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Hands reaching to shake each other

Risk and Protective Factors for Suicide
 

Suicide has been called the “permanent solution to a temporary problem.” Although there is evidence to suggest that some predisposing conditions are temporary, there is even greater evidence that this permanent act is associated with a constellation of longer-term factors that increase the likelihood that individuals take their own lives. Like other risky and life threatening behaviors, suicides are associated with a variety of risk and protective factors that can be influenced by a variety of evidence-based interventions.

The Department of Education's Substance Use and School Climate Survey (SUSCS) is no longer delivered in Idaho, thus the last available SUSCS data is from 2008. Additionally, the Youth Risk Behavior Surveillance System (YRBSS) is only delivered in Idaho on odd numberd years. The last available YRBSS data is from 2009.

Risk Factors

Prior to 2003, the research literature had identified a number of general suicide risk factors. Westefeld, Range, Rogers, Maples, Bromley and Alcorn’s (2000) literature review identified a series of risk factors including:

 

Ø Personality

Ø Cognitive

Ø Environmental stress

Ø Alcohol/drug use

Ø Behaviors

Ø Physical illness factors

 

Since then, research has identified and clarified other risk factors. The Center for Disease Control (CDC) currently lists15 different risk factors including:


Ø Family history of suicide

Ø Family history of child maltreatment

Ø Previous suicide attempt(s)

Ø History of mental disorders, particularly depression

Ø History of alcohol and substance abuse

Ø Feelings of hopelessness

Ø Impulsive or aggressive tendencies

Ø Local epidemics of suicide

Ø Isolation, a feeling of being cut off from other people

Ø Barriers to accessing mental health treatment

Ø Loss (relational, social, work or financial)

Ø Physical illness

Ø Easy access to lethal methods

Ø Unwillingness to seek help because of the stigma attached to mental health and substance abuse disorders or to suicidal thoughts.


The most recent research has added new items and clarity to some of the factors above. Additional risk factors include:

 

Ø Unrealistic fatalism (which appears in some Hispanic communities)

Ø Cognitive impairments (particularly as they apply to the elderly)

Ø Parental depression (as it applies to children of parents with depression)

Ø Mobility and transition (as it applies to adolescents)

Ø School connectedness (as it applies to adolescents)

Ø Deliberate self harm (as it applies to adolescents and college-aged adults)

Ø Age of alcohol initiation

Ø High risk behavior (adolescents) (Walsh & Eggert, 2008)


Individual Risk Factors

  • Age of First Full Drink 2002-2008
  • Age of First Full Drink by County 2004-2008
  • Mental Health Classification Rates by Age 2010
  • Mental Health Classifications Rates by Region 2010
  • Students Who Felt Sad or Hopeless 2001-2009
  • Students Forced to have Sexual Intercourse 2001-2009
  • Students Who Seriously Considered Suicide 2001-2009
  • Students Who Have Made a Suicide Plan 2001-2009
  • Student Suicide Attempts Needing Treatment by Medical Staff 2001-2009
  • Student Attempted Suicides in Past Year 2001-2009
Family Risk Factors
  • Child Maltreatment Rate 2009
  • Intimate Partner Violence 2004-2010
School Risk Factors
  • School Conflict by Grade 2004-2008
  • Students Called Names or Put-Down by County 2004-2008
  • Students Afraid of Being Beat up to or from School by County 2004-2008
  • Students Pushed Around by Someone by County 2004-2008
  • Students In a Fist Fight by County 2004-2008
  • Students Threatened with a Knife or Gun by County 2004-2008
Community Risk Factors
  • Annual Employment Average 2005-2010
  • Alcohol Sales by Type by County 2010
  • Impulsive Aggressive Behavior Group A Crimes by County 2010
  • Impulsive Aggressive Behavior Group B Crimes by County 2010

Protective Factors
–As is often the case in epidemiological research, identifying protective factors can be challenging. Events like an attempted or completed suicide serve to dichotomize the data. Often researchers compare the characteristics of individuals who attempt suicide with those who do not. Although this method has been used in a large number of studies, the conclusions that can be drawn are inherently limited because they are correlational. Despite the common methodological limitation, a number of suicide protective factors have been identified. According to the CDC, these factors include:
 

Ø Effective clinical care for mental, physical, and substance abuse disorders

Ø Easy access to a variety of clinical interventions and support for help seeking

Ø Family and community support

Ø Support from ongoing medical and mental health relationships

Ø Skill in problem solving, conflict resolution, and nonviolent way of handling disputes

Ø Cultural and religious beliefs that discourage suicide and support instincts for self-preservation (US Public Health Service, 1999)

 

Since the CDC created this list, the research community has identified additional protective factors and refined our understanding of the existing protective factors. For adolescents, for example, researchers have show that the following factors are associated with reduced suicide ideations, attempts and completed suicidal acts.

 

Ø School attendance

Ø School climate and safety

Ø Extracurricular activities
Ø Self efficacy & locus of control
Ø Future orientation and positive affect for the elderly
 
Individual Protective Factors
  • Students’ Regular Extracurricular School Activities by County 2004-2008
  • Students’ School Sports Participation by County 2004-2008
  • Students’ Regular Extracurricular Non-School Activities by County 2004-2008
Community Protective Factors
  • Idaho Licensed Counselors by County 2010
  • Idaho Licensed Social Workers by County 20109
  • Idaho Religious Establishments by County 2008
If you are aware of other data sources about suicides in Idaho, especially risk and protective factor data at the county level, please let us know using the Comments link.