Suicide in colleges in the United States

Last updated

In colleges and universities in the United States, suicide is one of the most common causes of death among students. [1] Each year, approximately 24,000 college students attempt suicide while 1,100 students succeed in their attempt, making suicide the second-leading cause of death among U.S. college students. [2] [3] Roughly 12% of college students report the occurrence of suicide ideation during their first four years in college, with 2.6% percent reporting persistent suicide ideation. [3] 65% of college students reported that they knew someone who has either attempted or died by suicide, showing that the majority of students on college campuses are exposed to suicide or suicidal attempts. [4]

Contents

According to the National Alliance on Mental Illness (NAMI), approximately 49% of the student population within the educational system have been diagnosed with or treated for depression. [5] Recent studies have also shown that underclassmen are less likely to commit suicide compared to upperclassmen due to a lack of worry over bills or work. Many are full-time students living with their parents. [6]

History

During the 20th century, universities and colleges drew limited attention to the issue of student suicides to avoid damages to the reputation and image of their institutions. [7]

However, after a 1978 PBS broadcast of College Can Be Killing, awareness was raised concerning suicide whilst in college; leading most schools to begin creating programs to assist students while they were attending their institutions. [7]

One of the earliest records of suicides of college students in the United States was in 1927, when 20 students across the entire continent committed suicide. [7] In 2006, 1100 students in the US committed suicide, and 24,000 attempted it. [8]

Since the year 2000, rates of suicide deaths have increased significantly. [9]

However, most recently research regarding the impact of the Covid-19 epidemic on college students has shown that suicidal ideation has decreased in colleges due to the increased emphasis on mental health and adaptive learning by collegiate institutions. [10]

Risk factors

Depression

Depression is the strongest correlate of suicidal behavior in college students. [11] The 2017 National College Health Assessment found that half of college students reported being overwhelmed by feelings of sadness or anxiety. [12] [13] The combination of new stressors, identity searching, and the fact that many common mental health problems arise within the age group most students fall under; all adds up as factors that can lead students to being more predisposed to depression. [14] The American College Health Association National College Health Assessment did a survey of over 20,000 students across the United States and found that almost 16% were diagnosed with depression. [15] Within that same study, it was found that 10.3% of the initial surveyed students had contemplated attempting suicide within the last year before taking the survey. [15] There is significant correlation between negative life events, such as sexual assault, and suicide risk. If untreated, the consequent emotional issues can result in the development of long-term mental health difficulties, including major depression, post-traumatic stress, and dissociation. [16]

Suicidal ideation

Suicidal ideation refers to the act of thinking about, considering, or planning suicide. Suicidal ideation has risen in prevalence amongst college-age students. [17] A study at Emory University found that 11.1% of students reported having suicidal ideation within the past four weeks and 16.5% of students attempted suicide or had a self-injurious event at least once in their lifetime. Suicidal ideation is associated with symptoms of depression, and students who reported current suicidal ideation had more of the severe depression symptoms. [17]

Among college students, depressive symptoms along with the severity level of past suicidal ideations in an individual's lifetime, are two short-term predictors of current suicidal ideation. [18] Factors indicating risk for persistent suicidal ideation include low social support, childhood or adolescent exposure to domestic violence, depression related to motherhood, and high self-reported symptoms of depression. [3] Females, individuals who have been previously screened for psychiatric illness, those with a positive family history of suicide, those that are more impulsive, and those that have higher motor impulsivity may be at greater risk of actually attempting suicide, rather than just the ideation. [19]

Stress

Stress has been shown to be highly correlated with suicide attempts. [20] The American College Health Association’s National College Health Assessment noted that 1.1% of college students made an attempt to commit suicide; citing that many other factors such as loneliness, issues within academics, relationships, money problems, and general helplessness play into that statistic. [21]

The amount and type of motivations for suicide can vary from student to student; however, a common motivation for suicide has been stress. [22] In a 2008 physiological study conducted by the Associated Press and MTVU, eight out of ten college students reported a feeling of horrible stress that impacted their grades. [22] Another common motivating factor has been issues at home that can impact their academic career. [23] Home-based issues can be composed of abuse, starvation, and overall poor living conditions. [23] Depression can also be a factor. [24]

Prevention

National Suicide Prevention Lifeline, a crisis line in the United States and Canada Lifelinelogo.svg
National Suicide Prevention Lifeline, a crisis line in the United States and Canada

Social support may be key to help prevent suicide in college populations. The link between depressive symptoms and hopelessness was shown to be reduced among college students who had high levels of social support. [25] Utilizing prevention training for those at colleges likely to interact with students has also been beneficial, as it has led to significant increases in the knowledge and skills needed for suicide prevention. [26]

Gatekeepers are another form of prevention utilized within some colleges and universities. “Gatekeepers” are those people who regularly encounter distressed individuals or groups. On college campuses, these individuals include instructors, students, resident assistants, and other campus life officials. [26] Gatekeeper training can teach those involved how to identify suicide warning signs and when and what to do when recognized. [27] Peer-led suicide prevention workshops are similar and have also been effective at improving participants’ knowledge about suicide and the resources available. [28]

Help-seeking behavior

In a national survey, it was shown that less than half of the college students who had seriously contemplated suicide during the previous twelve months received any mental health treatment during that time. [29] Of those that received treatment, the survey showed that students who deemed treatment necessary believed that treatment was effective, had contact with those involved in mental health services, showed a lower personal stigma and higher perceived stigma, did not have many positive relationships, belonged in a sexual minority group, or was Caucasian. [29] These correlations show that help seeking behavior among suicidal college students cover a wide range of personal and social factors. [30]

College programs and initiatives

Many universities and colleges have begun offering assistance to new and returning students with dealing with stress. [7] Some institutions have also begun providing educators and staff members with training and education on how to interact with a student that has expressed or shown suicidal interests or tendencies. [7] The most common intervention strategies used by colleges involve campaigns to reduce stigma and provide education on mental illness, screen the population and attempt to link at-risk individuals with resources, or train people who are in often in contact with other members of the community. [30]

Social and culture

Legislation

In total, nine states have passed legislation regarding suicide on college campuses. [31] Many of these laws require institutions of higher learning to inform entering students of available mental health resources, develop policies to inform students and staff of the proper procedures for addressing the needs of a suicidal student, and post all relevant mental health and suicide prevention information on the school's webpage. [31] Pending federal legislation would mandate that the Substance Abuse and Mental Health Services Administration to award financial grants to colleges and universities to improve mental health services, conduct research about the mental health of its students, and expand training programs on campus. [31]

See also

Related Research Articles

According to a 2023 Centers for Disease Control and Prevention study, suicide is the second leading cause of death for adolescents between the ages of 10 and 14, and the third leading cause of death for those between 15 and 25

Adjustment disorder is a maladaptive response to a psychosocial stressor. It is classified as a mental disorder. The maladaptive response usually involves otherwise normal emotional and behavioral reactions that manifest more intensely than usual, causing marked distress, preoccupation with the stressor and its consequences, and functional impairment.

<span class="mw-page-title-main">Suicide prevention</span> Collective efforts to reduce the incidence of suicide

Suicide prevention is a collection of efforts to reduce the risk of suicide. Suicide is often preventable, and the efforts to prevent it may occur at the individual, relationship, community, and society level. Suicide is a serious public health problem that can have long-lasting effects on individuals, families, and communities. Preventing suicide requires strategies at all levels of society. This includes prevention and protective strategies for individuals, families, and communities. Suicide can be prevented by learning the warning signs, promoting prevention and resilience, and committing to social change.

<span class="mw-page-title-main">Suicidal ideation</span> Thoughts, ideas, or ruminations about the possibility of ending ones life

Suicidal ideation, or suicidal thoughts, is the thought process of having ideas, or ruminations about the possibility of completing suicide. It is not a diagnosis but is a symptom of some mental disorders, use of certain psychoactive drugs, and can also occur in response to adverse life circumstances without the presence of a mental disorder.

Suicide risk assessment is a process of estimating the likelihood for a person to attempt or die by suicide. The goal of a thorough risk assessment is to learn about the circumstances of an individual person with regard to suicide, including warning signs, risk factors, and protective factors. Risk for suicide is re-evaluated throughout the course of care to assess the patient's response to personal situational changes and clinical interventions. Accurate and defensible risk assessment requires a clinician to integrate a clinical judgment with the latest evidence-based practice, although accurate prediction of low base rate events, such as suicide, is inherently difficult and prone to false positives.

<span class="mw-page-title-main">College health</span> Health of individuals enrolled in college

College health is a desired outcome created by a constellation of services, programs and policies directed at advancing the health and wellbeing of individuals enrolled in an institution of higher education, while also addressing and improving both population health and community health. Many colleges and universities worldwide apply both health promotion and health care as processes to achieve key performance indicators in college health. The variety of healthcare services provided by any one institution range from first aid stations employing a single nurse to large, accredited, multi-specialty ambulatory healthcare clinics with hundreds of employees. These services, programs and policies require a multidisciplinary team, the healthcare services alone include physicians, physician assistants, administrators, nurses, nurse practitioners, mental health professionals, health educators, athletic trainers, dietitians and nutritionists, and pharmacists. Some of the healthcare services extend to include massage therapists and other holistic health care professionals. While currently changing, the vast majority of college health services are set up as cost centers or service units rather than as parts of academic departments or health care delivery enterprises.

A suicide crisis, suicidal crisis or potential suicide is a situation in which a person is attempting to kill themselves or is seriously contemplating or planning to do so. It is considered by public safety authorities, medical practice, and emergency services to be a medical emergency, requiring immediate suicide intervention and emergency medical treatment. Suicidal presentations occur when an individual faces an emotional, physical, or social problem they feel they cannot overcome and considers suicide to be a solution. Clinicians usually attempt to re-frame suicidal crises, point out that suicide is not a solution and help the individual identify and solve or tolerate the problems.

Youth suicide is when a young person, generally categorized as someone below the legal age of majority, deliberately ends their own life. Rates of youth suicide and attempted youth suicide in Western societies and other countries are high. Amoung youth, attempting suicide is more common among girls; however, boys are more likely to actually perform suicide. Among youth, the rate of suicide nearly tripled between the 1960s and 1980s. For example, in Australia suicide is second only to motor vehicle accidents as its leading cause of death for people aged 15 to 25.

<span class="mw-page-title-main">Depression in childhood and adolescence</span> Pediatric depressive disorders

Major depressive disorder, often simply referred to as depression, is a mental disorder characterized by prolonged unhappiness or irritability. It is accompanied by a constellation of somatic and cognitive signs and symptoms such as fatigue, apathy, sleep problems, loss of appetite, loss of engagement, low self-regard/worthlessness, difficulty concentrating or indecisiveness, or recurrent thoughts of death or suicide.

<span class="mw-page-title-main">Suicide in South Korea</span> Statistics and causes of suicide

South Korea records the world's fourth highest suicide rate, and the highest suicide rate in the OECD. The elderly are at the highest risk of suicide, but teen suicide deaths have been rising since 2010: Suicide caused more than half of all deaths among South Koreans in their 20s in 2022, and it is the leading cause of death among those in their teens, 20s, and 30s.

Research has found that attempted suicide rates and suicidal ideation among lesbian, gay, bisexual, and transgender (LGBTQ) youth are significantly higher than among the general population.

The health issues of athletics concern their physical and mental well-being in organized sport. If athletes are physically and mentally underdeveloped, they are susceptible to mental or physical problems. Efforts to improve performance can lead to harm from overtraining, adopting eating habits that damage them physically or psychologically, like using steroids or supplements.

In 2014, the WHO ranked Nepal as the 7th in the global suicide rate. The estimated annual suicides in Nepal are 6,840 or 24.9 suicides per 100,000 people. Data on suicide in Nepal are primarily based on police reports and therefore rely on mortality statistics. However, the burden of suicide in communities is likely to be higher, particularly among women, migrant workers, and populations affected by disasters.

<span class="mw-page-title-main">Mental health in education</span>

Mental health in education is the impact that mental health has on educational performance. Mental health often viewed as an adult issue, but in fact, almost half of adolescents in the United States are affected by mental disorders, and about 20% of these are categorized as “severe.” Mental health issues can pose a huge problem for students in terms of academic and social success in school. Education systems around the world treat this topic differently, both directly through official policies and indirectly through cultural views on mental health and well-being. These curriculums are in place to effectively identify mental health disorders and treat it using therapy, medication, or other tools of alleviation. Students' mental health and well-being is very much supported by schools. Schools try to promote mental health awareness and resources. Schools can help these students with interventions, support groups, and therapies. These resources can help reduce the negative impact on mental health. Schools can create mandatory classes based on mental health that can help them see signs of mental health disorders.

Over the past few decades, mental health has become an increasingly serious issue in health in South Korea. A 2021 survey conducted by the Ministry of Health and Welfare found that 32.7% of males and 22.9% of females in South Korea developed symptoms of mental illness at least one time in their lives. Suicide in South Korea is the most frequent cause of death for people aged 9 to 24. Mental health issues are most common among the elderly and adolescents.

<span class="mw-page-title-main">Mental health during the COVID-19 pandemic</span> Psychological aspect of viral outbreak

The COVID-19 pandemic has impacted the mental health of people across the globe. The pandemic has caused widespread anxiety, depression, and post-traumatic stress disorder symptoms. According to the UN health agency WHO, in the first year of the COVID-19 pandemic, prevalence of common mental health conditions, such as depression and anxiety, went up by more than 25 percent. The pandemic has damaged social relationships, trust in institutions and in other people, has caused changes in work and income, and has imposed a substantial burden of anxiety and worry on the population. Women and young people face the greatest risk of depression and anxiety. According to The Centers for Disease Control and Prevention study of Mental Health, Substance Use, and Suicidal Ideation During the COVID-19 Pandemic, "63 percent of young people reported experiencing substantial symptoms of anxiety and depression".

Suicide and trauma is the increased risk of suicide that is caused by psychological trauma.

<span class="mw-page-title-main">Impact of the COVID-19 pandemic on suicide rates</span>

Suicide cases have remained constant or decreased since the outbreak of the COVID-19 pandemic. According to a study done on twenty-one high and upper-middle-income countries in April–July 2020, the number of suicides has remained static. These results were attributed to a variety of factors, including the composition of mental health support, financial assistance, having families and communities work diligently to care for at-risk individuals, discovering new ways to connect through the use of technology, and having more time spent with family members which aided in the strengthening of their bonds. Despite this, there has been an increase in isolation, fear, stigma, abuse, and economic fallout as a result of COVID-19. Self-reported levels of depression, anxiety, and suicidal thoughts were elevated during the initial stay-at-home periods, according to empirical evidence from several countries, but this does not appear to have translated into an increase in suicides.

Youth suicide in India is when young Indian people deliberately end their own life. People aged 15 to 24 years have the highest suicide rate in India, which is consistent with international trends in youth suicide. 35% of recorded suicides in India occur in this age group. Risk factors and methods of youth suicide differ from those in other age groups.

According to the World Health Organization (WHO), Mental health is essential for individuals' well-being and functioning, encompassing cognitive abilities, emotional understanding, and interpersonal interactions. Students worldwide consider psychological well-being, happiness, and contentment as essential life values. Research indicates that students' well-being is greatly influenced by specific needs, including the ability to make choices, express oneself freely, pursue passions and interests, achieve success, and feel psychologically and socially secure. Moreover, global studies suggest that an increased sense of well-being is associated with enhanced academic achievement, interpersonal relationships, and overall health.

References

  1. Taub, Deborah J.; Thompson, Jalonda (Spring 2013). "College Student Suicide". New Directions for Student Services. 2013 (141): 5–14. doi:10.1002/ss.20036.
  2. Appelbaum, Paul S. (July 2006). "Law & Psychiatry: "Depressed? Get Out!": Dealing With Suicidal Students on College Campuses". Psychiatric Services. 57 (7): 914–916. doi:10.1176/ps.2006.57.7.914. ISSN   1075-2730. PMID   16816275.
  3. 1 2 3 Wilcox, Holly C.; Arria, Amelia M.; Caldeira, Kimberly M.; Vincent, Kathryn B.; Pinchevsky, Gillian M.; O'Grady, Kevin E. (2010). "Prevalence and predictors of persistent suicide ideation, plans, and attempts during college". Journal of Affective Disorders. 127 (1–3): 287–294. doi:10.1016/j.jad.2010.04.017. PMC   2924459 . PMID   20471691.
  4. Cerel, Julie; Bolin, Mary Chandler; Moore, Melinda M (2013). "Suicide exposure, awareness and attitudes in college students". Advances in Mental Health. 12 (1): 46–53. doi:10.5172/jamh.2013.12.1.46. ISSN   1838-7357. S2CID   58339266.
  5. "College Student Mental Health Statistics". National Alliance on Mental Illness (via Chadron State College).
  6. De Luca, Susan (January 2016). "The Relationship Between Suicide Ideation, Behavioral Health, and College Academic Performance". Community Mental Health Journal. 52 (5): 534–540. doi:10.1007/s10597-016-9987-4. PMID   26831304. S2CID   7963924.
  7. 1 2 3 4 5 Brown, Peggy (Winter 2014). "College Can Be Killing: United States College and University Responses to Student Suicide During the 20th Century and Early 21st Century". Journal of College Admission: 35–48.
  8. Fernández Rodríguez, M. del C., & Huertas, I. B. (2013). Suicide Prevention in College Students: A Collaborative Approach. Revista Interamericana de Psicologia = Interamerican Journal of Psychology, 47(1), 53–60.
  9. Iarovici, Doris (July 2015). "Perspectives on College Student Suicide". Psychiatric Times: 27–32.
  10. Zhai, Yusen; Du, Xue (October 2022). "Trends and prevalence of suicide 2017–2021 and its association with COVID-19: Interrupted time series analysis of a national sample of college students in the United States". Psychiatry Research. 316: 114796. doi:10.1016/j.psychres.2022.114796. ISSN   0165-1781. PMC   9375853 . PMID   35987067.
  11. Holdaway, Alex S.; Luebbe, Aaron M.; Becker, Stephen P. (2018). "Rumination in relation to suicide risk, ideation, and attempts: Exacerbation by poor sleep quality?". Journal of Affective Disorders. 236: 6–13. doi:10.1016/j.jad.2018.04.087. PMC   6047760 . PMID   29704657.
  12. Fieseler, Robert W. (28 June 2019). "High Falls: A Human Chain". The Delacorte Review. Retrieved 2020-05-21.
  13. "Publications and Reports: ACHA-NCHA II". www.acha.org. Retrieved 2020-05-21.
  14. Kang, Harmeet Kaur; Rhodes, Christopher; Rivers, Emerald; Thornton, Clifton P.; Rodney, Tamar (2021-02-01). "Prevalence of Mental Health Disorders Among Undergraduate University Students in the United States: A Review". Journal of Psychosocial Nursing and Mental Health Services. 59 (2): 17–24. doi:10.3928/02793695-20201104-03. ISSN   0279-3695.
  15. 1 2 Miller, Elissa J.; Chung, Henry (September 2009). "A Literature Review of Studies of Depression and Treatment Outcomes Among U.S. College Students Since 1990". Psychiatric Services. 60 (9): 1257–1260. doi:10.1176/ps.2009.60.9.1257. ISSN   1075-2730.
  16. Li, Wenjing; Dorstyn, Diana S.; Jarmon, Eric (2020-07-02). "Identifying suicide risk among college students: A systematic review". Death Studies. 44 (7): 450–458. doi:10.1080/07481187.2019.1578305. ISSN   0748-1187.
  17. 1 2 Garlow, Steven J.; Rosenberg, Jill; Moore, J. David; Haas, Ann P.; Koestner, Bethany; Hendin, Herbert; Nemeroff, Charles B. (2008-06-01). "Depression, desperation, and suicidal ideation in college students: results from the American Foundation for Suicide Prevention College Screening Project at Emory University". Depression and Anxiety. 25 (6): 482–488. doi: 10.1002/da.20321 . PMID   17559087. S2CID   34343779.
  18. Nam, Boyoung; Wilcox, Holly C.; Hilimire, Matthew; DeVylder, Jordan E. (2018-11-17). "Perceived need for care and mental health service utilization among college students with suicidal ideation". Journal of American College Health. 66 (8): 713–719. doi:10.1080/07448481.2018.1434779. ISSN   0744-8481. PMID   29384469. S2CID   4477617.
  19. Wang, Yong-guang; Chen, Shen; Xu, Zhi-ming; Shen, Zhi-hua; Wang, Yi-quan; He, Xiao-yan; Cao, Ri-fang; Roberts, David L.; Shi, Jian-fei (2017). "Family history of suicide and high motor impulsivity distinguish suicide attempters from suicide ideators among college students". Journal of Psychiatric Research. 90: 21–25. doi:10.1016/j.jpsychires.2017.02.006. PMID   28214643.
  20. Liu, Cindy H.; Stevens, Courtney; Wong, Sylvia H.M.; Yasui, Miwa; Chen, Justin A. (January 2019). "The prevalence and predictors of mental health diagnoses and suicide among U.S. college students: Implications for addressing disparities in service use". Depression and Anxiety. 36 (1): 8–17. doi:10.1002/da.22830. PMC   6628691 . PMID   30188598.
  21. Hanover, MD (2012). "American College Health Association- National College Health Assessment II: Reference Group Executive Summary Fall 2011" (PDF). American College Health Association.
  22. 1 2 Wu, Joanne (February 29, 2000). "Stress in College Students". The American Institute of Stress.
  23. 1 2 Foster, Dawn (February 4, 2016). "Poor housing is bad for your mental health". The Guardian.
  24. Hawksworth, Elizabeth (September 18, 2014). "College drove me to the brink of Suicide". Washington Post.
  25. Lamis, Dorian A.; Ballard, Elizabeth D.; May, Alexis M.; Dvorak, Robert D. (2016). "Depressive Symptoms and Suicidal Ideation in College Students: The Mediating and Moderating Roles of Hopelessness, Alcohol Problems, and Social Support: College Student Suicidal Ideation". Journal of Clinical Psychology. 72 (9): 919–932. doi:10.1002/jclp.22295. PMID   27008096.
  26. 1 2 Wolitzky-Taylor, Kate; LeBeau, Richard T.; Perez, Marcelina; Gong-Guy, Elizabeth; Fong, Timothy (2019-03-25). "Suicide prevention on college campuses: What works and what are the existing gaps? A systematic review and meta-analysis". Journal of American College Health. 68 (4): 419–429. doi:10.1080/07448481.2019.1577861. ISSN   0744-8481. PMID   30908123. S2CID   85515338.
  27. Ross, Sarah G.; DeHay, Tamara; Deiling, Megan (January 2021). "The Suicide Prevention for College Student Gatekeepers Program: A Pilot Study". Crisis. 42 (1): 48–55. doi:10.1027/0227-5910/a000686. ISSN   0227-5910. PMID   32228037.
  28. Tsong, Yuying; Young, Jennifer T.; Killer, Jane Duong; Takemoto, Mary Ann; Compliment, Brad (2019-04-03). "Suicide Prevention Program on a Diverse College Campus: Examining the Effectiveness of a Peer-to-Peer Model". Journal of College Student Psychotherapy. 33 (2): 131–144. doi:10.1080/87568225.2018.1434716. ISSN   8756-8225. S2CID   148759163.
  29. 1 2 Downs, Marilyn F.; Eisenberg, Daniel (2012). "Help Seeking and Treatment Use Among Suicidal College Students". Journal of American College Health. 60 (2): 104–114. doi:10.1080/07448481.2011.619611. ISSN   0744-8481. PMID   22316407. S2CID   205582972.
  30. 1 2 Eisenberg, Daniel; Hunt, Justin; Speer, Nicole (2012). "Help Seeking for Mental Health on College Campuses: Review of Evidence and Next Steps for Research and Practice". Harvard Review of Psychiatry. 20 (4): 222–232. doi:10.3109/10673229.2012.712839. ISSN   1067-3229. PMID   22894731. S2CID   25881991.
  31. 1 2 3 "State Laws: Suicide Prevention on University and College Campuses" (PDF). American Foundation for Suicide Prevention. 2017. Retrieved April 21, 2019.