skip to primary navigationskip to content
 

Reducing the risk of student suicide

A Guide for those with Welfare Responsibilities

Background Information

Suicide is the second most common cause of death in young adults and the incidence is rising, particularly amongst young men. Yet most people who attempt suicide are ambivalent about killing themselves - frequently what they seek is to put a stop to unbearable feelings or a situation that seems intolerable. Someone who is suicidal may well be feeling frightened, trapped, hopeless, helpless, confused and distressed - and desperate to escape from his or her suffering rather than actually wanting to die. But at times like this suicide can feel like the only way out.

Thoughts about suicide are very common - the thought will probably cross the mind of the majority of people at some point in their lives. Approximately 5% of those who come to the UCS (approx. 40-50 students in a year) talk seriously of suicidal ideation.

Although studies suggest that the occurrence of suicide and attempted suicide in student populations is less than in the population at large, the figures are still alarming and increasing. A survey(1) into student stress and suicide rates conducted by Don Foster MP stated that between 1983 and 1994 "the total number of suicides ... has risen fourfold". This same survey indicated that young males were four times more likely to kill themselves than their female colleagues and that mature students were another particularly vulnerable group.

A study by Collins(2) of suicides at Cambridge University showed that statistically there are likely to be about two suicides in the university each year, but confirmed that the rate is somewhat lower than in the general age-matched population. While a study by Hawton(3) et al on suicide amongst Oxford University students found that nearly half of the students who had committed suicide had previously been identified as clinically depressed, most people who attempt or commit suicide are not 'mentally ill' in the formal sense.

Why would a student attempt to kill themselves?

For some students suicide will follow a period of depression while for others it is likely to be an impulsive act, perhaps triggered by a traumatic experience, for example the death of a loved one, or by a relatively insignificant event which may be seen as the 'final straw'. The following is a list of some of the feelings and experiences that may contribute to someone feeling suicidal:

  1. Loneliness - developing into the all-consuming feeling that there is no-one there and that no-one really cares or will notice whether they live or die. The suicidal person can feel totally alone and isolated.
  2. Feelings of hopelessness and helplessness - where the student feels that no matter what s/he does, nothing seems to get better, and that no-one is able to help.
  3. Feelings of worthlessness, of being 'a waste of space' - s/he will never amount to anything, and that any care, interest, or encouragement shown would be unjustified or based on a false premise. Convinced they are not worth caring about, such people are likely to have very low self-esteem, and to not readily accept compliments or praise.
  4. Depression - in those who are clinically depressed, their perceptions of themselves, others and their situation are usually unduly negative. Many of the above feelings are not only common but are also felt to be unquestionably true. Although observers may be clearly aware of the depressed person's talents, achievements, and of others who care deeply about them, it is their internal perceptions that need to be taken into account.
  5. Plans falling through - especially where the goals have considerable personal importance - e.g. not settling well at university, the break-up of an important relationship, or a student not achieving her/his academic goals. As a result the student can feel inadequate, a failure, ashamed, unlovable...
  6. Inappropriately high levels of stress - of the kind experienced by those with exceptionally or unrealistically high personal or academic expectations. Students can easily come to feel stressed by academic demands and for some there will be times when the level of stress becomes unbearable. Those who have been high achievers, in particular, can feel that their academic success is crucial to their personal identity, and if the former is under perceived or real threat, their identity is also endangered. To such people, the idea of not getting a 1st can be felt as an utter and unbearable humiliation. The Oxford study(3) on student suicide quoted above found that of those who had committed suicide "two-thirds of the students had been worried about academic achievement or their courses". However, the Collins study(2) at Cambridge did not find an increase in suicides around examination times.
  7. Anger - suicide can sometimes be seen as the act of someone who is very angry, perhaps even as an act of revenge, (for example after the ending of a relationship).
  8. Alcohol and drugs - for some a suicide attempt may be an impulsive act when under the influence of alcohol or drugs. In this state a person may seriously underestimate the risks of their actions, and be more vulnerable to the above feelings.
  9. A history of mental or physical illness.
  10. Feeling overwhelmed - when problems in a number of areas of life occur at the same time - for example academic problems, a family crisis, and the ending of a relationship - the sense of pain may be overwhelming.

Attempted suicide

Another study at Oxford on attempted suicide(4) by the same team found that "the most frequent problems faced by the students at the time of their attempts were interpersonal, especially difficulties regarding partners, followed by academic problems".

Don Foster MP found in his survey(1) that financial worries and the stress caused by academic pressures and concerns were the two main factors associated with suicide attempts.

Whatever the cause, suicide attempts should always be treated seriously. Statistics show that those who make several suicide attempts are more likely to finally die by their own hands, whether by intent or by accident.

Risk Indicators

Under normal circumstances people are likely to feel distressed, aggrieved or depressed in response to the difficulties and disappointments they encounter in the course of their daily lives. The person who responds by making a suicide attempt is more likely to have a history of trauma, hurts or disappointments that have gone unnoticed or unaddressed, and is more likely to be overwhelmed by major problems than to rise to the difficult task of facing them. Here are some risk indicators:

  • depression, including excessive feelings of guilt or shame, self reproach and anger
  • feelings of worthlessness and very low self-esteem, particularly if accompanied by very high ideals or expectations
  • feelings of hopelessness, helplessness and futility
  • feelings of alienation and isolation; being a loner
  • history of previous suicide attempts
  • a detailed suicide plan
  • alcohol and / or other substance abuse
  • comments about killing him/herself or about the pointlessness of life
  • a recent, severe trauma or stressful event such as a major loss, or the threat of loss
  • significant changes of behaviour, e.g. becoming withdrawn, when this is not typical of the individual.

It is not true that 'people who talk about suicide, don't actually do it'!

What to do if you think someone is contemplating suicide

If you are concerned that a student may be suicidal you can contact The Counselling Service Reception on (3)32865 or email .

Here are some other suggestions that may help if you are talking with the student:

Examine your own feelings and views. If you find that you use phrases like "a cry for help" or "attention seeking" in a derogatory or reductive manner, rather than seeing them as an expression of despair, then you might be wise to consider whether someone else would be better suited to help the student at this time.

  1. Ask. Asking if a person feels suicidal is very unlikely to put the idea into their head, and they may feel relieved to talk.
  2. Listen. Take the student and what he or she says seriously, and try to understand their perspective of the situation. The student may be able to tell you what they need and who might help.
  3. Discuss. Try to discover what might make a difference without imposing your solutions on the situation.
  4. Offer practical help towards problem solving - e.g. lifting an academic deadline.
  5. Don't over-reach your own limits of time or expertise, or promise something you can't deliver: a person who is suicidal doesn't need further disappointment.
  6. Refer. Do not take sole responsibility for the situation. Sensitively indicate that you are concerned enough to arrange for further help, even if it means breaking a confidence.

Discuss with the student who else might help: tutors, parents, relatives and friends might create a supportive network; the student's GP or the Counselling Service may well also be appropriate. Their GP will be able to consider whether medication could help and can access further medical or psychiatric support if needed. Even if you feel the student is "at risk" they may still be able to collaborate with you in arranging suitable help. You might consider speaking to the student's GP yourself - preferably with the student's permission (where this is possible).

The Counselling Service reserves appointments for urgent matters and should be able to see the student quickly in these circumstances - you may want to telephone the service to alert us to your concerns and involvement. If it is appropriate, we can usually arrange for a student to have a mental health assessment at the service within a week or so, but this is not an emergency service. In an emergency, psychiatric assessments can be arranged via the emergency services or the student's GP.

In an emergency ... call an ambulance

If the person is in immediate danger, call an ambulance and also inform someone else in the college / department. Stay with the person until help arrives. Remove any potentially dangerous objects.

If someone has already taken some action towards harming themselves, e.g. taken an overdose, give the emergency services information about the nature of the self-harm if possible, e.g. which drug(s) have been taken.

An alternative would be to take the person directly to Addenbrooke's Accident & Emergency Department in a taxi if this would be quicker and not place the student in greater danger, but ensure someone else knows what you are doing. (You are not advised to take a student in your own car.)

It does not make sense to call the Counselling Service at this point as we are not a medical or emergency service, but you may wish to inform us about what has happened later, so that counselling support can be offered to the student or others involved.

Following a student being hospitalised, or in the event of a death

When a student is hospitalised following a suspected suicide attempt, or when there is a student death:

  • alert the designated person in the College or University who will be the point of contact and information, and make this known where appropriate (advance planning in colleges / departments for responding to such situations is important!)
  • try to build up a picture of what happened - make written notes of the events, times and actions of all involved
  • consider who else might need to be informed, and how this should be done: the student's family, college / university authorities, friends and others who knew the student
  • where the student's family are informed (bearing in mind that students are adults) they may need considerable support
  • consider who else may need to be offered support - this is often more relevant after a few days rather than immediately, but may still be relevant weeks or months afterwards
  • where a student is hospitalised, consider who should be kept informed of his or her progress
  • do not discourage fellow students from talking with each other about their feelings at what has happened
  • find support for yourself - 'soldiering on' is not usually a good policy in the long term.
  • the press sometimes become aware of a student death, or a suspected suicide, very quickly - sometimes within an hour! Consider carefully before giving any information, and in the event of a death, never describe it as "suicide" prior to the coroner determining the cause of death.

Working through such emergencies is likely to be both distressing and personally draining. You are very welcome to contact the counselling service to discuss the situation and seek guidance for yourself. There may be others in the college who could also offer support (to the student or yourself), such as the College Nurse and/or Chaplain.

In conclusion

Whilst we will never be able to eliminate the risk of suicide, we can do some things to reduce the risk:

  • the Oxford study of student suicide recommended "careful induction upon arrival at university, means of alleviating academic stress and worries, and readily available and closely associated student counselling and psychiatric services."
  • alert freshers to the (apparently obvious) fact that their work is designed to be challenging, and there is nothing bad or unusual in finding it difficult - and they certainly won't be the only ones finding it so
  • avoid making public comments which imply it is 'weak' to seek help
  • be sensitive to change in students under your care
  • discern the difference between those who are comfortable with being alone, and the isolated or alienated
  • sarcastic criticism is never acceptable and can deeply wound
  • by all means challenge and encourage students to achieve their best, but avoid implying that to fall short of some standard (e.g. getting a 1st) would mean utter failure.

And it is worth reminding ourselves that despite all our best endeavours, sadly it will not be possible to prevent all such deaths.

 

References

  1. A Report on the Level of Student Stress and Suicide Rates
    Don Foster MP, 1995, House of Commons Library
  2. Suicide amongst Cambridge University Students 1970 - 1996
    Collins IP & Paykel ES,
    Soc Psychiatry Psychiatr Epidemiol, 2000, 35: 128-132
  3. Suicide in Oxford University Students, 1976-1990
    Hawton K, Simkin S, Fagg J & Hawkins M
    British Journal of Psychiatry, 1995, 166: 44-50
  4. Attempted Suicide in Oxford University Students, 1976-1990
    Hawton K, Haigh R, Simkin S & Fagg J
    Psychological Medicine, 1995, 25: 179-188