Applied Psychology

Suicide Unpacked: Risk Factors and Warning Signs

Sep 23, 2020 | By Saranne Durham
Suicide Unpacked: Risk Factors and Warning Signs

According to Psychiatrist Dr Kobus Roux, strategies to identify and manage risk in the early stages can avert most suicide deaths. This is especially encouraging in view of how serious a problem suicide is within South Africa.

It is estimated that world-wide someone dies by suicide every 40 seconds. 79% of global suicides occur in low and middle-income countries. Sadly, the South African suicide rate is approximately four times that of the global average.  It is believed that in South Africa there is one suicide every hour. Furthermore, for every 1 suicide there is an estimated 20 attempted suicides. The SA Depression and Anxiety Group (SADAG) report that they receive around 600 calls a day from people who are feeling depressed, have been raped or are being bullied.

Suicide doesn’t discriminate

Many factors can lead to suicidal inclinations. What should be remembered is that while something may seem insignificant to one person, it could be what tips someone else into a position of believing that suicide is the best option available to them. One of the most important things to remember is talking to someone who is or could be suicidal won’t make the person act on their feelings. It will help you decide what to do next and often can help de-escalate things for the person you talking to.

“Talking to someone won’t make them act on suicidal feelings.”

The single most important risk factor for suicide is a prior attempt. However, this is not always helpful. The reality is that while there are often warning signs, sometimes they are subtle and easy to miss because they happen over an extended period of time.

10 Suicide risk factors to be aware of:

  1. Previous suicide attempts
  2. History of mental health conditions e.g.: depression, anxiety, bi-polar, post-traumatic stress disorder (PTSD)
  3. Family history relating to suicide or suicide attempts
  4. History of abuse or trauma
  5. History of substance abuse or miss-use
  6. Prolonged or chronic pain, disability or terminal illness
  7. Sudden stress or trauma e.g.: Job security, loss of a loved one or relationship
  8. Legal, disciplinary or financial issues
  9. Ongoing exposure to bullying
  10. Access to harmful means e.g.: Gun, knives, pills

15 Possible suicide warning signs

These 15 warning signs are a guideline. They can’t replace what you already know about your friends and family. Always trust your instincts and if you feel like someone is struggling, reach out and see if they want to talk.

5 Emotional markers

  1. Sudden mood-swings or moody in general
  2. Aggressive tendencies
  3. Sudden change of behaviour e.g.: Calm and cheerful after being depressed
  4. Withdrawing or self-isolating (with no medical purpose)
  5. Disinterest in self-care / personal appearance

“Possible warning signs vary – if you think that something is wrong, ask them privately and in a non-judgmental and empathetic manner.”

5 Verbal markers (phrases to take note of)

  1. I want to kill myself
  2. I’m going to commit suicide
  3. Hints such as: I won’t be a bother / problem for you much longer or if something happens to me I want you to know…
  4. Describing strong feelings of guilt or shame
  5. Talking about feelings of hopelessness, emptiness or having no way out of a problem(s)

5 Behaviuoral markers (actions to take note of)

  1. Giving or throwing away of personal items that have held significant meaning or particular sentimental value
  2. Writing of notes that talk about suicide or leaving
  3. Changed sleeping patterns
  4. Reckless behaviour or general disregard for own safety
  5. Pre-occupation or focus on death

Complication factors

There are a number of complicating factors when it comes to suicide. These need to be considered ahead of talking to someone, as it could influence how best to approach them:

  • Cultural or social beliefs surrounding suicide e.g.: Suicide being a “noble” response to a personal dilemma
  • Stigma associated with seeking help
  • Consequence of seeking help e.g.: To a job or family if the person is hospitalised
  • Lack of health care facilities that cater for mental illness, substance abuse or have suicide watch / intervention
  • Lack of health protocol (country, local or facility) that adequately addresses or acknowledges suicide risk

Three steps to supporting someone who is suicidal

  1. Talk to them! Be direct, while remaining compassionate and non-judgmental. Remember, talking to someone who you think may be suicidal does not encourage them, usually the opposite is true. When you go to talk to them do it privately and have some resources such as a suicide hotline number or a therapist’s number on hand. If you start the conversation be prepared to conclude the conversation with a commitment to follow up on the them. Ask them simple, straight to the point questions such as: How are you coping with the changes / challenges you facing, are you thinking of hurting yourself or have you been thinking of taking your own life?
  2. Intervene: Take them to an emergency room, a doctor or call a crisis hotline with them. If they have already sought professional help, contact that person and update them on the situation.
  3. No Secrets:  Even if they want you to, don’t keep it a secret. You can’t keep them safe by yourself.

“Keeping secrets isn’t helpful – you can’t keep someone safe by yourself.”

Things to do if you’re feeling suicidal

If you are feeling suicidal, it is important that you:

  1. Share your feelings with someone non-judgmental that you trust and know to be empathetic
  2. Promise yourself that you won’t do anything just yet and set a timeframe (24 hours, a week or month) when you will reassess how you feeling
  3. Take hope that a suicide crisis is most often temporary and able to be worked through
  4. Remove threats by giving any weapons (guns or knives) as well as pills to someone outside your residence to keep
  5. Avoid drugs and alcohol since they will often make you feel worse in the long run

Problems and challenges may seem insurmountable. However, illnesses and pain management are possible through lifestyle changes, therapy and medical intervention. Solutions to problems in relationships, jobs or finances are seldom instant. They take time. So rather ask for help in finding a solution than giving up because you haven’t been able to so far.

Seeking Help

The South African Depression and Anxiety Group (SADAG) have multiple options for seeking support. Such as online resources, contact with Counsellors available daily between 8am to 8pm (011 234 4837), a 24 Hour Help Line (0800 456 789)  and a 24 hour Suicidal Emergency Helpline (0800 567 567). All of which give you access to free counselling, crisis intervention, information and nationwide referrals.

“Ask for help when problems and challenges seem overwhelming.”

The South African College of Applied Psychology (SACAP) graduates are making a difference in society! If you would like to be part of this difference then look into the range of psychology courses on offer, including a BPsych degree. These will provide you with an internationally recognised pathway to obtaining your Master’s Degree in Psychology. For more information, enquire today.

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