doctor assessing brain mri scans

For those who are working to reverse the rising rates of suicide in the United States and throughout the rest of the world, one of the greatest challenges is identifying which individuals are most likely to their own lives – and now, recent research suggests brain scans may offer a potential solution for this problem and help us accurately identify people with elevated suicide risk.

Continued advances in neuroimaging have allowed professionals to gain greater insights into both the structure and function of the human brain. Among their many potential benefits, these advances offer the hope that some day clinicians will be better able to treat people who have anxiety, depression, schizophrenia, and many other mental health disorders.

Experts also hope that neuroimaging may lead to improved outcomes for people who have an elevated risk of suicide.

Why This Research Is Important

Suicide prevention begins with awareness and education. Unfortunately, even after extensive efforts to teach people about the warning signs that someone may be thinking about ending their life, the suicide rate remains troublingly high.

While these types of efforts have surely saved lives, the harsh reality is that decades of data have not led to substantial improvements in detecting and assessing suicide risk. This lack of progress was noted in a meta-analysis of more than 360 prior studies into suicide risk factors.

In a press release that announce the publication of this report, one of its lead authors said that the dearth of progress in this essential area was “humbling.”

“Suicidal thoughts and behaviors are among the most common, deadly and potentially preventable public health problems,” said Joseph Franklin, PhD. “[Yet] despite major advances in medical and psychological science, the devastating impact of this problem has remained constant for at least several decades.”

Franklin added that, at the time his report was published, science-based efforts to predict suicide performed no better than random guesses would.

“In other words, a suicide expert who conducted an in-depth assessment of risk factors would predict a patient’s future suicidal thoughts and behaviors with the same degree of accuracy as someone with no knowledge of the patient who predicted based on a coin flip,” he said.

The Scope of the Problem

The ability to more accurately identify people who are at risk of suicide could have a monumental impact in the United States and throughout the rest of the world.

For example, the American Foundation for Suicide Prevention (AFSP) has reported the following about suicide in the U.S.

Suicide in 2021

  • The U.S. recorded 48,183 deaths by suicide in 2021. This averages out to 132 suicide deaths each day, or more than five suicide deaths per hour.
  • Experts estimate that there were more than 1.7 million suicide attempts in the U.S. in 2021. This number is equal to about 0.7% of the U.S. population age 18 and older.
  • In 2021, the age-adjusted suicide rate in the U.S. was 14.04 per 100,000 people. This represents an increase from 2020, when the suicide rate was 13.48 per 100,000, but it is lower than the all-time high of 14.23 per 100,000, which was recorded in 2018.

To underscore the degree to which all people are at risk of suicide, The Jason Foundation provided the following about the suicide risk among young people in the U.S.

Suicide Among Youth and Young Adults

  • Suicide is the second leading cause of death for adolescents aged 12-18.
  • Among younger adults in the 18-22 age range, suicide is the third leading cause of death.
  • An average of more than 3,700 high school students (grades 9-12) attempt suicide every day.

Of course, suicide is not only an American problem. The International Association for Suicide Prevention (IASP) provided the following data about the global impact of suicide.

Suicide: Worldwide Statistics

  • Every year, more than 700,000 people throughout the world die by suicide.
  • In 2019, suicide accounted for 1.3% of all deaths.
  • Suicide is the fourth leading cause of death for people aged 15-29.
  • About 58% of all suicide deaths involve people who are age 49 or younger.

As the information in this section indicates, an improved ability to identify (and intervene with) people who are considering suicide could potentially prevent hundreds of thousands of deaths ever year.

Though the science has not yet progressed to the point where it can offer such widespread benefits, initial results from brain scan studies suggest that experts may someday be able to accomplish this feat.

Assessing Suicide Risk Among Trauma-Exposed Veterans

In August 2023, the Journal of Affective Disorders published a report on the use of functional neuroimaging to detect brain abnormalities in people who have an elevated risk of suicide. This research, which was conducted by a team from Boston University, was also the focus of a May 2023 article on the BU website.

Features of this research effort included the following:

  • The study’s subjects were military veterans who had histories of trauma exposure.
  • The subjects underwent functional magnetic resonance imaging (fMRI) tests to assess connectivity between brain regions while they were at rest.
  • During one- and two-year follow-up assessments, the researchers conducted additional brain scans on subjects who reported having attempted suicide.

The researchers were able to compare the brain scans of these subjects before and after their suicide attempts. They could also compare these scans with those of a control group of veterans who also had depression and/or PTSD, but who had not attempted suicide.

These comparisons allowed the researchers to identify connectivity differences in two areas of the brain (the right amygdala and right middle temporal gyrus) that may indicate that a person has an increased risk of suicide.

Perhaps most significantly, the research group noted that the change in the right amygdala was detectable only in the scans of veterans who reported a suicide attempt – but it could be seen in scans taken both before and after the attempt.

“Our study provides evidence that this brain connectivity marker may be identifiable before a suicide attempt, suggesting that it could help identify those at risk for suicide,” the study’s lead author, Audreyana Jagger-Rickels, said in the BU article. “This could also lead to new treatments that target these brain regions and their underlying functions.”

Detecting Suicidal Thoughts in Young Adults

The August 2023 study that we discussed in the previous section is far from the first research effort to evaluate the brains of people who may be at risk of ending their own lives. To summarize some of this prior research, an international team analyzed 21 studies that had been conducted through the ENIGMA (Enhancing Neuroimaging Genetics through Meta Analysis) consortium.

This effort led to the discovery of a connection between the surface area of the brain’s frontal pole and a history of attempted suicide. Individuals whose frontal poles had smaller surface area, the researchers reported, had a greater likelihood of attempted suicide.

“By harmonizing neuroimaging data from research groups worldwide, we found that a deficit in the surface area of the frontal pole was related to actual (non-interrupted and non-aborted) suicide attempts in young people with mood disorders, which we interpret may represent a preexisting vulnerability to suicide attempts,” they wrote.

In a September 2022 article about their research, the team’s lead author, Laura S. van Velzen, noted that the surface area differences her team identified are relatively minor, but her team’s work could lead to major developments in the effort to prevent suicide.

“The structural brain differences that we found were very subtle, which means that most people with a history of suicidal behaviors have brains that are not very different from people without a history of suicidal behaviors, which is reassuring,” van Velzen said. “However, the subtle differences that we found … may eventually provide important targets for the next generation of more effective suicide prevention strategies.”

Preventing Suicides Today: Brain Scans and Suicide Risk

The neuroimaging research we discuss in this article suggests that mental health professionals may one day be able to identify and treat suicidal ideation and use brain scans to predict suicide risk in individuals, whether they’re victims of trauma or present with no mental health disorders or concerns whatsoever.

But what happens between now and this yet-to-be-determined future date?

How can concerned friends and family members help loved ones who may be thinking about suicide?

Here are three tips that can help.

Suicidality: Communication and Timely Support

  • Talk about the problem: If you suspect that someone in your life has been considering suicide, express your concerns to them and emphasize your love and support. Contrary to an unfortunately persistent myth, talking to someone about suicide will not prompt them to take their own life. In fact, reaching out to someone who may be secretly struggling with suicidal ideation may demonstrate to them that they are not alone, that someone cares, and that they have a reason to continue living.
  • Contact the 988 Suicide & Crisis Lifeline: If you live in the United States, you can reach the Lifeline by dialing 988 from any phone or by visiting Trained professionals who can assess your concerns and connect you or your loved one with appropriate resources near you operate these phone lines.
  • Seek professional treatment: Suicidal thoughts and behaviors are often (but not always) symptoms of an underlying mental health disorder. Someone who has been experiencing suicidal ideation should complete an assessment with a trained professional who can recommend appropriate treatment options. With the right type and level of care, people can learn to manage their symptoms and reduce their suicide risk.

If you or someone that you care about has been experiencing suicidal thoughts as a result of a complex mental health concern, Crownview Psychiatric Institute may have the solutions you are seeking. To learn more about how we can help you or your loved one, please visit our Contact Us page or call our center today.