Experts Link Increase Risk to Drinking and Drugs
One in 10 U.S. college students has seriously considered suicide, according to a government survey.
Based on data collected from 4,609 students nationwide who responded to the 1995 National College Health Risk Behavior Survey, 463 said they had contemplated suicide in the preceding 12 months.
And researchers at the Centers for Disease Control and Prevention (CDC) in Atlanta suggest that drinking, drug use and smoking may be considered red flags for potential suicide risk.
“The CDC figure doesn’t surprise me. In fact, it might be conservative,” said Melisa Poulos, executive director of Samaritans, a suicide prevention agency headquartered in Boston.
In 1997, 30,535 Americans died by their own hand, according to the National Center for Health Statistics; teenagers and young adults in the 15 to 24 age group accounted for 13.7 percent of the total. Suicide is now the third-leading cause of death in this age group, surpassed only by traffic accidents and homicide.
Clinical psychologist Deborah Kraus said official statistics probably underestimate the true rate of incidence. She noted that reckless driving and other high-risk behaviors could sometimes mask suicide attempts.
The study’s findings
In addition to the 10 percent who acknowledged contemplating suicide, 7 percent said they had made a suicide plan, 2 percent reported at least one attempt at suicide, and 0.4 percent said an attempt had required medical attention.
The CDC report supports previous research examining the frequency of suicidal thoughts among college and high school students. Among the findings:
Neither gender was more prone to having suicidal thoughts than the other.
Age and race were factors, with respondents who were more likely to have considered suicide tending to be under 25 years old, freshman or sophomores and nonwhite.
Roughly twice as many people with suicidal thoughts drank alcohol or used illegal drugs or smoked cigarettes, as compared with those who didn’t drink, use drugs or smoke. The relationship between substance use and thinking about suicide remained consistent even after the researchers controlled for demographic variables associated with substance use.
But, based on the data, researchers were unable to determine whether drug use leads to suicidal thoughts or if the reverse was true — or even if unidentified personality traits could increase a college student’s vulnerability to both substance abuse and suicidal thoughts.
“There is probably some evidence in both directions,” said Nancy D. Brener, the lead author of the CDC study. Establishing a relationship between drugs and thoughts of suicide would take a study that followed thousands of students for several decades, she said. “Our data was a snapshot at a single point in time.”
‘Thoughts, but not a plan’
Psychologists who counsel young adults agree that suicidal thoughts are fairly common in the college population.
For one thing, such mental disorders as depression, bipolar disorder and schizophrenia often surface between the ages 18 and 22, Poulos noted.
“At a high-powered place like this, the pressure on students is really remarkable,” said Kraus, a counselor at the University of Michigan’s Counseling and Psychological Services in Ann Arbor. “Put this on top of alcohol and drug abuse and it’s a strong argument for putting money toward counseling-related issues.”
Every person who comes to the counseling service is asked whether he or she has thoughts of death and dying, Kraus said.
“People may have thoughts, but not a plan,” Kraus said. “When suicide happens, it’s tragic, but it doesn’t happen all that often.”
Effective strategies sought
Brener advocates developing simultaneous prevention strategies, such as linking college mental health resources with those in the community, and putting staff training programs in place.
“We at CDC don’t know which strategies are effective in preventing suicide [among young adults]. We need a lot of research to determine that,” Brener said.
At the University of Michigan, the counseling center provides contacts for residence hall managers and helps train them on spotting a student who may need attention, said Kraus. On a campus where 90 percent of freshmen live in residence halls, “housing is the front line” of prevention, not the center, she said.
“We tell them, ‘You don’t have to figure out exactly what’s going on. You just have to get them to us.’”
Looking for trouble
Kraus would like friends and relatives of troubled students to do the same — especially after such emotional trauma as the breakup of a relationship. Don’t dismiss talk about death or dying, she said, particularly if someone starts giving away possessions.
“Call the family doctor or a crisis hot line,” Kraus advises. “Don’t try to do it by yourself.”
But don’t try to be a mind reader, said Poulos, who advised dealing with the subject head on.
“Ask whether they have a plan. Don’t be afraid that you’ll be planting the idea [of suicide]. A person who seems very hopeless probably has already thought about suicide. Talking opens the door safely,” Poulos said.
But Poulos acknowledged that “it can be a pretty scary situation. People feel intensely responsible about what might happen.”
She recently took a call from a frightened Harvard student whose roommate was feeling overwhelmed and hinting at thoughts of death.
“I helped her do some risk assessment … whether the roommate had the means available to kill herself,” Poulos said.
By the time the caller hung up, she was armed with a list of resources available at the university that could help her roommate.