For World Suicide Prevention Day and beyond, and as part of Springer Nature’s commitment to the Sustainable Development Goals (SDGs), we are endeavouring to help raise awareness of SDG 3.4.2 – reduce suicide mortality rate. To achieve this, it is important to understand factors contributing to why someone might wish to end their own life, as well as be able to identify those at risk of doing so.
Here Jonathan Singer, our third expert, provides insight into the research and wider dialogue around this important topic. Check out more content we've made available in support of World Suicide Prevention Day including David Gunnell's and Maurizio Pompili's responses to these questions.
Please note – Springer Nature is a publishing company and therefore does not provide direct medical advice. Whilst the research provided below is a useful resource, it should not replace direct consultation with a medical practitioner. Additional information and contact details can be found on the World Suicide Prevention Day homepages here.
What has research shown are the biggest risk factors for suicide, and what are the most effective prevention strategies?
There are risk factors at the individual, interpersonal, community and societal levels. Individual-level risk factors include hopelessness, loneliness, presence of a firearm in the home, and some of the psychopathologies like eating disorders. Interpersonal risk factors include feeling like you’re a burden to others, poor social skills, high conflict / low support relationships. Community-level risk includes poor access to health and mental health services, easy access to lethal means, and belief that suicide is an inevitable outcome. Societal-level risk factors include discrimination, economic downturn/unemployment, etc.
Effective prevention strategies at the individual level include increasing social connection, monitoring for youth, and psychotherapies like attachment-based family therapy, cognitive behavioral therapy for suicide prevention, and dialectical behavior therapy. Community level interventions include reducing access to lethal means and engaging in school-based screening for suicide risk. Societal level includes reducing homophobic, transphobic, xenophobic, racist and misogynistic remarks by elected officials, developing programs to reduce institutional support of the aforementioned biases and violence, and maintaining a strong economy.
Should the media’s reporting of suicides be self-regulated or monitored?
Both! The news media is responsible for telling the story that hasn’t been told, for holding people accountable, and for reporting on complex situations in a way that the general public can easily understand. It is unreasonable to expect journalists to be experts on everything, including preferred and problematic concepts, terms and ideas in suicide prevention. Therefore, it is up to suicidologists to monitor media, provide feedback when they are safe reporting and when they are not. Editors, journalists and educators have a responsibility to know the reporting recommendations and integrate them into their practice.
How can/should technology be used to prevent suicide?
So many ways. Technology is a tool. We should use all tools at our disposal to prevent suicide AND build lives worth living. One example of many - If social media companies can use our data to build algorithms that will predict what products we will buy and how we will vote in the next election, they should use those tools to identify and respond to suicide risk online.
Certain populations are at higher risk of contemplating, attempting, and dying by suicide. What factors contribute to this increased risk and what measures might be taken to reduce the incidence in these populations? (For example race/ethnicity, age, sex/gender, sexual orientation, geographic region, place of residence, etc.).
When we look at groups of youth with the highest risk for suicidal thoughts and behaviors, including American Indian/Alaska Native youth, elementary-aged African American males, Latina adolescents, LGBTQIA youth, we see youth who from communities that have experienced persistent and long-standing discrimination, marginalization and disenfranchisement, from dominant society. One of the things that we can do is to remember that America is strong because of difference and that no one is illegal. Affirming the fundamental value and worth of these marginalized groups and decreasing the amount of abuse and violence they experience as a result of their marginalized status will make significant strides towards reducing suicide risk in these groups. The other youth group with the highest suicide rates is white males. While it is true that white males enjoy privileges and support that are almost unheard of among these other groups, they are amongst the highest risk for death by suicide because they tend to attempt suicide with firearms. Reducing access to firearms, particularly for white males, will go a long way in reducing self- and other- inflicted violence in the USA.
Suicide and gun violence are closely related. Should addressing the latter be a key focus of suicide prevention?
Yes! David Brent found that youth are 32x more likely to die by suicide when there is a firearm in the home. Research by Michael Anestis and colleagues has found that states with laws restricting access to guns in the first place (e.g. waiting periods and background checks) have lower suicide rates than states with laws requiring storage and locks after ownership. Suicidology should address firearms and suicide risk because the issue is so complicated in the USA that only a thoughtful, multi-pronged approach will be able to address it.
How is suicide risk related to burnout? How can healthcare professionals and others who work with at-risk populations care for their own mental health?
Working with someone who is suicidal is among the most stressful of all professional activities. Professionals can and should provide informal support to each other. They should attend conferences and get continuing education on suicide prevention, assessment, intervention and postvention. Developing a selfcare plan is useful. After a suicide death, professionals should become involved in formal support groups for survivors of suicide loss.
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