Suicide and Substance Abuse

Suicide and Substance Abuse

College students may struggle with dual diagnosis


Michal Saraf, a senior staff psychologist at Rutgers, believes it is the responsibility of college professionals to stay attuned to students who use and abuse substances, as well as to those with other risk factors, such as mood disorders, legal or family problems, and other life stressors.

 “Our main mission is to prevent suicide, identify risk factors, and develop programs and services to get students engaged,” said Saraf, addressing an audience of mental health advocates and college leaders at a statewide conference on suicide prevention in higher education, which took place February 8 at Rutgers. It was hosted by the university's Office of the Vice President for Student Affairs.

College students – 1,350 of whom take their lives each year – are at risk just because of where they are developmentally. "Adolescents are trying to figure out who they are. Experimentation with lifestyle activities, relationships, and substances are part of the growth process,” Saraf said  

For most, this process will result in the identity consolidation that moves a young person into adulthood, but some students will develop patterns of abuse and dependence on substances. Although they may not realize it, Saraf said, students with emotional problems may self medicate with alcohol and drugs to cover up a mental illness,

A relationship exists between substance abuse and suicide:

  • 19 percent to 63 percent of all suicides involve substance abuse disorders
  •  Suicide risk increases again when substance abuse, particularly involving alcohol, is combined with a mood disorder
  • One third of all male suicides and 15 percent ofall female suicides involve substance abuse disorders
  • In adolescent and young adult populations the incidence of substance use in suicides increases with age.

Saraf sees students at the university’s counseling center and supervises the clinical portion of the Program for Addictions Consultation and Treatment (PACT), a collaborative effort of Rutgers' Center of Alcohol Studies and the Graduate School of Applied Psychology.

What she looks for in terms of assessing risk for suicide is first, clinical depression:”Is the student depressed, self-destructive, and intent on doing damage?” She also assesses the degree of alcohol and drug abuse, along with the impulsivity and risky behavior that often goes with it.  In addition, she plays close attention to whether the student is truly using the language of suicidality. Is he or she talking about suicide as a way to communicate distress? Sometimes, ‘I want to die,” may be a way of saying I’m lonely and not that a student wants to hurt herself or end her life.

Experts on suicide have noted two factors that occur most often in suicidal attempts: the perception of being a burden to family members or others and the lack of a sense of belonging.

Saraf said it’s essential to listen – and talk – carefully to students struggling with adjustment or engaged in risky behavior. “It takes a family, a community, a village to keep everybody afloat,” Saraf said.

 – Carla Cantor