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Rising Suicide Rates – A Treatment and Research Perspective

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By Jane G. Tillman, PhD, ABPP
Evelyn Stefansson Nef Director
Erikson Institute for Education and Research

Jane G. Tillman, PhD, ABPP is the Evelyn Stefansson Nef Director of the Erikson Institute for Education and ResearchThe Centers for Disease Control and Prevention (CDC) issued a report on Friday showing a 24% increase in the suicide rate between 1999 and 2014, the highest level in 30 years. These troubling statistics have not only caught the attention of the media, but also many researchers and public health experts, who note that the causes for suicide are complicated, involving biological, psychological and sociocultural factors. 

The research community has learned a great deal about suicide over the past 25 years and yet, as the data demonstrates, these findings have not translated into a lower rate of suicide. Stigma, lack of access to care, un- or undertreated depression and other barriers to seeking help are all implicated in the rising suicide rate. 

At the Austen Riggs Center we encounter a somewhat different challenge. Our patients are in an intensive treatment, and many have had multiple trials of widely-available, first-line treatments, including sophisticated psychopharmacology, electroconvulsive therapy, psychotherapy and other modalities – yet some of our patients remain preoccupied with suicidal thinking and impulses. Our challenge is to understand what barriers exist in certain patients that prevent them from benefitting from standard psychiatric care.  

We are pressed to reconcile the persistence of suicidal thinking and action in patients who are already receiving a treatment that addresses the symptoms of depression, anxiety, social isolation and maladaptive defenses and coping mechanisms. Understanding and treating a unique segment of the population – individuals, who, so far, have not responded to many psychiatric treatments – is part of the challenge for researchers and clinicians at Riggs. Learning what differentiates those who do not report any history of suicidal thinking and those who have suicidal thoughts, but have never made an attempt, from those who have made a suicide attempt are central aims of our research on self-destructive and suicidal behavior. 

Our hope is that, by understanding more specifically the personal meanings and proximal drivers for suicidal behavior, we will be able to more effectively treat this group, and ultimately contribute to the body of knowledge that will impact this significant public health problem.

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