We have all been struck by the tragic loss of Robin Williams, an esteemed actor who lost his life by way of suicide. In the aftermath, the public has been engrossed in the following question: how is it that such a successful individual could end up taking his own life? Unfortunately, for those of us familiar with the mentally ill, this is not a surprising or infrequent scenario, given that psychiatric illness has the ability to override a patient’s overall resolve. Suicide is a desperate measure by those burdened with severe mental illness and, contrary to popular commentary, it is not a selfish act. There are 50,000 suicide attempts in the U.S. every year and although it may seem an impenetrable event, it isn’t. If we teach the public to recognize the common risk factors that lead to suicide, they might be able to further identify an individual at risk and spur them to seek medical attention. More importantly, we must remove the stigma attached to mental illness and start taking responsibility for those around us, as this is the only effective approach that will result in the reduction of deaths by suicide.
Researchers have found a number of critical risk factors that predispose patients to suicide and, not surprisingly, psychiatric disease is at the top of the list. More than 90% of patients who have attempted suicide suffer from a psychiatric disorder; and the higher the severity of illness, the higher the risk. The most commonly encountered diseases include depression, bipolar disorder, schizophrenia, PTSD, alcoholism, and any other substance abuse disorder. Other significant determinants include being of male gender, being unmarried, suffering from a chronic illness, and having a history of childhood abuse. Of note, patients approaching the anniversary of a lost loved one or those who have had prior suicide attempts are also at great risk. Interestingly, data shows that the most critical protective factor for the prevention of suicide is having abundant social support and family connectedness. A psychiatrist will evaluate a patient at risk and if there is significant concern, the doctor will admit the patient to a psychiatric facility for further therapy.
The public may sometimes feel weary about asking someone if they are feeling suicidal because they are afraid that talking about the subject matter might lead an individual to commit the act. Studies have shown that this question has the opposite effect and patients are more likely to pursue aid when asked about their feelings. Kevin Hines, a patient who actually survived his suicide attempt, states that while sobbing for 40 minutes while standing on the Golden Gate Bridge, a tourist came by and asked him to take a picture. She never asked him why he was crying and he soon realized that nobody really cared; he took the picture and later proceeded to jump off the bridge. The moral of the story is that family, friends, and even strangers matter. Take the time to connect and listen to those around you, as you might detect something that nobody else will. This has been proven to be the most crucial intervention that can make the difference between living and dying.