The relationship between disability and suicide: prospective evidence from the Ten to Men cohort

Abstract

Background People with disabilities often face a range of social and economic adversities. Evidence suggests that these disadvantages result in poorer mental health. Some research also indicates that people with disabilities are more likely experience thoughts about suicide than people without disability, although most of this research is based on small cross-sectional samples. Methods We explored the relationship between self-reported disability (measured at baseline) and likelihood of reporting thoughts of suicide (measured at follow up) using a large longitudinal cohort of Australian males. A logistic regression model was conducted with thoughts of suicide within the past 12 months (yes or no) as the outcome and disability as the exposure. The models adjusted for relevant confounders, including mental health using the SF-12 MCS, and excluded males who reported thoughts of suicide at baseline. Results After adjustment, there was a 1.48 (95% CI: 0.98–2.23, P = 0.063) increase in the odds of thoughts of suicide among men who also reported a disability. The size of association was similar to that of being unemployed. Conclusions Males reporting disability may also suffer from thoughts of suicide. We speculate that discrimination may be one explanation for the observed association. More research on this topic is needed.

The association of physical multimorbidity with suicidal ideation and suicide attempts in England: A mediation analysis of influential factors

“…Disability (% mediated 26.3%-37.5%) and pain (35.6%-38.0%) were also identified as key mediating variables. Physical multimorbidity can give rise to disability and pain owing to specific symptoms of individual physical conditions (e.g., stroke, arthritis), and these may increase the risk for suicidal thoughts/behavior not only via the specific suffering due to the symptoms but other factors such as social exclusion (Milner et al, 2019) and hopelessness (Hooley et al, 2014). Moreover, the desire to escape physical pain by death is often seen as the only solution, and it has been suggested that chronic exposure to pain and pain tolerance can reduce fear about death and increase the capability to carry out suicide (Jacob et al, 2018).…”

Effects of Social Exclusion on Psychological-Well-Being and Suicidal Possibilities Among People With Physical Disabilities

“…Similar to our study, Meltzer et al (2012) determined that those who lived alone, those who were disabled for a long time, and those with a poor quality of life due to this condition committed suicide four times more than normal people. In another study examining the relationship between disability and suicide, it was found that those with low income, living alone, and those with low well-being were more likely to commit suicide (Milner et al, 2019, p. 710). As a result of a study examining the relationship between the hopelessness levels and the possibility of the suicide of people with physical disabilities, it was determined that living alone, low-income level, and congenital disability significantly increased suicidal probability, and it was seen that age and gender did not affect the probability of suicide.…”

“…In the study, the suicide probability of physically disabled people was examined, and according to the scale evaluation it was determined as above the medium level. A study by Milner et al (2019) found that disabled people had a high rate of suicidal thoughts and 10% of them displayed suicidal behavior. As a result of another study on the suicide rates of people with disabilities, it was determined that suicide attempts or thoughts were higher than those without disabilities (Freeman et al, 2017, p. 234).…”

Does physical ill-health increase the risk of suicide? A census-based follow-up study of over 1 million people

“…There could be several explanations for this relationship between activity limitation and suicide. Research suggests that individuals with disability face stigma, discrimination and a range of other social and economic challenges which compromise their mental Epidemiology and Psychiatric Sciences wellbeing and increase their likelihood of having suicidal thoughts (Milner et al, 2019). Loss of autonomy, becoming a burden to carers, despondency arising from the inability to deal with chronic unremitting pain, and cognitive and functional declines of dementia have been reported as precipitants of suicide (Choi et al, 2019).…”