How to spot suicidal tendencies

The Centers for Disease Control and Prevention (CDC) says the increase in suicides between 2009 and 2015 coincided with the economic recession. In 2014, the most recent year for which data is available, 18.2 suicides per 100,000 Americans were reported. That number jumped to 21.5 in 2015, according to the CDC. The number of suicides reported by Hispanics and black Americans (whites do not have a specific category in the statistics) were the highest.

Between 2009 and 2015, black Americans experienced a 28.3% increase in the number of suicides from 15.4 suicides per 100,000 to 18.9. Nearly 40% of black Americans in the US considered suicide last year, according to a Pew Research Center study that was published earlier this year.

“Black people who are in the lowest income or who have lower educational attainment are more likely to die from suicide than other groups are,” said Dr. Isidore Mihalakis, co-chair of the American Society of Clinical Oncology’s suicide prevention committee and professor and vice chair of the department of medical oncology at the University of Chicago.

Suicide clusters are becoming more common. In 2016, the last year for which data is available, there were 20 reported in all, according to the CDC. The bureau says that the states with the most reported suicides per 100,000 of people in each state were California, Utah, Florida, Pennsylvania, and North Carolina.

Some experts say that suicide and depression don’t always connect. “Even if you’re in a particularly stressful environment, you’re often not just dealing with depression but also other psychiatric conditions that go along with that,” Dr. Mihalakis said.

How do you spot signs of depression?

“We would need a clinically significant piece of information for a clinician or an employee to be confident enough to talk to somebody about suicide,” said Dr. Mihalakis.

Gaps in knowledge of depression and suicide risk also have a role in causing hesitance to approach those at risk for suicide, as well as misconceptions about the causes of suicide.

Factors that increase the risk of suicide include relationships, unemployment, divorce, substance abuse, and mental illness. “There are a number of factors that appear to be especially strong predictors of suicide,” said Dr. Janet Fisher, an American Psychological Association spokeswoman and assistant professor of psychiatry at the Mayo Clinic.

The American Psychological Association recommends opening up a dialogue with those at risk. It recommends:

• Talking with your child about their feelings

• Recognizing the signs of depression and suicide

• Finding a support network

• Encouraging them to reach out to others who can help

Dr. Fisher, who also is a clinical psychologist, says: “The most important thing is that [your child] feels that you understand and have compassion for them.”

“It’s not as simple as calling a suicide hotline. You need to have the resources available to talk to [your child] and also to listen,” she said.

Recent work published in the Journal of Psychology and Psychiatry suggests that bystander intervention is a key component in saving lives of people at risk of suicide. There are a number of ways that you can become an intervention peer:

• Connect young people with clinical services before reaching out to mental health professionals

• Mindful conversations

• Meet with those at risk of suicide and talk about concerns and questions that you have

• Actively volunteer at a suicide prevention hotline

• Help to recognize warning signs of someone that may need assistance

• Link younger people with people with mental illness.

The Institute of Medicine (IOM) warns that teens may resist talking about suicide because it’s easier to talk about suicide than discuss depression. To prevent misunderstandings, however, experts recommend listening openly, trusting your gut, and telling your child’s teacher or youth advocate if you think that your child needs help or is at risk.

Overestimating the severity of depression may also push people to commit suicide, the IOM says. Helping someone understand why they might be at risk, and helping them see that they have options, is also key to saving lives.

To get free access to the new IOM report on suicide prevention, click here.

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