Suicide is the 8th leading cause of death in the U.S., with approximately 11 suicides occurring per 100,000 people. Annually, there are approximately twice as many suicides nationally as homicides and firearms are used in 58% of all suicides.
The typical profile of a suicide completer or attempter is classically a person experiencing mental health problems such as severe depression who has poor coping skills and feelings of helplessness and hopelessness. Many are abusers of drugs and alcohol used for self-medication. People experiencing suicidal ideations are most often socially isolated from their peers, have no familial or social support systems, feel estranged from the mainstream and have recently experienced the loss of an intimate relationship. They also have a lethal means to accomplish their “death act.”
In the case of the Parkland, FL, school shooting suspect Nikolas Cruz, the psychological profile developing is quite like a suicide completer. It is interesting to note that 40% of active shooters end their event by suicide or by “suicide by cop.” Cruz is reportedly in the other 60%; police say he had a plan to escape and evade capture, it just didn’t work.
The objective of the assessment of verbal and written communication and behavioral indicators and stressors is to see the warning signs when they are being communicated; and to judge how close the person is at risk of suicide or violence to others. Such communications and behaviors are alarms that sound out to others to, “Notice me!” “I’m in trouble!” “I need help!” It is important to remember that the methods of both active shooters and suicide are determined by both availability to a means of lethality and the personality of the individual.
The psychiatric professional or law enforcement first responder assessing a suspected perpetrator of violence or a subject with suicidal intent should pay attention to the subject’s presentation of signs and symptoms of psychiatric disorders, with particular attention to mood disorders such as primary major depressive disorders, mixed episodes, schizophrenia, severe anxiety with panic and agitation, and personality disorders.