PIIMIC

Suicide - Self Inflicted Suicide

Attempted suicide - or a serious threat of suicide - is a frequent component of mental health emergency calls. The suicide impulse may seem like a rational or desperate cry for help but also may be compelled by psychosis and commanding voices; or it can be intensified by other disabling effects of mental illness, and therefore it must not be ignored. Whatever the circumstances, suicide is the source of profound pain for survivors: family members, friends, and people who must confront it in professional or volunteer roles. Counseling and support services are available, see Trauma and post-trauma support in this topic.

The categories most prone to suicide are severe forms of Depression, and Bipolar Disorder: these end in suicide for about 12 to 19 per cent of all those affected, with some studies placing the rates even higher. Schizophrenia is a less common illness but also has a significant suicide rate, generally agreed to be at least 10 per cent of all those affected, and probably higher. One recent study suggests a rate of 18% for all serious mental illness, led by untreated bipolar disorder. Suicidal subjects with schizophrenia tend to choose violent and highly lethal methods and therefore need to be taken most seriously.

Police, coroners, and health professionals should make sure to include information about known mental illness in their reports on suicide. This would help to improve the accuracy of suicide rates for serious mental illness. Coroner's reports are only as good as the medical evidence of cause of death, and mental illness is not always apparent or not always reported as a primary or secondary cause. If suicide statistics were more accurately compiled, appropriate resources would be devoted to its prevention. To paraphrase John Donne's poem, "send not to know for whom the suicide bell tolls, it tolls for thee." We all need to support early and diligent treatment of people with serious mental illness. If they cannot help themselves and we do not help them, they may depart prematurely, and part of us goes with them.

(See Glossary entries for "Parasuicide" and "SAFE" - self-inflicted injury. )