Why Is the Suicide Risk Greater with Schizophrenia?

Are people with schizophrenia at greater risk of suicide? 

People with schizophrenia have a much higher rate of suicide than the larger population: People with schizophrenia have a 10% rate of suicide compared with the larger population’s 1.3% rate of suicide.

Suicide is the biggest reason for the decreased life expectancy of people with schizophrenia.

A larger number of people with schizophrenia contemplate suicide. Around 40–79% of people with schizophrenia have reported having suicidal thoughts, according to a 2016 review of previous research.

Causes of suicidal ideation in people with schizophrenia 

According to a 2019 research overview, people with schizophrenia may be more likely to have suicidal thoughts due to the following factors:

• intense psychiatric symptoms, like hallucinations and delusions
• negative symptoms of schizophrenia, such as reduced emotional expression, social withdrawal, and lack of motivation
• psychosocial stressors
• substance misuse
• medication side effects
• co-occurring depression
• lack of support
• history of previous suicide attempts
• cognitive challenges
• sense of hopelessness

What are the risk factors for suicide in schizophrenia?

According to the same 2019 overview, the following demographic and psychosocial factors can increase the risk of suicide in people with schizophrenia:

• younger age
• being male
• being unmarried
• living alone
• unemployment
• high intelligence
• education
• a healthier baseline level of functioning before schizophrenia onset
• high personal expectations and hopes that are unlikely to be met
• recent stressful life events (within the past 3 months)
• poor work functioning
• access to lethal means, like firearms

The review notes that people with primarily paranoia symptoms of schizophrenia are eight times more likely to die from suicide than people with primarily negative symptoms of schizophrenia.

Delusions are also linked to increased suicidal behavior in people with schizophrenia.

According to 2016 research, the following factors may increase the risk of suicide in people with schizophrenia:

• First-year susceptibility: The first year of symptoms starting has a higher risk of suicide.
• Social aspects: Lack of social support, unstable relationships, and social drift after symptom episodes contribute to an increased risk of suicide.
• Previous attempts: Individuals with prior suicide attempts are more vulnerable.
• Specific symptoms: Symptoms like suspiciousness, paranoid delusions, mental disintegration and agitation, negative symptoms, depression and hopelessness, and command hallucinations are associated with a higher suicide risk.
• Substance misuse: Substance misuse amplifies the risk of suicide.
• Psychological traits: Perfectionism and good insight, or awareness and understanding of the condition and its effects, among people with recent symptoms of psychosis correlate with more suicide attempts.
• Brain circuitry: Dysfunction in prefrontal cortex-based circuits in the brain might be linked to suicide in early stage schizophrenia.

Learn more about the complex relationship between religion and the mental health of people with schizophrenia here.

Getting help for yourself 

If you have schizophrenia and are feeling suicidal, it’s important that you reach out for help. You are not alone and support is available right now:

• Talk with a mental health professional: Contact a psychologist or therapist specializing in schizophrenia who can provide support and guidance. Many therapists offer virtual sessions, which can be helpful if you cannot visit in person.
• Medication management: If you’re already taking medication for schizophrenia, contact your prescribing doctor to discuss whether any adjustments are needed.
• Seek support from loved ones: Reach out to friends, family members, or a support group. Sharing feelings with trusted individuals can provide emotional support.
• Contact a helpline: Call a crisis helpline or suicide prevention hotline. In the United States, you can reach the 988 Suicide & Crisis Lifeline by calling 988 anytime day or night.
• Use crisis text lines: Text-based crisis lines offer a discreet way to communicate with a trained counselor. For example, in the United States, you can text “HOME” to 741741 to reach the Crisis Text Line.
• Emergency services: If immediate assistance is needed, call 911 or your local emergency services, or go to the nearest emergency room.

How to support someone else 

Supporting a person with schizophrenia who feels suicidal requires compassion, understanding, and prompt action.

Here’s what you can do:

• Stay calm and listen: Approach them calmly and give them your full attention. Listen without judgment and let them express their feelings.
• Express concern: Let them know you care and are concerned about their well-being.
• Encourage professional help: Encourage them to reach out to mental health professionals or doctors who specialize in schizophrenia. Offer to help them find resources.
• Remove harmful items: If there are any harmful objects nearby, try to remove them from the person’s reach.
• Stay with them: If they’re in immediate danger, stay with them or ensure someone else is present until professional help arrives.
• Contact emergency services: If the person is in immediate danger, don’t hesitate to call 911 or a crisis hotline for immediate assistance.
• Stay connected: Regularly check in on them and offer your support. Let them know they’re not alone.

Takeaway 

People with schizophrenia have a much higher suicide risk than the larger population due to the condition’s severe symptoms.

If you or someone you love has schizophrenia and is experiencing suicidal thoughts, reach out for help. You can contact a mental health professional, a helpline, or a support group.

You don’t have to navigate this alone. Support is available to ensure your safety and get you the assistance you need.