SUICIDE

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Suicide is defined as the act of deliberately taking one's own life. It occurs most often in response to a crisis such as a death or the loss of a relationship or job. During a crisis people experience a wide range of feelings, and each person's response to crisis is different. It is normal to feel frightened or anxious or depressed. If a person feels overwhelmed or unable to cope, he or she may try to commit suicide.
Almost all people who kill themselves either suffered from depression or had substance abuse problems. People who are lonely and isolated or who have histories of previous suicide attempts are also at greater risk for attempting suicide.
Men are more than four times as likely as women to die by suicide, yet women are more likely to make a nonlethal suicide attempt.
Suicide is a major public health problem. Each year, firearms are used as many times for suicide as they are for murder. In some other countries, 71 percent of all firearm deaths are suicide.
Attempted and completed suicides result in enormous social, economic, and medical costs. Suicide is very disruptive to the quality of life of survivors and their families and friends.
Public health professionals have a major role to play in addressing the problem of suicide. Public health programs and policies can play a part before, during, and after completed or attempted suicides. First, public health programs are an important aspect of the prevention of suicide. Education campaigns can be used to increase knowledge and to change people's attitudes, beliefs, and values about suicide, and about people who may have attempted suicide. People may have distorted ideas about suicidal persons. For example, it is a myth that people who commit suicide never talk about it first. Most people provide important warning signs that can help to reduce the risk of suicide.
Health education can be combined with counseling or support programs. These programs can be provided by trained public health professionals or by peer counselors. For example, teenagers can be trained to provide counseling and support for other teens. Suicide awareness or prevention programs can be delivered in a variety of settings such as schools, churches, or in the community as a whole. They can also be delivered in psychiatric settings.
A second aspect of the prevention of suicide lies in judging or assessing a person's risk for suicide. Public health professionals such as nurses or doctors can help to prevent completed suicides by identifying people who may be thinking about or planning to try to commit suicide. They can also provide support through crisis or suicide-prevention counseling.
Public health can also play a valuable role during a suicide attempt. A suicide attempt is often a person's response to a crisis, or to a time when they feel overwhelmed or hopeless. Public health professionals can help during a suicide attempt through suicide-prevention counseling. This type of short-term counseling involves providing support and guidance to an individual who is suicidal. Its purpose is to decrease the person's emotional pain, to make sure that the person is safe, and to help develop a plan for coping. Sometimes suicide-prevention counseling includes connecting a person to community or health services. These services can then provide longer-term support.
Suicide prevention counseling is a valuable tool for public health. It is relatively low-cost, flexible, and simple to provide. A wide variety of health professionals, including doctors, nurses, psychologists, and social workers, can be taught to help people with suicide-prevention counseling techniques. These services can be provided in a wide variety of places or settings, including hospitals, community clinics, and telephone-based crisis centers or helplines. Suicide-prevention services provide an important link between the community and the formal health care system.
Public health professionals who work in suicide prevention and counseling are faced with a growing variety of issues and clients. Most communities are home to an increased number of people from a wide variety of cultural and ethnic backgrounds. There are also more older people in society. New issues that might trigger a suicide attempt include elder abuse, racism or discrimination, bullying, or gay bashing. Police officers, firemen, paramedics, and others are being trained to deliver on-the-spot suicide prevention counseling.
There is also a role for public health following a completed or attempted suicide. A suicide attempt or death can have a traumatic effect on the quality of life of survivors and their families and friends. Public health programs can provide important support services to survivors of a suicide attempt and their families.
Public health is only one important part of society's response to suicide as a health and social problem. There is also a role for law enforcement, the education system, the government, and the formal health care system in prevention, treatment, and follow-up to a suicide attempt.
Law enforcement (police officers) and public health professionals can cooperate to help suicidal persons. Police officers are often the first ones on the scene of a suicide attempt. They may act to prevent a suicidal person from hurting themselves (or someone else) through suicide prevention counseling. The may detain someone who is at high risk for suicide and refer him or her to appropriate public health resources.
The educational and health care systems also have a role to play in the prevention, treatment, and follow-up to a suicide attempt. Schools provide access to most young people and provide a place for delivering suicide prevention or awareness programs. They can also teach young people to recognize the warning signs of a potential suicide attempt in their friends, to provide peer counseling, and how to get immediate help and support. This is important because young people are at higher risk of attempting suicide than most adults.
The formal health care system (hospitals, clinics, doctor's offices) can play an important role in two main ways. First, people who are suicidal may come to an emergency room or a physician's office. In these cases, the health system serves as a "first-response" and crisis service. Second, once a person has been identified by a public health or law enforcement professional as suicidal, they may need to be hospitalized for a period of time. Health professionals can provide medications and further counseling or support to a suicidal person and their family.
Once a suicidal person is released from a hospital, public health professionals may make home visits or provide follow-up support through a community-based clinic. The prevention of suicide and the provision of support to people who are suicidal play an important and increasing role in the health of individuals, families, and communities.