A risk factor is an aspect of personal behavior or lifestyle, an environmental exposure, or an inborn or inherited characteristic that has been shown to be associated with an increased occurrence of death by suicide. People “possessing” the risk factor are considered to be at greater potential for suicidal behavior. Risk factors are not predictors or causes of suicide. Risk factors can be divided into five general categories:
1. Permanent and Non-Modifiable Risk Factors cannot be changed may alert others to the heightened risk of suicide during periods of the recurrence of a mental or substance abuse disorder or following stressful life events
Demographics: White, American Indian, Male, Older Age, Separation or Divorce, Early Widowhood
Personal history of suicide ideation and/or attempts
Personal and/or Family History of:
Self-Harm Behavior
Suicidal Behavior
Violence
Substance Abuse (Drugs or Alcohol)
Divorce
Trauma or Abuse (Physical or Sexual)
Psychiatric Hospitalization
Frequent Mobility
Impulsive / Reckless Behaviors
2. Predisposing and Potentially Modifiable Risk Factors can be reduced by certain interventions, such as prescribing mood stabilizing medication for Bipolar Disorder or strengthening social support in a community
Mental Illness
Mood disorder,
Anxiety Disorder
Schizophrenia
Substance Use Disorder (Alcohol Abuse or Drug Abuse/Dependence)
Eating Disorders
Body Dysmorphic Disorder
Conduct Disorder (in adolescents)
Low Self-esteem/High Self-hate
Tolerant/Accepting Attitude Toward Suicide
Exposure to Another’s Death by Suicide
Lack of Self or Familial Acceptance of Sexual Orientation
Smoking
Perfectionism (especially in context of depression)
3. Acute Risk Factors indicate an increase risk in the near-term and most can be modified with immediate crisis intervention
Recently Divorced or Separated
Feelings of Victimization
Suicide Ideation (Threatened, Communicated, planned, or Prepared for);
Current Self-Harm Behavior
Excessive or Increased Use of Substances (alcohol or drugs)
Psychological Pain (severe distress in response to loss, defeat, rejection, etc.)
Anger, Rage, Seeking Revenge
Aggressive Behavior
Withdrawal from Usual Activities, Supports, Interests, School or Work
Isolation (e.g. lives alone)
Anxiety, Panic
Agitation
Insomnia
Persistent Nightmares
Suspiciousness, Paranoia (ideas of persecution or reference)
Severe feelings of confusion or disorganization
Hallucinations Urging Suicide
Intense affect states (e.g. desperation, intolerable aloneness, self-hate…)
Dramatic Mood Changes (in either direction)
Hopelessness
Poor Problem-solving (thinking in black and white terms, not able to see gray areas, alternatives…),
Few Reasons for Living and inability to Imagine Possibly Positive Future Events
Perceived Burdensomeness
Recent diagnosis of terminal condition
Feeling Trapped, Like There is No Way Out (other than death)
Sense of Purposelessness or Loss of Meaning
Negative or mixed attitude toward help-receiving
Recklessness or Excessive Risk-Taking Behavior, Especially if Out of Character or
Impulsivity (without thinking of consequences)
4. Precipitating or Triggering Stimuli are events that put a person in a heighten period of risk, particularly if the person is vulnerable to suicide based on the presence of previously mentioned risk factors.
Any real or anticipated even causing or threatening:
Feelings of shame, guilt, despair, humiliation, rejection, abandonment, and/or unacceptable loss of face or status
Loss of freedom (legal problems), financial problems
Recent exposure to another’s suicide, especially when it is a friend or family member but can also occur through exposure by the media
Contributory Risk Factors add to the possibility that someone may attempt suicide or complete suicide
Firearm ownership or easy accessibility
Acute or enduring unemployment
Stress (job, marriage, school, relationships…)
Grief and Loss