.9 suicides in ages 10–14, 6.9 among ages 15–19, and 12.7 among ages 20–24. [22]

Sex Edit

China and São Tomé and Príncipe are the only countries in the world where suicide is more common among women than among men. [24] [ full citation needed ]

In the United States, suicide is around 4.5 times more common in men than in women. [25] U.S. men are 5 times as likely to commit suicide within the 15- to 19-year-old demographic, and 6 times as likely as women to commit suicide within the 20- to 24-year-old demographic. [22] Gelder, Mayou and Geddes reported that women are more likely to commit suicide by taking overdose of drugs than men. [11] Transgender individuals are at particularly high risk. [10] Prolonged stress lasting 3 to 5 years, such clinical depression co-morbid with other conditions, can be a major factor in these cases. [ citation needed ]

Ethnicity and culture Edit

In the United States white persons and Native Americans have the highest suicide rates, Black persons have intermediate rates, and Hispanic persons have the lowest rates of suicide. However, Native American males in the 15-24 age group have a dramatically higher suicide rate than any other group. [25] A similar pattern is seen in Australia, where Aboriginal people, especially young Aboriginal men, have a much higher rate of suicide than white Australians, a difference which is attributed to social marginalization, trans-generational trauma, and high rates of alcoholism. [26] A link may be identified between depression and stress, and suicide.

Sexual orientation Edit

There is evidence of elevated suicide risk among gay and lesbian people. Lesbians are more likely to attempt suicide than gay men and heterosexual men and women however, gay men are more likely to succeed. [10]

The literature on this subject consistently shows that a family history of committed suicide in first-degree relatives, adverse childhood experiences (parental loss and emotional, physical and sexual abuse), and adverse life situations (unemployment, isolation and acute psychosocial stressors) are associated with suicide risk. [27]

Recent life events can act as precipitants. Significant interpersonal loss and family instability, such as bereavement, poor relationship with family, domestic partner violence, separation, and divorce have all been identified as risk factors. Financial stress, unemployment, and a drop in socioeconomic status can also be triggers for a suicidal crisis. This is also the case for a range of acute and chronic health problems, such as pain syndromes, or diagnoses of conditions like HIV or cancer. [10] [23] : 18,25,41–42

Certain clinical mental state features are predictive of suicide. An affective state of hopelessness, in other words a sense that nothing will ever get better, is a powerful predictive feature. [10] High risk is also associated with a state of severe anger and hostility, or with agitation, anxiety, fearfulness, or apprehension. [23] : 17,38 [28] Research domain criteria symptom burdens, particularly the positive and negative valence domains, are associated with time varying risk of suicide. [29] Specific psychotic symptoms, such as grandiose delusions, delusions of thought insertion and mind reading are thought to indicate a higher likelihood of suicidal behavior. [3] Command hallucinations are often considered indicative of suicide risk, but the empirical evidence for this is equivocal. [28] [30] Another psychiatric illness that is a high risk of suicide is schizophrenia. The risk is particularly higher in younger patients who have insight into the serious effect the illness is likely to have on their lives. [11]

The primary and necessary mental state Federico Sanchez called idiozimia (from idios "self" and zimia "loss"), followed by suicidal thoughts, hopelessness, loss of will power, hippocampal damage due to stress hormones, and finally either the activation of a suicidal belief system, or in the case of panic or anxiety attacks the switching over to an anger attack, are the converging reasons for a suicide to occur. [31]

Suicidal ideation refers to the thoughts that a person has about suicide. Assessment of suicidal ideation includes assessment of the extent of preoccupation with thoughts of suicide (for example continuous or specific thoughts), specific plans, and the person's reasons and motivation to attempt suicide. [28]

Planning Edit

Assessment of suicide risk includes an assessment of the degree of planning, the potential or perceived lethality of the suicide method that the person is considering, and whether the person has access to the means to carry out these plans (such as access to a firearm). A suicide plan may include the following elements: timing, availability of method, setting, and actions made towards carrying out the plan (such as obtaining medicines, poisons, rope or a weapon), choosing and inspecting a setting, and rehearsing the plan. The more detailed and specific the suicide plan, the greater the level of risk. The presence of a suicide note generally suggests more premeditation and greater suicidal intent. The assessment would always include an exploration of the timing and content of any suicide note and a discussion of its meaning with the person who wrote it. [23] : 46 [28]

Motivation to die Edit

Suicide risk assessment includes an assessment of the person's reasons for wanting to commit suicide. Some are due to overwhelming emotions or others can have a deep philosophical belief. The causes are highly varied.

Other motivations for suicide Edit

Suicide is not motivated only by a wish to die. Other motivations for suicide include being motivated to end the suffering psychologically and a person suffering from a terminal illness may intend to commit suicide as a means of managing physical pain and/or their way of dealing with possible future atrophy or death. [32]

Reasons to live Edit

Balanced against reasons to die are the suicidal person's reasons to live, and an assessment would include an enquiry into the person's reasons for living and plans for the future. [23] : 44

There are people who commit suicide the first time they have suicidal thoughts and there are many who have suicidal thoughts and never commit suicide. [31]

All major mental disorders carry an increased risk of suicide. [33] However, 90% of suicides can be traced to depression, linked either to manic-depression (bipolar), major depression (unipolar), schizophrenia or personality disorders, particularly borderline personality disorder. Comorbity of mental disorders increases suicide risk, especially anxiety or panic attacks. [31]

Anorexia nervosa has a particularly strong association with suicide: the rate of suicide is forty times greater than the general population. [33] The lifetime risk of suicide was 18% in one study, and in another study 27% of all deaths related to anorexia nervosa were due to suicide. [34]

The long-term suicide rate for people with schizophrenia was estimated to be between 10 and 22% based upon longitudinal studies that extrapolated 10 years of illness for lifetime, but a more recent meta-analysis has estimated that 4.9% of schizophrenics will commit suicide during their lifetimes, usually near the illness onset. [35] [36] Risk factors for suicide among people with schizophrenia include a history of previous suicide attempts, the degree of illness severity, comorbid depression or post-psychotic depression, social isolation, and male gender. The risk is higher for the paranoid subtype of schizophrenia, and is highest in the time immediately after discharge from hospital. [30]

While the lifetime suicide risk for mood disorders in general is around 1%, long-term follow-up studies of people who have been hospitalized for severe depression show a suicide risk of up to 13%. [10] People with severe depression are 20 times more likely and people with bipolar disorder are 15 times more likely to die from suicide than members of the general population. [37] Depressed people with agitation, severe insomnia, anxiety symptoms, and co-morbid anxiety disorders are particularly at-risk. [38] Antidepressants have been linked with suicide as Healy (2009) stated that people on antidepressant have the tendency to commit suicide after 10–14 days of commencement of antidepressant.

People with a diagnosis of a personality disorder, particularly borderline, antisocial or narcissistic personality disorders, are at a high risk of suicide. In this group, elevated suicide risk is associated with younger age, comorbid drug addiction and major mood disorders, a history of childhood sexual abuse, impulsive and antisocial personality traits, and recent reduction of psychiatric care, such as recent discharge from hospital. While some people with personality disorders may make manipulative or contingent suicide threats, the threat is likely to be non-contingent when the person is silent, passive, withdrawn, hopeless, and making few demands. [39]

A history of excessive alcohol use is common among people who commit suicide, and alcohol intoxication at the time of the suicide attempt is a common pattern. [23] : 48 Meta analytic research conducted in 2015 indicates that a person with co-occurring alcohol use disorder and major depression is more likely to ideate, attempt, and complete suicide than those with individual disorders. [40]


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Edwin Shneidman, Authority on Suicide, Dies at 91

Edwin S. Shneidman, a psychologist who gave new direction to the study of suicide and was a founder of the nation’s first comprehensive suicide prevention center, died Friday at his home in Los Angeles. He was 91.

His death was confirmed by his son David.

Until Dr. Shneidman took up the study of suicide shortly after World War II, the subject had received little sustained attention from researchers or clinicians. But as a researcher, theoretician, lecturer and author, he helped establish the study of suicide as an interdisciplinary field and devised many concepts now widely accepted.

With Norman L. Farberow, Dr. Shneidman founded the Los Angeles Suicide Prevention Center in the 1950s. The center, where he was co-director, offered research, training and suicide prevention services and became the prototype for such centers in the United States and abroad.

In a career that spanned more than four decades, Dr. Shneidman was also the chief of the first national suicide prevention program, at the National Institute of Mental Health founded the American Association of Suicidology and was the first professor of thanatology (the study of death) at the University of California, Los Angeles.

In his early work, he and Dr. Farberow carried out a large suicide study that contradicted some widely held beliefs. For example, although it had long been thought that people had to be insane to take their own lives, they found that only 15 percent of suicides were psychotic.

They also developed the idea that most people who became acutely suicidal were in that state for a relatively brief period, and emphasized a need for active intervention.

They set up a telephone service to invite suicidal people to come in for an assessment and a referral for treatment. But, overwhelmed by the response, they had difficulty making referrals, and so they began offering treatment themselves.

Dr. Robert E. Litman, who was chief psychiatrist at the center, said Dr. Shneidman and Dr. Farberow had pioneered an approach in which trained nonprofessionals took calls from troubled people.

In an account in “The Enigma of Suicide,” by George Howe Colt, the author quotes Dr. Litman as recalling: “People were calling us and literally saying, ‘I’m just about to make a suicide attempt. Do I have to take these pills or jump off a building before I can talk to you? Or could I shortcut it and come in directly?’ ”

Staff members made house calls, escorted suicidal people to the hospital, tracked down estranged spouses and even traced telephone calls. One day, Mr. Colt wrote, a client ran out of the offices onto the roof, with staff members in hot pursuit they grabbed her before she could jump.

Three decades after the center was founded, the suicide rate in Los Angeles had been cut in half, Dr. Litman said in an interview.

Dr. Shneidman and his colleagues devised the “psychological autopsy,” a method used to help a coroner determine whether a death had been caused by suicide or accident when the circumstances were ambiguous. Staff members would interview friends and relatives of the deceased, study diaries and other documents, and try to reconstruct the person’s state of mind.

Their best-known case was that of Marilyn Monroe, who died of an overdose of barbiturates in 1962. After learning that she had twice previously tried to commit suicide and had been deeply depressed before she finally succeeded, they called the death a “probable suicide.” The coroner’s report agreed.

Dr. Shneidman left the Los Angeles center in 1966 to become the first chief of the Center for the Study of Suicide Prevention at the National Institute of Mental Health in Bethesda, Md., where he encouraged suicide prevention efforts in 40 states.

By March 1969, the number of suicide prevention centers in the United States had risen to 119 from 44 in July 1967, according to the American Association of Suicidology. There are now about 140 suicide prevention and crisis centers accredited by the association, and many more unaccredited ones.

Dr. Shneidman joined the U.C.L.A. faculty as professor of medical psychology in 1970 and became professor of thanatology in 1975. In addition to research and teaching, he counseled dying patients and their survivors. He retired in 1988 but continued to write and mentor researchers in his field.

Edwin Shneidman was born on May 13, 1918, in York, Pa. He received bachelor’s and master’s degrees at U.C.L.A. and earned a Ph.D. in psychology in 1948 at the University of Southern California.

In addition to his son David, of Seattle, he is survived by three other sons — Jon, of Fort Bragg, N.C. Paul, of Gibbsboro, N.J. and Robert, of Portland, Ore. — and six grandchildren. His wife of 56 years, Jeanne, died in 2001.

Among other books, Dr. Shneidman was the author of “Deaths of Man” (1973) “Voices of Death” (1980) “Definition of Suicide” (1985), which was considered a major theoretical treatment “Suicide as Psychache” (1993) and “The Suicidal Mind” (1996). His most recent book was “A Commonsense Book of Death: Reflections at Ninety of a Lifelong Thanatologist” (2008).

“Dying is the one thing — perhaps the only thing — in life that you don’t have to do,” he once wrote. “Stick around long enough and it will be done for you.”


Who Can Make the Request?

A short-term emergency detention, such as detention immediately following a suicide attempt, can generally be requested by anyone who has witnessed the situation that you are in, including friends, family, or the police. Even though almost anyone can initiate the process, most states do require either medical evaluation or court approval in order to ensure that you meet that particular state's criteria.  

The allowed duration of emergency detentions vary from state to state but are most often limited to 24–48 hours before a civil commitment proceeding must be initiated.  

Some states have longer detention periods that can range from four to 10 days.  


Overview of Durkheim's Text

The text of Suicide offered an examination of how suicide rates at the time differed across religions. Specifically, Durkheim analyzed differences between Protestants and Catholics. He found a lower rate of suicide among Catholics and theorized that this was due to stronger forms of social control and cohesion among them than among Protestants.

Demographics of Suicide: Study Findings

Additionally, Durkheim found that suicide was less common among women than men, more common among single people than among those who are romantically partnered, and less common among those who have children.

Further, he found that soldiers commit suicide more often than civilians and that curiously, rates of suicide are higher during peacetime than they are during wars.

Correlation Vs. Causation: Suicide's Driving Forces

Based on his gleanings from the data, Durkheim argued that suicide can be a result not only of psychological or emotional factors but of social factors as well. Durkheim reasoned that social integration, in particular, is a factor.

The more socially integrated a person is—that is, the more he or she is connected to society, possessing a feeling of general belonging and a sense that life makes sense within the social context—the less likely he or she is to commit suicide. As social integration decreases, people are more likely to commit suicide.

Durkheim's Typology of Suicide

Durkheim developed a theoretical typology of suicide to explain the differing effects of social factors and how they might lead to suicide:



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