Suicide: Risk factors, protective factors, and what we can do

View of the inside of the Elmer Holmes Bobst L...

Inside of Bobst Library at NYU

Last Wednesday, openly-gay 19 year-old sophomore Raymond Chase took his own life by hanging himself in his dorm room. Raymond, and countless others such as Seth Walsh, Asher Brown, and Billy Lucas chose to despair over getting help. They were being bullied for being openly gay.

I’m opening the blog portion of my site with the issue of suicide because of the recent suicides in the US and one of the most horrific murder-suicides that occurred here in Israel in September (see here but warning you, it’s gut wrenching). It’s something we’ve all faced. When I was at New York University studying social work, there were two suicides, both boys who jumped from the 10th floor of the Bobst Library. I remember there being memorials, which were extremely important to all of us, but there was very little education. No one spoke of untreated depression or risk factors.

The threat of suicide is almost omnipresent. It’s at school, in our communities, in our places of worship and at home. We encounter it but don’t know exactly what to do when it appears, and we are often unable to successfully deal with it.

People who need to be aware of risk factors are parents, teachers, rabbis, grandparents, fellow students, madrichot/school counselors, and administrators.  By being aware of certain risk factors, we can do more to prevent these occurrences.

Here in Israel, the CEO of Leader Capital Markets jumped to his death from his Tel-Aviv office. Suicide is not only a teen problem, although we hear a lot about it in that age-group. It’s a problem that permeates every age group and level of society. What can we do?

The Suicide Prevention Resource Center online states that by altering the interaction between risk factors (for the individual) and protective factors (such as coping skills, community resources, familial resources) we can create ways of preventing incidents of suicide. However, a limited number of studies on the subject exists today (Móscicki, 1997). Another problem which often comes up when treating adolescents, is how to quantify “intent to commit suicide”. For example, does self-injurious behavior count? Because this area is so difficult to study, one cannot yet say that self-injurious behavior and suicide are the same (Duberstein et al., 2000; Linehan, 1986).

But what we can glean from this information?  We, as parents, need to “be there”. Meaning to Listen (with a capital L). L’havdil- I’ll never forget when my two-year old son was having a tantrum one day when I brought him to daycare. All I wanted to do was take him to his class so I could get to work, but he was just screaming. I was getting flustered and he was getting louder. The administrator, a loving, sweet “Savta (grandmother)” type named Sima, came over and in her loving way said, “lets listen to him”. I didn’t feel slighted, but I did take a step back, got on my knees, and asked him what he wanted. I can’t remember now what it was – I think it was a cookie, but it doesn’t really matter. He felt like I was “there”. I was present for him. I think about that lesson every day.

Below is a list of risk factors and protective factors we should all be aware of.

Risk Factors for Suicide

Biopsychosocial Risk Factors
• Mental disorders, particularly mood disorders, schizophrenia, anxiety
disorders and certain personality disorders
• Alcohol and other substance use disorders
• Hopelessness
• Impulsive and/or aggressive tendencies
• History of trauma or abuse
• Some major physical illnesses
• Previous suicide attempt
• Family history of suicide

Environmental Risk Factors
• Job or financial loss
• Relational or social loss
• Easy access to lethal means
• Local clusters of suicide that have a contagious influence

Social-cultural Risk Factors
• Lack of social support and sense of isolation
• Stigma associated with help-seeking behavior
• Barriers to accessing health care, especially mental health and substance
abuse treatment
• Certain cultural and religious beliefs (for instance, the belief that suicide is
a noble resolution of a personal dilemma)
• Exposure to suicide, including through the media, and influence of others who
have died by suicide

So if you know of anyone that may be suffering in silence, do something! Talk to them or call the number below for tips on how to help them. Alternatively, seek out the many social workers and psychologists in your community who can point you in the right direction.

Protective Factors for Suicide
• Effective clinical care for mental, physical and substance use disorders
• Easy access to a variety of clinical interventions and support for
helpseeking
• Restricted access to highly lethal means of suicide
• Strong connections to family and community support
• Support through ongoing medical and mental health care relationships
• Skills in problem solving, conflict resolution and nonviolent handling of
disputes
• Cultural and religious beliefs that discourage suicide and support self
preservation
However, positive resistance to suicide is not permanent, so programs
that support and maintain protection against suicide should be ongoing.

If your community or school does not make the above protective factors clear, please take the time to fix that. Put the number for a hot-line up, talk to your principal, or talk to the parents committee (Yes, in Israel, we have parents committees too – they are called vaad horim).

Shvil HaChayim Hotline

03-964-0222

References

Duberstein, P.R., Conwell, Y., Seidlitz, L., Denning, D.G., Cox, C., & Caine, E.D.
(2000). Personality traits and suicidal behavior and ideation in depressed
inpatients 50 years of age and older. Journal of Gerontology, 55B, 18-26.
Linehan, M.M. (1986). Suicidal people: One population or two? Annals of the
New York Academy of Sciences, 487, 16-33.
Moscicki, E.K. (1997). Identification of suicide risk factors using epidemiologic
studies. Psychiatric Clinics of North America, 20, 499-517.

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