Suicide in colleges in the United States

In colleges and universities in the United States, suicide is one of the most common causes of death among students.[1] Approximately 1100 college students commit suicide each year, making it the second-leading cause of death among college students.[2] Roughly 12% of college students report the occurrence of suicide ideation during their four years in school, with 2.6% percent reporting persistent suicide ideation.[2] 65% of college students reported that they knew someone who has either attempted or committed suicide, showing that students on college campuses are likely to be exposed to suicide or suicidal attempts in some form.[3]

According to the National Alliance on Mental Illness (NAMI), approximately 43% of the student population within the educational system have been diagnosed with or treated for depression. Only 9% of those students were shown to be collegiate athletes.[4] Recent studies have also suggested that underclassmen were less likely to commit suicide due to a lack of worry over bills or work and because many were full-time students living with their parents.[5]

Prior to a 1978 PBS broadcast of College Can Be Killing universities were less vigilant about student suicides, which could cause issues with the reporting of statistics.[6] After the broadcast raised awareness for suicide in college, most schools began creating programs to assist students while they attend college. Since then more research has been conducted on suicide in college, resulting in improved assistance programs and better identification of at-risk students.[1]

History

During the 20th Century, Universities and colleges drew limited attention to the issue of student suicides to avoid damages to the reputation and image of their institutions.[6] One of the earliest records of suicides of college students in the United States was in 1927, when 20 students across the entire continent committed suicides.[6] In 2006, 1100 students in the US committed suicide, and 24,000 attempted it.[7]

Since the year 2000, rates of suicide deaths have increased significantly,which psychiatrist Doris Iarovici attributes to the rise in depression in students.[8]

Risk factors

Depression

Depression is the strongest correlate of suicidal behavior in college students.[9] The 2017 National College Health Assessment found that half of college students reported being overwhelmed by feelings like sadness or anxiety.[10][11]

Suicidal ideation

Suicidal ideation refers to the act of thinking about, considering, or planning suicide.[12] Suicidal ideation has risen in prevalence amongst college-age students.[13] A study at Emory University found that 11.1% of students reported having suicidal ideation within the past four weeks and 16.5% had a suicide attempt or self-injurious event at least once in their lifetime.[13] Suicidal ideation was associated with symptoms of depression and students who reported current suicidal ideation had more severe depression symptoms.[13]

Among college students, depressive symptoms and the severity level of the worst suicidal ideation in an individual's lifetime are two short-term predictors of current suicidal ideation.[14] Factors indicating risk for persistent suicidal ideation include low social support, childhood or adolescent exposure to domestic violence, maternal depression, and high self-reported symptoms of depression.[2] Females, individuals who have been previously screened for psychiatric illness, those with a positive family history of suicide, those that are more impulsive, and those that have elevated motor impulsivity may be at greater risk of developing suicidal ideation.[15]

Suicide attempts

Whilst suicide ideation does not always lead to a suicide attempt, attempts are correlated with previous family history of suicide and high motor impulsivity.[15] Other risk factors for suicide in college include alcohol use,[16] difficulty sleeping,[17] and lack of "body investment."[18]

Motives for suicide

The amount and type of motivations for suicide can vary from student to student, however a common motivation for suicide has been stress.[19] In a 2008 physiological study conducted by the Associated Press and MTVU, eight out of ten college students reported a feeling of horrible stress that impacted their grades.[19] Another common motivating factor has been issues at home that can impact their academic career.[20] Home-based issues can be composed of abuse, starvation, and overall poor living conditions.[20] Depression can also be a factor.[21]

Prevention
National Suicide Prevention Lifeline, a crisis line in the United States and Canada

Social support is proven to preventing suicide in college populations, as the link between depressive symptoms and hopelessness was reduced among college students who had high levels of social support.[22] Universal prevention interventions, through training people of power on suicide, has been beneficial as it has led to significant increases in suicide prevention knowledge, skills, and self-efficacy.[23] In gatekeeper interventions, “gatekeepers” are those people who regularly encounter distressed individuals or groups.[23] On college campuses, these individuals include instructors, students, resident assistants, and other campus life officials.[23] Peer-led suicide prevention workshops have also been effective at improving their participants’ knowledge about suicide and the resources available.[24]

Help Seeking Behavior

In a national survey, less than half of the college students who seriously contemplated suicide during the previous twelve months received any mental health treatment during that time.[25] Among college students who reported having had serious thoughts of suicide, those that had a higher perceived need, believed that treatment would be effective, contacted other users of mental health services, had lower personal stigma, a higher perceived stigma, fewer positive relationships, was a sexual minority, or a Caucasian were more likely to access campus mental health services.[25] Because help seeking behavior among with suicidal college students is correlated with such a wide range of personal and social factors, campus initiatives should attempt to limit barriers to treatment for target populations and enhance aspects that encourage treatment seeking.[25]

College programs and initiatives

Many universities and colleges have begun offering assistance to new and returning students with dealing with stress.[6] Some institutions have also begun providing educators and staff members with training and education on how to interact with a student that has expressed or shown suicidal interests or tendencies.[6] The most common intervention strategies used by colleges involve campaigns to reduce stigma and provide education on mental illness, screen the population and attempt to link at-risk individuals with resources, or train people who are in often in contact with other members of the community.[26]

Social and Culture

Legislation

In total, nine states have passed legislation regarding suicide on college campuses.[27] Many of these laws require institutions of higher learning to inform entering students of available mental health resources, develop policies to inform students and staff of the proper procedures for addressing the needs of a suicidal student, and post all relevant mental health and suicide prevention information on the school's webpage.[27] Pending federal legislation would mandate that the Substance Abuse and Mental Health Services Administration to award financial grants to colleges and universities to improve mental health services, conduct research about the mental health of its students, and expand training programs on campus.[27]

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References
  1. Taub, Deborah J.; Thompson, Jalonda (Spring 2013). "College Student Suicide". New Directions for Student Services. 2013 (141): 5–14. doi:10.1002/ss.20036.
  2. Wilcox, Holly C.; Arria, Amelia M.; Caldeira, Kimberly M.; Vincent, Kathryn B.; Pinchevsky, Gillian M.; O'Grady, Kevin E. (2010). "Prevalence and predictors of persistent suicide ideation, plans, and attempts during college". Journal of Affective Disorders. 127 (1–3): 287–294. doi:10.1016/j.jad.2010.04.017. PMC 2924459. PMID 20471691.
  3. Cerel, Julie; Bolin, Mary Chandler; Moore, Melinda M (2013). "Suicide exposure, awareness and attitudes in college students". Advances in Mental Health. 12 (1): 46–53. doi:10.5172/jamh.2013.12.1.46. ISSN 1838-7357.
  4. "College Student Mental Health Statistics". National Alliance on Mental Illness (via Chadron State College).
  5. De Luca, Susan (January 2016). "The Relationship Between Suicide Ideation, Behavioral Health, and College Academic Performance". Community Mental Health. 52 (5): 534–540. doi:10.1007/s10597-016-9987-4. PMID 26831304.
  6. Brown, Peggy (Winter 2014). "College Can Be Killing: United States College and University Responses to Student Suicide During the 20th Century and Early 21st Century". Journal of College Admission: 35–48.
  7. Fernández Rodríguez, M. del C., & Huertas, I. B. (2013). Suicide Prevention in College Students: A Collaborative Approach. Revista Interamericana de Psicologia = Interamerican Journal of Psychology, 47(1), 53–60.
  8. Iarovici, Doris (July 2015). "Perspectives on College Student Suicide". Psychiatric Times: 27–32.
  9. Holdaway, Alex S.; Luebbe, Aaron M.; Becker, Stephen P. (2018). "Rumination in relation to suicide risk, ideation, and attempts: Exacerbation by poor sleep quality?". Journal of Affective Disorders. 236: 6–13. doi:10.1016/j.jad.2018.04.087. PMC 6047760. PMID 29704657.
  10. Fieseler, Robert W. (28 June 2019). "High Falls: A Human Chain". The Delacorte Review. Retrieved 2020-05-21.
  11. "Publications and Reports: ACHA-NCHA II". www.acha.org. Retrieved 2020-05-21.
  12. "Suicidal ideation", Wikipedia, 2019-04-11, retrieved 2019-04-25
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  14. Nam, Boyoung; Wilcox, Holly C.; Hilimire, Matthew; DeVylder, Jordan E. (2018-11-17). "Perceived need for care and mental health service utilization among college students with suicidal ideation". Journal of American College Health. 66 (8): 713–719. doi:10.1080/07448481.2018.1434779. ISSN 0744-8481. PMID 29384469.
  15. Wang, Yong-guang; Chen, Shen; Xu, Zhi-ming; Shen, Zhi-hua; Wang, Yi-quan; He, Xiao-yan; Cao, Ri-fang; Roberts, David L.; Shi, Jian-fei (2017). "Family history of suicide and high motor impulsivity distinguish suicide attempters from suicide ideators among college students". Journal of Psychiatric Research. 90: 21–25. doi:10.1016/j.jpsychires.2017.02.006. PMID 28214643.
  16. Dvorak, Robert D.; Lamis, Dorian A.; Malone, Patrick S. (2013). "Alcohol use, depressive symptoms, and impulsivity as risk factors for suicide proneness among college students". Journal of Affective Disorders. 149 (1–3): 326–334. doi:10.1016/j.jad.2013.01.046. PMC 3672262. PMID 23474093.
  17. Becker, Stephen P.; Dvorsky, Melissa R.; Holdaway, Alex S.; Luebbe, Aaron M. (2018). "Sleep problems and suicidal behaviors in college students". Journal of Psychiatric Research. 99: 122–128. doi:10.1016/j.jpsychires.2018.01.009. PMC 5962276. PMID 29448236.
  18. Lamis, Dorian A.; Malone, Patrick S.; Langhinrichsen-Rohling, Jennifer; Ellis, Thomas E. (2010). "Body Investment, Depression, and Alcohol Use as Risk Factors for Suicide Proneness in College Students". Crisis. 31 (3): 118–127. doi:10.1027/0227-5910/a000012. ISSN 0227-5910. PMC 2892815. PMID 20573605.
  19. Wu, Joanne (February 29, 2000). "Stress in College Students". The American Institute of Stress.
  20. Foster, Dawn (February 4, 2016). "Poor housing is bad for your mental health". The Guardian.
  21. Hawksworth, Elizabeth (September 18, 2014). "College drove me to the brink of Suicide". Washington Post.
  22. Lamis, Dorian A.; Ballard, Elizabeth D.; May, Alexis M.; Dvorak, Robert D. (2016). "Depressive Symptoms and Suicidal Ideation in College Students: The Mediating and Moderating Roles of Hopelessness, Alcohol Problems, and Social Support: College Student Suicidal Ideation". Journal of Clinical Psychology. 72 (9): 919–932. doi:10.1002/jclp.22295. PMID 27008096.
  23. Wolitzky-Taylor, Kate; LeBeau, Richard T.; Perez, Marcelina; Gong-Guy, Elizabeth; Fong, Timothy (2019-03-25). "Suicide prevention on college campuses: What works and what are the existing gaps? A systematic review and meta-analysis". Journal of American College Health: 1–11. doi:10.1080/07448481.2019.1577861. ISSN 0744-8481. PMID 30908123.
  24. Tsong, Yuying; Young, Jennifer T.; Killer, Jane Duong; Takemoto, Mary Ann; Compliment, Brad (2019-04-03). "Suicide Prevention Program on a Diverse College Campus: Examining the Effectiveness of a Peer-to-Peer Model". Journal of College Student Psychotherapy. 33 (2): 131–144. doi:10.1080/87568225.2018.1434716. ISSN 8756-8225.
  25. Downs, Marilyn F.; Eisenberg, Daniel (2012). "Help Seeking and Treatment Use Among Suicidal College Students". Journal of American College Health. 60 (2): 104–114. doi:10.1080/07448481.2011.619611. ISSN 0744-8481. PMID 22316407.
  26. Eisenberg, Daniel; Hunt, Justin; Speer, Nicole (2012). "Help Seeking for Mental Health on College Campuses: Review of Evidence and Next Steps for Research and Practice". Harvard Review of Psychiatry. 20 (4): 222–232. doi:10.3109/10673229.2012.712839. ISSN 1067-3229. PMID 22894731.
  27. "State Laws: Suicide Prevention on University and College Campuses" (PDF). American Foundation for Suicide Prevention. 2017. Retrieved April 21, 2019.
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