Suicide

Preventable Tragedies: Suicide

Suicide is a leading cause of preventable death for people with severe mental illness (SMI) and has a devastating impact on families and communities. Although the frequency of suicide is tragic and alarming, there is hope. Treatments focused on preventing suicidal thoughts and behaviors have been shown to decrease suicide and self-harm for people with SMI. If you or someone you know is having thoughts of self-harm or suicide, please call or text 988 to reach the National Suicide and Crisis Lifeline. A counselor from this lifeline is available to speak with you at any time of day, 365 days a year.

How common are suicidal thoughts and behaviors for people with SMI?

Suicidal thoughts and behaviors are much more common among people with SMI than the general population. Research suggests that 35% of people with schizophrenia experience suicidal ideation at some point in their life. At any given time, six to 13% of people with schizophrenia are estimated to have an active plan for suicide.

Rates of attempted suicide are also high for many types of SMI diagnoses. One systematic review and meta-analysis found that 20% of people with schizophrenia attempted suicide at some point in their lifetime. This was true for 47% of people with schizoaffective disorder, 11% of people with delusional disorder, and 13% of people with first-episode psychosis. Among people with bipolar disorder, up to 60% attempt suicide at some point in their lifetime, and five to 20% die by suicide. These rates are much higher than that of the general population, 5.5% of whom have serious thoughts of suicide and 0.8% of whom attempt suicide.

When are people with SMI most at risk for suicide?

Over the course of a person’s illness, symptoms, circumstances, and suicide risk can vary. Research suggests there are a number of factors associated with increased risk of suicide for people with severe mental illness including co-occurring depression, recent improvements in insight, abuse of stimulants, and poor treatment adherence. Suicide risk is also greater during the first few years of the illness and in the weeks following discharge from an inpatient hospitalization.

Are there any evidence-based treatments for decreasing suicide and self-harm for people with SMI?

People with SMI, particularly those who are at an elevated risk of suicide, should be provided with evidence-based, individualized treatment plans to help mitigate suicide risk. Early-intervention services, the antipsychotic clozapine, and psychosocial treatments like intensive case management have some evidence supporting their ability to decrease suicide risk among people with psychotic disorders. However, there are still many unknowns about the best ways to prevent suicide among people with severe mental illness.

Do you have any resources for friends and family members?

Yes, our Schizophrenia and Psychosis Resource Center has a number of resources that you may find helpful, including resources on how to make your home safer for someone experiencing suicidal ideation and how to plan for emergencies. You can also send our team an email at help@tac.org, and we will respond within one to three business days. If you are experiencing an emergency, please contact 988.