Talk:Suicide awareness

Education in a non-threatening environment is critical to a growth in awareness among adolescents. Health education is closely related to health awareness.^[1] School can be the best place to implement a suicide education program because it is the pivotal location that brings the major influences in an adolescent's life together.^[2] Pilot programs for awareness, and coping and resiliency training should be put into place for all adolescent school-aged children to combat life stressors and to encourage healthy communication.^[3]

According to Dr. John Draper, psychologist and director of the National Suicide Prevention Lifeline, “The best way to effectively prevent suicide is to give voice to the suicidal,"^[4] meaning that their stories can inspire and teach others, and aid in reducing stigma. Dr. Christine Moutier, chief medical officer at the American Foundation for Suicide Prevention, agrees that it is imperative to encourage suicide attempt survivors to speak up, and is holding focus groups with those who tried to kill themselves. Her message is to treat suicide awareness the same as breast cancer awareness, which also had been stigmatized in the past, but has now been brought into the public eye through research, communication, marketing and survivors speaking out publicly.^[4]

Send Silence Packing is a suicide awareness program trademarked by Active Minds, Inc. to connect college students to mental health resources, raise awareness about the impact of suicide, and inspire action and dialogue regarding suicide.^[5] The program uses donated backpacks (from loved ones), each one representing a student lost to suicide, in an exhibition which travels around US college campuses. The backpacks are displayed in the college quads and emphasize the scope of suicide and the connection to real individuals. Since its initial exhibition in 2008 in Washington DC, Send Silence Packing has traveled to more than 140 cities around the United States. Surveys of students viewing the exhibit rated the experience as “powerful to very powerful” and 97% reported it was very educational. The program determined that each person who witnessed the exhibition told three friends, and that it encourages help-seeking for those viewing it and those they tell about it.^[5]

Another program promoting education is The Center for Suicide Awareness. This organization's mission is to reduce suicide by providing proactive education and support resources to suicide attempt survivors and survivors, in addition to providing student presentations and training for educators, healthcare professionals, youth, police and community leaders. Their environment is compassionate, barrier-free and stigma-free.^[6]

There are also organizations who deal with specifically vulnerable groups. The Trevor Project raises suicide awareness within the lesbian, gay, bisexual, transgender and questioning (LGBTQ) community, aged 13–24 years of age. Their mission to end suicide is fostered through four strategies: providing crisis counseling to LGBTQ youth considering suicide; offering a sense of non-judgmental community, supportive counseling and resources to reduce risk; educate youth and adults on LGBTQ-competent suicide risk detection and response; and advocacy for laws and policies to reduce suicide in the LGBTQ community.^[7]

With the lack of constructive dialogue and resistance to suicide reporting due to stigma, it is critical to continue to explore the medical science of suicide, using it in a delicate balance with emotional and social education. Researchers have recently looked at developing a measure for suicide stigma, both for suicide attempt survivors and suicide survivors. The Stigma of Suicide Attempt scale (STOSA) and the Stigma of Suicide and Suicide Survivor scale (STOSASS) were created to quantify stigma at the individual level and general population levels.^[1] Results underlined the importance of both groups coming forward and participating in a study of this nature. It also illustrated differences in stigma evaluation for suicide attempt survivors and survivors. However, the study was based on self-reporting which can be limited in capturing behavioral attitudes. Also, the scales developed did not distinguish whether suicide stigma is specific to suicide or to mental illness in general. Still, the researchers believe STOSA and STOSASS could be beneficial in predicting therapeutic intervention outcomes for suicide attempters and survivors. More in-depth research needs to be continued on this, as well as exploring internalized stigma, which has not been measured thus far.^[1]

Suicide does not have one single cause or factor. Suicide is considered to occur most often when stress and pressures exceed the coping abilities of a person suffering from mental health issues. Depressive disorders are considered to be the most frequently associated cause of suicide, but they are often undiagnosed or untreated,^[1] and are not always the singular factor.
Risk factors have been evaluated for suicide as characteristic markers or conditions that can increase the chance a person may try to take their life. Odds are significantly increased when several risk factors are present at the same time.^[2] The most frequently cited risk factors for suicide are:^[3][4]

• Depression
• Bipolar disorder
• Problems with alcohol or drugs
• Loss
  (relational, social, work, or financial)
• Social isolation
• Unusual thoughts and behavior, or confusion about reality
• Personality traits that create a pattern of intense and unstable relationships or troubles with the law
• Impulsivity and aggression, especially combined with a mental disorder risk factor
• Previous suicide attempt or family history of a suicide attempt or mental disorder risk factor
• Serious medical condition and pain
• Childhood trauma^[5]
• Heredity^[6]

Over 90% of suicides in the United States are a result of mental illness and/or alcohol and substance abuse, but 10% of those who die by suicide do not have any psychologically-known diagnosis.^[7]

Youth vulnerability to suicide is compounded by the increased levels of impulsivity, more than other age groups, as reported by the United States Institute of Medicine.^[8] This can be attributed to neurological and cognitive changes in adolescent brain function, stimulated by a rapid increase in dopamine during puberty.^[9] It is also suggested this impulsive, risk-taking behavior is often associated with the early use of alcohol and illegal substances.^[10][11] Abuse of illicit substances and alcohol can also be attributed to family dysfunction and genetic personality traits, and can be a predictor of hopelessness, especially among lonely and isolated youth.^[12] A comprehensive list of risk factors is outlined on Suicide Prevention Lifeline website.

Trend analysis shows there is an increase in suicide among the youth population.^[1] Between 1999-2006, according to the Center for Disease Control, suicide was the third leading cause of death in adolescents aged 15 to 19 years, and the fourth leading cause of death for children aged 10 to 14 years.^[1] As of 2011, suicide increased in this age group, becoming the second cause of death for youth between the ages of 15 and 24 years, below homicide statistics and above those of accidents.^[2] Within the general population, female teens attempt suicide more frequently than males;^[3] however, white males accounted for seven out of 10 suicide deaths in 2015.^[4]

Among college students, suicide has become the second leading cause of death.^[5] The National Mental Health Association has divided students at risk for suicide into two groups upon college entrance: those already diagnosed with mental health issues, and those who develop issues while in college.^[6] Research suggests poor sleep habits, substance and alcohol experimentation, in addition to academic and social stress, may trigger or worsen mental health issues and increase suicide risk.^[6]

Geographically within the United States, western states have statistically higher rates of suicide. Per 100,000 people, Montana is ranked first, Alaska ranked second, and Wyoming is third.^[7] There may be a link between these states and firearm regulations, which make access to guns easier, as statistics show firearm suicides in states with the highest rates of gun ownership are 3.7 times higher for men, and 7.9 times higher for women.^[8] These are often rural areas without heavily populated urban communities (which brings social pressure stressors), but may indicate a lack of accessibility to medical and psychological health assistance in these remote areas.^[9][10]

According to the World Health Organization, in wealthier countries, three times as many males die by suicide than females, while low and middle-income countries have a lower ratio at 1.5 men to each woman.^[11] Globally, suicide is the second leading cause of death in 15−29-year-olds.^[12]

Within the last 100 years, suicides have outnumbered homicides by 3 to 2.^[13] Statistics show that the number of youth who self-harm is increasing, but it is difficult to determine if suicide is the ultimate intention. In 2015, 494,169 people were treated at US hospitals for injuries as a result of self-harm. This suggests approximately 12 people harm themselves for every reported death by suicide.^[14] Recent surveys have tallied as many as one million people in the US engaging in intentional self-harm.^[14] Many suicides go unreported because of social stigma or are left untreated due to lack of education, which clouds the available statistics.