View source for Suicidal ideation

{{short description|Thoughts, ideas, or ruminations about the possibility of attempting suicide}}
{{redirect|Suicidal thoughts|the The Notorious B.I.G. song|Suicidal Thoughts}}
{{Infobox medical condition (new)
| name          = Suicidal ideation
| synonyms      = Suicidal thoughts, suicidal ideas
| image         = Stückelberg Sappho 1897.jpg
| caption       = ''Sappho'', an 1897 portrait by [[Ernst Stückelberg (painter)|Ernst Stückelberg]]
| speciality    = [[Psychiatry]], [[psychology]], [[emergency medicine]]
}}

'''Suicidal ideation''', or '''suicidal thoughts''', is the [[thought process]] of having ideas or ruminations about the possibility of dying by [[suicide]].<ref name=ICD>World Health Organization, ''ICD-11 for Mortality and Morbidity Statistics'', ver. 09/2020, [https://icd.who.int/browse11/l-m/en#/http://id.who.int/icd/entity/778734771 MB26.A Suicidal ideation]</ref> It is not a diagnosis but is a symptom of some [[mental disorder]]s, use of certain [[psychoactive drug]]s, and can also occur in response to adverse life circumstances without the presence of a mental disorder.<ref name="Barry">Barry, Lisa C. [[doi:10.1016/j.jagp.2019.08.003|Passive Suicidal Ideation in Older Adults: Implications for Suicide Prevention]], ''American Journal of Geriatric Psychiatry'' 27, no. 12 (December 2019): 1411 ("... growing evidence points toward a subgroup of individuals who endorse passive SI [suicidal ideation] in later life outside the context of clinical depression.")</ref>

On suicide risk scales, the range of suicidal ideation varies from fleeting thoughts to detailed planning. '''Passive suicidal ideation''' is thinking about not wanting to live or imagining being dead.<ref name="Falcone">{{Cite book|last1=Falcone|first1=Tatiana|url=https://books.google.com/books?id=-j9bDwAAQBAJ|title=Suicide Prevention: A Practical Guide for the Practitioner|last2=Timmons-Mitchell|first2=Jane|date=2018-05-18|publisher=Springer |isbn=978-3-319-74391-2 |pages=38|language=en|chapter=Mood Disorders and Suicide}}</ref><ref name=":1">{{Cite book|last=Kumar|first=Updesh|chapter-url=https://books.google.com/books?id=qaI7DwAAQBAJ&q=%22passive+suicidal+ideation%22&pg=PA269|title=Handbook of Suicidal Behaviour|date=2017-10-26|publisher=Springer|isbn=978-981-10-4816-6|pages=269|language=en|chapter=Suicidal Ideation in Adolescents–A Transcultural Analysis}}</ref> '''Active suicidal ideation''' involves preparation to kill oneself or forming a plan to do so.<ref name="Falcone"/><ref name=":1"/>

Most people who have suicidal thoughts do not go on to make suicide attempts, but suicidal thoughts are considered a risk factor.<ref name="Gliatto1999">{{cite journal |last1=Gliatto |first1=MF |last2=Rai |first2=AK |date=March 1999 |title=Evaluation and Treatment of Patients with Suicidal Ideation |journal=[[American Family Physician]] |volume=59 |issue=6 |url=http://www.aafp.org/afp/990315ap/1500.html |access-date=2007-01-08 |pmid=10193592 |pages=1500–6 |archive-url=https://web.archive.org/web/20060925091838/http://www.aafp.org/afp/990315ap/1500.html |archive-date=2006-09-25 |url-status=live }} {{open access}}</ref> During 2008–09, an estimated 8.3 million adults aged 18 and over in the United States, or 3.7% of the adult U.S. population, reported having suicidal thoughts in the previous year, while an estimated 2.2 million reported having made suicide plans in the previous year.<ref>{{cite journal |last1=Crosby |first1=Alex |last2=Beth|first2=Han |date=October 2011 |title=Suicidal Thoughts and Behaviors Among Adults Aged ≥18 Years --- United States, 2008-2009 |journal=Morbidity and Mortality Weekly Report |volume=60 |issue=13 |url=https://www.cdc.gov/mmwr/preview/mmwrhtml/ss6013a1.htm |access-date=2015-01-08 |archive-url=https://web.archive.org/web/20150107083836/http://www.cdc.gov/mmwr/preview/mmwrhtml/ss6013a1.htm |archive-date=2015-01-07 |url-status=live }}</ref> In 2019, 12 million U.S. adults seriously thought about suicide, 3.5 million planned a suicide attempt, 1.4 million attempted suicide, and more than 47,500 died by suicide.<ref>{{cite web|last1=CDC|title=Facts About Suicide|url=https://www.cdc.gov/suicide/facts/index.html |access-date=2022-01-09 |archive-url=https://web.archive.org/web/20220107040758/https://www.cdc.gov/suicide/facts/index.html |archive-date=2022-01-07 |url-status=live }}</ref><ref>{{cite web|last1=Substance Abuse and Mental Health Services Administration|year=2020 |title=Key substance use and mental health indicators in the United States: Results from the 2019 National Survey on Drug Use and Health|url=https://store.samhsa.gov/product/key-substance-use-and-mental-health-indicators-in-the-united-states-results-from-the-2019-national-survey-on-Drug-Use-and-Health/PEP20-07-01-001 |access-date=2022-01-09 |archive-url=https://web.archive.org/web/20211009013956/https://store.samhsa.gov/product/key-substance-use-and-mental-health-indicators-in-the-united-states-results-from-the-2019-national-survey-on-Drug-Use-and-Health/PEP20-07-01-001 |archive-date=2021-10-09 |url-status=live}}</ref> Suicidal thoughts are also common among teenagers.<ref>{{cite journal |last1=Uddin |first1=R |last2=Burton |first2=NW |last3=Maple |first3=M |last4=Khan |first4=SR |last5=Khan |first5=A |date=2019 |title=Suicidal ideation, suicide planning, and suicide attempts among adolescents in 59 low-income and middle-income countries: a population-based study |journal=The Lancet Child & Adolescent Health |volume=3 |issue=4 |pages=223–233 |url=https://eprints.qut.edu.au/127817/1/127817a.pdf |doi=10.1016/S2352-4642(18)30403-6 |pmid=30878117 |hdl=10072/387579 |s2cid=81982117 |access-date=2019-11-29 |archive-url=https://web.archive.org/web/20200218002359/https://eprints.qut.edu.au/127817/1/127817a.pdf |archive-date=2020-02-18 |url-status=live |hdl-access=free }}</ref>

Suicidal ideation is associated with [[Major depressive disorder|depression]] and other [[mood disorder]]s; however, many other [[mental disorders]], life events and family events can increase the risk of suicidal ideation. [[Mental health]] researchers indicate that healthcare systems should provide treatment for individuals with suicidal ideation, regardless of diagnosis, because of the risk for suicidal acts and repeated problems associated with suicidal thoughts.<ref>{{Cite journal|last1=Griffin|first1=E.|last2=Kavalidou|first2=K.|last3=Bonner|first3=B.|last4=O'Hagan|first4=D.|last5=Corcoran|first5=P.|date=2020|title=Risk of repetition and subsequent self-harm following presentation to hospital with suicidal ideation: A longitudinal registry study|url= |journal=eClinicalMedicine|volume=23|pages=100378|doi=10.1016/j.eclinm.2020.100378|issn=2589-5370|pmc=7280762|pmid=32529177}}</ref><ref>{{Cite journal|last=Kleiman|first=Evan M.|date=2020|title=Suicidal thinking as a valuable clinical endpoint|url= |journal=eClinicalMedicine|language=en|volume=23|page=100399|doi=10.1016/j.eclinm.2020.100399|issn=2589-5370|pmid=32566922|pmc=7298405|doi-access=free}}</ref> There are a number of treatment options for people who experience suicidal ideation.

==Definitions==
The [[ICD-11]] describes suicidal ideation as "thoughts, ideas, or ruminations about the possibility of ending one's life, ranging from thinking that one would be better off dead to formulation of elaborate plans".<ref name=ICD/>

The [[DSM-5]] defines it as "thoughts about [[self-harm]], with deliberate consideration or planning of possible techniques of causing one's own death".<ref name="DSM5 830">{{cite book|title=Diagnostic and statistical manual of mental disorders (DSM-5)|year=2013|isbn=978-0-89042-555-8|location=Arlington|publisher=American Psychiatric Publishing|page=830}}</ref>

The U.S. [[Centers for Disease Control and Prevention]] defines suicidal ideation "as thinking about, considering, or planning suicide".<ref name="Klonsky">{{Cite journal|last1=Klonsky|first1=E. David|last2=May|first2=Alexis M.|last3=Saffer|first3=Boaz Y.|date=2016-03-28|title=Suicide, Suicide Attempts, and Suicidal Ideation|journal=Annual Review of Clinical Psychology|volume=12|issue=1|pages=307–330|url=https://www2.psych.ubc.ca/~klonsky/publications/AnnualReview2016.pdf|doi=10.1146/annurev-clinpsy-021815-093204|pmid=26772209|issn=1548-5943|doi-access=free}}</ref>

==Terminology==
Another term for suicidal ideation is ''suicidal thoughts''.<ref name="Gliatto1999"/>

When someone who has not shown a history of suicidal ideation experiences a sudden and pronounced thought of performing an act which would necessarily lead to their own death, psychologists call this an [[intrusive thought]]. A commonly experienced example of this is the ''high place phenomenon'',<ref>{{cite journal | last1 = Adam | first1 = David | year = 2014 | title = How OCD creates prisoners of the mind | journal = New Scientist | volume = 222 | issue = 2966| pages = 36–39 | doi=10.1016/s0262-4079(14)60832-0| bibcode = 2014NewSc.222...36A }}</ref> also referred to as ''the call of the void'', which is a sudden urge to jump when in a high place.<ref>Demont, Marc, and Of Male Friendship. "Gender Studies: Masculinity Studies."</ref>

A euphemism for suicidal ideation is ''internal struggle'',<ref>{{cite journal | last1 = Brown | first1 = Gregory K. |display-authors=etal | year = 2005 | title = The internal struggle between the wish to die and the wish to live: a risk factor for suicide | journal = American Journal of Psychiatry | volume = 162 | issue = 10| pages = 1977–1979 | doi=10.1176/appi.ajp.162.10.1977| pmid = 16199851 }}</ref> while ''voluntary death''<ref>{{cite journal | last1 = Miller | first1 = Franklin G. | last2 = Meier | first2 = Diane E. | year = 1998 | title = Voluntary death: a comparison of terminal dehydration and physician-assisted suicide | journal = Annals of Internal Medicine | volume = 128 | issue = 7| pages = 559–562 | doi=10.7326/0003-4819-128-7-199804010-00007| pmid = 9518401 | s2cid = 34734585 }}</ref> and ''eating one's gun''<ref>{{cite journal | last1 = Baker | first1 = Thomas E | year = 2009 | title = Dell P. Hackett and John M. Violanti, Police Suicide: Tactics for Prevention | journal = Journal of Police and Criminal Psychology | volume = 24 | issue = 1| pages = 66–67 | doi=10.1007/s11896-008-9037-4| s2cid = 142153854 }}</ref> are a synonym and a euphemism, respectively, for suicide itself.

==Risk factors==
{{See also|Suicide#Risk factors}}
The risk factors for suicidal ideation can be divided into three categories: psychiatric disorders, life events, and family history.

=== Mental disorders ===
Suicidal ideation is a symptom of many mental disorders and can occur in response to adverse life events without the presence of a mental disorder.<ref name="Barry"/>

There are several psychiatric disorders that appear to be [[Comorbidity|comorbid]] with suicidal ideation or considerably increase the risk of suicidal ideation.<ref name= "Hemelrijk et al.">{{cite journal |last1=Hemelrijk |first1=E |last2=Van Ballegooijen |first2=W |last3=Donker |first3=T |last4=Van Straten |first4=A |last5=Kerkhof |first5=A |year=2012 |title=Internet-based screening for suicidal ideation in common mental disorders |journal=Crisis: The Journal of Crisis Intervention and Suicide Prevention |volume=33 |issue=4 |pages=215–221 |doi=10.1027/0227-5910/a000142 |pmid=22713975|s2cid=21192564 }}</ref> For example, many individuals with [[borderline personality disorder]] exhibit recurrent suicidal behavior and suicidal thoughts. One study found that 73% of patients with borderline personality disorder have attempted suicide, with the average patient having 3.4 attempts.<ref name=PS00>{{cite journal |last1=Soloff |first1=PH |last2=Kevin |first2=GL |last3=Thomas |first3=MK |last4=Kevin |first4=MM |last5=Mann |first5=JJ |title=Characteristics of Suicide Attempts of Patients With Major Depressive Episode and Borderline Personality Disorder: A Comparative Study |journal=American Journal of Psychiatry |date=1 April 2000 |volume=157 |issue=4 |pages=601–608 |doi=10.1176/appi.ajp.157.4.601 |pmid=10739420|s2cid=27150913 }}</ref> The following list includes the disorders that have been shown to be the strongest predictors of suicidal ideation. These are not the only disorders that can increase the risk of suicidal ideation. The disorders in which risk is increased the greatest include:<ref name= "Harris & Barraclough">{{cite journal |last1=Harris |first1=EC |last2=Barraclough |first2=B |year=1997 |title=Suicide as an outcome for mental disorders. A meta analysis |journal=The British Journal of Psychiatry |volume=170 |issue=3 |pages=205–228 |pmid=9229027 |doi=10.1192/bjp.170.3.205|s2cid=33824780 |url=https://semanticscholar.org/paper/9bded38da06964cd831081e11ad6e2b59bc710bc }}</ref>
* [[Major depressive disorder|Major Depressive Disorder]]
* [[Anxiety disorders]]
* [[Autism spectrum disorder]]<ref>{{Cite web |title=The Link Between Suicide and Autism {{!}} Psychology Today |url=https://www.psychologytoday.com/us/blog/caring-autism/201902/the-link-between-suicide-and-autism |access-date=2022-04-18 |website=www.psychologytoday.com |language=en}}</ref><ref name="DSM-5-Suicidal"/>{{rp|162}}
* [[Dysthymia]]
* [[Bipolar disorder]]
* [[Attention deficit hyperactivity disorder]] (ADHD)
* [[Premenstrual dysphoric disorder]] (PMDD)
* [[Post-traumatic stress disorder]] (PTSD) and [[complex post-traumatic stress disorder]] (C-PTSD)<ref name="DSM-5-Suicidal"/>{{rp|278}}
* [[Personality disorders]]
* [[Psychosis]] (detachment from reality)
* [[Paranoia]]
* [[Schizophrenia]]<ref name="DSM-5-Suicidal"/>{{rp|104}}
* [[Substance use disorders]],<ref name= "Lemon TI, Shah R D.">{{cite journal |last1=Lemon |first1=TI |last2=Shah |first2=RD |title=Needle exchanges – a forgotten outpost in suicide and self-harm prevention |journal=Journal of Psychosomatic Research |year=2013 |volume=74 |issue=6 |pages=551–552 |doi=10.1016/j.jpsychores.2013.03.057 }}</ref><ref name= "Lemon TI">{{cite journal |last=Lemon |first=TI |title=Suicide ideation in drug users and the role of needles exchanges and their workers |journal=Journal Psych Med |year=2013 |volume=6 |issue=5 |doi=10.1016/j.ajp.2013.07.003 |page=429 |pmid=24011693}}</ref> 
* [[Nightmare disorder]]<ref name="DSM-5-Suicidal">{{cite book |author=American Psychiatric Association |title=Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) |year=2013 |location=Arlington, VA |publisher=American Psychiatric Publishing |isbn=978-0-89042-559-6 |doi=10.1176/appi.books.9780890425596 |hdl=2027.42/138395 }}</ref>{{rp|405}}
* [[Gender dysphoria]]<ref name="DSM-5-Suicidal"/>{{rp|454}}
* [[Conduct disorder]]<ref name="DSM-5-Suicidal"/>{{rp|473}}
* [[Specific learning disorder]]<ref name="DSM-5-Suicidal"/>{{rp|70}}
* [[Obsessive compulsive disorder]] 
* [[Eating disorders]], such as [[Anorexia]], [[Binge eating disorder]], and [[Bulimia]]

===Medication side effects===
{{Main article|Antidepressants and suicide risk}}
Antidepressant medications are commonly used to decrease the symptoms in patients with moderate to severe [[clinical depression]], and some studies indicate a connection between suicidal thoughts and tendencies and taking antidepressants,<ref name="Teicher1993">{{Cite journal|last1=Teicher|first1=M. H.|last2=Glod|first2=C. A.|last3=Cole|first3=J. O.|date=March 1993|title=Antidepressant drugs and the emergence of suicidal tendencies|url=https://pubmed.ncbi.nlm.nih.gov/8452661/|journal=Drug Safety|volume=8|issue=3|pages=186–212|doi=10.2165/00002018-199308030-00002|issn=0114-5916|pmid=8452661|s2cid=36366654}}</ref> increasing the risk of suicidal thoughts in some patients.<ref>{{Cite journal|last1=Reeves|first1=Roy R.|last2=Ladner|first2=Mark E.|date=2010|title=Antidepressant-Induced Suicidality: An Update|url= |journal=CNS Neuroscience & Therapeutics|language=en|volume=16|issue=4|pages=227–234|doi=10.1111/j.1755-5949.2010.00160.x|issn=1755-5949|pmc=6493906|pmid=20553304}}</ref>

Some medications, such as [[selective serotonin reuptake inhibitor]]s (SSRIs), can have suicidal ideation as a side effect but can also be effective as antidepressants. Monitoring is advised for those who take SSRIs.<ref>{{Cite web|title=The most commonly prescribed type of antidepressant|url=https://www.mayoclinic.org/diseases-conditions/depression/in-depth/ssris/art-20044825|access-date=2020-10-08|website=Mayo Clinic|language=en}}</ref>

In 2003, the [[U.S. Food and Drug Administration]] (FDA) issued the agency's strictest warning for manufacturers of all antidepressants (including [[tricyclic antidepressants]] [TCAs] and [[monoamine oxidase inhibitors]])<ref>{{Cite journal|last1=Selvaraj|first1=Vithyalakshmi|last2=Veeravalli|first2=Snehamala|last3=Ramaswamy|first3=Sriram|last4=Balon|first4=Richard|last5=Yeragani|first5=Vikram K.|date=2010|title=Depression, suicidality and antidepressants: A coincidence?|journal=Indian Journal of Psychiatry|volume=52|issue=1|pages=17–20|doi=10.4103/0019-5545.58890|issn=0019-5545|pmc=2824975|pmid=20174513 |doi-access=free }}</ref> due to their association with suicidal thoughts and behaviors.<ref name="Fornaro">{{Cite journal|last1=Fornaro|first1=Michele|last2=Anastasia|first2=Annalisa|last3=Valchera|first3=Alessandro|last4=Carano|first4=Alessandro|last5=Orsolini|first5=Laura|last6=Vellante|first6=Federica|last7=Rapini|first7=Gabriella|last8=Olivieri|first8=Luigi|last9=Di Natale|first9=Serena|last10=Perna|first10=Giampaolo|last11=Martinotti|first11=Giovanni|date=2019-05-03|title=The FDA "Black Box" Warning on Antidepressant Suicide Risk in Young Adults: More Harm Than Benefits?|journal=Frontiers in Psychiatry|volume=10|page=294|doi=10.3389/fpsyt.2019.00294|issn=1664-0640|pmc=6510161|pmid=31130881|doi-access=free}}</ref> Further studies disagree with the warning, especially when prescribed for adults, claiming more recent studies are inconclusive in the connection between the drugs and suicidal ideation.<ref name="Fornaro"/>

Individuals with anxiety disorders who [[self-medicate]] with drugs or alcohol may also have an increased likelihood of suicidal ideation.<ref>{{Cite journal|last1=Bolton|first1=James|last2=Cox|first2=Brian|last3=Clara|first3=Ian|last4=Sareen|first4=Jitender|date=November 2006|title=Use of alcohol and drugs to self-medicate anxiety disorders in a nationally representative sample|url=https://pubmed.ncbi.nlm.nih.gov/17102705/|journal=The Journal of Nervous and Mental Disease|volume=194|issue=11|pages=818–825|doi=10.1097/01.nmd.0000244481.63148.98|issn=0022-3018|pmid=17102705|s2cid=7515999}}</ref>

<!-- Sedatives (EtOH, benzodiazepines, opioids -->
Most people are under the influence of [[sedative|sedative-hypnotic drugs]] (such as alcohol or benzodiazepines) when they die by suicide,<ref name="Youssef2008">{{cite journal | vauthors = Youssef NA, Rich CL | title = Does acute treatment with sedatives/hypnotics for anxiety in depressed patients affect suicide risk? A literature review | journal = Annals of Clinical Psychiatry | volume = 20 | issue = 3 | pages = 157–69 | year = 2008 | pmid = 18633742 | doi = 10.1080/10401230802177698 }}</ref> with alcoholism present in between 15% and 61% of cases.<ref name="Drug2011">{{cite journal | vauthors = Vijayakumar L, Kumar MS, Vijayakumar V | s2cid = 206143129 | title = Substance use and suicide | journal = Current Opinion in Psychiatry | volume = 24 | issue = 3 | pages = 197–202 | date = May 2011 | pmid = 21430536 | doi = 10.1097/YCO.0b013e3283459242 }}</ref> Use of prescribed [[benzodiazepine]]s is associated with an increased rate of suicide and attempted suicide. The pro-suicidal effects of benzodiazepines are suspected to be due to a psychiatric disturbance caused by side effects, such as [[disinhibition]], or withdrawal symptoms.<ref name=Dod2017>{{cite journal | vauthors = Dodds TJ | title = Prescribed Benzodiazepines and Suicide Risk: A Review of the Literature | journal = The Primary Care Companion for CNS Disorders | volume = 19 | issue = 2 | date = March 2017 | pmid = 28257172 | doi = 10.4088/PCC.16r02037 | doi-access = free }}</ref>

===Life events===
Life events are strong predictors of increased risk for suicidal ideation. Furthermore, life events can also lead to or be comorbid with the previously listed psychiatric disorders and predict suicidal ideation through those means. Life events that adults and children face can be dissimilar and for this reason, the list of events that increase risk can vary in adults and children. The life events that have been shown to increase risk most significantly are:<ref name = "Fergusson, Woodward & Horwood">{{cite journal |last1=Fergusson |first1=DM |last2=Woodward |first2=LJ |last3=Horwood |first3=LJ |year=2000 |title=Risk factors and life processes associated with the onset of suicidal behavior during adolescence and early adulthood |journal=Psychological Medicine |volume=30 |issue=1 |pages=23–39 |pmid=10722173 |doi=10.1017/s003329179900135x|s2cid=5803465 }}</ref>

* [[Alcohol use disorder]]
** Studies have shown that individuals who [[Binge drinking|binge drink]], rather than drink socially, tend to have higher rates of suicidal ideation<ref name= "Gonzalez">{{cite journal |last=Gonzalez |first=VM |year=2012 |title=Association of solitary binge drinking and suicidal behavior among emerging adult college students |journal=Psychology of Addictive Behaviors |volume=26 |issue=3 |pages=609–614 |doi=10.1037/a0026916 |pmid=22288976 |pmc=3431456}} {{open access}}</ref>
**Certain studies associate those who experience suicidal ideation with higher alcohol consumption<ref name= "Valenstein, et al.">{{cite journal |last1=Valenstein |first1=H |last2=Cronkite |first2=RC |last3=Moos |first3=RH |last4=Snipes |first4=C |last5=Timko |first5=C |year=2012 |title=Suicidal ideation in adult offspring of depressed and matched control parents: Childhood and concurrent predictors |journal=Journal of Mental Health |volume=21 |issue=5 |pages=459–468 |doi=10.3109/09638237.2012.694504 |pmid=22978501|s2cid=9842249 }}</ref>
**Not only do some studies show that solitary binge drinking can increase suicidal ideation, but there is a positive feedback relationship causing those who have more suicidal ideation to have more drinks per day in a solitary environment<ref name= "Gonzalez" />
*Minoritized [[gender expression]] and/or [[LGBT|sexuality]]<ref>{{Cite journal|last1=McDermott|first1=Elizabeth| author-link1=Elizabeth McDermott |last2=Hughes|first2=Elizabeth|last3=Rawlings|first3=Victoria|date=February 2018|title=Norms and normalisation: understanding lesbian, gay, bisexual, transgender and queer youth, suicidality and help-seeking|journal=Culture, Health & Sexuality|volume=20|issue=2|pages=156–172|doi=10.1080/13691058.2017.1335435|pmid=28641479|issn=1369-1058|doi-access=free}}</ref> or being a [[Minority group|minority]] group of any kind
* [[Unemployment]]<ref name= "Valenstein, et al." />
* [[Chronic condition|Chronic illness]] or pain<ref>{{cite journal |last1=Smith |first1=Michael |title=Suicidal ideation, plans, and attempts in chronic pain patients: factors associated with increased risk |url=https://pubmed.ncbi.nlm.nih.gov/15327824/ |journal=Pain|year=2004 |volume=111 |issue=1–2 |pages=201–208 |doi=10.1016/j.pain.2004.06.016 |pmid=15327824 |s2cid=6745062 }}</ref>
* Death of family members or friends
* End of a relationship or being [[social rejection|rejected]] by a romantic interest
*Major change in life standard (e.g. relocation abroad)
* Other studies have found that [[tobacco use]] is correlated with depression and suicidal ideation<ref name= "Dugas, et al.">{{cite journal |last1=Dugas |first1=E |last2=Low |first2=NP |last3=Rodriguez |first3=D |last4=Burrows |first4=S |last5=Contreras |first5=G |last6=Chaiton |first6=M |last7=O'Loughlin |first7=J |display-authors=6 |year=2012 |title=Early Predictors of Suicidal Ideation in Young Adults |journal=Canadian Journal of Psychiatry |volume=57 |issue=7 |pages=429–436 |pmid=22762298|doi=10.1177/070674371205700706 |doi-access=free }}</ref>
* [[Social isolation]]
* [[Unplanned pregnancy]]
* [[Bullying]], including [[cyberbullying]]<ref>{{cite web |title=Cyberbullying Research Summary – Cyberbullying and Suicide |url=http://www.cyberbullying.us/cyberbullying_and_suicide_research_fact_sheet.pdf |publisher=Cyberbullying Research Center |access-date=3 July 2012 |archive-url=https://web.archive.org/web/20120904001101/http://www.cyberbullying.us/cyberbullying_and_suicide_research_fact_sheet.pdf |archive-date=4 September 2012 |url-status=live }}</ref><ref>{{cite web |title=The relationship between bullying, depression and suicidal thoughts/behaviour in Irish adolescents |url=http://www.childrensdatabase.ie/database-project/document.asp?DocID=1222 |publisher=Department of Health and Children |access-date=3 July 2012 |archive-url=https://web.archive.org/web/20140901151217/http://www.childrensdatabase.ie/database-project/document.asp?DocID=1222 |archive-date=1 September 2014 |url-status=dead }}</ref> and [[workplace bullying]]<ref name="bullyingandharassment">{{cite book |editor-last1=Einarsen |editor-first1=Stale |editor-last2=Hoel |editor-first2=Helge |editor-last3=Zapf |editor-first3=Dieter |editor-last4=Cooper |editor-first4=Cary| author-first1=Annie |author-last1= Hogh| author-first2= Eva |author-last2= Gemzøe Mikkelsen|author-first3= Åse Marie |author-last3= Hansen |title=Bullying and Harassment in the Workplace: Developments in Theory, Research, and Practice |chapter=Chapter 4: Individual Consequences of Workplace Bullying/Mobbing |date=2010 |publisher=CRC Press |location=Boca Raton, Florida|isbn=9781439804896|oclc=1087897728}}</ref>
* Previous suicide attempts
** Having previously attempted suicide is one of the strongest indicators of future suicidal ideation or suicide attempts<ref name= "Gonzalez" />
* Military experience
** Military personnel who show symptoms of PTSD, major depressive disorder, alcohol use disorder, and generalized anxiety disorder show higher levels of suicidal ideation<ref name= "Richardson et al.">{{cite journal |last1=Richardson |first1=JD |last2=St Cyr |first2=KC |last3=McIntyre-Smith |first3=AM |last4=Haslam |first4=D |last5=Elhai |first5=JD |last6=Sareen |first6=J |year=2012 |title=Examining the association between psychiatric illness and suicidal ideation in a sample of treatment-seeking Canadian peacekeeping and combat veterans with posttraumatic stress disorder PTSD |journal=Canadian Journal of Psychiatry |volume=57 |issue=8 |pages=496–504 |pmid=22854032|doi=10.1177/070674371205700808 |doi-access=free }}</ref>
* Community violence<ref name= "Thompson, et al.">{{cite journal |last1=Thompson |first1=R |last2=Litrownik |first2=AJ |last3=Isbell |first3=P |last4=Everson |first4=MD |last5=English |first5=DJ |last6=Dubowitz |first6=H |last7=Proctor |first7=LJ |last8=Flaherty |first8=EG |display-authors=6 |year=2012 |title=Adverse experiences and suicidal ideation in adolescence: Exploring the link using the LONGSCAN samples |journal=Psychology of Violence |volume=2 |issue=2 |pages=211–225 |pmid=24349862 |pmc=3857611 |doi=10.1037/a0027107}} {{open access}}</ref>
* Undesired changes in body weight<ref name= "Carpenter, Hasin, Allison & Faith">{{cite journal |last1=Carpenter |first1=KM |last2=Hasin |first2=DS |last3=Allison |first3=DB |last4=Faith |first4=MS |year=2000 |title=Relationships between obesity and DSM-IV major depressive disorder, suicidal ideation, and suicide attempts: Results from a general population study |journal=American Journal of Public Health |volume=90 |issue=2 |pages=251–257 |pmid=10667187 |pmc=1446144 |doi=10.2105/ajph.90.2.251}}</ref>
** Women: increased [[Body mass index|BMI]] increases chance of suicidal ideation
** Men: severe decrease in BMI increases chance of suicidal ideation
*** In general, the obese population has increased odds of suicidal ideation in relation to individuals that are of average-weight
* Exposure and attention to suicide related images or words<ref name= "Cha et al.">{{cite journal |last1=Cha |first1=CB |last2=Najmi |first2=S |last3=Park |first3=JM |last4=Finn |first4=CT |last5=Nock |first5=MK |year=2010 |title=Attentional bias toward suicide-related stimuli predicts suicidal behavior |journal=Journal of Abnormal Psychology |volume=119 |issue=3 |pages=616–622 |doi=10.1037/a0019710 |pmid=20677851 |pmc=2994414}} {{open access}}</ref>

===Family history===
* Parents with a history of depression
** Valenstein et al. studied 340 adults whose parents had experienced depression. They found that 7% of the offspring had suicidal ideation in the previous month alone<ref>{{Cite journal|title = Suicidal ideation in adult offspring of depressed and matched control parents: Childhood and concurrent predictors|last = Valenstein|first = Helen|date = 2012|journal = Journal of Mental Health|volume = 21|issue = 5|pages = 459–468|doi = 10.3109/09638237.2012.694504|pmid = 22978501|s2cid = 9842249}}</ref>
* Abuse<ref name= "Thompson, et al." />
** Childhood: physical, emotional and sexual abuse<ref>{{Cite journal|title = Suicidal thoughts and behaviours in former sexual abuse victims|last = Briere|first = John|date = 1986|journal = Canadian Journal of Behavioural Science|volume = 18|issue = 4|pages = 413–423|doi = 10.1037/h0079962}}</ref>
** Adolescence: physical, emotional and sexual abuse
* Family violence
* Childhood residential instability
**Certain studies associate those who experience suicidal ideation with [[family disruption]]<ref name= "Valenstein, et al."/>

===Relationships with parents===
According to a study conducted by Ruth X. Liu of [[San Diego State University]], a significant connection was found between the parent–child relationships of adolescents in early, middle and late [[adolescence]] and their likelihood of suicidal ideation. The study consisted of measuring relationships between mothers and daughters, fathers and sons, mothers and sons, and fathers and daughters. The relationships between fathers and sons during early and middle adolescence show an inverse relationship to suicidal ideation. Closeness with the father in late adolescence is "significantly related to suicidal ideation".<ref>{{cite journal |last=Liu |first=Ruth X. |title=Parent-Youth Closeness and Youth's Suicidal Ideation; The Moderating Effects of Gender, Stages of Adolescence, and Race or Ethnicity |journal=Youth & Society |date=December 2005 |volume=37 |issue=2 |pages=160–162 |doi=10.1177/0044118X04272290|s2cid=144519020 }}</ref> Liu goes on to explain the relationship found between closeness with the opposite sex parent and the child's risk of suicidal thoughts. It was found that boys are better protected from suicidal ideation if they are close to their mothers through early and late adolescence; whereas girls are better protected by having a close relationship with their father during middle adolescence.

An article published in 2010 by Zappulla and Pace found that suicidal ideation in adolescent boys is exacerbated by detachment from the parents when depression is already present in the child. Lifetime prevalence estimates of suicidal ideation among nonclinical populations of adolescents generally range from 60% to 75% and in many cases its severity increases the risk of suicide.<ref>{{cite journal |last=Zappulla |first=Carla |title=Relations between suicidal ideation, depression, and emotional autonomy from parents in adolescence |journal=Journal of Child and Family Studies |date=2010 |volume=19 |issue=6 |pages=747–756 |url=https://www.academia.edu/15733869 |archive-url=https://web.archive.org/web/20230216221434/https://www.academia.edu/15733869 |url-status=dead |archive-date=February 16, 2023 |publisher=Springer Science + Business Media LLC |access-date=10 April 2012 |doi=10.1007/s10826-010-9364-9 |s2cid=145370728 }}</ref>
Parents who are unaccepting of their child's expressed LGBT sexuality create a hotbed for suicidal ideation (see under LGBT youth below).

==Prevention==
{{See also|Suicide prevention}}
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[[File:Lifelinelogo.svg|thumb|upright|right|[[Crisis hotline]]s, such as the [[National Suicide Prevention Lifeline]], enable people to get immediate emergency telephone counselling.]]
[[File:Caringletterhw.jpg|thumb|upright|A [[Caring letters|caring letter]] written by hand]]
Early detection and treatment are the best ways to prevent suicidal ideation and suicide attempts.<ref>{{cite book |last1=Harmer |first1=Bonnie |last2=Lee |first2=Sarah |last3=Rizvi |first3=Abid |last4=Saadabadi |first4=Abdolreza |title=StatPearls |date=2024 |publisher=StatPearls Publishing |url=https://www.ncbi.nlm.nih.gov/books/NBK565877/ |access-date=2 June 2024 |chapter=Suicidal Ideation|pmid=33351435 }}</ref> If signs, symptoms, or risk factors are detected early then the individual might seek treatment and help before attempting to take their own life. In a study of individuals who did die by suicide, 91% of them likely had one or more mental illnesses. However, only 35% of those individuals were treated or being treated for a mental illness.<ref name= "Cavanagh, Owens & Johnstone">{{cite journal |last1=Cavanagh |first1=JO |last2=Owens |first2=DC |last3=Johnstone |first3=EC |year=1999 |title=Life events in suicide and undetermined death in south-east Scotland: a case-control study using the method of psychological autopsy |journal=Social Psychiatry and Psychiatric Epidemiology |volume=34 |issue=12 |pages=645–650 |pmid=10703274 |doi=10.1007/s001270050187|s2cid=31350280 }}</ref> This emphasizes the importance of early detection; if a mental illness is detected, it can be treated and controlled to help prevent suicide attempts. Another study investigated strictly suicidal ideation in adolescents. This study found that depression symptoms in adolescents as early as 9th grade is a predictor of suicidal ideation. Most people with long-term suicidal ideation do not seek professional help.{{citation needed|date=November 2013}}

The previously mentioned studies point out the difficulty that mental health professionals have in motivating individuals to seek and continue treatment. Ways to increase the number of individuals who seek treatment may include:
* Increasing the availability of therapy treatment in early stage
* Increasing the public's knowledge of when psychiatric help may be beneficial to them
** Those who have adverse life conditions seem to have just as much risk of suicide as those with mental illness<ref name= "Cavanagh, Owens & Johnstone" />

A study conducted by researchers in Australia set out to determine a course of early detection for suicidal ideation in teens stating that "risks associated with suicidality require an immediate focus on diminishing self-harming cognitions so as to ensure safety before attending to the underlying etiology of the behavior". A Psychological Distress scale known as the K10 was administered monthly to a random sample of individuals. According to the results among the 9.9% of individuals who reported "psychological distress (all categories)" 5.1% of the same participants reported suicidal ideation. Participants who scored "very high" on the Psychological Distress scale "were 77 times more likely to report suicidal ideation than those in the low category".<ref name="Chamberlain">{{cite journal |last1=Chamberlain |first1=P |last2=Goldney |first2=R |last3=Delfabbro |first3=P |last4=Gill |first4=T |last5=Dal Grande |first5=L |title=Suicidal Ideation: The Clinical Utility of the K10 |journal=Crisis |year=2009 |volume=30 |pages=39–42 |doi=10.1027/0227-5910.30.1.39 |pmid=19261567 |issue=1}}</ref>

In a one-year study conducted in Finland, 41% of the patients who later died by suicide saw a healthcare professional, most seeing a psychiatrist. Of those, only 22% discussed suicidal intent on their last office visit. In most of the cases, the office visit took place within a week of the suicide, and most of the victims had a diagnosed depressive disorder.<ref>{{Cite book |last=Halgin |first=Richard P. |author2=Susan Whitbourne  |title=Abnormal psychology: clinical perspectives on psychological disorders |publisher=[[McGraw-Hill]] |location=Boston |year=2006 |pages=267–272 |isbn=978-0-07-322872-3}}</ref>

There are many centers where one can receive aid in the fight against suicidal ideation and suicide. Hemelrijk et al. (2012) found evidence that assisting people with suicidal ideation via the internet versus more direct forms such as phone conversations has a greater effect. In a 2021 research study, Nguyen et al. (2021) propose that maybe the premise that suicidal ideation is a kind of illness has been an obstacle to dealing with suicidal ideation.<ref name="SuicideMindsponge">{{cite journal |last1=Nguyen |first1=MH |last2=Le |first2=TT |last3=Nguyen |first3=HKT |last4=Ho |first4=MT |last5=Nguyen |first5=TTH |last6=Vuong |first6=QH |title=Alice in Suicideland: Exploring the Suicidal Ideation Mechanism through the Sense of Connectedness and Help-Seeking Behaviors |journal=Int. J. Environ. Res. Public Health |year=2021 |volume=18 |series=7 |issue=7 |pages=3681 |doi=10.3390/ijerph18073681 |pmid=33916123 |pmc=8037954 |doi-access=free }}</ref> They use a Bayesian statistical investigation, in conjunction with the mindsponge theory,<ref name="SuicideMindsponge2">{{cite journal |last1=Vuong |first1=QH |last2=Napier |first2=Nancy K. |title=Acculturation and global mindsponge: an emerging market perspective |journal=International Journal of Intercultural Relations |year=2015 |volume=49 |pages=354–367 |doi=10.1016/j.ijintrel.2015.06.003 }}</ref> to explore the processes where mental disorders have played a very minor role and conclude that there are many cases where the suicidal ideation represents a type of cost-benefit analysis for a life/death consideration, and these people may not be called "patients".

==Assessment==
{{See also|Evidence-based assessment}}
Assessment seeks to understand an individual by integrating information from multiple sources such as clinical interviews; medical exams and physiological measures; standardized psychometric tests and questionnaires; structured diagnostic interviews; review of records; and collateral interviews.<ref>Coaley, Keith, "Introduction: Individual Differences and Psychometrics", chap. 1 in ''An Introduction to Psychological Assessment and Psychometrics'', 2nd ed. (London: Sage, 2014), 1–34. {{ISBN|978-1-4462-6714-1}}</ref>

===Interviews===
Psychologists, psychiatrists, and other mental health professionals conduct clinical interviews to ascertain the nature of a patient or client's difficulties, including any signs or symptoms of illness the person might exhibit. Clinical interviews are "unstructured" in the sense that each clinician develops a particular approach to asking questions, without necessarily following a predefined format. Structured (or semi-structured) interviews prescribe the questions, their order of presentation, "probes" (queries) if a patient's response is not clear or specific enough, and a method to rate the frequency and intensity of symptoms.<ref>Rogers, Richard. ''Handbook of Diagnostic and Structured Interviewing''. New York: Guilford, 2001.</ref>

===Standardized psychometric measures===
{{See also |Assessment of suicide risk#In practice}}
* Beck Scale for Suicide Ideation
* Nurses' Global Assessment of Suicide Risk
* Suicidal Affect–Behavior–Cognition Scale (SABCS)<ref>{{cite journal | last1 = Harris | first1 = K. M. | last2 = Syu | first2 = J. J. | last3 = Lello | first3 = O. D. | last4 = Chew | first4 = Y. L. E. | last5 = Willcox | first5 = C. H. | last6 = Ho | first6 = R. H. M. | year = 2015 | title = The ABC's of suicide risk assessment: Applying a tripartite approach to individual evaluations | journal = PLOS ONE | volume = 10 | issue = 6| page = 6 | doi=10.1371/journal.pone.0127442 | pmid=26030590 | pmc=4452484| bibcode = 2015PLoSO..1027442H | doi-access = free }}</ref>
* [[Columbia Suicide Severity Rating Scale]]

==Management==

Treatment of suicidal ideation can be problematic due to the fact that several medications have actually been linked to increasing or causing suicidal ideation in patients. Therefore, several alternative means of treating suicidal ideation are often used. The main treatments include: therapy, hospitalization, outpatient treatment, and medication or other modalities.<ref name=Gliatto1999/>

===Diet===
There are no specific diets that can treat suicidal ideation. 
===Therapy===
In [[psychotherapy]] a person explores the issues that make them feel suicidal and learns skills to help manage emotions more effectively.<ref name=Gliatto1999/><ref>{{Cite web | url=http://www.mayoclinic.org/diseases-conditions/suicide/basics/treatment/con-20033954 | title=Suicide and suicidal thoughts - Diagnosis and treatment - Mayo Clinic | website=[[Mayo Clinic]] | access-date=2016-06-03 | archive-url=https://web.archive.org/web/20160605091131/http://www.mayoclinic.org/diseases-conditions/suicide/basics/treatment/con-20033954 | archive-date=2016-06-05 | url-status=live }}</ref>

===Hospitalization===

Hospitalization allows the patient to be in a secure, supervised environment to prevent suicidal ideation from turning into suicide attempts. In most cases, individuals have the freedom to choose which treatment they see fit for themselves. However, there are several circumstances in which individuals can be hospitalized involuntarily. These circumstances are:

* If an individual poses a danger to self or others
* If an individual is unable to care for oneself

Hospitalization may also be a treatment option if an individual:

* Does not have social support or people to supervise them
* Has a suicide plan
* Has symptoms of a psychiatric disorder (e.g., [[psychosis]], [[mania]], etc.)

===Outpatient treatment===

Outpatient treatment allows individuals to remain at their place of residence and receive treatment when needed or on a scheduled basis. Being at home may improve quality of life for some patients, because they will have access to their personal belongings, and be able to come and go freely. Before allowing patients the freedom that comes with outpatient treatment, physicians evaluate several factors of the patient. These factors include the patient's level of social support, [[impulse control]] and quality of judgment. After the patient passes the evaluation, they are often asked to consent to a "no-harm contract". This is a contract formulated by the physician and the family of the patient. Within the contract, the patient agrees not to harm themself, to continue their visits with the physician, and to contact the physician in times of need.<ref name=Gliatto1999/> There is some debate as to whether "no-harm" contracts are effective. These patients are then checked on routinely to assure they are maintaining their contract and avoiding dangerous activities (drinking alcohol, driving fast and not wearing a seat belt, etc.).

===Medication===

Prescribing medication to treat suicidal ideation can be difficult. One reason for this is that many medications lift patients' energy levels before lifting their moods. This puts them at greater risk of following through with attempting suicide. Additionally, if a person has a comorbid psychiatric disorder, it may be difficult to find a medication that addresses both the psychiatric disorder and suicidal ideation.

Antidepressants may be effective.<ref name=Gliatto1999/> Often, [[SSRIs]] are used instead of [[Tricyclic antidepressant|TCAs]] as the latter typically have greater harm in overdose.<ref name=Gliatto1999/>

Antidepressants have been shown to be a very effective means of treating suicidal ideation. One correlational study compared mortality rates due to suicide to the use of SSRI antidepressants in certain counties. The counties which had higher SSRI use had a significantly lower number of deaths caused by suicide.<ref name= "Simon">{{cite journal |last=Simon |first=GE |year=2006 |title=How can we know whether antidepressants increase suicide risk? |journal=American Journal of Psychiatry |volume=163 |issue=11 |pages=1861–1863 |doi=10.1176/APPI.AJP.163.11.1861|pmid=17074930}}</ref> Additionally, an experimental study followed depressed patients for one year. During the first six months of that year, the patients were examined for suicidal behavior including suicidal ideation. The patients were then prescribed antidepressants for the six months following the first six observatory months. During the six months of treatment, experimenters found suicidal ideation reduced from 47% of patients down to 14% of patients.<ref name= "Mulder">{{cite journal |last1=Mulder |first1=RT |year=2008 |title=Antidepressant treatment is associated with a reduction in suicidal ideation and suicide attempts |journal=Acta Psychiatrica Scandinavica |volume=118 |issue=12 |pages=116–122 |doi=10.1111/j.1600-0447.2008.01179.x |pmid=18384467 |last2=Joyce |first2=P. R. |last3=Frampton |first3=C. M. A. |last4=Luty |first4=S. E.|s2cid=34987889 }}</ref> Thus, it appears from current research that antidepressants have a helpful effect on the reduction of suicidal ideation.

Although research is largely in favor of the use of antidepressants for the treatment of suicidal ideation, in some cases antidepressants are [[Antidepressants and suicide risk|claimed to be the cause of suicidal ideation]]. Upon the start of using antidepressants, many clinicians will note that sometimes the sudden onset of suicidal ideation may accompany treatment. This has caused the Food and Drug Administration (FDA) to issue a warning stating that sometimes the use of antidepressants may actually increase suicidal ideation.<ref name= "Simon" /> Medical studies have found antidepressants help treat cases of suicidal ideation and work especially well with psychological therapy.<ref name= "Zisook, et al.">{{cite journal |last1=Zisook |first1=S |last2=Lesser |first2=IM |last3=Lebowitz |first3=B |last4=Rush |first4=AJ |last5=Kallenberg |first5=G |last6=Wisniewski |first6=SR |last7=Nierenberg |first7=AA |last8=Fava |first8=M |last9=Luther |first9=JF |last10=Morris |first10=DW |last11=Trivedi |first11=MH |display-authors=6 |year=2011 |title=Effect of antidepressant medication treatment on suicidal ideation and behavior in a randomized trial: An exploratory report from the Combining Medications to Enhance Depression Outcomes Study |journal=Journal of Clinical Psychiatry |volume=72 |issue=10 |pages=1322–1332 |doi=10.4088/JCP.10m06724 |pmid=22075098|s2cid=20222046 }}</ref> [[Lithium (medication)|Lithium]] reduces the risk of suicide in people with mood disorders.<ref>{{cite journal|vauthors=Cipriani A, Hawgon K, Stockton S |title=Lithium in the prevention of suicide in mood disorders: updated systematic review and meta-analysis|journal=BMJ|date=27 June 2013|volume=346|issue=jun27 4|pages=f3646|doi=10.1136/bmj.f3646|pmid=23814104|display-authors=etal |doi-access=free}}</ref> Tentative evidence finds [[clozapine]] in people with schizophrenia reduces the risk of suicide.<ref>{{cite journal|last1=Wagstaff|first1=A|last2=Perry|first2=C|title=Clozapine: in prevention of suicide in patients with schizophrenia or schizoaffective disorder.|journal=CNS Drugs|date=2003|volume=17|issue=4|pages=273–80; discussion 281–3|pmid=12665398|doi=10.2165/00023210-200317040-00004}}</ref>

===Others===
{{expand section|date=June 2024}}

====Dialectical behavior therapy====

====Transcranial magnetic stimulation====

[[Electroconvulsive therapy]]

== LGBT youth ==
{{Main article|Suicide among LGBT youth}}
Suicidal ideation rates among [[lesbian]], [[Gay men#Youth|gay]], [[bisexual]], [[transgender]] ([[LGBT]]) [[youth]] are significantly higher than among the general population.<ref name="Haas2011">{{cite journal |last1=Haas |first1=Ann P. |last2=Eliason |first2=Mickey |last3=Mays |first3=Vickie M. |last4=Mathy |first4=Robin M. |last5=Cochran |first5=Susan D. |last6=D'Augelli |first6=Anthony R. |last7=Silverman |first7=Morton M. |last8=Fisher |first8=Prudence W. |last9=Hughes |first9=Tonda |last10=Rosario |first10=Margaret |last11=Russell |first11=Stephen T. |last12=Malley |first12=Effie |last13=Reed |first13=Jerry |last14=Litts |first14=David A. |last15=Haller |first15=Ellen |date=30 December 2010 |title=Suicide and Suicide Risk in Lesbian, Gay, Bisexual, and Transgender Populations: Review and Recommendations |journal=Journal of Homosexuality |volume=58 |issue=1 |pages=10–51 |doi=10.1080/00918369.2011.534038 |pmc=3662085 |pmid=21213174 |last16=Sell |first16=Randall L. |last17=Remafedi |first17=Gary |last18=Bradford |first18=Judith |last19=Beautrais |first19=Annette L. |last20=Brown |first20=Gregory K. |last21=Diamond |first21=Gary M. |last22=Friedman |first22=Mark S. |last23=Garofalo |first23=Robert |last24=Turner |first24=Mason S. |last25=Hollibaugh |first25=Amber |author26-link=Paula Clayton |last26=Clayton |first26=Paula J.}}{{indent}}{{cite journal |last1=Proctor |first1=Curtis D. |last2=Groze |first2=Victor K. |year=1994 |title=Risk Factors for Suicide among Gay, Lesbian, and Bisexual Youths |journal=Social Work |volume=39 |issue=5 |pages=504–513 |doi=10.1093/sw/39.5.504 |pmid=7939864}}{{indent}}{{cite journal |last1=Remafedi |first1=Gary |last2=Farrow |first2=James A. |last3=Deisher |first3=Robert W. |year=1991 |title=Risk Factors for Attempted Suicide in Gay and Bisexual Youth |journal=Pediatrics |volume=87 |issue=6 |pages=869–875 |doi=10.1542/peds.87.6.869 |pmid=2034492 |s2cid=42547461}}{{indent}}{{cite journal |last1=Russell |first1=Stephen T. |last2=Joyner |first2=Kara |year=2001 |title=Adolescent Sexual Orientation and Suicide Risk: Evidence From a National Study |journal=American Journal of Public Health |volume=91 |issue=8 |pages=1276–1281 |doi=10.2105/AJPH.91.8.1276 |pmc=1446760 |pmid=11499118}}{{indent}}{{cite journal |last1=Hammelman |first1=Tracie L. |year=1993 |title=Gay and Lesbian Youth |journal=Journal of Gay & Lesbian Psychotherapy |volume=2 |issue=1 |pages=77–89 |doi=10.1300/J236v02n01_06}}{{indent}}{{cite journal |last1=Johnson |first1=R. B. |last2=Oxendine |first2=S. |last3=Taub |first3=D. J. |last4=Robertson |first4=J. |year=2013 |title=Suicide Prevention for LGBT Students |url=http://libres.uncg.edu/ir/uncg/f/B_Johnson_Suicide_2013.pdf |journal=New Directions for Student Services |volume=2013 |issue=141 |pages=55–69 |doi=10.1002/ss.20040}}</ref> Suicidal ideation, which has a higher prevalence among LGBT teenagers compared to their cisgender and heterosexual peers, has been attributed to [[minority stress]], bullying, and parental disapproval.<ref name="Newport Academy 2023">{{cite web |date=27 February 2023 |title=New Research on LGBTQ Teen Suicide Rates |url=https://www.newportacademy.com/resources/mental-health/lgbt-suicide-rates/ |access-date=26 May 2023 |website=Newport Academy}}</ref><ref>{{cite web |date=1999-10-27 |title=Definition of Bisexual suicide risk |url=http://www.medterms.com/script/main/art.asp?articlekey=10851 |url-status=dead |archive-url=https://web.archive.org/web/20111208215013/http://www.medterms.com/script/main/art.asp?articlekey=10851 |archive-date=December 8, 2011 |access-date=2011-08-21 |publisher=Medterms.com |df=mdy-all}}</ref>

Within the LGBTQ+ population, transgender youths face the highest rate of suicidal ideation. It is estimated that 82% of transgender people consider suicide with another estimated 40% actually attempting to kill themselves.<ref>{{Cite journal |last1=Austin |first1=Ashley |last2=Craig |first2=Shelley L. |last3=D'Souza |first3=Sandra |last4=McInroy |first4=Lauren B. |date=March 2022 |title=Suicidality Among Transgender Youth: Elucidating the Role of Interpersonal Risk Factors |url=https://pubmed.ncbi.nlm.nih.gov/32345113 |journal=Journal of Interpersonal Violence |volume=37 |issue=5–6 |pages=NP2696–NP2718 |doi=10.1177/0886260520915554 |issn=1552-6518 |pmid=32345113}}</ref> 

=== South Korea ===
{{Main|Suicidal ideation in South Korean LGBT youth}}
[[South Korea]] has the [[Suicide in South Korea|4th highest rate of suicide]] in the world and the highest in the [[OECD]]. Within these rates, suicide is the primary cause of [[death]] for [[South Korea]]n [[Youth suicide|youth]], ages 10–19.<ref name=":0">{{Cite journal |last1=Sohn |first1=Min |last2=Oh |first2=Heymin |last3=Lee |first3=Sang-Kyu |last4=Potenza |first4=Marc N. |date=2017-10-09 |title=Suicidal Ideation and Related Factors Among Korean High School Students |journal=The Journal of School Nursing |volume=34 |issue=4 |pages=310–318 |doi=10.1177/1059840517734290 |issn=1059-8405 |pmid=28992754 |s2cid=1207678}}</ref> While these rates are elevated, suicidal ideation additionally increases with the introduction of LGBT identity.<ref name=":2">{{Cite journal |last1=Kim |first1=SungYeon |last2=Yang |first2=Eunjoo |date=February 2015 |title=Suicidal Ideation in Gay Men and Lesbians in South Korea: A Test of the Interpersonal-Psychological Model |journal=Suicide and Life-Threatening Behavior |volume=45 |issue=1 |pages=98–110 |doi=10.1111/sltb.12119 |pmid=25220014}}</ref>

==See also==
* [[Existential angst]]
* [[Existential crisis]]
* [[Existential nihilism]]
* [[Finno-Ugrian suicide hypothesis]]
* [[Mental health first aid]]
* [[Suicide attempt]]
* [[Suicide crisis]]
* [[Wellness check]]

==References==
{{Reflist}}

==Further reading==
{{Scholia}}
* {{Cite journal |last=Beck |first=AT |author2=Steer, RA |author3=Kovacs, M |author4= Garrison, B  |year=1985 |title=Hopelessness and eventual suicide: a 10-year prospective study of patients hospitalized with suicidal ideation |journal=[[American Journal of Psychiatry|Am J Psychiatry]] |volume=142 |issue=5 |pages=559–563 |pmid=3985195|doi=10.1176/ajp.142.5.559 |citeseerx=10.1.1.462.6328 }}
* {{Cite journal |last=Uncapher |first=H |year=2000–2001 |title=Cognitive biases and suicidal ideation in elderly psychiatric inpatients |journal=Omega |volume=42 |issue=1 |pages=21–36 |doi=10.2190/6uu8-hk8e-hl0v-q4cu|s2cid=144242247 }}
* {{Cite journal |last=Uncapher |first=H |author2=Gallagher-Thompson, D |author3=Osgood, NJ  |year=1998 |title=Hopelessness and suicidal ideation in older adults |journal=The Gerontologist |volume=38 |issue=1 |pages=62–70 |pmid=9499654 |doi=10.1093/geront/38.1.62|doi-access=free }}

== External links ==
* [http://www.aafp.org/afp/990315ap/1500.html Evaluation and Treatment of Patients with Suicidal Ideation] {{Webarchive|url=https://web.archive.org/web/20060925091838/http://www.aafp.org/afp/990315ap/1500.html |date=2006-09-25 }}
* [http://www.aamft.org/imis15/content/Consumer_Updates/Suicidal_Thoughts.aspx Suicidal Thought] {{Webarchive|url=https://web.archive.org/web/20140702121052/http://www.aamft.org/imis15/content/Consumer_Updates/Suicidal_Thoughts.aspx |date=2014-07-02 }}
* [http://www.suicidepreventionlifeline.org/Learn/WarningSigns National Suicide Prevention Lifeline: Warning signs] {{Webarchive|url=https://web.archive.org/web/20160408232612/http://www.suicidepreventionlifeline.org/Learn/WarningSigns |date=2016-04-08 }}

{{Medical resources
|  DiseasesDB     = 
|  ICD11          = {{ICD11|MB26.A}}
|  ICD10          = {{ICD10|R45.8}} 
|  ICD9           = {{ICD9|V62.84}} 
|  ICDO           = 
|  OMIM           = 
|  MedlinePlus    = 
|  eMedicineSubj  = 
|  eMedicineTopic = 
|  MeshID         =D059020
}}

{{Cognition, perception, emotional state and behaviour symptoms and signs}}
{{Borderline personality disorder}}
{{Mood disorders}}
{{Suicide navbox}}

{{DEFAULTSORT:Suicidal Ideation}}
[[Category:Anxiety disorders]]
[[Category:Attention deficit hyperactivity disorder]]
[[Category:Autism spectrum disorders]]
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[[Category:Borderline personality disorder]]
[[Category:Major depressive disorder]]
[[Category:Mental disorders]]
[[Category:Paranoia]]
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[[Category:Post-traumatic stress disorder]]
[[Category:Psychosis]]
[[Category:Symptoms of schizophrenia]]
[[Category:Substance dependence]]
[[Category:Substance-related disorders]]
[[Category:Suicide|Ideation]]
[[Category:Symptoms and signs of mental disorders]]
[[Category:Symptoms or signs involving content of thought]]