An Unexpected Ending: Robin Williams' Suicide Heightens Mental Health Awareness

The best comment health care professionals can make about celebrity deaths is that they heighten suicide awareness.

To many, Robin Williams’ suspected suicide is incongruous with his bubbling public persona. Yet, the famed actor’s suicide is not necessarily an unexpected ending when considering the entire man.

Williams was forthright about his risk factors for suicide, including major depressive disorder and alcoholism. He was also approaching membership into the group at the highest risk for suicide: men aged older than 65. According to the US Centers for Disease Control and Prevention (CDC), approximately 30 men per 100,000 in this age group complete suicide annually. White men over the age of 65 are 3 times more likely to commit suicide than all Americans, 8 times more likely to kill themselves than women of the same age, and twice as likely to commit suicide than male contemporaries in other ethnic groups, the CDC reports.

Although Williams was best known for his entertaining roles, he also narrated an informative and enlightening documentary for the Discovery Channel, titled “Curiosity: Your Body on Drugs.” In this reality-based demonstration of how cocaine, marijuana, heroin, and methamphetamine users differ in real-world ways, Williams used his acting skills to teach science and health care delightfully, visually, and accurately.

Undoubtedly, Williams’s clinicians asked the right suicide assessment questions, such as:

• Do you have thoughts about taking your life?
• Do you have a plan to take your life?
• Have you ever attempted suicide?

Unfortunately, the sensitivity and specificity of these questions is low. Regardless, some confluence of factors caused Williams emotional pain so great and hopelessness so vast that only one solution presented itself.

Some mental health researchers believe the severity of psychiatric illness influences suicidal thinking, and the duration of such illness may also be a factor in suicide attempts. Comorbid mood disorders can increase the risk of suicide tremendously, and the decision to commit suicide is undoubtedly dependent on mood state, as well as psychological and neurocognitive factors.

A lab test that can help identify suicide risk is needed, as some researchers believe polyamines will someday be useful biomarkers to predict suicide risk. Until the health care community has a better understanding of all of these influences, the only tools available are constant vigilance, appropriate medication with effective antidepressants or mood stabilizers, and therapy. Even with these instruments, however, suicide still happens.

Heroin users are much harder to spot and treat than methamphetamine addicts — a point raised by Williams in the aforementioned documentary and underlined by the 2 recent deaths of celebrities Phillip Seymour Hoffman and Cory Monteith. The best comment health care professionals can make about these celebrity deaths is that they heighten awareness.

Although it is never easy to lose the ones we love to suicide, it serves as a reminder to review risk factors, be vigilant, and continue the quest to determine why people take their own lives.