Like other health problems, substance abuse and suicide can be prevented. However, these issues are very difficult to reduce or prevent, especially among college students. Many approaches to substance abuse and suicide prevention focus on providing the knowledge, skills, and attitudes needed to change harmful behaviors and make good choices.
College campuses can adopt, and many already have, environmental prevention strategies tailored to the local community and campus. University administrators, professors, and students can address the root causes of risky behaviors by fostering environments that promote healthy lifestyles.
Effective prevention is a coordinated effort between individuals and their community or environment. Students must be willing to talk about mental health and connect with one another. Colleges must promote substance-free housing and counter peer pressures and cultural norms that glamorize drug and alcohol use. To help students improve their lives, substance abuse and suicide prevention requires attention, understanding, and taking action.
The Connection Between Substance Abuse And Suicide
Although there are multiple factors that influence suicidal behaviors, substance abuse (particularly alcohol abuse) is a major factor associated with suicide attempts, and the number of suicides. Suicide is a leading cause of death for those who suffer from drug and alcohol addiction.
Almost 25% of deaths by suicide involve severe alcohol intoxication, with blood-level contents well above the legal limit.
Alcohol abuse, which is prevalent on college campuses, contributes to suicide risk because alcohol decreases inhibition and increases depressive moods. Alcohol use increases the risk of suicide because it can:
- increase aggressive behavior
- increase psychological distress
- limit rational thinking about suicide (impair a student’s ability to effectively cope with stressors or other issues)
- propel suicidal ideation into action (alcohol can motivate a student to complete the act, believing alcohol makes it painless)
Data shows that those with a diagnosis of an alcohol use disorder are ten times more likely to have suicidal thoughts than the general population.
Severe alcohol intoxication occurs in about 40% of suicide attempts.
In many cases, young people with severe depression are more likely to use alcohol than those without depression.
College And Co-Occurring Disorders
Co-occurring disorders exist when a person suffers from both substance abuse problems and a mental health disorder. On campus, students often struggle with mental health issues like depression, anxiety, eating-disorders, and self-injurious behaviors. One survey found nearly 50% of college students reported feelings of hopelessness, and over 30% reported feeling so depressed it was difficult to engage in academics over the past year.
Many students may attempt to self-medicate their feelings of hopelessness, isolation, and despair with alcohol or other drugs. Substance abuse can be detrimental for college students struggling with mental health problems and can have devastating consequences, like an increased risk of suicide.
Almost 50% of students seeking counseling services for mental health issues also suffer from alcohol abuse.
It’s important for college campuses to address these issues by placing mental and behavioral health supports that have proven to reduce the risk of both substance abuse and suicide. Without services in place, students suffering from these conditions are likely to influence peers around them, potentially worsening the problem.
College Students And Alcohol
Drinking at college has become almost ritualistic, and many students see drinking as a crucial part of the college experience. Approximately 58% of full-time college students drank alcohol in the past month. For students who go to college with established drinking habits, the partying environment at college can make things worse and may lead to an alcohol use disorder. Researchers have found some disturbing trends about some of the consequences of drinking in college.
Each year, alcohol abuse contributes to:
- academic problems: Roughly 1 in 4 students report having trouble with academics as a result of drinking. This includes missing class, falling behind on assignments, not studying for exams, and receiving worse grades.
- alcohol use disorder: It’s reported around 20% of college students meet the criteria for the medical diagnosis of a drinking problem.
- assault: Nearly 700,000 college students are attacked or assaulted by a fellow student who has been drinking.
- death: About 1,825 college students die from alcohol-related injuries, accidents, or motor-vehicle crashes.
- sexual assault: Almost 100,000 students report suffering from an alcohol-related date rape or sexual assault.
Drinking at college can have further consequences like health problems, other injuries, unprotected sex, vandalism, property damage, suicidal thoughts or actions, and other risky behaviors that can lead to criminal activity.
College Students And Suicide
The sad truth is suicide is one of the leading causes of death among college students. Suicidal thoughts and attempted suicide are also disturbingly prevalent. More and more universities and colleges are becoming aware of the problem and are taking preventative measures to combat this growing concern. While data on suicide rates among college students is sparse, consider the following general statistics:
- each year, it’s estimated 41,000 people die from suicide
- males represent almost 80% of all suicides
- one person dies from suicide in the United States every 12 minutes
- suicide is the second leading cause of death between ages 15-24, which includes college students
- suicide rates for individuals with mental illness or mood disorders is 25x greater than the public at large
- thoughts about suicide, making plans, or attempts has increased for college age persons (18-25)
In a collection of studies about suicide among college or university students, the rates were about half compared to the general public. Like the public, male students accounted for the majority of suicides on campus. Part of preventing both suicide and substance abuse is knowing the warning signs and intervening when necessary.
Warning Signs Of Suicide
There is still much to learn about preventing suicide. One strategy students, college professors, administrators, and parents can all do is learn about the warning signs of suicide. There is no one sign or behavior that can predict a suicide attempt.
However, pay attention to behaviors and things people say, such as:
- acting anxious or agitated; behaving recklessly
- displaying extreme mood swings
- expressing emotions about being a burden to others
- looking for a way to kill oneself, like searching online for weapons or buying a gun
- losing interest in things or losing the ability to experience pleasure
- having feelings of hopelessness or wondering what’s the point
- showing rage or talking about getting revenge
- talking about wanting to die or killing oneself
- sleeping too much or too little
- feeling trapped or experiencing unbearable pain
Warning Signs Of Substance Abuse
Like suicide, spotting warning signs for addiction and substance abuse can help get students into treatment earlier. The earlier a person receives treatment for substance abuse problems, the better.
Look out for the following warning signs of addiction:
- a “nothing matters” attitude (low-energy, not interested in favorite activities, not engaged in classes or campus activities)
- academic problems (low attendance, poor grades, trouble with professors)
- changing friend groups
- changes in appearance (poor hygiene or poorly dressed)
- finding drugs, alcohol, or paraphernalia in dorm room
- mood changes (quick to rage, irritable, defensive)
- physical or mental changes (memory problems, can’t concentrate on academics, always hungover, lack of coordination)
Risk Factors For Suicide
Risk factors are understood as certain characteristics that relate to suicide. Identifying risk factors is a crucial element of prevention. Those who have more risk factors than others may have a greater risk of suicidal behavior. There are some risk factors that cannot be changed or prevented, like a prior suicide attempt, but other factors can be used to help identify, and then help, someone with suicidal tendencies. The following risk-factors are psychological, biological, social, and environmental:
- access to lethal means of suicide (weapons, etc.)
- exposure to dangerous portrayals of suicide in the media
- feelings of hopelessness and isolation
- history of suicide in family or loved one’s family
- financial, work, or school stress
- genetic and biological factors
- history of mental illness or depression
- history of violence towards others
- lack of social support
- limited access to behavioral healthcare providers
- limited connectedness with others on campus
- previous suicide attempts
- stigma associated with getting help for suicidal ideation
- substance abuse
- violent or high-conflict relationships
There is no single factor that increases a student’s risk for suicide. Suicide may occur as a result of multiple factors that interact with one another. It’s important to understand most people who suffer from depression, attempt suicide, or experience other risk factors, do not die as a result of suicide.
Risk Factors For Substance Abuse
Like suicide risk, there is no single risk factor that determines a substance abuse problem. College students are exposed to a variety of individual, relationship, communal, and societal risk factors, including:
- ability to buy booze on campus; availability of drugs at school
- aggressiveness towards teachers or other students
- family history of substance abuse (alcoholism); parents are tolerant to drug or alcohol use
- favorable attitudes towards substance use, likes to party; attends lots of BYOB parties and binge drinks
- friends use alcohol or other drugs, and judge them on whether they do or not
- impulsiveness to seek sensory experiences; struggles to refuse or say no to alcohol or drugs
- member of a fraternity or sorority/involvement in greek life
- poor commitment to school and academics; skips classes and gets poor grades
- poor social skills; problems with commitment, attachment, and self-control
- suicidal thoughts
Friends using drugs or alcohol can influence more academic students with no prior risk factors for substance abuse. Struggling in class, or having a hard time socializing, may also increase the risk of substance abuse and addiction. Other risk factors of addiction include early use, method of administration, and biology or genetics.
Substance Abuse And Suicide Prevention Strategies For College Students
The execution of prevention strategies often falls on campus administration or other university officials. Environmental strategies on campus can also be promoted by student leaders and activities. A continuum of care to address both substance abuse and suicide may involve the following prevention strategies on campus:
- Promotion — On campus, promotion works to raise awareness about behavioral health services. Promotion should also create environments to destigmatize reaching out for help, while also supporting the many challenges students face.
- Prevention — Before a substance use disorder onsets, or a student attempts suicide, interventions and resources can help reduce or prevent the risk of developing these issues.
- Treatment — Services that provide care for people diagnosed with substance use disorders or mental health problems. Often times, inpatient treatment is a great resource for young adults.
- Recovery — After substance abuse problems are treated, or someone is identified as having suicidal thoughts, recovery supports can help students live productive and healthy lives on and off campus.
Substance Abuse Prevention For College Students
Preventing substance abuse on college campuses typically involve multiple strategies to address individual students, the student body, and the college community at large. The following preventative measures are designed to address individual behaviors and change attitudes regarding drugs and alcohol:
- academic competence and support
- education and awareness programs
- cognitive-behavioral skills-based programs
- motivation and feedback-related approaches
- interventions by behavioral health professionals
- strong campus attachment
Preventative measures for the student body and campus community are designed to improve environments where drinking and drug use occurs. Often times, a major goal is to limit the availability of alcohol on campus. Without easy access to alcohol, students are less likely to engage in risky behaviors, use drugs, and experience harmful consequences.
Suicide Prevention For College Students
Suicide prevention programs on college campuses work to reduce the likelihood of suicide. Hopeful outcomes include reducing suicidal thoughts and behaviors, changing suicide-related risk, and improving protective factors. While each program may differ in approach, many will consider the prevention model that includes promotion, prevention, treatment, and recovery.
Common strategies for prevention on college campuses include:
- creating protective environments — Reduce access to any lethal means of suicide; promote a culture on campus that is organized and healthy; promote campus policy that reduces heavy drinking and excessive alcohol use.
- identifying and supporting people at risk — Provide gatekeeper training, or increase the knowledge and skills students need to identify at-risk persons; host crisis-intervention programs and activities; provide treatment for at-risk persons; provide treatment to prevent further attempts.
- lessening harms and preventing future risk — Students should learn safe reporting and messaging about suicide; host post-vention programs to address future risk.
- promoting connections — Establish student to student peer norm programs to promote community among students on campus; host activities that bolster students engagement on campus.
- strengthening access and delivery of suicide care — Colleges should cover or offer services that treat mental health conditions; reduce shortages of providers on campus; provide suicide care that is both accessible and affordable for students.
- strengthening economic supports — improve financial security through meeting with advisors; provide financial aid if the student is eligible and worried about paying for school.
- teaching coping and problem-solving skills — provide social-emotional learning programs; foster family and relationship skills in interesting ways on campus.
The primary goal of prevention strategies is to provide students with the skills needed to find solutions to problems at school, in relationships, and with peers. These preventative measures can help students address negative issues and influences, like substance abuse, that are commonly associated with suicide.
Five Action Steps For Suicide Prevention
If you know someone on campus who is experiencing emotional pain, consider these five action steps to help them find care and prevent self-harm.
- Ask: Approach the person and ask them straight up. It can be awkward and difficult, but many studies suggest asking at-risk individuals if they’re thinking about suicide does not make things worse and can improve the situation.
- Keep them safe: Reducing a person’s access to lethal items can prevent them from hurting themselves. This isn’t easy, but helping them get rid of dangerous means is an important preventative measure.
- Be there: Carefully listen to the person and try to learn what they’re thinking and feeling. Acknowledging suicide, or simply talking about it, has shown to reduce suicidal thoughts and behaviors.
- Help them connect on campus: Help the person reach out to campus supports or other trusted individuals like mental health professionals or spiritual advisors. Save suicidal helpline numbers in your phone so you have it handy when you need it.
- Stay connected: If the person has a crisis, stay in touch. Showing them you care after discharge can make a huge difference. Suicide deaths decrease when a loved one or friend follows up with the person.
With the right tools, suicide can be prevented. There isn’t one protective factor that best prevents suicide. Rather, the most effective way to prevent suicide is focusing on individuals, relationships, communities, families, and cultures within college campuses.
Resources For Substance Abuse And Suicide Prevention
Besides coordinated prevention plans and action steps, there are many things someone can do for themselves or others if they’re thinking about suicide. If the problem requires immediate action, please call 9-1-1.
Other crisis resources include:
- National Suicide Prevention Helpline: This lifeline provides free and confidential support for people in distress, 24 hours a day, seven days a week. Call 1-800-273-8255 or visit the website.
- Suicide Prevention Resource Center (SPRC): SPRC is devoted to promoting and advancing the National Strategy for Suicide Prevention and is funded by the U.S. government.
- Veterans Crisis Line: This helpline provides support for veterans in a crisis, as well as for their family and friends. Call 1-800-273-8255, then press 1.
- Crisis Text Line: A free, 24/7 support line for people in crisis. Text START to 741-741 to connect with a crisis counselor.
- American Foundation For Suicide Prevention (AFSP): AFSP is a voluntary health organization dedicated to providing resources and hope for those affected by suicide.
If a student has a problem with alcohol or drugs, reaching out for help is the first step. Resources for college students struggling with substance abuse includes:
- College Age and Young Adults: An informative resource about young people and addiction researched by the National Institute for Drug Abuse.
- College Drinking Prevention: Part of the National Institute on Alcohol Abuse and Alcoholism, this resource provides statistics, materials, and other tools to promote responsible drinking and sobriety on campus.
- National Center for Safe and Supportive Learning Environments: This resource offers informational assistance for universities, schools, and communities focused on improving academic, social, and behavioral supports.
- CollegeAIM: The College Alcohol Intervention Matrix is a resource to help schools and students address underage and problematic drinking.
Treatment And Inpatient Rehab Programs
Treatment for suicidal thoughts or actions will vary from student to student, but will be similar to treatments for other mental health disorders like anxiety and depression. Behavioral therapies like cognitive behavioral therapy (CBT) and dialectical behavior therapy (DBT) can prevent further self-injurious behaviors and improve quality of life.
For substance abuse, therapy can help change a person’s thinking and attitudes towards substance use and develop coping skills to avoid relapse. Medications may also be used to treat certain addictions, like alcohol and opioid use disorders, and are most effective when used in combination with therapy.
For college students, time away from their environment can be effective. Young people often do better within inpatient rehab programs, where there is around-the-clock care and supervision, evidence-based therapies, and a network of peer and professional support.
- American Psychological Association—The Crisis on Campus
- National Center for Injury Prevention and Control: Division of Violence Prevention—Preventing Suicide: A Technical Package of Policy, Programs, and Practices
- National Institute on Alcohol Abuse and Alcoholism—College Drinking
- National Institute of Mental Health—Suicide Prevention
- Substance Abuse and Mental Health Services Administration—Prevention of Substance Abuse and Mental Illness, Substance Use and Suicide, Suicide Prevention Facts and Resources
- Suicide Prevention Resource Center—Suicide Among College and University Students in the United States
- Youth.gov—Co-Occurring Disorders, Warning Signs