The first decade after becoming disabled is a high-risk period for suicide; this shouldn’t be dismissed as “just a matter of staying positive.”

In the first few years after becoming disabled, it’s very common for both the disabled individual and their family members to experience severe emotional distress — this is not a sign of weak willpower at all. Long-term follow-up studies conducted at two spinal cord injury centers in the UK found that the suicide rate among this group is five times higher than that of the general population. Over 90% of all suicides among these individuals occur within the first decade after their injury. For people whose injury was directly caused by a prior suicide attempt, this risk is even higher.

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This study tracked 2,304 patients with traumatic spinal cord injuries who were newly admitted between 1991 and 2010, survived the first year after injury, and had residual neurological impairments at discharge, with follow-up lasting until the end of 2014. Among them, 63 patients (2.7%) had suffered their injury as a direct result of a prior suicide attempt. By the end of the follow-up period, 533 patients had died, of which 4.2% died by suicide; 91% of all suicides occurred within the first ten years after injury. The age-standardized suicide mortality rate was 62.5 cases per 100,000 people per year (95% CI 36.4–88.6), which is five times the average suicide rate of 12.2 cases per 100,000 people in England and Wales in 2014. Compared to patients with other causes of injury, those whose injury was triggered by a prior suicide attempt had a 4.32-fold higher risk of death overall (P<0.001), and a 9.46-fold higher risk of suicide specifically (P<0.001).

This research was limited to spinal cord injury patients only, so the findings should be extrapolated with caution to other causes of disability such as blindness, amputation, or burns. Its main takeaway is the time window of heightened risk: this elevated risk does not fade away immediately after discharge, and requires close monitoring for a full decade. For support services, please refer to Section 29, Item 11 (12356). To prevent accidental harm, avoid storing sleeping pills or pesticides at home; see Section 1, Item 25 (thoughts of suicide). If feelings of grief and emotional distress persist for more than six months, seek help from a psychiatrist or clinical psychologist; see Section 29, Item 8 (grief lasting over half a year).

Savic G, DeVivo MJ, Frankel HL, Jamous MA, Soni BM, Charlifue S (2018). Suicide and traumatic spinal cord injury - a cohort study. Spinal Cord, 56(1):2-6. https://doi.org/10.1038/sc.2017.98