Suicide Prevention


Surging suicide rates plague the United States, especially among adolescents. One in seven deaths among those 15 to 19 years of age results from suicide. According to the National Center for Health Statistics, suicide rates in this age group have soared 400% from 1950 to 1990.

One study of 525 adolescents found that religious commitment significantly reduced risk of suicide (Stein et al., 1992). Adolescent suicide has also been linked to prior depression. Another study of adolescents found that frequent church-goers with high spiritual support had the lowest scores on the Beck Depression Inventory (Wright et al., 1993). High school students of either gender who attended church infrequently and had low spiritual support had the highest rates of depression, often at clinically significant levels.

How significantly might religious commitment prevent suicide? One early large-scale study found that people who did not attend church were four times more likely to kill themselves than were frequent church-goers (Comstock and Partridge, 1972). Stack (1983) found rates of church attendance predicted suicide rates more effectively than any other evaluated factor, including unemployment. He proposed several ways in which religion might help prevent suicide, including enhancing self-esteem through a belief that one is loved by God and improving moral accountability, which reduces the appeal of potentially self-destructive behavior.

Many psychiatric inpatients indicate that spiritual/religious beliefs and practices help them to cope. Lindgren and Coursey (1995) reported 83% of psychiatric patients felt that spiritual belief had a positive impact on their illness through the comfort it provided and the feelings of being cared for and not being alone it engendered.

Yet Kehoe and Gutheil (1994), evaluating suicide assessment instruments, recently observed, "Although religion is noted as a highly relevant factor in suicide literature, the number of religious items included on assessment scales approaches zero." They noted the need to recognize and include religion/spirituality in suicide prevention, treatment and care.

Potential Harmful Effects


Psychiatry still needs more research and clearer hypotheses in differentiating between the supportive use of religion/spirituality in finding hope, meaning, and a sense of being valued and loved versus harmful beliefs that may manipulate or condemn.

For example, in assessing multiple personality disorder, Bowman (1989) described rigid religious families whose harsh parenting practices border on abuse. Children from these families harbored negative images of God. Josephson (1993) described individual psychopathology linked with families whose enmeshment, rigidity and emotional harshness were supported by enlisting spiritual precepts.

Sheehan and Kroll (1990) studied 52 seriously mentally ill hospitalized patients diagnosed with major depression, schizophrenia, manic episode, personality disorder and anxiety disorder. Almost one-fourth of them believed their sinful thoughts or acts may have contributed to the development of their illness. Without the psychiatrist inquiring about potential religious concerns, these beliefs would remain unaddressed, potentially hindering treatment until discovered and resolved. Collaboration with hospital chaplains or clergy may help in some of these instances of spiritual problems or distress.

Conclusion


Religious/spiritual commitment may enhance recovery from depression, serious mental or physical illness, and substance abuse; help curtail suicide; and reduce health risks. More longitudinal research with better multidimensional measures will help further clarify the roles of these factors and whether they are beneficial or harmful.
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