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Adolescent: A person aged 13-18 years of age, Data reported by the government in 2000 noted that suicide was the 3rd leading cause of death among young people.

Other associated terms: adolescence; teen; youth; juvenile; teenager; detection

Affect: A feeling or emotive state of being. Persons at risk for suicide may feel down or appear sad. Depression, a mood disorder, is one of the most commonly associated risk factors for a suicide attempt. (Flat affect, where the person appears to not show much emotion to the outside, is most commonly associated with schizophrenia. In depression, individuals often appear sad or down and show their emotions in their facial expression).

Other associated terms: emotion; mood; feeling; detection

Ambivalence: having conflicting and opposite feelings at the same time. Usually associated with an inability to make a decision. In terms of suicide prevention, ambivalence usually means wishing to both live and die simultaneously.

Other associated terms: confusion; ambivalent; uncertain; detection

Anxiety: A diffuse or acute apprehension associated with feelings of hopelessness or uncertainty. Anxiety is felt subjectively by the person and can be present in people at risk for suicide.

Other associated terms: panic; apprehension; nervousness; concern; distress; detection

At risk: A person at risk for suicide is said to have a high potential to complete suicide.  Risk factors vary from men to women, among various age groups, and among various races, ethnicities, and cultures. (See Associated Factors).

Other associated terms: risk factor; threat; lethality; intent; means; detection

Attempted suicide: An action taken by a person which if carried out to completion would result in his/her death. There may be as many as 25 attempted suicides for every one completed suicide.

Other associated terms: suicide attempt; self-destructive behavior; self-harm; parasuicide; detection

Behavior: Any observable or measurable act. In suicide prevention, this refers to any type of behavior that is consistent with a suicide attempt.

Other associated terms: act; action; expression; attitude; detection

Borderline Personality Disorder: A mental health disorder that affects a person's thinking, mood and behavior. A person with a diagnosis of a borderline personality disorder often experiences a repetitive pattern of disorganization (unfocused and non-purposeful behavior) and instability in self-image, mood, behavior and close personal relationships. Self-mutilative behaviors such as “cutting oneself” or “pulling one's own hair out” are also often present in this diagnosis.   Borderline Personality is an associated risk factor for suicide.

Other associated terms: disorder; mental illness; unstable; instability; psychiatric diagnosis; detection

Bipolar Disorder: A mental health disorder which primarily affects a person's affect and   mood. A person with a diagnosis of Bipolar affective disorder often experiences occurrences of at least one episode of manic behavior with or without a history of depression. Bipolar disorder is an associated risk factor for suicide.

Other associated terms: depression; manic; manic-depressive; detection

Commitment: Involuntary admission to an in-patient mental health facility. When committed, an individual loses the right to leave when he or she wishes. In the case of suicide, a person at risk for suicide might be committed if there is evidence which supports that the person poses a serious threat of inflicting self-harm.

Other associated terms: hospitalization; acute care; in-patient treatment; involuntary admission; treatment

Community Mental Health Centers: Institutions that provide comprehensive mental health services, usually on an outpatient; day treatment; or partial hospitalization basis. Some community mental health agencies may be privately funded, affiliated with a church or charitable organization and some may use federal or state funds. A person at risk for suicide, but one who does not seem to pose an acute danger to harming him or herself, might seek treatment through a community mental health center.

Other associated terms: outpatient treatment; sub-acute treatment; day treatment; partial hospitalization; treatment

Completed suicide: The act that results in suicidal behavior being carried out and leading to death. In 1999, the total number of deaths by suicide exceeded 29,000 persons in the United States.

Other associated terms include: die by suicide, death, self-harm; detection

Crisis: The internal feeling or experience that results from a stressful event or a perceived threat to a person. The crisis experience is usually self-limiting and averages about 6 weeks in length. Many helpers often falsely believe that a suicide attempt or suicidal behavior is associated with a specific crisis. This is usually not the situation although a specific event or perceived threat when accompanied with other risk factors may prompt a suicide attempt.

Other associated terms: threat, vulnerable, stress, cause; detection

Depression: The emotional state often associated with sadness and grief. It is the level of depression that determines whether or not it is a “normal and expected state” or extended beyond that which is considered normal. Depression can be seen as a sign, symptom, emotional statement, reaction, clinical disease or state, which is one reason that it is difficult to categorize. Experts note depression is one of the most significant risk factors for a suicide attempt.

Other associated terms: risk factor; grief; sad; clinical depression; depressed; disinterest; detection.

Drug abuse: The use of chemical substances (including alcohol) for reasons other than medical treatment. Drug abuse, especially in the form of alcoholism and cocaine use, is once of the most significant risk factors associated with a person at risk for a suicide attempt.

Other associated terms: risk factor; drug abuse, alcohol abuse, cocaine use, substance abuse; detection

Elder Suicide: The occurrence of suicide among the aged. The elderly are a “high risk” group for a suicide attempt. The NIMH reports that in 1997, 13 percent of the U.S. population, individuals ages 65 and older accounted for 19 percent of all suicide deaths. Many elder suicide attempts occur in co-existence with major depression and a physiological disease. Many seniors' depression goes undiagnosed. It is estimated that as many as 6% of the elderly suffer from a diagnosable depression which in turn is one of the major factors associated with a person at risk for attempting suicide.

Other associated terms: risk factor; senior; elderly; older adult; aged; depression; detection

Ethical Guidelines: Standards of valued behavior by an individual or a group. Mental health clinicians and other “professional” helpers are guided by the recognized standards of their profession. Any helper, whether a “professional” or not should abide by the principle of “doing no harm”.

Other associated terms: ethic; standard; guideline; best practice; treatment

Facts: Research has offered many facts about the detection and treatment for those persons at risk for suicide.

Other associated terms: myth, common concerns, risk factor; associated factor; detection

Grief: An individual's specific and subjective response to an actual or perceived loss. Grief is a normal and expected response when individuals experience loss. It is the degree or extent of grief responses that contribute to the risk of a person for a suicide attempt. Unresolved grief is often associated with major depression which in turn is a major risk factor in suicide. Important dates such as birthdays or holidays and anniversaries of the loss make a person particularly vulnerable to a suicidal attempt.

Other associated terms: risk factor; depression; elderly; loss; depressed; detection

Guilt: A person's sense of wrongdoing against self or another. Intermediaries, often experience a sense of guilt, if their attempts fail, and a completed suicide results.

Other associated terms: professional; standard, guideline; grief; treatment

Helplessness: The term has two meanings. In the first, it deals with persons at risk for suicide, and is their belief that they are powerless or incapable to change or act effectively. In the second, it addresses the feelings of powerlessness of those intermediaries trying to help persons at risk for suicide.

Other associated terms: risk factor; depression; warning signs; detection

Hopelessness: The belief on the part of persons at risk for suicide that nothing can be done to help them. Usually associated with increased risk for suicide.

Other associated terms: risk factor; depression; warning sign;
detection

Hotlines: Assistance in the form of 24hour help, phone lines. People who work these help lines are trained in listening for specific dangers and key warning signs for a potential suicide attempt. Help lines are available 24 hours a day, 7 days a week and are available through national 800 numbers or through local phone numbers (See Suicide hotlines).

Other a ssociated terms: help line; facility; mental health clinician; treatment

Intent: What the person who is at risk for suicide intends through his behavior. Sometimes suicidal persons do not hold a strong psychological wish to die, but use means that are extremely lethal, or die by accident when someone does not rescue them in time. All threats of suicide, even those with a low psychological wish to die, must be taken seriously.

Other associated terms: means; plan; lethality; detection

Intermediaries: Someone who is attempting to help a person at risk for suicide. Intermediary roles include but are not limited to: mental health clinicians, teachers, ministers, police, family members and friends.

Other associated terms: all of the intermediary roles listed on the “Tailored Search Page”; helper; mental health clinician

Legal Guidelines: Regulations that direct the practice of health care professionals. Professionals who are licensed are governed not only by laws that are enforced by regulatory boards, but who are also monitored by professional organizations that maintain practice guidelines for the profession. Health care professionals who offer counseling and/or other assistance to persons at risk for suicide must abide by the legal guidelines of their licenses.

Other associated terms: professional; standard; regulation; guideline; organization; treatment

Lethality: The potential for some specific means (such as drugs, firearms, knives or other weapons) to cause death. A significant factor related to the potential danger for a completed suicide, is the lethality and availability of the means. For example, the possession of a firearm is viewed as potentially more dangerous for a person at risk.

Other associated terms: means; intent; lethal; completed suicide; threat; risk; detection

Mania: A condition that is characterized by an elevated or expanded mood. Mania is one feature of Bipolar disorder, a known mental health diagnosis, and is an associated factor with suicide.

Other associated terms: manic, bipolar disorder, depression; manic-depressive; detection

Mental Status Examination: A formal assessment of a person's mental processes, biological, social and psychological well-being. Information is gathered about a person's thought process; mood, self-perception, appearance and behavior. Portions of a mental status examination might be performed by a mental health clinician when trying to determine if a person is at risk for suicide.

Other associated terms: assessment; sign; symptoms; mood; warning signs; detection

MAO Inhibitors: Monoamine oxidase inhibitors are a group of chemically related antidepressant medications. Persons who are at risk for suicide, or who have a clinical diagnosis of major depression may be prescribed a MAO Inhibitor. They need to be careful to avoid tyramine in the diets, usually in the form of aged foods such as wine or cheeses.

Other associated terms: medications; mental health clinician; antidepressant; treatment

Mood: A person's emotional state. In a person at risk for suicide, an evaluation must be made for feelings of sadness; grief; helplessness; hopelessness; anxiety and/or depression which are all associated factors for suicide.

Other associated terms: feelings; affect; emotion; depression; detection

Myths: There are many myths that abound about suicide. For example, one common myth is that by asking a person who is displaying suicidal behavior, if he or she is suicidal, the thought is “planted in their head”. That is simply not true, research has shown that persons at risk for suicide are often relieved to be able to talk about their feelings openly. Research has offered many other facts about the detection and treatment for those persons at risk for suicide.

Other associated terms: facts, common concerns, risk factor; associated factor; detection

Plan: The specific preparation for carrying out a suicide attempt. Specific plan agendas often include: where; how (the means); when, completing a suicide note and offering subtle hints such as giving away prized possessions; or offering verbal hints such as: “the world would be better off without me”. Experts believe that suicide plans are often communicated at a subtle level, as the person at risk for suicide often has ambivalence right up to the suicide act.

Other associated terms: risk factors; warning sign; associated factor; symptom; screening tool; common concern; detection

Postvention: The therapeutic intervention with significant others following a completed suicide. There is never a single “victim” of a completed suicide. Family members, loved ones, and intermediaries need psychological support following a suicide.

Other associated terms: completed suicide; guilt; treatment

Psychosis: Distorted thinking usually associated with an inability to recognize reality, most commonly seen as hallucinations and delusions. Although some individuals suffering from psychosis may be at greater risk for harming themselves (usually those who hear voices telling them to kill themselves), most suicidal people are not psychotic. It's a myth that persons who attempt suicide must be psychotic.

Other associated terms: risk factors; causes; psychotic behavior; mentally ill, psychotic disorders; detection

Rescue fantasy: The term has two meanings with respect to suicide prevention. The first describes the suicidal person's belief that through the act of a suicide attempt, attention will be paid to the problems or issues leading up to the attempt and that things will improve. This situation can exist in teenagers who try and win back a boyfriend or girlfriend after a break-up, or in spouses when a separation or divorce occurs. The second describes an unrealistic belief on the part of the intermediary or helper that he or she can help or save the person at risk for suicide.

Other associated terms: intent; plan; means; detection

Rights: A claim made by persons or a group that requires the application of ethical principles. Persons, who are at risk for suicide, have rights when it comes to their treatment. All treatment facilities have a “Patient Bill of Rights” and persons receiving treatment for suicidal behavior must be apprised of their rights. If a person is deemed to be an imminent danger to himself or herself such as is the case for at person at high risk for attempting suicide, that individual's rights may become limited as the law may require that he or she be involuntarily committed.

Other associated terms: ethic, legal, ethical guideline; legal guideline; treatment

Risk Factor: Attribute linked to likelihood of completing suicide. For example, experts note that white males who are single are at greater risk for completing a suicide. A risk factors is not a cause, however, it is another indicator to determine the threat or risk for a suicide attempt.

Other associated terms: the associated terms listed on the “Tailored Search Page”; risk; at risk; threat; lethality; intent; mean; screening tool, detection

Secondary gain: Fringe benefits that are received by friends, family and co-workers that are associated with a psychological or physical illness. Secondary gains are sometimes seen following an attempted suicide, in that the attempter obtains a release of responsibility, experiences a temporary change in behavior from a loved one, and receives more attention.

Other associated terms: intent, plan, mean, detection

Self-destructive behavior: Behavior, direct or indirect, that if uninterrupted will lead to the death of an individual. An example of indirect self-destructive behavior is anorexia, a mechanism by which a person practices self-starvation. Direct self-destructive behavior includes self-mutilation (instances where persons may cut themselves) and suicide.

Other associated terms: suicide; attempted suicide; self-harm; screening tools; detection

SSRI: Selective Serotonin Reuptake Inhibitors (SSRI) is one of the leading drug groups used to treat depression and for prevention of relapse into another depressive episode.  SSRIs are also used to treat other mental health diagnoses such as panic disorder.

Other associated terms: medication; mental health clinician; antidepressant; treatment

Stigma: An irrational belief or feelings and thoughts associated with stereotypes. In suicide prevention as well as all of mental health, there is a stigma surrounding seeking help for feelings of depression or the despair that surrounds suicide. The stigma of suicidal thoughts and feelings can prevent both persons at risk or their loved ones from seeking help.

Other associated terms: risk factor; myths, facts, detection

Stress: Some event, occurrence or stimulus that a person perceives as threatening or challenging. Stressors may be a contributing factor to someone being at risk for suicide and should be evaluated by a mental health clinician.

Other associated terms: stressor; associated factor; risk factor; stressed; detection

Suicidal behavior: The range of suicidal actions including suicide gestures, attempts, ideations and completions.

Other associated terms: suicide; attempted suicide, screening tool; common concern; warning sign; detection

Suicide gesture: A suicide attempt that is planned to be discovered in an attempt to influence the behavior of others. In this instance the intent is not to die. Regardless of the intent of the suicidal person, all suicidal behavior should be taken seriously. If left disregarded, an accidental suicide might occur where the individual never desired to die, or subsequent attempts may become increasingly lethal.

Other associated terms: suicide; attempted suicide, screening tool; common concern; warning sign; detection

Suicidal ideation: Thoughts about attempting or completing suicide. Persons at risk for suicide may have thoughts about “what life would be like without them” or have ongoing thoughts about attempting suicide.

Other associated terms: suicide; attempted suicide, fantasy suicide screening tool; common concern; warning sign; detection

Suicide threat: A warning that may be direct or indirect, verbal or nonverbal that a person may be planning a suicide attempt. An indirect warning might include giving away prized possessions. A verbal warning might include words such as: “you would be better off without me”. Suicide threats need to be determined and evaluated by mental health clinicians.

Other associated terms: suicide; attempted suicide, screening tool; common concerns; warning sign; detection

Warning Signs: An indicator of the overt individual risk of suicide.   Warning signs include the factors in a suicide threat and also include the availability of the means to complete a suicide, a plan, and the person's psychological intent to die.  

Other associated terms: suicide; attempted suicide, screening tool; common concern; detection

Withdrawal: The attempt of a person to avoid interaction with others. In persons who are at risk for suicide, there may be a withdrawal from others and from routine life activities. Withdrawal is a factor associated with suicide risk.

Other associated terms: suicide; attempted suicide, screening tool; common concern; warning sign; detection

Years Potential Life Lost: The years lost from a completed suicide based on the age at the completion of a suicide to age 65.

Other associated terms: myth; fact; detection

Developed with the support of NIMH SBIR contract # N44MH22044

© Copyright iTeleHealth Inc., 2004

Last Updated: July 2004