Suicide Awareness and Prevention
Information from the American Foundation for Suicide Prevention.
Physicians have higher rates of burnout, depressive symptoms, and suicide risk than the general population. Physicians and trainees can experience high degrees of mental health distress and are less likely than other members of the public to seek mental health treatment. Physicians report several barriers to seeking mental health care, including time constraints, hesitancy to draw attention to self-perceived weakness, and concerns about reputation and confidentiality. Other facts include:
- Suicide generally is caused by the convergence of multiple risk factors — the most common being untreated or inadequately managed mental health conditions.1, 2
- Physicians who took their lives were less likely to be receiving mental health treatment compared with nonphysicians who took their lives even though depression was found to be a significant risk factor at approximately the same rate in both groups.3
- The suicide rate among male physicians is 1.41 times higher than the general male population. And among female physicians, the relative risk is even more pronounced — 2.27 times greater than the general female population.4
- Suicide is the second-leading cause of death in the 24–34 age range (Accidents are the first).5
- Twenty-eight percent of residents experience a major depressive episode during training versus 7–8 percent of similarly aged individuals in the U.S. general population.6
- Among physicians, risk for suicide increases when mental health conditions go unaddressed, and
self-medication occurs as a way to address anxiety, insomnia or other distressing symptoms. Although
self-medicating, mainly with prescription medications, may reduce some symptoms, the underlying health problem is not effectively treated. This can lead to a tragic outcome.
- In one study, 23 percent of interns had suicidal thoughts. However, among those interns who completed four sessions of web-based cognitive behavior therapy, suicidal ideation decreased by nearly 50 percent.7
- Drivers of burnout include workload, work inefficiency, lack of autonomy and meaning in work, and work-home conflict.
- Unaddressed mental health conditions, in the long run, are more likely to have a negative impact on a physician’s professional reputation and practice than reaching out for help early.
Articles and Resources
- Confronting Depression and Suicide in Physicians - A Consensus Statement -- JAMA
- Addressing Burnout, Depression, and Suicidal Ideation in the Osteopathic Profession - An Approach That Spans the Physician Life Cycle
- After a Suicide: A Toolkit for Physician Residency/Fellowship Programs
- Virtual Hope Box: A mobile app for suicide prevention that helps users with coping, relaxation, distraction, and positive thinking. Click here for Apple details. Click here for Android details.
- Stay Alive: A suicide prevention app that provides customized safety plans, breathing and grounding exercise tutorials, and an online discussion forum. Click here for Apple details. Click here for Android details.
Facts About Suicide
From the Tennessee Suicide Prevention Network
In the United States alone, someone dies by suicide once every 12 minutes. Suicide is the second leading cause of death for youth between the ages of 10 and 24. But because suicide has been considered such a “taboo” subject to think or to talk about, there are a lot of misconceptions about which individuals may be at risk, about when, how and why people might consider killing themselves, and about how best to help yourself of someone else who’s contemplating suicide.
This misinformation – or the lack of information altogether – often means that desperate people can’t get the help they need in times of crisis. Being well-informed about depression and suicide can help you save your own life or the life of someone you know or love!
- Suicide is the tenth-leading cause of death (2016 data) in Tennessee, claiming over 1,000 lives per year. Roughly 100 of these are between the age of 10-24—suicide is the second-leading cause of death within this age group.
- Nationally, suicide rates among youth (ages 15-24) have increased more than 200% in the last fifty years.
- The suicide rate is higher for the elderly (ages 85+) than for any other age group.
- Suicide is preventable. Most suicidal people desperately want to live; they are just unable to see alternatives to their problems.
- Most suicidal people give definite warning signals of their suicidal intentions, but others are often unaware of the significance of these warnings or unsure what to do about them.
- Talking about suicide does not cause someone to become suicidal.
- Four times more men than women kill themselves, but three times more women than men attempt suicide.
- Firearms are the most common method of suicide regardless of sex and race.
- Suicide cuts across ethnic, economic, social and age boundaries.
- Surviving family members not only suffer the loss of a loved one to suicide, but are also themselves at higher risk of suicide and emotional problems.
THE LINKS BETWEEN DEPRESSION AND SUICIDE
- Major depression is the psychiatric diagnosis most commonly associated with suicide.
- About two-thirds people who die by suicide are clinically depressed at the time of their deaths.
- Statistically, one out of every sixteen people who are diagnosed with depression (about seven out of every 100 diagnosed males and one out of every hundred diagnosed females) will eventually die by suicide.
- The risk of suicide in people with major depression is about 20 times that of the general population.
- People who have had multiple episodes of depression are at greater risk for suicide than those who have had one episode.
- People who have a dependence on alcohol or drugs in addition to being depressed are at greater risk for suicide.
- People who are depressed and exhibit the following symptoms are at particular risk for suicide:
- Extreme hopelessness
- A lack of interest in activities that were previously pleasurable
- Heightened anxiety and/or panic attacks
- Global insomnia
- Talk about suicide or a prior history of attempts/acts
- Irritability and agitation
Suicide Warning Signs
There is no typical suicide victim. No age group, ethnicity, or background is immune. Fortunately, many troubled individuals display behaviors deliberately or inadvertently signal their suicidal intent. Recognizing the warning signs and learning what to do next may help save a life.
THE WARNING SIGNS
The following behavioral patterns may indicate possible risk for suicide and should be watched closely. If they appear numerous or severe, seek professional help at once. The National Suicide Prevention Lifeline at 1-800-273-TALK (8255) provides access to trained telephone counselors, 24 hours a day, 7 days a week.
• Giving away prized possessions
• Previous history of suicide attempts, as well as violence and/or hostility
• Unnecessary risks; reckless and/or impulsive behavior
• Loss of interest in personal appearance
• Increased use of alcohol and/or drugs
• General hopelessness
• Recent experience humiliation or failure
• Unwillingness to connect with potential helpers
• Talking about suicide, death, and/or no reason to live
• Preoccupation with death and dying
• Withdrawal from friends and/or social activities
• Experience of a recent severe loss (especially a relationship) or the threat of a significant loss
• Experience or fear of a situation of humiliation of failure
• Drastic changes in behavior
• Loss of interest in hobbies, work, school, etc.
• Preparation for death by making out a will (unexpectedly) and final arrangements
FEELINGS, THOUGHTS, AND BEHAVIORS
Nearly everyone at some time in his or her life thinks about suicide. Most everyone decides to live because they come to realize that the crisis is temporary, but death in not. On the other hand, people in the midst of a crisis often perceive their dilemma as inescapable and feel an utter loss of control. Frequently, they:
• Can’t make the sadness go away
• Can’t see the possibility of change
• Can’t see themselves as worthwhile
• Can’t get someone’s attention
• Can’t seem to get control
• Can’t stop the pain
• Can’t think clearly
• Can’t make decisions
• Can’t see any way out
• Can’t sleep eat or work
• Can’t get out of the depression
WHAT DO YOU DO?
1. Be aware. Learn the warning signs listed on the first page.
2. Get involved. Become available. Show interest and support.
3. Ask if s/he is thinking about suicide.
4. Be direct. Talk openly and freely about suicide.
5. Be willing to listen. Allow for expressions of feelings and accept those feelings.
6. Be non-judgmental. Avoid debating whether suicide is right or wrong, whether someone’s feelings are good or bad, or on the value of life.
7. Avoid taunting the person or daring him/her to “do it”.
8. Avoid giving advice by making decisions for someone else to tell them to behave differently.
9. Avoid asking “why.” This only encourages defensiveness.
10. Offer empathy, not sympathy.
11. Avoid acting shocked. This creates distance.
12. Don’t keep someone else’s suicidal thoughts—or your own—a secret. Get help—silence can be deadly.
13. Offer hope that alternatives are available. Avoid offering easy reassurance; it only proves you don’t understand.
14. Take action. Remove anything that the person could use to hurt themselves means. Get help from individuals or agencies specializing in crisis intervention and suicide prevention.
• A family physician
• A suicide prevention/crisis intervention center
• A religious/spiritual leader
WHO CAN YOU TALK TO?
• A community mental health agency
• A private therapist
• A school counselor or psychologist
If you or someone you know is severely depressed or actively suicidal, call the National Suicide Prevention Lifeline at 1-800-237-TALK (8255). Trained counselors in your area are standing by to provide you with the help you need.