SUICIDE AMONG PERSONS
WITH MENTAL ILLNESS
On the order of 1% of the general population kill themselves. However, persons suffering from certain mental illnesses are particularly susceptible
to suicide ideation and suicide attempts. Their suicide rate may be 10 or
20 times higher than for the average citizen. Unfortunately, not a great deal is known about effective
methods of combating suicide, because it is considered unethical to
conduct studies on such matters.
Elderly persons who are terminally ill, for whom the quality of life
has shrunk to zero, are often not depressed when they seek assistance in
ending their life, or when they commit suicide. However, suicide is
otherwise generally associated with severe depression.
One study showed that only 3% of persons who completed suicide had been
receiving adequate antidepressant therapy. 7 There is a
common belief that patients who are recovering from severe depression --
particularly after a week or two of antidepressant treatment -- are at
high risk for suicide.
It is generally accepted that abuse of alcohol or other drugs, coupled
with depression, greatly increases the likelihood of suicide. 8
This is sometimes called Bipolar Affective Disorder, Manic Depressive Illness, or Manic Depression. It is a
type of disorder in which the individual suffers extremes in mood: periods of deep
depression alternating with periods of extreme excitement or mania. Symptoms
often first appear in the late teen years.
Among persons with bipolar disorder,
||The highest risk for attempted suicide is shortly after the onset of
||About 20% of those whose disorder is not treated commit suicide at
some time during their lifetime.
||About 25% to 50% will attempt suicide at least once.
||About 19% will die by suicide. 4
||Men and women commit suicide at equal rates. This is different from
persons who do not suffer from Bipolar Disorder. In the general population,
four times as many men as women commit suicide.
||Creative individuals, such as artists, writers, musicians, composers, etc.
appear to suffer disproportionately from mood disorders, and suicidal
Fortunately, medication will alleviate symptoms in about 80% of cases, thus
greatly reducing the risk of suicide.
Borderline Personality Disorder:
Persons with borderline personality disorder (BPD) "display poor
control or dyscontrol of their emotional states. It is characterized by
impulsivity, self-destructive behavior, problems with anger, lability of
emotions and stormy interpersonal relationships." 3
||About 10% will end their life through suicide.
||About 75% have made at least one suicide attempt; almost 50% have
made at least one severe attempt.
||About 80% have engaged in self-mutilation. This usually takes the
form of cutting or burning their skin -- often on their forearms.
||Since many persons with BPD repeatedly self-mutilate as a reaction
to relatively minor stressors in their life, they are often dismissed
as attention seekers. Their suicidal ideation may not be treated
||Dialectical Behavior Therapy (DBT) has been shown to reduce suicide
attempts, incidences of self-injury, and inpatient hospitalization.
DBT combines cognitive behavioral therapy with skills training.
Schizophrenia is "the most persistent and disabling of the
major mental illnesses." 6 The term means
"split-mindedness;" it refers to a disruption of the balance
among the four mental functions: thinking, feeling, perception and
behavior control. Many incorrectly confuse it with split or multiple
personality, a disorder that is either non-existent or phenomenally
rare. Schizophrenia effects about 1% of the population. Symptoms, such as
delusions, hallucinations, illusions, and thought disturbances, usually
first appear between the ages of 16 and 30. A predisposition to
schizophrenia appears to be caused by a chemical and/or structural defect
in the brain. It is then triggered by an external stressor. Long term,
about one in four recover fully; another one in four require long-term
care; the rest make a partial recovery.
||About 10% of persons diagnosed with schizophrenia will die an
unnatural death - usually by suicide.
||About 40% are known to have attempted suicide. 5
||They are not generally driven to committing suicide as a result of
their internal voices or delusions. One expert, Dr Jock Cleghorn,
estimated in 1992 that only 2% of suicides by persons with
schizophrenia did so in response to their voices. They usually kill
themselves because of a collapse of their support network, the loss of
their job, loss of accommodation, death of a beloved relative, etc.
||Risk factors include: having a good educational background, having
high performance expectations, being recently released from hospital,
and going through an upswing in the disorder, having a sudden change
in mood from gloomy to cheerful.
Iatrogenic (physician induced) disorders:
During the 1980's and early 1990's, many mental health therapists used
various experimental recovered memory therapies to
reconstruct what were believed to be their patients' long-suppressed
memories of childhood sexual abuse. About 17% of the patients who had
recovered images of sexual abuse, eventually concluded that they had been the victims of Satanic
Ritual Abuse (SRA). These images coalesced into what felt like
memories of real events from the past. It was only in the 1990's that a
consensus grew that these therapeutic methods were quite unreliable and
that most of the memories that they created were of events which never
actually happened. Over a decade of police investigations have produced a
total lack of hard evidence that SRA exists. Belief in Satanic Ritual
Abuse has now largely collapsed.
During the same period, some mental health therapists started to
diagnose many of their patients as suffering from Multiple
Personality Disorder (MPD; a.k.a. Dissociative Identity Disorder -
DID). They seem to exhibit many discrete personalities, called alters, who
appeared within the single individual. Belief in the widespread existence
of MPD faded rapidly during the late 1990's. Many, if not most,
therapists believe that alters are actually created by the therapist and
patient during therapy without either being aware of the process.
False memories of Satanic Ritual Abuse, and invalid diagnosis of
MPD/DID have been responsible for many suicides. Unfortunately, statistics are
not available that would give an indication of how many physician-induced
suicides have actually occurred.
"Facts about Bipolar Disorder and Suicide," American
Foundation for Suicide Prevention, at: http://www.afsp.org/about/manicdep.htm
Barbara Stanley, "Suicidal behavior in borderline personality
disorder: The scope of the problem and psychotherapeutic approaches,"
Leonardo Tondo et al., "Lithium and suicide risk in bipolar
disorder," at: http://www.afsp.org/education/tondo.htm
"Pamphlet #23: Schizophrenia and suicide," World
Fellowship of Schizophrenia, at: http://www.world-schizophrenia.org/publications/
"Pamphlet #1: No family is immune," World Fellowship of
Schizophrenia, at: http://www.world-schizophrenia.org/publications/
Isometsa, et al., American Journal of Psychiatry, (1994) 151: Pages
530-36, as quoted in Reference 8.
"Ask the expert: Depression and suicide," at: http://www.mhsource.com/expert/exp1121597b.html.
Copyright © 2000 by Ontario Consultants on Religious
Originally written: 2001-FEB-6
Latest update: 2001-FEB-11
Author: B.A. Robinson