15 For example during 2014 among adults aged 18 years and older for every one

15 for example during 2014 among adults aged 18 years

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15 For example, during 2014, among adults aged 18 years and older, for every one suicide there were 9 adults treated in hospital emergency departments for self- harm injuries, 27 who reported making a suicide attempt, and over 227 who reported seriously considering suicide. 6,16 Suicide is associated with several risk and protective factors. Suicide, like other human behaviors, has no single determining cause. Instead, suicide occurs in response to multiple biological, psychological, interpersonal, environmental and societal influences that interact with one another, often over time. 1,5 The social ecological model—encompassing multiple levels of focus from the individual, relationship, community, and societal—is a useful framework for viewing and understanding suicide risk and protective factors identified in the literature. 17 Risk and protective factors for suicide exist at each level. For example, risk factors include: 1,5 Individual level : history of depression and other mental illnesses, hopelessness, substance abuse, certain health conditions, previous suicide attempt, violence victimization and perpetration, and genetic and biological determinants Relationship level : high conflict or violent relationships, sense of isolation and lack of social support, family/ loved one’s history of suicide, financial and work stress Community level : inadequate community connectedness, barriers to health care (e.g., lack of access to providers and medications) Societal level : availability of lethal means of suicide, unsafe media portrayals of suicide, stigma associated with help-seeking and mental illness. It is important to recognize that the vast majority of individuals who are depressed, attempt suicide, or have other risk factors, do not die by suicide. 18,19 Furthermore, the relevance of each risk factor can vary by age, race, gender, sexual orientation, residential geography, and socio-cultural and economic status. 1,5
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Preventing Suicide: A Technical Package of Policy, Programs, and Practices 9 Exposure to violence is associated with increased risk of depression, post-traumatic stress disorder (PTSD), anxiety, suicide, and suicide attempts. Protective factors, or those influences that buffer against the risk for suicide, can also be found across the different levels of the social ecological model. Protective factors identified in the literature include: effective coping and problem-solving skills, moral objections to suicide, strong and supportive relationships with partners, friends, and family; connectedness to school, community, and other social institutions; availability of quality and ongoing physical and mental health care, and reduced access to lethal means. 1,5 These protective factors can either counter a specific risk factor or buffer against a number of risks associated with suicide.
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