Suicide is the tenth leading cause of deaths in America and the second leading cause of death for adolescents aged 15 to 24 years (CDC, 2021). Since 1999, America's suicide rate has increased by more than 25%, with increases occurring in every state except Nevada (CDC, 2021). There were at least 1.38 million suicide attempts reported in 2019, 47,000 of which were fatal (CDC, 2021). About half of these deaths involved handguns. In the United States, mental health and drug use conditions are the leading risk factors for suicide. The 4Ds of pathological psychology – deviance, disorder, anxiety, and risk – are critical for clinicians working with suicide survivors while examining their mental, cognitive, and behavioral problems. In this situation, deviance is manifested through socially inappropriate actions, discord is manifested through social interaction disturbance, depression is manifested through self-defeating activities such as fear, and skewed thoughts manifest risk. This paper will examine the factors that contribute to suicide and how it can be avoided. Although access to guns is considered to be the primary cause of suicide in the United States, the underlying challenges are mental health and drug misuse.
Ignorance of Mental Health Issues and Inaccessibility of Treatment by Patients
According to Holliday (2018), laws on mental health parity that increase mental health services access help decrease public suicide rates. Mental health problems are often overlooked by lawmakers and impacted individuals, preventing many people from receiving necessary care. Suicidal thoughts are more prevalent in individuals experiencing mental health issues than in individuals without mental health issues. Thus, depressed and suicidal individuals are more likely to commit suicide if they lack access to health services. It is crucial to encourage governments to pursue and integrate mental health policies in public health and social policy. Mental illness imposes heavy burdens on society, impedes the achievement of other health and development objectives, contributes to poverty, and disproportionately affects the poor. It is necessary to recognize stigma related to mental health disorders and mental illness to enforce mental health strategies. Stigma leads to a loss of ministerial and widespread concern, resulting in a lack of resources and trust, a deterioration of institutions, a lack of leadership, inadequate knowledge systems, and a lack of legislation. Stigma hurts, by culminating in a social stigma, not just people with mental health, but also the social welfare of society as a whole. Far too much, our programs, rather than turning blocks to social integration, act as gates to alienation.
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According to the National Institute of Mental Health (NIMH) (2021), almost one in every five adult Americans, accounting for more than 50 million individuals, has an underlying mental health disorder. Despite these alarming figures, mental health problems appear to be overlooked, with over 60% of those affected not receiving care. There is mounting evidence of mental illnesses worldwide impact. Mental health issues are a significant addition to the global cost of sickness and impairment. Mental health problems have long been neglected in terms of their effect on health and efficiency. The research presents data on rates of failure and therapy initiation delay after mental disorder onset in various countries. While the arsenal of successful drugs continues to expand, few nations are capable or willing to pay for their extensive use. Indeed, particularly in socially developed countries, the number of individuals who have recently experienced a mental disorder appears to go untreated. One promising approach is to emphasize the utilization of recovery services early in affected patients' disease courses, before the onset of numerous detrimental consequences of mental disorders.
Alcohol and Substance Abuse as Leading Cause of Mental Health Disorders
Individuals with alcoholism and those with drug use problems have ten and fourteen times at increased risk of suicide, respectively, compared to the general public (Esang & Ahmed, 2018). Alcohol was involved in over 22% of suicides, while traces of heroin, tobacco, and cocaine were discovered in 20%, 10.2 percent, and 4.6 percent of suicide victims, respectively. Alcoholism and binge drinking can coexist with, lead to, or arise from a variety of different mental syndromes. As a result, intoxication can exacerbate or replicate almost any psychiatric disorder observed in the mental health environment, making the correct diagnosis of the psychiatric complaints is challenging at times. As alcoholism and psychological illnesses co-occur, patients are more likely to struggle with abstinence maintenance, try or commit suicide, and seek mental health treatment. Numerous studies indicate that depressive symptoms often precede the onset of alcoholism in women, especially. Patients suffering from alcohol-induced depression tend to exhibit distinct characteristics from those suffering from unrelated depressive conditions. For instance, individuals suffering from alcohol-induced depression are more likely to have a previous history of a suicide attempt;
only between 7.5 percent to 20% of those who have a drug use disorder seek care (Boumparis et al., 2019). Owing to the stigma associated with and linked to alcohol and drug use disorders, individuals with these disorders should not seek care. Additionally, they fear that coercive abstinence would be recommended as the primary treatment choice and that in certain circumstances, medication would be withheld owing to a lack of available resources. Although increasing public awareness of mental and drug use disorders may have a beneficial effect on general standards, there is evidence that framing these disorders as brain ailments has a mixed impact on people's views and actions toward mental and substance use disorders. As previously stated, public outreach initiatives framing psychiatric and alcohol use disorders as brain diseases can have adverse effects, such as heightened perceptions of disparity and skepticism about the chances of rehabilitation.
Prevention of Alcohol and Substance Abuse as Key to Preventing Danger Among Youth
With the addition of tobacco and alcohol, cannabis is the most widely consumed drug by adolescents. Epidemiological evidence, which is mainly focused in high-income countries, indicates that the perceived ease of access to cannabis, combined with expectations of a low risk of damage, makes cannabis the third most commonly consumed drug, after tobacco and alcohol (Wang & Yen, 2017). It is usually first seen in late adolescence and reaches a plateau in early adulthood. Adolescent substance abuse is associated with various health issues, including stress and abnormal brain functioning, all of which are risk factors for suicidal behavior. Medical literature indicates that those who consume cannabis before reaching the required age face acute harm and an elevated chance of experiencing substance use disorders and mental health disorders, such as personality disorders, anxiety, and depression. Around 9% of people who experiment with cannabis experience cannabis use disorders, compared to 1 in 6 of those who begin as teenagers.
The brain is exquisitely receptive to psychosocial interactions during development. Such interactions profoundly affect a child's ability to self-regulate and, potentially, on addiction to alcohol use. Adolescent drug use is particularly concerning, as research indicates that drugs with psychoactive effects have a more significant impact on teenagers than adults. Age-related discrepancies in drug reactions are most likely due to differences in the pharmacological effects of substances on developing brain structures. These distinctions can have significant consequences for teenagers, enhancing their propensity to take larger quantities and varieties of drugs, thus impairing their neurodevelopment.
Individuals with personality disorders (PDs) exhibit irregular patterns of inner perception and behavior. BPD is correlated with a broad spectrum of psychopathology, including mood instability, impulsive behavior, and dysfunctional intimate relationships. BPD patients make an average of three suicidal attempts throughout their lives, mostly by overdose. Patients with BPD struggle with social control and cut themselves compulsively to alleviate traumatic inner states. By and wide, suicides in BPD occur later in the disease and are associated with lengthy periods of inadequate therapy. According to a meta-analysis, suicidality is "more troubling" in young adults, with a high prevalence of suicidal activities. Nonetheless, the vast majority of BPD patients develop over time, and those who suffer from suicide are typically those who do not survive.
Conclusion
In the United States, mental health and drug abuse issues are the leading causes of suicide. Policymakers should enact legislation that encourages people with mental health and drug abuse issues to seek care. These policies can provide optional multimedia programs aimed at reducing the stigma associated with the two conditions. Therefore, clinicians must be aware of the role that alcohol, medications, and other substances play in exacerbating people's mental health problems and precipitating suicidal ideation.
References
Boumparis, N., Schulte, M. J., & Riper, H. (2019). Digital mental health for alcohol and substance use disorders. Current Treatment Options in Psychiatry, 6, 352–366. https://doi.org/10.1007/s40501-019-00190-y
Centers for Disease Control and Prevention (CDC). (2021). Suicide and self-harm injury. https://www.cdc.gov/nchs/fastats/suicide.htm
Esang, M., & Ahmed, S. (2018). A closer look at substance use and suicide. The American Journal of Psychiatry, 13 (6), 6-8. https://doi.org/10.1176/appi.ajp-rj.2018.130603
Holliday, S. B. (2018, March 2). The relationship between mental health care access and suicide. Gun Policy in America. https://www.rand.org/research/gun-policy/analysis/essays/mental-health-access-and-suicide.html
National Institute of Mental Health (NIMH). (2021). Mental illness. https://www.nimh.nih.gov/health/statistics/mental-illness.shtml
Too, L. S., Spittal, M. J.,Bugeja, L., Reifels, L., Butterworth, P., & Pirkis, J. (2019). The association between mental disorders and suicide: A systematic review and meta-analysis of record linkage studies. Journal of Affective Disorders, 259, 302-313 . https://doi.org/10.1016/j.jad.2019.08.054
Wang, P., & Yen, C. (2017). Adolescent substance use behavior and suicidal behavior for boys and girls: a cross-sectional study by latent analysis approach. BMC Psychiatry, 17 (1), 392. https://doi.org/10.1186/s12888-017-1546-1
