A review of risk factors associated with suicide in adults with intellectual disability

Abstract

Purpose -Suicide is one of the top three leading causes of death amongst those aged between 15 and 44 years; and tenth leading cause of death in the wider population. The base rates of suicide, suicide attempts and suicide-related behaviours are comparably low in the general population with between 17 and 68 per cent of individuals who successfully commit suicide having made a previous attempt to take their own life. As recently as the 1980's it was still a widely held belief that individuals with intellectual disability (ID) did not have the cognitive capacity to experience mental health problems and this acted as a "buffer" against suicidal behaviour. The paper aims to discuss these issues. Design/methodology/approach -The literature review covered the time period 1993-2013 and returned 117 studies, 77 of which related to individuals with ID, 37 of which related to adults. Following screening titles and abstracts 28 articles were removed. A total of nine studies were found to be eligible for inclusion in the review. A further two studies examining suicide in adolescents (up to adulthood) with ID were also considered. From the eligible studies the following information was considered: study design, sample size, strengths, limitations and the risk factors associated with an increased risk of suicide. Findings -The suicide risk factors identified during the review were found to be in keeping with the general population and included a diagnosis of clinical depression, history of self-harm, unemployment, loneliness, unemployment, an increased need for support from others, early onset mental illness and being treatment resistive. Originality/value -Suicide in individuals with ID is a topic that has not received a great deal of attention from professionals and clinicians alike. People with ID have higher rates of mental health problems and therefore it could be argued that they are more likely to be at risk. This study aims to look at risk factors specific to people with ID for clinicians to consider in their daily practice.

Suicide amongst people with intellectual disability: An Australian online study of disability support staff experiences and perceptions

“…In general, these data are not surprising as it mirrors international research that has previously reported on suicidal behaviours by people with ID, both within community and residential settings and across a variety of ID classifications (e.g. Patja et al ., ; Merrick et al ., ; Mollison et al ., ; Dodd et al ., ). However, the current study does represent one of the few Australian studies that has specifically considered suicide amongst this cohort of people and reinforces the fact that suicide is not unknown in this population despite the minimal research focus.…”

“…It would appear that individuals with ID are a potentially high-risk group for suicide, and yet there is little consideration of suicide as a potential issue for this subgroup of the community (Merrick et al, 2006;Salvatore, 2012;Mollison et al, 2014;Dodd et al, 2016). This is perhaps surprising given what is currently understood about the general risk factors for suicidal behaviour and also the knowledge garnered from the limited research base specifically regarding persons with ID.…”

Characteristics of prisoners with intellectual disabilities

“…A 35 year old follow up study of 2369 Finnish people with ID, reported that the rate for completed suicides for people with ID was one-third of the general population rate (Patja et al 2001). The risk factors which increase the risk of suicide such as clinical depression, history of self-harm, unemployment, loneliness, unemployment, lack of support, early onset mental illness and being treatment resistive are the same as the general population (Mollison et al 2014). The lack of screening for ID means this vulnerable group continue to go unrecognised and therefore are not represented in cases of completed suicide.…”

The clinical characterization of the adult patient with an anxiety or related disorder aimed at personalization of management

“…Social support is also associated with reduced risk for anxiety disorders prospectively 214,217 and can mitigate the development of PTSD following exposure to trauma. Given the role of financial strain in anxiety 197 , it is not surprising that employment is robustly associated with reduced symptoms of depression and anxiety and decreased suicide risk, especially among men [218][219][220] .…”