Suicide, where one intentionally seeks to take their life, is a major public health issue globally. Statistics show that it accounts for approximately 1.4% of global deaths (Brådvik, 2018), while it’s the third leading cause of death among adolescents in the United States (Zalsman, 2012). Further, Brådvik (2018) shows that most suicide cases have been shown to have a direct relationship with psychiatric disorders such as depression, psychosis, and substance use disorders. The scholar reports findings from other studies which have shown that most people who have died as a result of suicide have experienced mental health issues, with statistics showing up to 90%.
Common Suicide/Depression Mechanisms and Progression
The common mechanism and progression of Suicide/Depression show that it has certain predictive and protective factors. According to the World Health Organization (2021). depression which is a common mental disorder experienced by approximately 5% of the world’s adult population, can lead to suicide. The condition can cause people who experience it to suffer greatly, negatively impacting their school, work, and family. When the condition reaches its worst, it can propel a person to commit suicide. The issue of depression arises from a complex interaction of psychological, biological, and social factors. For example, people who have experienced such adverse issues as traumatic events, bereavement, and unemployment are likely to develop depression. The World Health Organization (2021) shows that depression can also progress to dysfunction and stress, worsening the affected individual’s life.
According to the Suicide Prevention Resource Center & Rodgers (2011), the major predictive risk factors for suicide include substance abuse, mood disorders, prior suicide attempts as well as access to lethal weapons. These factors affected the individual’s health by putting them at risk of taking their own lives. On the other hand, the main protective factors against suicide include having access to effective mental health care, problem-solving skills, being connected and having contact with caregivers,
Dutta et al. (2017) identified a higher rate of suicidal ideation among women than men. Other predictive factors for suicidal ideation included low education levels, divorce or termination of the marriage relationship, losing a parent for a child, stressful life events, and low economic standards. In terms of genetics, the scholars established that there was a substantial contribution of genetic factors. There was, however, a differentiation between men and women where it was mediated by depression in women, while for men, it was a significant heritable component separate from depression (Dutta et al., 2017)
Regarding environmental issues, predictive factors identified include Adverse childhood experiences (ACE), which have been associated with negative health outcomes such as suicide and mental health disorders (Suicide Prevention Resource Center, & Rodgers, 2011). Therefore, children who were exposed to an environment where they were subjected to ACEs, such as neglect and abuse, were more likely to experience adverse health outcomes and try to commit suicide.
Research Studies on Suicide/Depression
A look at suicide and depression shows that numerous studies have been conducted to shed insight on the subject. One interesting study in the area is Dutta et al. (2017), who sought to research “Genetic and other risk factors for suicidal ideation and the relationship with depression.” In this study, the scholars sought to investigate the various risk factors that are associated with suicidal ideation and the relationship that it has to depression. Prompted by the contradictory evidence presented by various studies, the scholars sought to investigate whether suicidal ideation could be classified as a familial phenotype regarding suicidal behavior.
The implication of Research findings to Nursing Practice
In their study, Dutta et al. (2017) showed that there was sparse prior research on the genetics that led to suicidal ideation. Through their study, the scholars sought to assess issues of active and passive suicide ideation from a twin and non-twin sample from Sri Lanka. The scholars examined the association of suicidal ideation with psychiatric symptoms, environmental exposures, and socio-demographic factors. They also sought to assess suicidal ideation’s heritability.
The research findings indicated a higher level of suicidal ideation for women than men in a lifetime. However, they established that there was no difference between members of the study population who were twins and those that were not. In terms of factors that predicted suicidal ideation, the study identified the female gender, low levels of education, marital relationship termination, living in an urban residence, low economic standards, experiencing stressful events within the previous twelve months, or having a parent die when the individual was young. The study also established a strong association between having the individual experience depression and suicidal ideation as well as alcohol use and abnormal fatigue. Another important element that the scholars identified with their study is the substantial contribution that environmental factors, which were not shared, and genetic factors made to men and women. However, there was a difference with depression being a mediating factor for women, while men had a heritable component associated with suicidal ideation, which was separate from depression.
These research findings have a huge implication for the nursing practice since they shed light on the diverse factors that predict suicidal ideation and suicide. Nursing practitioners can, therefore, rely on this evidence-based information to inform their practice and provision of service. For example, they can recognize these predictive factors in their patients and recommend the necessary mental health care to prevent the escalation of the issue and adverse patient outcomes. As a study based on an LMIC whose findings align with previous scholarly findings, it adds weight and credibility to the development of evidence-based interventions.
A look at Dutta et al. (2017) study shows that it has both pros and cons. On the one hand, the study’s main pro is that it constituted a huge study population with high participation, which made it possible to obtain information from a wide population base and, in turn, more generalizable. Further to shed significant insight, it had an interesting composition with its population, which was made up of twin and non-twin respondents and therefore could investigate the contribution of environmental and genetic factors to suicidal ideation.
However, in terms of cons, the study had certain gaps which can be addressed and thus strengthen the existing base of evidence of suicide and depression. For example, the scholars relied on a cross-sectional approach to the study, which made it impossible to determine causation. It was also challenging to use the epidemiological data to determine causation since depression and suicidal ideation were assessed based on a lifetime while life event was only for one year. In terms of future research possibilities, suicide and depression present many possibilities. One potential idea is undertaking a longitudinal study that would allow the scholar to gather data over an extended period and shed light on the causation relationship.
Brådvik, L. (2018). Suicide Risk and Mental Disorders. Int J Environ Res Public Health. 2018 Sep; 15(9): 2028. doi: 10.3390/ijerph15092028. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6165520/
Dutta, R., Ball, H. A., Siribaddana, S. H., Sumathipala, A., Samaraweera, S. McGuffin, P. & Hotopf, M. (2017). Genetic and other risk factors for suicidal ideation and the relationship with depression. Psychol Med. 2017 Oct; 47(14): 2438–2449. doi: 10.1017/S0033291717000940. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5964447/
Suicide Prevention Resource Center, & Rodgers, P. (2011). Understanding risk and protective factors for suicide: A primer for preventing suicide. Newton, MA: Education Development Center, Inc. https://www.sprc.org/sites/default/files/migrate/library/RiskProtectiveFactorsPrimer.pdf
World Health Organization (2021). Depression. https://www.who.int/news-room/fact-sheets/detail/depression
Zalsman G. (2012). Genetics of Suicidal Behavior in Children and Adolescents. In: Dwivedi Y, editor. The Neurobiological Basis of Suicide. Boca Raton (FL): CRC Press/Taylor & Francis; 2012. Chapter 14. Available from: https://www.ncbi.nlm.nih.gov/books/NBK107198/