SUICIDE RISK FACTORS
Through various studies in suicide, it is now quite clear which
groups are at greatest risk. Also, often it is not just one factor,
but a combination of factors which triggers a person to suicide.
It is through the understanding of these risk factors, that we
can better assess the risk of suicide in our patients.
A. Demographic Risk Factors
1. Suicide rates are highest in elderly Chinese males.
2. Males are 1.5 times more likely to suicide than females. This
ratio is smaller (1:1) in the younger age-group and larger
(2:1) in the older age group.
3. Rates in ethnic Chinese (13.3 per 100,000) and Indians
(13.0 per 100,000) are much higher than that in ethnic
Malays (2.3 per 100,000).
4. Divorced individuals are at greatest risk, and while marriage
appears to protect against suicide in young females and older
males, it does not in young males and elderly females.
B. Social Risk Factors
Social or life stressors are one of the potential stimuli to suicide.
From affidavits from family and friends and from reviews
of suicide letter from 2000-4, common themes of suicide
include
1. Relationship problems (girl-boy and parent-child), andschool stress (examinations) in the young (aged < 24
years).
2. Marital, financial, unemployment and other job-related
problems (e.g. unhappiness at work) in the adult age group
(24-59 years).
3. Physical illness, relationship problems (parent- child),
loneliness, bereavement and fear of being a burden in the
elderly (>60 years).
Overall, relationship problems were associated with one third
of all suicides, and were seen across the spectrum in all
age groups.
Financial (failed business, debt and legal issues) or
employment problems were associated with a further one-third.
As a group, risk of suicide in the unemployed is particularly
high, with unemployment rates in suicide victims (aged 24-59
years) being 20 times higher than the employed.
Gradual physical disability and suffering (due to illness
and advance age) are important risk factors in the elderly
suicide, particularly if coupled with poor community and
family support. The percentage of cancer-related suicides, for
example, has increased in recent years as our population ages.
Recent initiatives to focus on improving health and community
support in palliative and elderly care are therefore welcome, and
will hopefully help to lower suicide risk in this very vulnerable
age group.
C. Clinical (Psychological and Psychiatric) Risk
Factors
1. Those with certain personality type are at risk (28%). Most
typically they tend to be proud, secretive, lonely people
with low self esteem, a tendency to worry un-necessary and
with poor problem solving skills. These personality types
find it difficult to relate to other, share problems and seek
solutions.
2. People with addictions are also at risk. These include those
with drug addiction (10.5%), alcoholism (5%), gambling
problem (5%) and deviant sexuality (0.6%).
3. Mental illness is also a major risk-factor; and is associated
with suicide in 58%.
http://www.cfps.org.sg/sfp/36/361/361_unit_6.pdf
Things might have changed with the introduction of new attractions in Singapore and the change in demographic and the socio-economic landscape. But the causes of suicide remain basically unchanged.