Suicide Risk Factors and Warning Signs

Suicide, or the intentional ending of one’s life, is a topic that often causes significant anxiety to both professionals and the general public. Often, knowing some of the key risk factors that elevate and lower suicide risk can assist in working with a suicidal person and help them stay alive. In addition, if you are a professional, it can help you feel more confident in making decisions related to treatment and referral.

According to SuicideOutreach.org, a program of the Veteran’s Administration, “Risk factors refer to an individual’s characteristics, circumstances, history and experiences that raise the statistical risk for suicide.” If you are a medical or psychiatric professional, completing a thorough risk assessment may be known knowledge; however, reviewing these risk factors periodically can prove to be helpful when working with clients in a variety of settings. Risk factors commonly fall into three categories:

  1. Chronic
  2. Acute
  3. Protective

Chronic risk often stays consistent and is not fluid to day-to-day changes in mood, situation, or condition. Examples of chronic risk factors might be mental health issues in a family, previous suicide attempts, a chronic medical condition such as HIV or cancer, age, and gender.

Acute risk factors can change quickly and are often situational. Some examples include current mental status, current desire to kill self, alcohol and illicit substance intoxication, access to a gun or means of killing self, a plan to end life, or pending legal action. Current impulsivity, a decline in judgment, or psychosis seen in certain mental health diagnoses significantly increases potential harm to self and others.

Protective factors are those things that mitigate or reduce suicide risk. Common factors include a willingness to live, children at home, active in treatment such as therapy, a pet, being married or never attempting to harm self. Also, future orientation is an excellent factor to explore with the person. A person who is excited about the future or who has something to live for will be less inclined to see suicide as an option.

The more protective factors one has, the lower the overall risk is thought to be. In contrast, the more chronic, and especially acute, risk factors one has, the higher the risk to harm self.

There are some risk factors that must be assessed when determining if a person is suicidal and safe to remain in the community. Here are some common ones:

  • Family history of suicide
  • Suicide attempts in the past
  • How likely lethal past attempts could have been
  • Recent discharge from a psychiatric facility
  • Substance use (recent) or current intoxication
  • Current impulsivity
  • Is there a current diagnosis (e.g. bipolar, schizophrenia) that is preventing a person from having clear thought and safe judgment?
  • Isolation or lack of a social network or close friends/family
  • Access to a weapon or means to end life
  • Current desire to kill self
  • Current or past physical, sexual, or emotional abuse
  • Recent loss, or the anniversary of a significant loss (e.g. job, death, a dream)
  • Worsening or beginning of a chronic medical condition

The above risk factors can be helpful in determining overall risk. In addition, there are some common warning signs that are seen in folks considering suicide. They are:

  • Withdrawing from others
  • Sudden happiness following significant sadness (note: person may have resolved to end their pain by suicide and is now happy with their future)
  • Giving away possessions
  • Getting finances and beneficiaries suddenly in order
  • Increase in self-destructive behaviors such as driving fast, unsafe sex, and substance use
  • Asking questions about best ways to die. Sometimes people will begin asking friends for extra medications or ways to obtain weapons.

Knowing common risk factors and warning signs can prove life-saving when working with the general public. It is important to know that these warning signs and factors are only a part in the overall assessment and treatment of suicidality. If you are a mental health professional, using structured risk assessments and clinical consultation will help in arriving at a more accurate risk level. If you are not a mental health professional, knowing some of the common signs can help you to decide if contacting a professional is needed.

If someone you know is actively stating they want to die, it is important that you get them help NOW. Contacting 911, having them taken to a local emergency room/department (assuming their safety level permits and they are willing), or, if not life threatening, having the person call a local suicide/crisis line number are all ways to address an emergency situation. The national suicide phone number is 1-800-273-TALK (8255). This phone number is answered 24/7 by trained volunteers who can talk to a person in need. If life is in danger, please call 911.

© Copyright 2012 GoodTherapy.org. All rights reserved. Permission to publish granted by Andrew Mendonsa, PsyD, therapist in Sacramento, California

The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by GoodTherapy.org. Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

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  • Jenn F

    Jenn F

    January 16th, 2012 at 5:17 PM

    My own brother ended his life a few years ago.
    I guess the warning signs were there, we just did not take the time out of our won lives to see them.
    Looking back now, I recognize that the intent for him to do this had been there for a long time, we just did not see.
    He did not explicitly tell us so, but it was in the little things that he did.
    Things that I look back on today and say yes, that was a sign that something was wrong.
    But he never said anything.
    And we did nothing.
    And now he is gone all too soon.

  • tim

    tim

    January 16th, 2012 at 11:21 PM

    i think the warning signs r always there..most often the person becomes disoriented or how’s changed but if others around him don’t recognize this then no prevention can happen..identifying it is an important step in prevention..

    but some people also isolate themselves so there is not much scrutiny they go through.

  • Olivia

    Olivia

    January 17th, 2012 at 5:18 AM

    Jenn F,
    I am so sorry to hear about that loss that you and your family are having to manage and try to come to terms with. It sounds like you have a lot of regrets about maybe things that were left undone or unsaid. But you have to remember that this was his choice, and in the end short of being with him right at the time that he killed himself, there was probably very little that you could have to done to ease his pain and stop him from doing what he was obviously intent to do. The thing that you have to do now is try as hard as you can to remember the good times and the times that you shared together and let go of that guilt that you are feeling, because it is totally misplaced.

  • Gene

    Gene

    January 17th, 2012 at 3:59 PM

    Can’t imagine something like this happening in my own family but the more I read and talk to others I see how lucky I am that something like this has not happened..

  • BEN

    BEN

    January 17th, 2012 at 5:01 PM

    Well I just think a lot of ppl cud be saved if everybody knew the signs and actually did something bout having identified them.Its a service to humanity after all-saving a human life n giving some1 a hope to live.

  • sylvester

    sylvester

    January 18th, 2012 at 12:14 AM

    just having someone to talk to at the right time could convince a person to not take the step.suicide is not a single action. it I a set of actions and everything that happens over a period of time. yes sometimes people are instantaneous but even that often happens due to a long-running episode and at one point they decide they just can’t take it anymore.

    suicide prevention is best done at grassroots levels,that is everybody looks around themselves and offers help to any friend or family member who may display signs.

  • T Rex

    T Rex

    January 18th, 2012 at 7:13 AM

    Family history of suicide?! Surprised to read this. How is that a predictor? Its not like some people have ‘suicide’ genes! People who contemplate suicide do so due to life conditions most often and not just because they FELT like it because its in their genes!

  • marnie

    marnie

    January 18th, 2012 at 4:15 PM

    why is it that the families of suicide who are left behind seem to be the ones who suffer the most? the not knowing why and the not understanding si so hard to see.

  • Joe singer

    Joe singer

    January 19th, 2012 at 1:53 PM

    Man, suicide ruins lives. There is nothing that can touch it in terms of how much pain and grief it causes. Yeah it sucks any time that you lose someone important in life, no matter how you lose them, But with suicide. . . it is hard to even describe the feelings that you have when you lose them to this. It makes us mad, you know, to think about the life that they have thrown away, life that could have made such a positive impact on others now will never have the chance to.

  • Bennett

    Bennett

    January 22nd, 2012 at 7:15 AM

    If someone who is normally very responsible starts acting erratically, you have to stop and ask yourself is there is something pretty serious going on there. It is not something that can be ignored, or else you might find that you have a friend in big trouble.

  • helenwillow

    helenwillow

    January 26th, 2012 at 3:30 PM

    I have had one suicide I was revived from (needed 3 pints of blood), and with in the past 3 weeks have attempted it (didn’t) take enough sleeping pills. I mention this as background. The thing is you would be surprised what a lethal weapon can be to yourself. Swallowing sharp objects, ANY thing that can be sharpened, alot of perscription medications, clothing, bedding and alot more things. If some one is suicidal and at all creative it is best to monitor them visually and often. One way I started an attempt in the past was with a body piercing needle which is hollow like a hypodermic needle, I put it in my vien. I just thought people should know a better definition of what a lethal weapon can be other than conventional things like razor blades, knives, guns and pills

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