CONTENTS

About This Course

Table of Contents

1. The Nature and Scope of Suicide
2. Recognizing the Progressive Development of Suicide
3. Substance Abuse as a Major Contributor to Suicide
4. Suicide Across the Life Span
5. Special Populations and Suicide Risk
6. Prevention and Early Intervention for Suicide and Substance Abuse Problems

Supplements
References
Resources

Holding the Lifeline
A Guide to Suicide Prevention

Public Health Responses

The rates of completed suicides have decreased about 6 percent during the past decade. However, given the major inroads in treatment options for mental health disorders over the past decade, it is difficult to understand why suicide rates haven't declined even more. Meanwhile, although deaths by suicide have declined, research indicates that other suicidal behaviors have not. A report comparing the results of surveys taken in 1990-1992 and in 2001-2003 found no significant differences in suicidal behaviors, such as ideation, plans, or attempts. ref

Suicide is not classified as a mental disorder, such as depression. Rather, it is a complex set of behaviors usually caused by a combination of factors.ref According to a ground-breaking U.S. Surgeon General's report, society must respond to suicide at the individual level--taking a clinical/medical approach to determine the history and health conditions resulting in suicidal behavior--and at the societal level with a public health approach. A public health approach seeks to prevent suicidal behaviors well before an individual is imminently at risk for taking his or her own life. ref

Thus, the public health approach focuses on identifying and understanding patterns of suicide and suicidal behavior throughout a group or population. The steps in this process include:

• Defining the problem
• Identifying risk factors and causes of the problem
• Developing interventions evaluated for effectiveness
• Implementing such interventions in a variety of communities ref

Suicide "is a huge but largely preventable public health problem," according to the World Health Organization (WHO). Suicide results in nearly one million fatalities every year and billions of dollars in economic costs.ref The National Institute of Mental Health's Frequently Asked Questions About Suicide summarizes current findings about those populations at greatest risk and addresses other topics of concern.

Substance Abuse, Mental Illness, and Suicide

In many cases, people who die from suicide are either under the influence of drugs or alcohol or have a substance abuse problem. Substance abuse is defined as "a maladaptive pattern of substance use manifested by recurrent and significant adverse consequences related to repeated use; includes maladaptive use of legal substances such as alcohol; prescription drugs such as analgesics, sedatives, tranquilizers, and stimulants; and illicit drugs such as marijuana, cocaine, inhalants, hallucinogens and heroin."ref (A Prevention Glossary includes definitions of substance abuse, mental illness, and related terms).

In fact, research shows that alcohol is the substance most frequently associated with suicide risk. ref