Risk Factors – Unchangeable And Changeable

Risk Factors are aspects of a person’s life that may put the person at greater risk of suicide, suicidal behavior or self-harm.  Many suicides are in response to some immediate or specific stress (e.g. relationship breakdown or job loss). Each person reacts to stress differently. Although there is a lot of variation in the characteristics of those who suicide, the most common feature is that a number of risk factors have come together at one point in time.

Risk factors may include:


Unchangeable (Static)

  •          Male
  •          Aged 25-55
  •          Retirement
  •          Family history of:
    •           Suicide
    •           Mental illness
  •          Natural disasters
  •          Chronic or terminal illness
  •          History of:
    •           previous attempts
    •           deliberate self-harm
    •           childhood abuse and/or neglect
    •           medical illness
    •           cultural issues
    •           long-term unemployment
    •           anti-social behavior
    •           domestic violence


Changeable (Dynamic)

  • Suicidal thinking
  • Suicide plan/intent
  • Feelings of hopelessness
  • Stressful life events
  • Legal problems
  • Financial problems
  • Intoxication (drunkenness)
  • Drug problems
  • Poor social support
  • Impulsivity
  • Interpersonal problems
  • Perceived inability to cope
  • Recent loss
  • Shame
  • Health problems
  • Employment problems
  • Bullying
  • Loneliness/isolation
  • Low self-esteem
  • Music, movies or websites with negative messages 

This list is by no means exhaustive. Some of the factors listed merit their own link. Some of these risk factors are more relevant to certain groups and will be outlined under their respective group headings. "Having protective factors lowers suicide risk. Examples of protective factors are: supportive family/friends; involving self in community; an understanding doctor. An activity or help seeking behaviour that reduces any risk factor is a protective factor.”

Self-harming and suicidal acts

While suicide and self-harm are interconnected issues and may have some similar risk factors, they are not the same. There are important distinctions to be made between these two behaviours. The following table outlines differences between self-harming and suicidal acts in the person’s intention for carrying out the act, the method used in the act, and its potential to be fatal.

Table 1

Differences between self-harming and suicidal acts.[1]


Self-harming acts

Suicidal acts

The intent is to relieve emotional distress; to live and feel better.

The intent is to end unbearable pain; to die.

The method used is thought by the person to be non-lethal (for example, shallow cutting, burning).

The method used is lethal or thought by the person to be lethal.

The potential for the act to be fatal is usually unlikely or perceived by the person as unlikely; however can inadvertently result in death.

The potential for the act to be fatal is highly likely or perceived by the person as likely.

[1] Department of Communities. (2008). Responding to people at risk of suicide. How can you and your organisation help? Queensland Government.

Mental health disorders

Suicide among those with a mental health disorder is a notable public health problem.  Various severe psychiatric disorders have been found to be present in suicides.

A number of mental health disorders and substance use were found to be associated with an increased risk of suicide.[1],[2],[3],[4],[5],[6],[7]These included alcohol misuse, bipolar disorder, major depression, dysthymia, personality disorder, schizophrenia, panic disorder, post-traumatic stress, eating disorder, substance use. Having any substance use disorder may increase the risk of suicide and suicide attempts in people with mental illness.

Discrimination and stigma are thought to contribute to suicidal risk as they link to distress and shame, and may lead to isolation, may reduce self-esteem, and may act as a barrier to help seeking.[8]

Suicide prevention programs need to address issues such as stigma, substance abuse and the vast range of mental health issues to increase awareness and understanding in the community.  As well, they need to give specific information to patients on how to deal with suicidal thoughts if they occur.

The people who treat depression

Choose someone you can work well with and who helps you to feel safe.  This may include considerations of culture and gender issues.

General Practitioners (GPs)

A GP can treat some cases of depression, and refer patients to other healthcare professionals when necessary.

[1] Østergaard, M. L. D., Nordentoft, M., Hjorthøj, C. (2017). Associations between substance use disorders and suicide or suicide attempts in people with mental illness: a Danish nation-wide, prospective, register-based study of patients diagnosed with schizophrenia, bipolar disorder, unipolar depression or personality disorder. Addiction,112 (7),1250-1259. doi: 10.1111/add.13788

[2]Pallaskorpi, S., Suominen, K., Ketokivi, M., Valtonen, H., Arvilommi, P., Mantere, O., Leppämäki, S., & Isometsä, E. (2017). Incidence and predictors of suicide attempts in bipolar I and II disorders: A 5‐year follow‐up study. Bipolar Disorders,19 (1), 13-22.  doi: 10.1111/bdi.12464

[3]Johnson, S. L., Carver, C. S., Tharp, J. A. (2017). Suicidality in bipolar disorder: The role of emotion‐triggered impulsivity. Suicide and Life‐Threatening Behavior, 47 (2), 177-192. doi: 10.1111/sltb.12274  

[4] Tseng, M. M., Chang, C. H., Chen, K. Y., Liao, S. C., & Chen, H. C. (2015). Prevalence and correlates of bipolar disorders in patients with eating disorders. Journal of Affective Disorders,190, 599-606. doi: 10.1016/j.jad.2015.10.062

[5]Albanese, B. J., Norr, A. M., Capron, D. W., Zvolensky, M. J., Schmidt, N. B. (2015). Panic symptoms and elevated suicidal ideation and behaviors among trauma exposed individuals: Moderating effects of post-traumatic stress disorder. Comprehensive Psychiatry, 61, 42-48. doi:10.1016/j.comppsych.2015.05.006  

[6]Rudolf, U. (2014). Persistent depressive disorder, dysthymia, and chronic depression: Update on diagnosis, treatment. Psychiatric Times, 31 (8).              

[7]Tartakovsky, M. (2018). A Current Look at Chronic Depression. Psych Central. Retrieved on June 5, 2018, from https://psychcentral.com/lib/a-current-look-at-chronic-depression/

[8]Carpiniello, B., & Pinna, F. (2017). The Reciprocal Relationship between Suicidality and Stigma. Frontiers in Psychiatry, 8 (35)   doi: 10.3389/fpsyt.2017.00035         



A Psychologist has expertise in testing, diagnosing, and treating emotional and psychological disturbances. A psychologist does not prescribe medication in Australia.


A Psychiatrist is a medical doctor with special training in helping those with emotional and psychological problems. They can assess and diagnose mental illnesses, counsel patients, and prescribe medication.

Counsellors and other therapists

These include accredited professionals such as psychiatric nurses, registered counsellors, psychotherapists, social workers, school counsellors and guidance officers, etc., who are trained in various counselling techniques to help people cope with their problems. 


Others who provide support would include clergy, school chaplains, friends and families and natural health practitioners. Also included are paraprofessional support workers – those who have some training in supporting people, but who are not specialised professionals. These may include youth workers, health staff and volunteers working with at-risk groups, and providers of telephone support services. Within Aboriginal and Torres Strait Islander communities, there may be specific people who are known to provide such support.


Substance misuse

Substances misused may include, but are not limited to, alcohol, tobacco and other drugs (legal and not legal), inhalants such as petrol, aerosols, chrome-based paints (chroming), and other easily accessible, potentially harmful chemicals. 

Alcohol use has been consistently implicated in hastening suicidal behavior.[1] Its misuse may lead to suicidality through reducing inhibitions, increasing impulsiveness and impaired judgment, and may function as a means to ease the distress associated with the act of suicide.

In 2016 suicide by drug poisoning was the cause of death for 411 people (210 males and 201 females).[2] Half of these deaths had two or more substances identified on the toxicology report at death. 

[1]Pompili, M., Serafini, G., Innamorati, M., Dominici, G., Ferracuti, S., Kotzalidis, G., Serra, G., Girardi, P., Janiri, L., Tatarelli, R., Sher, L., & Lester, D. (2010). Suicidal behavior and alcohol abuse. International Journal of Environmental Research and Public Health, 7, 1392–1431. doi: 10.3390/ijerph7041392

[2] Australian Bureau of Statistics (2018). Causes of Death, Australia, 2016 (Catalogue number 3303.0). Retrieved from http://www.abs.gov.au/ausstats/abs@.nsf/Lookup/by%20Subject/3303.0~2016~Main%20Features~Drug%20Induced%20Deaths%20in%20Australia~6#

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