Suicide The Facts and Myths

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SuicideThe Facts and Myths

• Deputy Chief Michael Jungbluth
• MATC Recruit Academy

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Definition

• The act or instance of intentionally killing
  oneself.
• An individuals most sincere form of
  self-analysis and critique.

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Suicide Has a Long History

• Biblical Suicides
• Abimelech (Judges 950 57)
• Samson (Judges 1628 - 31)
• Sauls armor-bearer (1 Samuel 315)
• Ahithopel (2 Samuel 1723)
• Zimri (I Kings 1617 19)
• Judas Iscariot (Matthew 273 5)

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• The Medieval Period
• Suicide became extremely uncommon.
• Thomas Aquinas (Summa Theologica) stated
• 1.) Suicide is a violation of natural law.
• 2.) Suicide is a violation of moral law.
• 3.) Suicide is a violation of divine law.
• Suicide was considered to be worse than murder
  for in killing ones fellow man, one is only
  killing the body, whereas in suicide, one is
  killing the body and soul.

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• The Seventeenth Century Onwards
• Walter Charlton coined the term suicide in
  1651.
• During this time, attempting suicide became an
  indictable offense in many places. From 1844 to
  1855 13 of the 40,000 who attempted suicide were
  prosecuted 308 of these were sent to jail, and
  in 1855, a man received a two year jail sentence
  for trying to commit suicide, although this was
  subsequently reduced to a month.

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• Emile Durkheim (1897 1951), a French
  Sociologist published his exhaustive survey
  entitled Le Suicide. He stated that where social
  solidarity is strong against suicide, occurrence
  is low. He also broke suicide down into three
  catgories Egoistic- a failure to integrate
  onself with society, Altruistic- motivated by the
  persons desire to further group goals, Anomic
  suicide- A persons relationship to society is
  unbalanced... a dramatic shift in society. This
  study later led to the development of both
  intrapsychic and biochemical explanations.

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Suicide Statistics

• There were 30,810 suicide deaths in the United
  States in 1997, representing 1.4 of the total
  deaths.
• Suicide is the 11th leading cause of death in the
  United States. Homicide ranks 14th.
• Ranks 3rd for the young (15-24 years)
• Every year, there are more suicide deaths in the
  United States than homicides.

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• The state with the highest suicide rate was
  Nevada at 24.8 per 100,000 population. The lowest
  was the District of Columbia at 6.6 per 100,000.
• Suicide rates for the U.S. are average among
  industrialized nations and generally higher than
  developing countries.
• Generally, the suicide rate in the United States
  has been level over the past 90 years, peaking at
  a rate of 17.4 per 100,000 population in 1932 and
  ranging from 12.0 to 14.0 per 100,000 over the
  past ten years.

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• GENDER
• Men account for 80 of all suicides in the United
  States.
• Generally, women are more likely than men to make
  suicide attempts, as over 50 of suicide attempts
  are made by women. However, men are much more
  likely to be successful at killing themselves as
  they choose more lethal methods of suicide.

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• AGE
• People 75-84 years of age have the highest
  suicide rate of any group at 23.5 per 100,000.
• Elderly, white men over the age of 65 have a
  higher risk of suicide with a rate of 42.7 per
  100,000 population. Non-white elderly men have a
  suicide rate of 16.7 per 100,000.
• In comparison, women over the age of 65 have a
  suicide rate of 6.0 per 100,000 population.

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• ETHNICALLY
• Generally, communities of color have lower rates
  of suicide than whites. However, these
  differences in suicide rates are much more
  dramatic in older adults.
• Adolescents and younger adults, representing
  communities of color, have lower suicide risks
  than whites, usually 30 to 40 lower.
• Some Native Americans in certain tribes have
  dramatically high suicide rates, particularly
  among male adolescents, reaching rates of 44.0
  per 100,000 population.
• White males account for 70 of all suicides.

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• MENTAL DISORDERS AND SUBSTANCE ABUSE
• Mental and addictive disorders are central risk
  factors for suicide. More than 90 of completed
  suicides are associated with these disorders.
• 20 of men and women with unipolar depression or
  bipolar disorder commit suicide, 13 of
  schizophrenic patients commit suicide, and 10 of
  patients with a personality disorder commit
  suicide. This is 10 to 15 times the rate of the
  general population.
• Only 3 of alcoholics commit suicide, but since
  alcoholism is so prevalent in society, 33 of all
  suicides involve alcoholism. Most alcoholics who
  commit suicide have over 20 years of alcohol
  abuse before dying. Few suicides are reported in
  alcoholics under age 40.

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• ADOLESCENTS
• Generally, suicide rates decrease with age in
  this group. However, since fewer young people die
  of health related causes, suicide is a leading
  cause of death among adolescents.
• Suicide rates among adolescents have
  significantly increased over the past forty
  years. In 1950, the rate for people ages 15-24
  was 4.5 per 100,000 population. In 1990, the rate
  tripled to 13.2 per 100,000.

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• As with adults, the majority of adolescent
  suicides are committed by males. Among 15-24 year
  olds, 73 of suicides are committed by males. As
  with adults, female adolescents are far more
  likely to attempt suicide. For youth
  hospitalization after a suicide attempt 1 out of
  12 males succeed in committing suicide while only
  1 in 300 females are successful in committing
  suicide.
• Among 15-24 year olds, suicide is the third
  leading cause of death with a suicide rate of
  13.1 per 100,000 population.

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• SUICIDE METHODS
• Over 60 of all suicides are committed by
  firearms, and 80 of all firearm suicides are
  committed by white men. Hanging is the second
  most common method of suicide.
• Drug overdose accounts for 70 of suicide
  attempts, although the vast majority of overdose
  attempts are unsuccessful.

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Warning Signs of Suicide

• Conditions associated with increased risk of
  suicide
• Death or terminal illness of relative or friend.
• Divorce, separation, broken relationship, stress
  on family.
• Loss of health (real or imaginary).
• Loss of job, home, money, status, self-esteem,
  personal security.
• Alcohol or drug abuse.

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• Depression. In the young, depression may be
  masked by hyperactivity or acting out behavior.
  In the elderly, it may be incorrectly attributed
  to the natural effects of aging. Depression that
  seems to quickly disappear for no apparent reason
  is cause for concern. The early stages of
  recovery from depression can be a high risk
  period. Recent studies have associated anxiety
  disorders with increased risk for attempted
  suicide.

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• Emotional and behavioral changes associated with
  suicidal people
• Overwhelming Pain pain that threatens to exceed
  the persons pain coping capacities. Suicidal
  feelings are often the result of long-standing
  problems that have been exacerbated by recent
  precipitating events. The precipitating factors
  may be new pain or the loss of pain coping
  resources.
• Hopelessness the feeling that the pain will
  continue to get worse things will never get
  better.
• Powerlessness the feeling that ones resources
  for reducing pain are exhausted.

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• Feelings of worthlessness, shame, guilt,
  self-hatred, no one cares. Fears of losing
  control, harming self or others.
• Personality becomes sad, withdrawn, tired,
  apathetic, anxious, irritable, or prone to angry
  outbursts.
• Declining performance in school, work, or other
  activities. (Occasionally the reverse someone
  who volunteers for extra duties because they need
  to fill up their time).
• Social isolation or association with a group
  that has different moral standards than those of
  the family.

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• Declining interest in sex, friends, or activities
  previously enjoyed.
• Neglect of personal welfare, deteriorating
  physical appearance.
• Alteration in either direction of sleeping or
  eating habits.
• (Particularly in the elderly) Self-starvation,
  dietary mismanagement, disobeying medical
  instructions.
• Difficult times holidays, anniversaries, and the
  first week after discharge from a hospital just
  before and after diagnosis of a major illness
  just before and during disciplinary proceedings.
  Undocumented status adds to the stress of a
  crisis.

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• History of mental disorders, particularly
  depression
• History of alcohol and substance abuse
• Family history of suicide
• Family history of child maltreatment
• Barriers to accessing mental health treatment
• Loss (relational, social, work, or financial)
• Physical illness
• Easy access to lethal methods
• Unwillingness to seek help because of the stigma
  attached to mental health and substance abuse
  disorders or suicidal thoughts
• Cultural and religious beliefsfor instance, the
  belief that suicide is a noble resolution of a
  personal dilemma
• Local epidemics of suicide
• Isolation, a feeling of being cut off from other
  people

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• SUICIDAL BEHAVIOR
• Previous suicide attempts, mini-attempts
• Explicit statements of suicidal ideation or
  feelings.
• Development of suicidal plan, acquiring means,
  rehearsal behavior, setting a time for the
  attempt.
• Self-inflicted injuries, such as cuts, burns, or
  head banging.
• Reckless behavior.
• Making out a will or giving away favorite
  possessions.
• Inappropriately saying good-bye.
• Verbal behavior that is ambiguous or indirect
  You wont have to worry about me anymore.
  Requests for euthanasia information,
  inappropriate joking, stories or essays on morbid
  themes.

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What Can I Do to Help Someone Who May be Suicidal?

1. Realize that someone may be SUICIDAL.
2. Take it seriously.
3. Remember suicidal behavior is a cry for help.
4. Be willing to give and get help sooner rather
   than later.
5. Listen. Talking things out can save a life.
6. ASK Are you having thoughts of suicide?
7. If the person is suicidal, do not leave him
   alone.
8. No Harm Contract.
9. Urge professional help.
10. No secrets.
11. Referral to MH Facility / Emergency Detention