Preventing Suicide: Developing Meaning in Life

Abstract

In the last 45 years, suicide rates have increased by 60% worldwide. Suicide is now the third leading cause of death among those aged 15 to 44 years (both sexes). Mental disorders (particularly depression and substance abuse) are associated with more than 90% of all cases of suicide; however, suicide results from many complex sociocultural factors and is more likely to occur particularly during periods of socioeconomic, family, and individual crisis situations (e.g., loss of a loved one, employment, honor). Although traditionally suicide rates have been highest among elderly men, rates among young people have been increasing. This age group now is the group at highest risk in a third of countries, in both developed and developing countries. Importantly, these figures do not include suicide attempts up to 20 times more frequent than completed suicide (World Health Organization, 2009World Health Organization Suicide: Global facts. 2009www.who.orgGoogle Scholar).Key WHO goals are important to addressing the global issue of suicide prevention. First is to create a societal understanding that mental health is essential to overall health. Such an understanding is essential for establishing a health system that treats mental illness with the same urgency as it treats physical illnesses. Additional goals include the need to advance and implement a global campaign to reduce the stigma of seeking care, develop and implement a global strategy for suicide prevention, and address mental health needs with the same urgency as physical health needs (World Health Organization, 2009World Health Organization Suicide: Global facts. 2009www.who.orgGoogle Scholar).One therapeutic approach is to focus on helping individuals, particularly those who are suicidal, find meaning in their lives (Fitzpatrick, 2008aFitzpatrick J.J. Meaning in life: Translating nursing concepts to research.Asian Nursing Research. 2008; 2: 1-4Abstract Full Text PDF Scopus (11) Google Scholar). The intervention is based on the underlying assumption that individuals who are suicidal are questioning their life's worth and have lost the desire to live without finding meaning. Throughout a program of research based on our experiences in clinical practice with individuals experiencing a life crisis, including those in suicidal crisis, our research team has implemented interventions to refocus individuals from a past or future perspective to a present orientation. Although the past and future may be overwhelmingly immobilizing to an individual in crisis, the present orientation helps individuals understand their life experiences in a more meaningful way. Interventions are targeted around identifying holistic practices that would provide meaningful life experiences based on the individual's past and present circumstances and helping build connections to both the inner self and to others in the supportive environment (Fitzpatrick, 2008bFitzpatrick J.J. The importance of temporality for nursing science and professional practice.Nursing Science Quarterly. 2008; 21: 223-225Crossref PubMed Scopus (1) Google Scholar). Of particular interest in our research has been the “silent suicide” of elderly persons who have experienced a loss of health status and independence (Fitzpatrick, 2005Fitzpatrick J.J. Signs of silent suicide among depressed hospitalized geriatric patients.Journal of the American Psychiatric Nurses Association. 2005; 11: 290-292Crossref Scopus (4) Google Scholar). These individuals are among the most vulnerable in a society that values youth and independence and thus the most important to address. Our clinical practice in this area has been most rewarding, and the research agenda, although new, is promising. In the last 45 years, suicide rates have increased by 60% worldwide. Suicide is now the third leading cause of death among those aged 15 to 44 years (both sexes). Mental disorders (particularly depression and substance abuse) are associated with more than 90% of all cases of suicide; however, suicide results from many complex sociocultural factors and is more likely to occur particularly during periods of socioeconomic, family, and individual crisis situations (e.g., loss of a loved one, employment, honor). Although traditionally suicide rates have been highest among elderly men, rates among young people have been increasing. This age group now is the group at highest risk in a third of countries, in both developed and developing countries. Importantly, these figures do not include suicide attempts up to 20 times more frequent than completed suicide (World Health Organization, 2009World Health Organization Suicide: Global facts. 2009www.who.orgGoogle Scholar). Key WHO goals are important to addressing the global issue of suicide prevention. First is to create a societal understanding that mental health is essential to overall health. Such an understanding is essential for establishing a health system that treats mental illness with the same urgency as it treats physical illnesses. Additional goals include the need to advance and implement a global campaign to reduce the stigma of seeking care, develop and implement a global strategy for suicide prevention, and address mental health needs with the same urgency as physical health needs (World Health Organization, 2009World Health Organization Suicide: Global facts. 2009www.who.orgGoogle Scholar). One therapeutic approach is to focus on helping individuals, particularly those who are suicidal, find meaning in their lives (Fitzpatrick, 2008aFitzpatrick J.J. Meaning in life: Translating nursing concepts to research.Asian Nursing Research. 2008; 2: 1-4Abstract Full Text PDF Scopus (11) Google Scholar). The intervention is based on the underlying assumption that individuals who are suicidal are questioning their life's worth and have lost the desire to live without finding meaning. Throughout a program of research based on our experiences in clinical practice with individuals experiencing a life crisis, including those in suicidal crisis, our research team has implemented interventions to refocus individuals from a past or future perspective to a present orientation. Although the past and future may be overwhelmingly immobilizing to an individual in crisis, the present orientation helps individuals understand their life experiences in a more meaningful way. Interventions are targeted around identifying holistic practices that would provide meaningful life experiences based on the individual's past and present circumstances and helping build connections to both the inner self and to others in the supportive environment (Fitzpatrick, 2008bFitzpatrick J.J. The importance of temporality for nursing science and professional practice.Nursing Science Quarterly. 2008; 21: 223-225Crossref PubMed Scopus (1) Google Scholar). Of particular interest in our research has been the “silent suicide” of elderly persons who have experienced a loss of health status and independence (Fitzpatrick, 2005Fitzpatrick J.J. Signs of silent suicide among depressed hospitalized geriatric patients.Journal of the American Psychiatric Nurses Association. 2005; 11: 290-292Crossref Scopus (4) Google Scholar). These individuals are among the most vulnerable in a society that values youth and independence and thus the most important to address. Our clinical practice in this area has been most rewarding, and the research agenda, although new, is promising.