Among some of the most serious concerns regarding college student health is suicide. A national survey of over 70 universities found that almost 9 % of students experience suicidal thoughts. While thoughts of suicide may occur with some frequency, suicide death does much less so. Roughly seven out of every 100,000 college students die by suicide. Recent news articles about deaths on campuses have brought attention to this issue and have lead some to believe that suicides are more frequent then they are and that suicide is easily avoided. While suicide is one of the most preventable forms of death, doing so is quite complex. This article discusses prevention efforts and steps that one can take to help someone who is suicidal.

In recent years sweeping national efforts have been undertaken to reduce suicide. Research studies of the general population have examined depression and other conditions that can increase suicidality such as use of substances and sexual abuse. Attitudes toward suicide and understanding risk and preventive factors for suicide have been studied as well.  In recent years there has greater attention paid to the suicide in the college student population. There have been national studies that have looked into unique factors that lead to suicide in college students, the nature of their suicidal thoughts, and what prevents students from getting the help they need. The federal government, through SAMHSA, has funded the development of suicide prevention strategies on campus through the Garrett Lee Smith Memorial Act. Since 2005 over 78 colleges and universities have developed programs to combat suicide on campus. 

Despite these and other research and prevention efforts, suicide remains the third leading cause of death among the 15-24 year old age group, of which most college students fall within. Why do suicides continue on campus? There continues to be impediments to getting individuals into treatment.

Stigma of mental health services prevents students from getting the attention they need. Seventy-five percent of students who die by suicide never come for counseling. Research and prevention efforts at Pace University have aimed at understanding the individual factors that prevent help-seeking, particularly in ethnically and sexually diverse students. This is particularly important as enrollment by diverse students in the United States is growing exponentially.  Another factor that makes it difficult for students to get the help they need and contributes to suicide in college students is that it is often an impulsive act. While a student may be depressed, the decision to kill oneself in some cases may be come upon hastily. Intervention strategies are now being used to train all members of a campus to identify students at the first signs of distress before they make a rash decision. One other factor preventing treatment is the involvement of alcohol and drugs. Rates of substance use are high in college students who kill themselves and their substance use may mask an underlying disorder. Colleges and universities are now beginning to take a comprehensive approach in their prevention efforts to include substance use intervention strategies to prevent suicide.

What can be done to help individuals who are suicidal? Knowing the warning signs and symptoms of suicide can help. Suicidal individuals can be depressed, hopeless, angry, or socially isolated. They often have difficulty with sleeping or eating and demonstrate obvious changes in their appearance. Students who are suicidal have significant academic or financial problems or experience a significant loss, such as a relationship break up, divorce, or move. Suicidal individuals also talk about dying-either indirectly, such as saying that they want to end their pain or make it all go away, or directly, such as stating that they want to kill themselves. Students whom have attempted to kill themselves in the past are particularly at risk for future suicide death. Finally, as mentioned earlier, with college students a significant proportion of suicides involve drug or alcohol use.

What can one do if you believe someone is at risk? If someone is talking about killing themselves or is experiencing some of these symptoms, it is essential to intervene. One should listen without judgment and acknowledge the pain they are suffering. Even if they downplay their symptoms, one should take them seriously. It is essential to get them to a psychologist quickly. Sometimes a college student may feel that there is a stigma connected to going to a campus counseling center. One should let them know that the counseling is another form of academic support just like a writing center or tutoring service and that many students go to these centers for a wide variety of concerns, not because they are mentally ill. Some students fear that if they go to the center their personal information will be shared with others. By law all information shared with a psychologist is confidential and will not be a part of their academic record or disclosed to another unless there is an imminent crisis. By attending counseling, a crisis is averted and there is no need for information to be shared. 

Getting someone help also requires overcoming one’s own anxiety about suicide. Some people have the misperception that if you ask someone if they are suicidal, and they are not, then you plant that idea in their mind. There is no truth in this claim. In fact asking about suicide decreases a person’s isolation and can give them hope. Research has shown that getting counseling is very effective not only in preventing suicide death but in improving their quality of life.

The good news is that research confirms that getting help is effective. Rates of suicide drop significantly if one is in counseling. If someone is trying to help a suicidal individual, they do not have to do it alone, resources are available. Each college or university has psychological services or can get people connected to services. Additionally there are a number of resources at the New York State Psychological Association, American Foundation for Suicide Prevention, and American Association of Suicidology.

Dr. Richard Shadick is the Director of the Counseling Center and an adjunct Professor of Psychology at Pace University. He is a psychologist and psychoanalyst who frequently presents at conferences on issues related to suicide, trauma, 9/11, and complicated bereavement. He trains mental health professionals nationally to assess and manage suicide risk, and is a consultant to high schools on suicide and homicide risk. He has been awarded federal and state grants on suicide prevention, which are aimed at preventing suicide in diverse college student populations and underage drinking. He has a private practice in lower Manhattan.