Suicide Ideation Across the Lifespan

Suicide Ideation Across the Lifespan

Suicide ideation is a phenomenon whereby an individual actively plans suicide. In 2020,

12.2 million people in the US reported seriously thinking about suicide, and of these, around ten

percent attempted killing themselves (Large et al., 2021). According to Klonsky et al. (2021),

suicide ideation exists on a spectrum of intensity, beginning with a general desire to die without

any concrete plan to active ideation, which involves a detailed plan and a determined intent to act

on the ideas.

In children and adolescents, suicide ideation is hard to spot as they may not be able to

express their feelings any better. Risk factors for suicide in this demographic include bullying,

Suicide assessment tools like the Columbia-Suicide Severity Rating Scale (C-SSRS) are

effective for this age group. The C-SSRS is designed to assess the severity and immediacy of

suicidal ideation and behaviour, and it can be adapted for use with children and adolescents.

Also, the Ask Suicide-Screening Questions (ASQ) is a brief screening tool specifically tailored

for use in pediatric settings (Qu et al., 2021).

As one transitions into independence during the young adulthood phase, one may

experience unique stressors that can precipitate suicide ideation. Risk factors in this stage include

relationship issues, financial challenges, and academic and career pressures. Young adults facing

economic hardships may feel as though they have failed and become hopeless. Looking at this

age group from another perspective, the community expects them to have figured out their

careers, gained a solid financial ground and perhaps started a family. Failing to meet these

expectations may subject young adults to emotional torture, pushing them to suicide ideation

(Klonsky et al., 2021). The Patient Health Questionnaire-9 (PHQ-9) and Suicide Behaviors

Questionnaire-Revised (SBQ-R) are frequently used to assess suicide risk in young adults as they

contain specific items on suicidal thoughts and can be administered in primary care and mental

health settings (Helm et al., 2020).

Career plateaus, marital issues, and the responsibility of raising children and/or elderly

Finally, older adults idealize death due to factors such as chronic illnesses, loss of loved

ones, and decreased physical abilities. Beach et al. (2021) mention that many elderly people

think they are a financial, emotional, and physical burden to their families and may think the

only way out is to die. Moreover, older adults with limited financial resources may experience

feelings of despair and helplessness. Developmentally, older people may fail to cope with the

thoughts of loss of autonomy and acknowledgement of death, which aggravates the suicidal

impulses. The Geriatric Suicide Ideation Scale (GSIS) is specifically designed to assess suicide

risk in older adults by considering the unique factors that influence suicide ideation in this

population (Schmutte et al., 2020).

Suicide ideation is a common problem, but with support and treatment, it is possible to

prevent one from acting on these thoughts. As nurses, we ought to understand the risk factors and

different assessment tools for suicide ideation across the lifespan.

References

Beach, V. L., Brown, S. L., & Cukrowicz, K. C. (2021). Examining the relations between

hopelessness, thwarted interpersonal needs, and passive suicide ideation among older

adults: Does meaning in life matter? Aging & Mental Health, 25(9), 1759–1767.

Helm, P. J., Medrano, M. R., Allen, J. J. B., & Greenberg, J. (2020). Existential isolation,

loneliness, depression, and suicide ideation in young adults. Journal of Social and

Clinical Psychology, 39(8), 641–674. https://doi.org/10.1521/jscp.2020.39.8.641

Klonsky, E. D., Dixon‐Luinenburg, T., & May, A. M. (2021). The critical distinction between

suicidal ideation and suicide attempts. World Psychiatry, 20(3), 439–441.

https://doi.org/10.1002/wps.20909

Large, M., Corderoy, A., & McHugh, C. (2021). Is suicidal behaviour a stronger predictor of

later suicide than suicidal ideation? A systematic review and meta-analysis. Australian &

New Zealand Journal of Psychiatry, 55(3), 254–267.

https://doi.org/10.1177/0004867420931161

Qu, G., Shu, L., Zhang, J., Wu, Y., Ma, S., Han, T., Zhang, H., Wang, J., & Sun, Y. (2021).

Suicide ideation, suicide plan, and suicide attempt among left‐behind children and

adolescents: A systematic review and meta‐analysis. Suicide and Life-Threatening

Behavior, 51(3), 515–527. https://doi.org/10.1111/sltb.12731

Schmutte, T., Olfson, M., Xie, M., & Marcus, S. C. (2020). Self-harm, suicidal ideation, and

attempted suicide in older adults: A national study of emergency department visits and

follow-up care. The American Journal of Geriatric Psychiatry, 28(6), 646–658.