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Suicide Prevention: From Illness and Risk Factors, to Thoughts and Actions

Current Affairs, Tiago Zortea

Suicide Prevention: From Illness and Risk Factors, to Thoughts and Actions

Photo by Austin Ban ©. Unsplash. Used with permission.


By Tiago Zortea

As a PhD student carrying out research in suicidality, I am recurrently asked why people take their own lives. The thing is, there is not an obvious, quick, or complete answer. Suicide is a complex phenomenon, and it involves biological, psychological and social factors that interact with each other, and these interactions vary across cultures, genders, and ages. The main reason why researchers have been working so hard to understand it and to develop effective interventions is the fact that there is no time to lose when the aim is saving lives; equivalently, someone dies by suicide every 40 seconds somewhere in the world [1].

In this challenging task of understanding suicide, several theoretical approaches have been developed and are still being shaped by every new research result. Because of the diversity of professionals coming from different areas, the range of contrasting points of view contributes unique elements to help us understand more about suicide. Although much has been done in diversifying our approach to suicide prevention, it is still the dominant opinion to view suicide as a result of risk factors – what can increase the risk for suicidal behaviour? – especially psychiatric diagnoses (e.g., depression, schizophrenia, bipolar disorder) [2]. Identifying risk and protective factors is extremely important, as it improves actions for suicide prevention. However, risk factors alone do not explain why some people take their own lives and how different variables interact to translate suicidal thoughts into suicidal actions.

Aimed at addressing this issue, the Integrated Motivational-Volitional Model [3-7] of suicidal behaviour (IMV) was developed to provide a theoretical framework for examining the elements involved in the development of suicidal ideation and how they are translated into a suicide attempt. Alongside its strong theoretical foundation, there is also something unique in the IMV: it conceptualises suicide as a behavioural process – “rather than a by-product of mental disorders” [4:212], and differentiates in detail the aspects involved in the development of suicidal thoughts from those factors related to making a  suicide attempt (see the figure below).


Understanding suicide as a behavioural process gives the opportunity to examine the details of how psychobiological processes operate, enhancing the chances of achieving better comprehension of suicidal thoughts and behaviours, as well as aiding the development of more individually specific interventions for suicide prevention. Although suicide is also determined by biological and social components, dying by suicide is related to an individual’s decision to end their own life, which makes psychological analysis crucial for understanding the mechanisms operating and driving this phenomenon. We must try to understand the psychology behind why, for some people, suicide seems the only option.

In the field of human behaviour there are no categories, normality, madness, or insanity, only human experiences. Looking at suicide as a behavioural process shows that this human phenomenon may emerge in situations of extreme desperation, with unbearable feelings of defeat, humiliation, and entrapment, when our hopelessness is heavier than our strength, and the illusion of a nonexistent escape from our problems appears to be more real than anything else. This is the time when we must get rid of our judgements and social barriers, making ourselves available to help, to listen to, and to talk to those who are in pain; we must support new possibilities, help to find new doors, restoring hope, and reaffirming life.

If you are in immediate need of some support, Samaritans are there to listen 24/7: 08457 90 90 90 or if you are in Scotland, you can also contact Breathing Space: 0800 83 85 87



[1] World Health Organization. (2014b). Preventing suicide: A global imperative. Geneva, Switzerland.

[2] Van Heeringen, K. (2001). Towards a psychobiological model of the suicidal process. In K. van Heeringen (Ed.), Understanding Suicidal Behaviour. Chichester: John Wiley & Sons, Ltd.

[3]  O’Connor, R. C. (2011). Towards an Integrated Motivational-Volitional Model of Suicidal Behaviour. In R. C. O’Connor, S. Platt, & J. Gordon (Eds.), International Handbook of Suicide Prevention (1st ed., pp. 181–198). Chichester, UK: John Wiley & Sons, Ltd.

[4] Dhingra, K., Boduszek, D., & O’Connor, R. C. (2015). Differentiating suicide attempters from suicide ideators using the Integrated Motivational–Volitional model of suicidal behaviour. Journal of Affective Disorders, 186, 211-218.

[5] O’Connor, R.C. (2011). The integrated motivational-volitional model of suicidal behaviour. Crisis, 32, 295-298.

[6] O’Connor, R.C., O’Carroll, R.E., Ryan, C., & Smyth, R. (2012). Self-Regulation of Unattainable Goals in Suicide Attempters: A Two Year Prospective Study. Journal of Affective Disorders, 142, 248-255.

[7] O’Connor, R.C., Nock, M.K. (2014).  The Psychology of Suicidal Behaviour. Lancet Psychiatry, 1, 73-85.

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