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Why are people with mental disorders at higher risk for suicide?

Suicide results from multiple factors, but people with mental health problems are at highest risk. Mental disorders (including alcohol and drug problems) are highly associated with suicide (up to 90 percent in the West, but less so in Asia). Nevertheless, a relatively small proportion of persons with mental disorders die by suicide. Several explanations are possible:

1. Suicide and mental illness may have a common etiology. Suicide and mental illness relate to the same risk factors, and therefore may have an association. Perhaps the biogenetic and psychosocial vulnerability that leads to mental illness also brings about suicide, triggered by negative life events, isolation, and loneliness. Nevertheless, some studies illustrate different biogenetic pathways for mental disorders and suicide.

2. Some mental disorders may be alternatives to suicide. A person may turn to alcohol or drugs as self-medication to treat his or her problems -- or, alternatively, a person may use substances as a slow, indirect means to take his or her own life. Perhaps obsessive-compulsive disorders may be a means to control suicidal impulses.

3. Suicide can be a direct consequence of some types of mental illness. In this scenario, a mental disorder results in cognitive distortions, depressive delusions, or psychotic command hallucinations that signal to a person there is no way out.

4. People with a mental illness can feel hopeless and/or stigmatized. They may be under-employed or unemployed, unable or unlikely to sustain satisfying family relationships, marginalized, and dependent. With these consequences of living with a mental illness, suicide chances increase.

5. Higher risk can be linked to inadequate, inappropriate, or incomplete treatment of mental illness. Suicide may follow when a person does not have adequate outpatient follow-up after a suicide attempt, when the level of medications is insufficient, or when persons do not fill their prescriptions or take prescribed medications. In addition, controversial studies of the class of antidepressants known as selective serotonin reuptake inhibitors (SSRIs) show that a possible side effect may be increased risk of suicidal thoughts or attempts.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.