Study Reveals Key Signs Indicating Higher Suicide Risk

A recent study by the Institute of Mental Health (IMH) in Singapore has identified specific warning signs that may indicate a higher risk of suicide. Released on September 17, 2024, the study highlights that individuals exhibiting four or more “acute warning signs” could be at significant risk. This groundbreaking research is reportedly the first of its kind in Singapore, funded by the Ministry of Health.

The study outlines ten warning signs, which are derived from a framework established by the American Association of Suicidology. These signs include ideation, substance abuse, purposelessness, anxiety, feelings of being trapped, hopelessness, withdrawal, anger, recklessness, and mood changes. Collectively, the first letters of these warning signs form the mnemonic “Is Path Warm,” making them easier to remember. Researchers found that these signs typically emerge about a week before a suicide attempt.

Methodology and Findings

Utilizing a method known as “psychological autopsy,” the IMH study involved a thorough retrospective analysis of individuals who had died by suicide. Researchers gathered data from family, friends, and coroner’s reports, examining a total of 73 cases of suicide alongside 73 control cases of individuals who did not die by suicide. The age range for those in the suicide group was between 11 and 76 years, while the control group ranged from 10 to 76 years. Interviews were conducted face-to-face from May 2021 to February 2024.

The study aims to provide a clearer understanding of the circumstances, personality traits, and health issues that may contribute to suicide. According to provisional data from the Samaritans of Singapore, there were 314 deaths by suicide in 2024, reflecting a decrease from 434 in 2023 and 476 in 2022.

Contextualizing the Findings

The IMH emphasizes that, while core risk factors may be similar to those found in Western contexts, the cultural and social experiences surrounding distress and help-seeking behavior differ widely. The study revealed that many individuals who died by suicide faced significant life challenges, including unemployment, substance abuse, and relationship difficulties.

For instance, over half of the participants who died by suicide, specifically 52.1 percent, did not possess an educational qualification beyond a diploma from the Institute of Technical Education. In contrast, only 13.7 percent of those not at risk had similar educational backgrounds. Furthermore, 30.6 percent of suicide cases were unemployed in the year leading up to their deaths, compared to just 5.5 percent in the control group.

In addition to economic factors, lifestyle choices played a significant role. The study found that 22.8 percent of individuals who died by suicide were known to smoke, while 24 percent reported drinking alcohol weekly, in stark contrast to 11 percent and 2.7 percent of the control group, respectively. These statistics underline the complexity of factors contributing to suicide risk.

Mental Health Considerations

The research also corroborated previous findings that a significant proportion of individuals who died by suicide had been diagnosed with mental health conditions. Approximately 71 percent of these individuals were likely to have a mental health diagnosis, compared to 13.9 percent in the control group. Major depressive disorder was identified as the most prevalent condition, affecting 40 percent of those who died by suicide.

Moreover, the study highlighted that mental health conditions often went unrecognized by loved ones. Many reported difficulty distinguishing between ordinary stress and severe mental health issues, which led to delays in seeking treatment. For instance, individuals who had experienced insomnia in the weeks prior to their deaths were notably more common among suicide cases.

Professor Chong Siow Ann, a senior consultant at IMH, stated that warning signs like withdrawal and hopelessness may sometimes be subtle and mistaken for typical stress. He emphasized the importance of awareness regarding these signs, suggesting that opportunities exist for intervention if individuals recognize changes in behavior.

As the conversation around mental health continues to grow, resources for those in need remain crucial. The National Mental Health Helpline can be reached at 1771, while the Samaritans of Singapore Hotline is available at 1767. The Singapore Association for Mental Health also offers support at 1800 283 7019.

In conclusion, the IMH study provides valuable insights into the warning signs and life circumstances that may lead to suicide, reinforcing the need for increased awareness and culturally relevant mental health support.