The International Handbook of Suicide Prevention: Research, Policy and Practice

By Rory C. O’Connor; Jane Pirkis | Go to book overview

34
Why Mental Illness is a Risk
Factor for Suicide
Implications for Suicide Prevention

Brian L. Mishara and François Chagnon

Evidence from numerous empirical studies, mostly using psychological autopsy methods in which characteristics of the person who died by suicide and the circumstances are reconstructed by retrospective investigations, suggests that up to 90% of persons who die by suicide have a diagnosable mental disorder (Arsenault-Lapierre, Kim, & Turecki, 2004; Cavanagh, Carson, Sharpe, & Lawrie, 2003; Chen et al., 2014; Fleischmann, Bertolote, Belfer, & Beautrais, 2005; Hawton & van Heeringen, 2009; Singhal, Ross, Seminog, Hawton, & Goldacre, 2014; Souminen et al., 1996; Wasserman & Wasserman, 2009; Whiteford et al., 2013; Windfuhr & Kapur, 2011; Yoshimasu, Kiyohara, & Miyashita, 2008). These meta-analyses and reviews have shown that the most common diagnoses are affective disorders, substance abuse disorders, personality disorders, and schizophrenia. However, the proportion of persons who die by suicide and who have a mental disorders has been found to be much less in some Asian studies using comparable methodologies (Phillips et al., 2009). Despite the strong association between suicide and mental disorder in Western countries, there are many hundreds of other factors that are associated with suicide risk (Mishara & Tousignant, 2004; World Health Organization, 2014). These factors range from macro-level variables, such as unemployment, to individual demographic characteristics, such as gender, age, and marital status and a wide range of social variables (for example, social support) and psychological characteristics of the individual (for example, personality traits and coping mechanisms). Certain environmental variables at the time of the suicide attempt are also associated with increased risk, such as access to lethal means. Consequently, it is said that suicide is multidetermined.

Given the strong association between suicide and mental disorders in many countries, national strategies for suicide prevention have tended to focus on the treatment of mental illnesses as the most important preventive action. However, we need to note that the vast majority of people with a mental disorder will not take their own lives: a mental disorder does not necessarily result in a suicide and is not sufficient to explain why people kill themselves. It is the thesis of this chapter that an understanding of the mechanisms underlying the association between mental disorders and suicide can

The International Handbook of Suicide Prevention, Second Edition. Edited by Rory C. O’Connor and Jane Pirkis. © 2016 John Wiley & Sons, Ltd. Published 2016 by John Wiley & Sons, Ltd.

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