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Counseling and Psychological Services

Suicide Risk Factors and Warning Signs

Many of you in the MUSC community may have noticed recent media reports of several student suicides at Cornell University this year. We at MUSC Counseling and Psychological Services would like to provide, given the heightened attention on the subject, some information regarding suicide, including risk factors and warning signs, and what you can do to help yourself, a friend, or a colleague about whom you are concerned.

Facts About Suicide

  • Suicide is believed to be the second leading cause of death for college students (CDC, 2007). 
  • Overall, suicide is the third leading cause of death for people ages 15-24, and the second leading cause of death for individuals between the ages of 25-34 years. 
  • Regarding gender differences, men are more likely to make successful suicide attempts, given their propensity to use more lethal methods such as firearms. Women, however, are more likely than men to make a suicide attempt. 
  • The National Comorbidity Survey found that 34% of individuals in the general population with suicidal ideation develop a suicide plan and, of those who plan, more than 70% will attempt suicide. Notably, 26% of those individuals with suicidal ideation progressed directly to an unplanned suicide attempt.

A 2009 investigation of over 26,000 undergraduate and graduate students from over 70 institutions of higher education revealed that suicidal ideation is prevalent on college campuses to a concerning degree, indicating that:

  • Over half of college students reported some form of suicidal thinking in their lives.
  • 18% of undergraduates and 15% of graduate students endorsed having seriously considered attempting suicide at some point in their lives. Of these, 47% of undergraduates and 43% of graduate students endorsed 3 or more periods of serious ideation.
  • 8% of undergraduates and 5% of graduate student reported previously making at least 1 serious attempt to commit suicide.
  • 6% of undergraduates and 4% of graduate students reported that they had seriously considered attempting suicide during the last 12 months. 
  • 80% of students who complete suicide never contact mental health services.

Results from additional large-scale studies suggest that graduate students and medical students are at greater risk for suicide than younger students (e.g., 11% of medical students endorsing suicidal ideation within the last year), illustrating the salience of this topic within our own student community. 

Suicide Risk Factors

The National Institute of Mental Health provides a list of risk factors for suicide that includes:

  • depression and other mental disorders, or a substance-use disorder
  • prior suicide attempt
  • family history of mental disorder or substance abuse
  • family history of suicide
  • family violence, including physical or sexual abuse
  • firearms in the home
  • incarceration
  • exposure to suicidal behavior in others

The American Psychological Association provides a list of more acute warning signs that may indicate someone is at greater risk for suicide:

  • talks about committing suicide (occurs in 75% of cases)
  • has trouble eating or sleeping
  • exhibits drastic changes in behavior
  • withdraws from friends, family, or social activities
  • loses interest in school, work, or hobbies
  • prepares for death by writing a will and making final arrangements
  • gives away prized possessions
  • has attempted suicide before (in 20-40% of cases)
  • takes unnecessary risks
  • has recently experienced serious losses (occupational, marital/relationship, etc.)
  • seems preoccupied with death and dying
  • loses interest in personal appearance
  • increases alcohol or drug use

What You Can Do

If you suspect a friend may be contemplating suicide, or at risk for doing so, there are a number of things you can do which can help. 

  • It is first important that you do not assume that the situation will take care of itself. Any concern you have for your friend should be addressed, and not ignored, as there is no guarantee that others will step in to provide assistance. 
  • Do not promise to keep what he or she tells you a secret, regardless of concerns you may have about angering your friend. Remember that your friend’s welfare takes precedence over hurt feelings. 
  • If you would like to talk to your friend, but are not sure how to approach the subject, CAPS staff can assist you in determining how best to discuss the topic with your friend. 
  • Be willing to listen. This is one of the most important ways you can help a friend in crisis. Even if professional help is needed, your friend will be more willing to seek help if you have listened to him or her. 
  • Voice your concern. Ask what is troubling your friend and attempt to overcome reluctance to talk about it. Do not argue with your friend, or debate the morality of suicide. Let them know that you are concerned about them, and are available to support them. You may have to be insistent.
  • Take it seriously. Do not dismiss or undervalue what someone shares with you. 75% of individuals who commit suicide talk to a friend or family member about it first. All suicidal talk should be taken seriously even if your friend assures you he or she will be fine. 
  • Ask if your friend has a specific plan for committing suicide, and how far he/she has gone towards carrying it out. It is a myth that asking about suicide will cause the person to think about it or commit suicide. 
  • Let them know that you care. Reassure your friend that he/she is not alone and that, although powerful, suicidal feelings are temporary. Problems can be solved. Depression can get better, but suicide is permanent. 
  • Get professional help. If you are concerned about your friend’s immediate safety, seek assistance. Calling 911, escorting him/her to the nearest emergency room, and calling Public Safety are all appropriate measures in an acute safety situation. 
  • If you have concerns about a friend that do not involve imminent safety risks, you may contact CAPS anonymously and speak with a therapist who will then assist you in determining the proper steps to take. Additionally, if you are uncomfortable personally confronting your friend, you may anonymously report your concerns to CAPS staff, who will then take appropriate measures to address the safety and well-being of your friend. 
  • Ensure that your own needs are being met. Assisting others in this way can be stressful and emotionally draining. Consider talking to someone you trust about how you are feeling, and know that CAPS is available to help you address your own experience and reactions. 

It should be noted that, while most people who attempt suicide are also depressed, not everyone who is depressed is considering, or will attempt, suicide. That said, suicide prevention is an important issue on any university campus, and ensuring the health and well-being of students is MUSC’s primary concern. We at Counseling and Psychological Services are available to help with any and all aspects of student mental and emotional health. Please do not hesitate to contact us. 


  • Emergency: 911
  • Public Safety –Emergency Line: (843) 792-4196
  • Suicide/Crisis Hotlines
    • National Suicide Prevention Lifeline: 1-800-273-TALK
    • National Hopeline Network: 1-800-784-2433
  • Counseling and Psychological Services: (843) 792-4930

Justin Quattlebaum, M.A.
Postdoctoral Fellow
Counseling and Psychological Services
Medical University of South Carolina






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