Suicide is a serious public health concern, impacting individuals, families, and communities globally. It is a complex issue influenced by personal, social, and cultural factors. Understanding these factors is important for developing effective prevention strategies and providing meaningful support. This article explores the primary risk factors associated with suicide and outlines pathways to support and resilience.
Previous Suicide Attempts
A history of previous suicide attempts is a strong predictor of future attempts and death by suicide. Individuals with a prior attempt are approximately 25 times more likely to die by suicide compared to the general population. This elevated risk can persist for many decades following an initial attempt.
The underlying reasons for this heightened vulnerability are multifaceted. A previous attempt may indicate sustained psychological distress, an established pattern of coping mechanisms, or neurobiological changes that lower the threshold for suicidal behavior. While most people who attempt suicide and survive will not die by suicide later, roughly 5% to 11% of hospital-treated attempters do eventually die by suicide. This rate is considerably higher than the general population’s annual suicide rate of about 1 in 10,000.
Mental Health and Substance Use Disorders
Mental health disorders, particularly major depressive disorder, are strongly associated with an increased risk of suicide. Half of all individuals who die by suicide may have major depressive disorder, and having this or other mood disorders like bipolar disorder can increase the risk twenty-fold. Other conditions, including schizophrenia, personality disorders, anxiety disorders, and post-traumatic stress disorder, also contribute to suicide risk.
Substance use disorders, including alcohol, illicit drugs, and prescription medications, are significant risk factors for suicide. Alcohol misuse or dependence, for instance, can increase suicide risk tenfold. Alcohol intoxication is involved in approximately 22% of suicide deaths and 30-40% of attempts in the U.S. Opiates are present in about 20% of suicides, while injection drug use can increase risk fourteen-fold. These substances can lead to disinhibition, worsen mood, increase distress and aggressiveness, and propel suicidal thoughts into action. Risk is greater when mental health conditions co-occur with substance use disorders.
Additional Factors Increasing Risk
Beyond these primary factors, several others contribute to suicide risk. Easy access to lethal means, such as firearms or certain medications, can increase the likelihood of a completed suicide. A family history of suicide or child maltreatment also raises risk.
Chronic physical pain or debilitating illnesses, along with feelings of hopelessness, impulsiveness, or aggressiveness, are contributing factors. Social isolation and lack of supportive connections can intensify feelings of despair.
Major life stressors, such as job loss, financial problems, relationship breakdowns, or bullying, can exacerbate vulnerability. A history of trauma or abuse, including childhood abuse or neglect, is also a significant risk factor.
Protective Factors and Path to Support
Understanding risk factors is important, but focusing on protective factors offers pathways to resilience and prevention. Strong social connections and support networks, including familial bonds and friendships, significantly reduce isolation, a known risk factor. These connections foster open communication and normalize seeking assistance.
Developing effective coping and problem-solving skills, and adapting to change, helps individuals navigate stressful events. Access to appropriate mental health care provides timely interventions and ongoing support. Cultural, religious, or personal beliefs that discourage suicide and promote meaning or purpose can serve as powerful buffers. Responsibility to family or pets can also provide a reason to continue living.
If you or someone you know is struggling, help is available. The 988 Suicide & Crisis Lifeline provides free, confidential support 24/7 (call or text 988, or chat at 988lifeline.org). Mental health professionals offer longer-term interventions, and emergency services should be contacted immediately if someone is in immediate danger.