Dr. Val Farmer
Rural Mental Health & Family Relationships

What Are The Facts About Suicide

May 22, 2000

In 1997, suicide in the United States claimed 30,535 lives. It was the eighth ranking cause of all deaths. Homicide ranked 13th.

Suicide is the 3rd ranking cause of death among the young. In 1997, those over 65 made up 12.7 percent of the population but committed 18.8 percent of the suicides. Those 15 to 24 years old represented 13.7 percent of the population and committed 13.7 percent of the suicides. There are 4.1 male completions for each female completion.

Ten to 20 percent mean to die while 80 percent or more are ambivalent about death and are choosing suicide as one way of solving a problem. Seventy percent of victims give verbal and nonverbal cues prior to committing suicide.

How many people actually kill themselves when attempting suicide? An estimated 765,000 people attempt suicide annually in the United States. There are 25 attempts for every complete. When it comes to attempts to complete suicides among young people, the ratio is 100-200:1 while the number of attempts to completed suicides is 4:1 for the elderly. There are 3 female attempts for each male attempt. An estimated 5 million living Americans have attempted to kill themselves.

Of all people who attempt suicide, only 10 percent complete suicide. However of all people who complete suicide, 45 percent had previously attempted suicide.

Twenty percent of teenagers have actively thought about suicide. Seventy five percent of all teen suicides involve drugs or alcohol. In the past 25 years, the suicide rate among teens has increased by more than 50 percent.

How many people are directly affected by a family member or friend who commits suicide? Each suicide affects at least six other people. Based on the 742,00 suicides between 1972 and 1997, there are 4.51 million survivors of suicide. In 1997, this represents 1 in every 59 people. The number of survivors of suicide grows by more than 180,000 each year.

How prominently do firearms play in suicide? Firearms account for 57.5 percent of all suicidal deaths. The percentage rises to 61.8 percent among the young and 70 percent among the old.

What are the main signs of suicidal behavior? The main factors are, 1) intolerable psychological pain, 2) extreme external pressures that frustrate important psychological needs, 3) a high degree of emotional distress or agitation, 4) a loss of hope, and 5) a negative assessment of self and one's ability to help change the situation. The most common purpose in suicide is to seek a solution to escape emotional pain.

What are the mental health issues connected with suicide? Mood disorders (depression and bipolar depression), substance abuse disorders (alcohol is involved in 40 percent of all suicides), presence of two or more disorders, learning disabilities, and schizophrenia and borderline personality disorders.

Behavioral issues include social withdrawal and isolation, acting out, or underachievement. As depression deepens, thinking becomes more black and white, rigid, and constricted - a refusal to think about alternatives.

What should you do if someone is depressed and despairing about life?

  • Be yourself. Say what is natural for you. There are no formulas, just safe guidelines.
  • Get them to trust you to tell you what is going on in their mind. Your words won't matter as much as projecting genuine concern through your body language and tone of voice. Talk as an equal. Don't come on with a lot of advice.
  • Be calm and understanding. Be willing to hear and accept feelings. Don't interrupt their flow of thought. Show interest without giving the third degree.
  • Ask simple, direct questions. "What happened?" versus probing, complicated questions. Steer them toward the pain instead of away from it.
  • Don't side with the people who he or she is hurting or who may be hurting him or her. Let your friend struggle for his or her own answers even if you think your solution is obvious. When you don't know what to say, say nothing. Being silent is OK.
  • Find out who in their support system is a source of strength and connect him or her with that person.
  • Assess specificity and lethality of their suicidal plan. Have they thought about how and when they would do it? Do they have the means available? The more specific and well thought out the plan, the more dangerous the intent. Take away their access to the means they have of killing themselves.

What shouldn't you do? Don't ignore suicidal threats. Take all threats or attempts seriously. Don't keep it a secret. Don't promise confidentiality.

Besides listening and referring, what is helpful to despairing individuals? Most people don't want to kill themselves. They want to end their pain. Communication helps bring relief. They have thought through their reasons for dying. They need help in verbalizing their reasons for living. Explore both sides.

The frankness and matter-of-factness about the discussion will help them engage their thinking and problem-solving abilities. Use your bond with them to form an alliance. Come up with a specific plan for the next few days and get them to commit to following the plan.

The background for this column came from David Jobes, associate professor of psychology at Catholic University, Washington D.C., and Harold Elliot, police chaplain and author of, "Ripples of Suicide.