While difficult to talk about, suicide is a major public health risk with particular relevance to individuals with mental health issues and neurodevelopmental disorders. Adults and young people alike are affected by factors that increase their suicidal risks. Based on the 2017 Youth Risk Behaviors Survey, 7.4% of youth in grades 9-12 reported that they had made at least one suicide attempt in the past 12 months. Female students attempted almost twice as often as male students (9.3% vs. 5.1%). Black students reported the highest rate of attempts (9.8%) with White students at 6.1%. Approximately 2.4% of all students reported making a suicide attempt that required treatment by a doctor or nurse. For those requiring treatment, rates were highest for Black students (3.4%).
Dr. Thomas Joiner is a psychologist who has devoted his professional career to the study of suicide. Dr. Joiner’s interest in suicide is based at least in part by the impact of suicide on his family. Over the past 20 years he and his colleagues have researched suicide and developed the Interpersonal Theory of Suicide. This theory puts forth that two psychological states of mind contribute to the desire to take one’s own life:
- the perception of being a burden
- thwarted belongingness (social disconnection/isolation and loneliness)
However, the theory also explains why most individuals who have suicidal ideation do not go on to commit suicide. Years of research on human behavior and suicide have helped us understand that, as humans, we strive toward self-preservation. Thus, the prospect of suicide is frightening and those who engage in suicidal behavior must have the capability to do so. Dr. Joiner’s research helps us understand that those who have capability must have the following characteristics:
- elevated physical pain tolerance
The diagram be http://www.constructionworkingminds.org/suicide-risk-model.html low helps to illustrate the connection between desire and capability.
This model may help explain why individuals with neurodevelopmental disorders and psychiatric disorders have higher rates of suicidal ideation and attempts. For example, individuals with Autism Spectrum Disorder, particularly those without Intellectual Disabilities, have a significantly increased rate of suicidal thought and completion compared to those without ASD. Cassidy et al. (2014) reported that, in a group of 374 adults with Asperger’s Disorder (ASD without ID), 66% had a history of suicidal ideation and 35% had history of suicidal plans and/or attempts. That is in comparison to a rate of 5.4% of adults in the general population in England in 2014 who had suicidal thoughts. Of those participating in that study, 6.7% reported a lifetime incident of suicide attempt. Thus, the rate of suicidal thoughts in one year was significantly greater in those with ASD as was the rate of suicidal plans and/or attempts in their lifetime. These comparative statistics are consistent with findings from the National Survey on Drug Use and Health (2015), in which 4.0% of American adults had thoughts of suicide, 1.1% had made suicidal plans, and 0.6% had made suicide attempts.
A recent systematic review of the research by Balzas et al. (2018) revealed that individuals with ADHD are at increased risk of suicidal ideation and attempts. Adolescents with ADHD reported suicidal ideation at a rate of 50%. Almost 10% of adolescents with ADHD had a history of suicide attempts. Both males and females with ADHD are at increased risk of suicidal ideation and attempts. A study by Hinshaw et al. (2012) revealed that in a long-term follow-up of females with ADHD Combined Type, 22.4% were reported to have suicide attempts as compared to 6% without ADHD. The risk of suicidal ideation and attempts is even greater when an individual has co-existing psychiatric disorders.
CRG has been committed to evaluating and treating children, adolescents, young adults and, more recently, adults since 1993. In that time, we have recognized the increased mental health needs of those we serve, especially in those with neurodevelopmental disorders such as ASD, LD, and ADHD. People with these conditions have increased risks for psychiatric conditions that are often unrecognized, undiagnosed, and untreated. This pattern is confirmed by the research. Thus, we are committed to helping to identify individuals with desire for suicide and to intervene most aggressively when there is also capability. Please continue to follow our efforts to educate ourselves, our patients and families, and the public on the suicide epidemic and what we can do to address the problem.