A Brief Note to Mental Health Professionals about Suicide Awareness

September 13th, 2018

At the Seleni Institute, we focus on destigmatizing mental illness. And, because 90% of those who die by suicide have a mental illness that has not been diagnosed or that has not been adequately treated, it is imperative that we understand and support all, including mothers, who are suffering with suicidal ideation. As our Founding Chairwoman, Executive Director and Psychotherapist, Nitzia Logothetis, noted recently, “in the United States, we have seen a 20 percent rise in suicide between 1999 and 2013, which is a shocking statistic. And the group with the greatest increase? Women. Forty-five percent more women and girls took their lives in 2013 compared with 1999.”

While suicide in the postpartum time is mostly associated with postpartum psychosis, which is rare and occurs only in approximately 1 to 2 of every 1000 births, suicidal ideation and risk is often present in postpartum women experiencing a Perinatal Mood or Anxiety Disorder or perinatal emotional distress. And, completed suicide is a leading cause of maternal mortality.

In the postpartum time there are often many strong emotions and truly significant physical changes. While there is no single cause for a completed suicide, death by suicide often occurs when a mental illness is present and stressors far exceed current coping abilities. And, suicidal ideation often stems from unbearable mental pain and loss of hope.

Suicide is probably one of the most complex and least understood of all human behaviors. Complicating the situation is that a postpartum woman who has suicidal thoughts is likely to be ambivalent about ending her life. She both wants to die and doesn’t want to die. She most likely is experiencing unbearable mental pain that also reflects her desperation with no hope of relief. Too many postpartum women do not seek help out of shame and the very real stigma around expressing suicidal thoughts and feelings.

What can we do to help?

  • When working clinically, ask directly: “Are you thinking about ending your life?” Asking this question does not increase the risk of death by suicide. Acknowledging and talking about suicidal thoughts has been found to reduce the risk of suicide.

  • Pay attention to the message being communicated: Listen.

  • Establish trust and rapport that can also remind her she is not alone.

  • Build hope and explore how to increase coping and social supports while also overcoming suicidal thinking.

  • As mental health professionals, it is important to use language that helps reduce stigma. For example, instead of “committed suicide,” which implies that the suicide was a sin or a crime, use “died by suicide,” or “completed suicide,” or “killed him or herself.”

  • As mental health professionals, we need to educate ourselves about suicide. For example, what are risk factors and what are protective factors? What is the effect of suicide on family functioning? What do those who are bereaved need? What do those who have considered or attempted suicide need?

  • As mental health professionals we can raise awareness about suicide and suicide risk and eradicate stigma with compassion, knowledge, and hope, while providing effective treatment and interventions at the individual and community levels.

Additional Resources

American Association of Suicidology (AAS)

American Foundation for Suicide Prevention (AFSP)

The Seleni Institute

If you are in crisis, contact the National Suicide Prevention Hotline at 1-800-273-TALK (8255).

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