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

Severe and Persistently Mentally Ill (SPMI) and Homeless Populations

The Severe and Persistently Mentally Ill (SPMI), who are frequently impoverished, as well as the homeless population, are two of the populations most vulnerable to suicide. These are the people who have the fewest economic and financial resources. They frequently also have the weakest support systems, particularly among family and friends. These populations cut across all ethnic, racial, and religious populations. While there are more SPMI and homeless people in larger urban areas; they exist in all kinds of communities, and are of all ages.

Frequently, alcohol and other drug use fuels the suicide risks of these populations. There appears to be a reciprocal relationship between mental health problems and substance abuse, in many instances creating a vicious cycle of decline over a period of years.

The SPMI and homeless populations are among the most likely to feel hopeless; to express a desire to hurt and/or kill themselves; to feel trapped in their problems; to have withdrawn from society, family, and friends; to feel anxious, agitated, or have difficulty sleeping; to experience dramatic mood changes; to see no reason or purpose for living; and to seek ways to kill themselves or be killed. Each of these factors represents a major warning sign for suicide, as listed by the Suicide Prevention Lifeline.

The mental health system in the United States has become fragmented, making it even more difficult for those who are poor, homeless, and/or severely mentally ill, to get the help they need. The National Alliance on Mental Illness (formerly the National Alliance for the Mentally Ill) works with the SPMI population, their family members, and other concerned individuals on suicide prevention and/or substance abuse prevention.

Society has yet to come to grips with the extent of the fragmentation of mental health and/or substance abuse services. These are problems that exist within the larger framework of spotty and inconsistent healthcare delivery in general. Responses to the needs of special populations, as well as to the needs of individuals across the life span, require a concerted effort among government institutions, the private and nonprofit sectors, nongovernmental organizations, and others.