By Saul Roth
In 2001, Ireland had the first registry in the world to help recognize signs of suicidal ideation. This organization is a parasuicide registry, maintained by the National Suicide Research Foundation. Parasuicide is a deliberate act of self-harm that could cause serious injury or even death. The registry has determined that in Ireland, at least one third of suicide victims have attempted suicide in the past. Moreover, one in five people that have attempted suicide will try to do it again within the next six months. Among men ages 15 to 40, the suicide rate in Ireland has quadrupled and is now the leading cause of death for men in that age group. One study in Ireland showed that within this age range, 50 per cent of suicide victims were abused as children, 67 per cent had learning difficulties, and 55 per cent had some sort of depression (Birchard, 2001).
In Canada and worldwide, older adults also have a high rates of suicide, often associated with depression. Most with suicidal ideation do not report their feelings to a doctor or mental health clinician, nor do they seek mental health treatment. Among those that do attempt or commit suicide, 75% have seen a doctor shortly before the act. Doctors would be well advised to be alert for signs of suicidal ideation. If possible, doctors should speak to the patient’s support group, which might consist of friends or family. These are the people closest to the patient and would be most likely to see signs of suicide ideation (Heisel, Conwell, Pisani, & Duberstein, 2011)
Even though depression is the main psychiatric problem associated with suicide, other difficulties can cause suicidal ideation. One cross national community study found that 9.2 percent of the sample experienced suicidal ideation at some point in their lifetime. Of those 9.2 percent, 33.6 percent had made suicide plans and 29 percent had actually attempted suicide. In addition to depression, anxiety disorders have some relationship with suicide ideation. However, there are different kinds of anxiety and social phobia, obsessive-compulsive disorder and generalized anxiety disorder do not seem to be as closely related to suicide ideation as depression. Posttraumatic stress disorder (PTSD), on the other hand, is a type of anxiety shown to be closely related with suicidal ideation. Depression has symptoms of sleep disruption, ill temper, and low self-esteem, while PTSD includes dysphoria, intrusions, avoidance, and hyper arousal. PTSD is an intrusive re-experiencing of a traumatic event (Naragon-Gainey, 2011). This finding of PTSD in the general public is significant, as suicidal ideation relates to the law enforcement population.
n 1997, suicide ideation was studied in Iceland’s most populous city, Reykjavik. The study acknowledges factors contributing to suicidal ideation include old age, unemployed single males, depression, alcohol abuse, and criminal behavior. The younger victims experience negative life events, weak social support from friends and family, and low self-esteem (Vilhjalmsson, Sveinbjarnardottir, & Kristjansdottir, 1998).
Although the highest rate of suicide occurs among older men from western countries, suicidal ideation crosses gender and age lines. Suicidal ideation is more prevalent among young, single people. Those with low self-esteem are also at a major risk for suicidal thoughts. Individuals with medical difficulties that experience frequent headaches or stomach pains are at high risk for suicide these medical problems could relate to an underlying psychological problem (Vilhjalmsson et al., 1998).