Although no one can predict with 100% accuracy who will attempt suicide and when, the following signals may indicate a risk of suicide. Generally speaking, the more warning signs present, the greater the risk of suicidal behavior
Depression: Signs of clinical depression include:
Feelings of hopelessness, helplessness, and/or worthlessness
Insomnia or excessive sleeping
Significant appetite loss or gain
Decreased interest or pleasure in previously enjoyable activities
Themes of death in artwork, poetry and/or conversation
Suicide Plan: The more specific the plan, the more serious the intent.
Giving Possessions Away.
Talking About Suicide: This may be stated directly--"I'm going to kill myself." Or indirectly-- "You would be better off without me," or, "Soon you won't have to worry about me anymore."
Many college students feel chronically depressed, worthless and rejected by their families, and they struggle to gain some measure of acceptance and worth through academic achievement or athletic success. The inner life of such a chronically depressed person is not a slumbering state of dull unhappiness, but a confused melange of contradictory feelings of self-loathing and hate for the very people from whom he seeks love, the parents whom he feels have so hurt and frustrated him. Academic drudgery in the service of winning parental love perpetuates these students' connections with their parents, even as it threatens these connections by edging the student closer to graduating into an autonomous life.
The students who move beyond depression into suicide possess an additional attraction to death itself, which is seen as a soothing comfort and as a device for cementing a union with approving parents. They hold fantasies of rebirth as good, "cleansed" people; fantasies of returning to a world made better by their death; fantasies of reunion with loving people. These fantasies may help suicidal individuals to function and adapt in the world, but when they are profoundly stressed by interpersonal losses or academic setbacks, they mobilize plans to enact these fantasies.
Many suicidal students experience anxiety, insomnia, and other symptoms, though these may disappear shortly before the suicidal act, as the plan to commit suicide provides a seeming solution to their psychic pain. Those whose symptoms remit when they activate their suicide plans may be especially resistant to seeking any help that entails reexamining and re-experiencing the issues that so depressed them. When they do go for help, few report their suicidal intent, and few receive any psychiatric treatment, even though nearly half the suicidal students present for some medical treatment in the months before committing suicide.
While most suicidal students draw little attention to themselves, their multi-year residence in the monitored college environment offers the possibility that a sufficiently determined effort could detect suicidal students and press them into treatment. Teachers, coaches, and residence hall counselors should focus not only on disruptive students, but also on those who are quietly withdrawal whose dormitory discussions or classroom essays may disclose their hopelessness and suicidal interest.
Once suicidal students are detected, schools hold considerable ability to assure their compliance with treatment. In the past, students who were recognized to have any interest in suicide were promptly sent home on medical leave. Students are not well served by such policies that impose automatic medical leaves and return them stigmatized into families that may be chaotically disorganized. For many, a supportive campus setting enables them to continue their studies while receiving treatment.
Schools should prepare postvention plans in case a suicide does occur on the campus. The plans should focus on outreach to survivors and on preventing suicide contagion by managing the information that is presented to the press and public. As few suicides occur on each campus, however, few schools have prepared such plans for managing the acute disruption in campus life that follows a suicide.
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