Risk factors are characteristics that place an individual at a heightened risk of contemplating suicide over the long term. Risk factors can help identify individuals or population groups that are more likely to contemplate suicide. Although the particular combination of risk factors that leads an individual to suicidality remains unclear, by being aware of risk factors and warning signs better equips professionals working with young people to identify and respond to risk of suicidality promptly.
Risk factors are very different from warning signs. While risk factors help identify individuals who are more likely to contemplate suicide over the long term, warning signs indicate a current or immediate risk of suicide for an individual. Suicidal thoughts and actions are often the consequence of a complex interaction of risk factors, warning signs and precipitating events, rather than having a single determinant cause. Often some risk factors can make individuals more susceptible to other risk factors. For example, Indigenous communities often live in remote areas of Australia and have a higher rate of alcohol and substance abuse.
There are three main risk factors for suicide in young people identified (Hider, 1998; Suicide Prevention Australia, 2010):
Prior attempt or self-harm
A previous attempt of suicide is a strong predictor of future attempts or completing suicide for young people (Hawton & James, 2005). It is estimated that 25% of young people who attempted suicide will make a future attempt, with 5-10% completing suicide (Larkin & Beautrais, 2010). Although self-harming behaviours are distinct from attempts of suicide, there is strong evidence to indicate that young people engaging in self-harming behaviours are at a higher risk of suicide (AIHW, 2007b; LIFE, 2007; Hawton & James).
The relationship between psychiatric disorders and suicide in young people is now well established. It is estimated that up to 90 percent of young people who completed suicide or made a suicide attempt had a mental illness at the time (Cantor, Neulinger, Roth & Spinks, 1998; Cosgrave et. al., 2007). Higher rates of depression, anxiety, bipolar disorder, personality disorders and substance abuse disorders are particularly linked to suicide in young people (Brausch & Gutierrez, 2010; Mendoza & Rosenberg, 2010). An undiagnosed or untreated mental illness in a young person is particularly concerning.
Alcohol or drug abuse
Higher rates of suicide have been reported in individuals with alcohol or drug abuse issues, and alcohol or substance abuse significantly increases the risk of suicide in young people aged 16 or older (Conner et. al., 2006; Pompili et. al., 2010; Windle, 2004; Wu et. al., 2004). In particular, alcohol abuse and cannabis use have been associated with increased depressive symptoms and suicidality (Conner et. al.; Cosgrave et. al., 2007). Substance abuse is known to exacerbate an individual’s impulsiveness, lower inhibitions, reduces problem-solving ability and increases aggressive behaviours, all of which may increase the risk of suicide (Mendoza & Rosenberg, 2010).
Additionally, other risk factors for young people include (Hider, 1998; SPA, 2010):
- Social isolation
- Unstable family dynamics, including family breakdown/ conflict and family history of suicide and/or mental illness
- A history of abuse (sexual, physical or emotional) or childhood adversities
- Suicidality in friends or family members
- Poor resilience and limited coping skills
Although stress is part of everyday life, for some people stressful events and experiences can lead to suicidality. When there is a build-up of stressful events or a crisis, the likelihood of suicidality is significantly higher if risk factors are present. Thus, when a young person with suicide risk factors is experiencing a particularly stressful time, you are able to pay closer attention for warning signs of suicidality and respond appropriately.
Important precipitating events include (Mendoza & Rosenberg, 2010; SPA, 2010):
- Relationship breakup
- Bullying at school or in the workplace
- Loss of employment
- In trouble with the law
- Loss of an important person (e.g. death or divorce)
- Recent suicide (or attempted suicide) of a friend or relative
- Anniversary of a death or suicide of someone close to them