Reducing Suicide A National Imperative (2002) / Chapter Skim
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1 Introduction
1 Introduction
Pages 17-32
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From page 17... ...
Approximately 650,000 people per year in the United States are seen in emergency rooms after attempting suicide (PHS, 2001~. It is the third leading cause of death among American youths and among the top 12 for Americans of all ages.
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A minority of those who kill themselves actually write suicide notes, and these only infrequently try to communicate the complex reasons for the act. Still, some consistent psychological themes emerge.
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THE FEDERAL RESPONSE For decades, the federal government of the United States has been concerned about the high suicide rates. In 1966, the Center for Studies of Suicide Prevention (later the Suicide Research Unit)
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The federal commitment to reducing suicide rate is further illustrated by the goals of Healthy People 2010 to reduce the overall suicide rate to 6 per 100,000 by the year 2010 and to reduce adolescent suicide attempts by one percent each year (US DHHS, 2000~. STATEMENT OF TASK Despite its long history and the deep suffering it causes, despite the increased understanding that has come with research over the past decades, suicide continues to claim tens of thousands of lives each year.
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SUICIDE TH R O U G H HISTO RY Suicide is not a new phenomenon. Strikingly, accounts of suicide across the last millennium catalog the same factors associated with suicide as those revealed by modern scientific study in western cultures: serious mental illness, alcohol and substance abuse, co-morbidity, childhood abuse, loss of a loved one, fear of humiliation, and economic dislocation and insecurity.
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Plagues, famine, and war continually took their toll on the population, and both the Catholic Church and the Roman Empire needed to sustain their population. The Romans outlawed all manners of reducing the population including contraception, abortion, infanticide, and suicide by the end of the fourth century, and instituted forfeiture of worldly goods of suicides by the government.
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These categories are: · egoistic, focus on individual functioning and lack of social integra· altruistic, insufficient independence and over-identification with a group or cults; · anomie, abrupt disruptions of normative restraint as in wartime or after the stock market crash; · fatalistic, excessive constraints such as in incarcerated populations. Durkheim contrasted higher suicide in Northern European Protestant societies with lower suicide in Southern European Catholic societies, which he attributed to religion.
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Mental disorders and substance abuse, childhood and adult trauma, social isolation, economic hardship, relationship loss, and indi1Attachment theory "deals with the affectional bonds between individuals, their origins in childhood and adolescent relationships, the distress caused by involuntary severance of such bonds or by their faulty development, and the treatment of these disturbances" (Bowlby, 1978~.
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The Committee consensus was that universally accepted definitions of suicide, suicide attempts, suicidal ideation, and suicidal communications are needed to facilitate efforts in the field. Early classifications of suicidal behavior were typologies with implied causal relationships, but were not evidence-based.
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Suicidality: All suicide-related behaviors and thoughts including completing or attempting suicide, suicidal ideation or communications. ORGANIZATION OF THE REPORT The report explores what is known about the epidemiology, risk factors, and interventions for suicide and suicide attempts.
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National Vital Statistics Reports, 49~8~: 1-113.
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National Vital Statistics Reports, 49~12~: 140. Minois G
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Aher great pain, a formal feeling comesThe Nerves sit ceremonious, like TombsThe stiff Heart questions was it He, that bore, And Yesterday, or Centuries before The Feet, mechanical, go roundOf Ground, or Air, or Ought A wooden way Regardless grown, A quartz contentment, like a stone. ._ This is the Hour of LeadRemembered, if outlived, As Freezing persons, recollect the Snow First Chill then Stupor then the letting go EMILY DICKINSON Reprintecl by permission of the publishers and the Trustees of Amherst College from The Poems of Emily Dickinson, Thomas H
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From page 32... ...
Co-occurrences of mental illness, substance abuse, conduct disorder, or all three are significant risk factors for suicide, but especially in adolescent males (Brent et al., 1999; Shaffer et al., 19961. in general, suicidal behavior is a more impuIsive act in younger people.
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