By Richard P. Holm, MD
South Dakota has the 14th highest suicide rate in the U.S., and, during this last year, suicide as a cause of death has grown faster here in South Dakota than most places. Two SD counties rank in the top one percent in the nation. I have heard that, in general, the highest risk individual for suicide is the widower, the elderly male who recently lost his wife. But the South Dakota public health department tells us that suicide rates are higher here in younger people than in most other states. For example, men aged 19 to 21-years-old, are at the highest suicide risk. In addition, American Indians are at 1.8 times higher risk than other South Dakotans.
Risk factors for suicide include: a family history of suicide; a history of abuse—be it the abused or the abuser; previous suicide attempts or a history of mental disorders (particularly depression) and especially if the individual has difficulty accessing mental health treatment when needed; a history of alcohol and substance abuse; feelings of hopelessness and loneliness especially with isolation; recent loss (whether it be the death of a family member, a friend that moves, a divorce, or a large financial loss); any new and significant physical illness; and access to lethal methods. There is also a higher risk is for anyone present during local epidemics of suicide, especially where cultural beliefs suggest that suicide is noble. All this multiplies when the person is reluctant to seek help because of the stigma attached to mental health disorders.
The challenging concern is that suicide remains extremely hard to predict. Even when we’ve identified who is at risk, suicide can be difficult to prevent. We know that “talking about it” is probably our most important means of helping someone who is suicidal. Although we should all try to guide these at risk individuals to talk about their feelings with a professional, the most important preventer of suicide in many cases is not the doctor or the care provider, but the kindly neighbor who can give that person an ear, offer true friendship, and call for help when red flags are flying.
You may never know it, but you might save a life by listening and just being a friend.
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