Legendary comedian Robin Williams recently raised awareness of depression-related suicide after tragically losing a lifelong battle with the mental health disorder. In the wake of his death, the issue of suicide prevention has been brought to the forefront of national and even international discussion. Recently, the World Health Organization released its first global report on suicide, finding that one person dies from suicide every 40 seconds.1 This global phenomenon happens all over the world and affects people of ages.2 Unfortunately, in many regions of the world there is a stigma linked to mental disorders and suicidal tendencies; however, suicide is preventable and needs to be addressed in the U.S. and around the world. To do so will require better understanding of symptoms, increasing access to treatment options for those experiencing depression or other suicidal tendencies, erasing sensationalism that often accompanies suicide in the media and advancements in pharmacy technology.
First WHO report on suicide
The WHO first adopted a Mental Health Action Plan at an assembly in May 2013. With the plan’s implementation, the WHO hopes to reduce suicides by 10 percent worldwide by 2020.3 According to the WHO’s first global report, more than 800,000 people die from suicide each year, most commonly by pesticide poisoning, hanging or firearms. In general, men are found to be at higher risk of committing suicide than women, as much as three times as likely in wealthy countries. The WHO found that only 28 countries had national suicide prevention strategies and that 75 percent of suicides occur in low- and middle-income countries.4 Globally, suicide is the No. 2 cause of death in those 15-29 years old.5 In a news release, Dr. Margaret Chan, Director-General of WHO states, “This report is a call for action to address a large public health problem which has been shrouded in taboo for far too long.”6 Numbers on suicide are likely under-reported because killing oneself is illegal in some countries. Moreover, for every person that dies from suicide there are more that have attempted suicide in the past. This is a key factor in prevention efforts, as many people that eventually die from suicide have attempted it before. The WHO reports that improving the availability and quality of suicide data is essential in prevention measures.7
Suicide in the US
According to the U.S. Centers for Disease Control and Prevention, 38,364 died from suicide in the U.S. in 2010.8 The majority of these deaths were caused by firearms, although suffocation also accounted for a high percentage of suicides. However, the CDC found that an estimated 1 million adult Americans attempted suicide between 2008 and 2009, leading to the conclusion that approximately 25 suicides are attempted for every death by suicide.9 For young adults, ages 15 to 24, there are approximately 100-200 attempts for every death by suicide.10 Numbers in the U.S. suggest that the WHO is correct in its speculation that suicide often goes unreported. The WHO reports that the Americas have high percentages of suicide deaths by firearms in comparison to the rest of the world. Firearms are used mostly in wealthier countries where as much as 46 percent of suicides are carried out using this method.11
Risk factors
One of the key messages emphasized by the WHO is that suicide is preventable. Those considering suicide often show symptoms of depression and other suicidal tendencies. According to the Mayo Clinic, the following symptoms are warning signs that a person may be considering suicide:12
- Talking about suicide or the idea of harming oneself
- Finding access to a means of committing suicide, such as purchasing a firearm or stockpiling pills
- Preoccupation with death or violence
- Increasing or dangerous use of alcohol and drugs
- Social withdrawal
- Erratic mood swings
- Saying goodbye to friends and loved ones or giving away possessions
- Self-destructive tendencies that may cause harm to oneself or others
- Erratic eating or sleeping patterns
- Broad changes in personality such as constantly being anxious or irritable
However, not everyone experiencing suicidal thoughts will exhibit these symptoms. While some sufferers may display any of the following in an obvious manner, others may keep their feelings secret.
Prevention
In regard to prevention, the WHO report states, “While moving forward, two points should be considered. First, suicide prevention activities should be carried out at the same time as data collection. Second, even if it is felt that a country is not yet ready to have a national prevention strategy, the process of consulting stakeholders about a national response often generates interest and creates an environment for change.”13 As knowledge of the biological, cultural and social factors behind suicide become more understood, medical professionals will be tasked with finding better means of reporting attempted suicides, addressing risk factors and making suicide prevention a more integral part of health care. Furthermore, as a nation Americans will be responsible for eliminating the stigma associated with suicide and other mental disorders and communally look at benefiting the health of both youths and adults suffering from suicidal thoughts. 1“Preventing suicide: A global imperative” Executive Summary. World Health Organization. September 4, 2014. http://www.who.int/mental_health/suicide-prevention/exe_summary_english.pdf?ua=1 2“Preventing suicide: A global imperative” Executive Summary. World Health Organization. September 4, 2014. http://www.who.int/mental_health/suicide-prevention/exe_summary_english.pdf?ua=1 3“Preventing suicide: A global imperative” Executive Summary. World Health Organization. September 4, 2014. http://www.who.int/mental_health/suicide-prevention/exe_summary_english.pdf?ua=1 4“Preventing suicide: A global imperative” Executive Summary. World Health Organization. September 4, 2014. http://www.who.int/mental_health/suicide-prevention/exe_summary_english.pdf?ua=1 5“Preventing suicide: A global imperative” Executive Summary. World Health Organization. September 4, 2014. http://www.who.int/mental_health/suicide-prevention/exe_summary_english.pdf?ua=1 6“First WHO report on suicide prevention” News Release. September 4, 2014. http://www.who.int/mediacentre/news/releases/2014/suicide-prevention-report/en/ 7“Preventing suicide: A global imperative” Executive Summary. World Health Organization. September 4, 2014. http://www.who.int/mental_health/suicide-prevention/exe_summary_english.pdf?ua=1 8“Suicide fact at a glance” Centers for Disease Control and Prevention. 2012. http://www.cdc.gov/violenceprevention/pdf/Suicide-DataSheet-a.pdf 9“Suicide fact at a glance” Centers for Disease Control and Prevention. 2012. http://www.cdc.gov/violenceprevention/pdf/Suicide-DataSheet-a.pdf 10“Suicide fact at a glance” Centers for Disease Control and Prevention. 2012. http://www.cdc.gov/violenceprevention/pdf/Suicide-DataSheet-a.pdf 11“First WHO report on suicide prevention” News Release. September 4, 2014. http://www.who.int/mediacentre/news/releases/2014/suicide-prevention-report/en/ “Suicide and suicidal thoughts symptoms” by Mayo Clinic Staff. Mayo Clinic. June 9, 2012. http://www.mayoclinic.org/diseases-conditions/suicide/basics/symptoms/con-20033954 13“Preventing suicide: A global imperative” Executive Summary. World Health Organization. September 4, 2014. http://www.who.int/mental_health/suicide-prevention/exe_summary_english.pdf?ua=1
