SuicideSuicide

One of the 10 leading causes of One of the 10 leading causes of deathdeath

Second leading cause of death Second leading cause of death among youthamong youth

Many people have suicide thoughts, Many people have suicide thoughts, fewer have suicide attempts (likely fewer have suicide attempts (likely 8-10 times the number of 8-10 times the number of completed), fewer still completecompleted), fewer still complete

Canadian StatisticsCanadian Statistics

2003 suicide caused the deaths of 3,765 Canadians (11.9 per 100,000)

27 individuals aged under 15 years; 522 aged 15–24 years; 1,437 aged 25–44 years; 1,337 aged 45–64 years; 442 aged 65 years and over. This represents 1.7% of all deaths in

Canada.

Suicide AttemptsSuicide Attempts

Not all attempters are hospitalizedNot all attempters are hospitalized

Compare the Following Compare the Following SlidesSlides

Statistical CautionsStatistical Cautions

1.1. Some suicides disguised Some suicides disguised 1.1. police officer, accident investigator: “No police officer, accident investigator: “No

one would ever know my death would be a one would ever know my death would be a suicide”)suicide”)

2.2. Life insurance for death but not suicideLife insurance for death but not suicide

2.2. Some attempts are not attempts (e.g., Some attempts are not attempts (e.g., woman in garage)woman in garage)

3.3. Some completions not regarded as Some completions not regarded as completions (MVA single fatality)completions (MVA single fatality)

Suicide ResearchSuicide Research

Going on long timeGoing on long time Lots of atheoretical work that gives Lots of atheoretical work that gives

us facts but not necessarily us facts but not necessarily cohesive understandingcohesive understanding

E.G. E.G. - Rates higher when - Rates higher when birthday has a 0 (30, 40, 50, etc.) birthday has a 0 (30, 40, 50, etc.) Mondays, Afternoon or eveningMondays, Afternoon or evening

Relevant Factors in Relevant Factors in SuicideSuicide

Age and GenderAge and Gender Suicide, Parasuicide, Suicide Suicide, Parasuicide, Suicide

Ideation, Self MutilationIdeation, Self Mutilation Warnings and NotesWarnings and Notes MediaMedia ProfessionsProfessions

Age and GenderAge and Gender

Males 3 times more likely to Males 3 times more likely to commitcommit

Females 3 times more likely to Females 3 times more likely to attemptattempt

Male versus Female Male versus Female SuicidesSuicides

Male versus Female Male versus Female Suicides IISuicides II

Suicide Attempts by Gender Suicide Attempts by Gender & Age& Age

Suicide Method: Males Suicide Method: Males (Alberta, 2000) (Alberta, 2000)

Suicide Method: Females Suicide Method: Females (Alberta, 2000)(Alberta, 2000)

Men vs. Women SuicideMen vs. Women Suicide

Suicide, Parasuicide, Suicide, Parasuicide, Ideation, MutilationIdeation, Mutilation

Overt Suicide: Note, etc.Overt Suicide: Note, etc. Covert Suicide: Disguised Covert Suicide: Disguised Parasuicide: Suicidal gestureParasuicide: Suicidal gesture Suicide Ideation: Actually not Suicide Ideation: Actually not

uncommonuncommon Self Mutilation: Not a suicide Self Mutilation: Not a suicide

gesturegesture

Warnings and NotesWarnings and Notes

Suicide tends not to be impulsive, Suicide tends not to be impulsive, but rather planned and prepared but rather planned and prepared

E.G. of evaluation of suicide E.G. of evaluation of suicide potential:potential:– ThoughtsThoughts– Plan (well articulated)Plan (well articulated)– Means to enact planMeans to enact plan– Desire to enact (i.e., going to do it?Desire to enact (i.e., going to do it?– Reasons for livingReasons for living

Suicide NotesSuicide Notes

1 in 4 write a note1 in 4 write a note Get only briefest of glimpses into Get only briefest of glimpses into

motivesmotives Most have concrete instructions Most have concrete instructions

(handle body, insurance, feed pet, (handle body, insurance, feed pet, etc.)etc.)

Some very brief:Some very brief:– ““I could not bear it any more”I could not bear it any more”– “ “ I am tired of living”I am tired of living”

Notes Cont’dNotes Cont’d

Lots of work done on notes but not Lots of work done on notes but not of much helpof much help

Emotional content study:Emotional content study:– 51% expressed gratitude, affection, 51% expressed gratitude, affection,

& concern& concern– 25% were neutral25% were neutral– 24% expressed negative emotions24% expressed negative emotions

Media and SuicideMedia and Suicide

Presentation of suicides in media Presentation of suicides in media increases suicide rates & fatal increases suicide rates & fatal single MVAsingle MVA

Public reporting of suicide in Public reporting of suicide in known or famous person (e.g., Kurt known or famous person (e.g., Kurt Colbain)Colbain)

Golden Gate BridgeGolden Gate Bridge

Golden Gate BridgeGolden Gate Bridge

Bay BridgeBay Bridge

Golden Gate BridgeGolden Gate Bridge

Suicide Deaths BC 2000Suicide Deaths BC 2000

Highlights of TableHighlights of Table

Of the 344 suicide deaths in the province in 2000, Of the 344 suicide deaths in the province in 2000, about three quarters (262) were male. about three quarters (262) were male.

The distribution of suicide deaths by month varies The distribution of suicide deaths by month varies from year to year. In 2000, April and June were from year to year. In 2000, April and June were tied at 38 suicides each, with March and January tied at 38 suicides each, with March and January following in third (37) and fourth place (36), following in third (37) and fourth place (36), respectively. December had the least (12) total respectively. December had the least (12) total suicides, followed by November with 14 suicides. suicides, followed by November with 14 suicides.

Male deaths from suicide were highest in Male deaths from suicide were highest in April April and Juneand June and lowest in December. Female suicide and lowest in December. Female suicide deaths were highest in deaths were highest in January and MarchJanuary and March, and , and lowest in October. lowest in October.

Schneidman’s ModelSchneidman’s Model

Death SeekerDeath Seeker: Clearly intends to : Clearly intends to end life a time of attemptend life a time of attempt

Death InitiatorDeath Initiator: Death has already : Death has already started the person takes controlstarted the person takes control

Death IgnorerDeath Ignorer: Not end of existence: Not end of existence Death DarerDeath Darer: Russian roulette : Russian roulette

playersplayers

Vulnerabilities to SuicideVulnerabilities to Suicide

Transgenerational Transgenerational Mental Illness (depression, Mental Illness (depression,

schizophrenia, bipolar disorder, etc.)schizophrenia, bipolar disorder, etc.) AbuseAbuse Early LossEarly Loss Personality (socially prescribed Personality (socially prescribed

perfectionism, hopelessness)perfectionism, hopelessness)

Warning Signs of SuicideWarning Signs of Suicide

Repeated expressions of hopelessness, helplessness or Repeated expressions of hopelessness, helplessness or desperation desperation

Signs of depression (loss of interest in usual activities, Signs of depression (loss of interest in usual activities, changes in sleep pattern, loss of appetite, loss of changes in sleep pattern, loss of appetite, loss of energy, expressing negative comments about self) energy, expressing negative comments about self)

Loss of interest in friends, hobbies or previously enjoyed Loss of interest in friends, hobbies or previously enjoyed activities activities

Giving away prized possessions or putting personal Giving away prized possessions or putting personal affairs in order affairs in order

Telling final wishes to someone close Telling final wishes to someone close Expressing suicidal thoughts to others Expressing suicidal thoughts to others Expressing intent to commit suicide and having a plan, Expressing intent to commit suicide and having a plan,

such as taking pills or hanging oneself at a specific such as taking pills or hanging oneself at a specific place and time place and time

Precipitants to AttemptPrecipitants to Attempt

Stressful eventsStressful events Serious illnessSerious illness Abusive EnvironmentsAbusive Environments Occupational StressOccupational Stress Situations wherein person Situations wherein person

experiences: “Unendurable experiences: “Unendurable psychological pain”psychological pain”

Suicide by Month Alberta Suicide by Month Alberta 20002000