Religion and Suicide: Mental Health Assessment and Treatment Practice Implications

Background and Purpose:

Religion impacts suicidality. Across history, religions have incorporated elements of life and death, and have exerted an influence on their followers understanding, perceptions, and behaviors related to suicide. This study examines the relationship between religion and suicide. One’s degree of religiosity can potentially serve as a protective factor against suicidal behavior. To accurately assess risk of suicide, it is imperative to understand the role of religion in suicidality. This study examines the current state of empirical knowledge regarding the relationship between religion and suicide. Specifically, the aims of this study include examining the suicide rates, and risk and protective factors for suicide across the following four religions: Christianity, Hinduism, Islam, and Judaism.

Methods:

PsycINFO, MEDLINE, SocINDEX, and CINAHL databases were searched for peer-reviewed published articles on religion and suicide between 2008 and 2017. The boolean search strategy and keywords included: religion, Christianity, Christian, Catholic, Catholicism, Judaism, Islam, Muslim, Hindu, or Hinduism; and attempted suicide, suicide, suicide prevention, or suicide risk and related mapped terms. Across the four electronic databases 1745 articles were yielded; after removing 472 duplicates, results totaled 1273 articles. The authors reviewed the abstracts and rejected 1192 articles including, resulting in a final total of 81 articles included in the review.

Results:

Research over the last decade has expanded our understanding of the complicated relationship between religiosity and suicidality. While it is now generally accepted that religion most often serves as a protective factor against suicide across religious denominations, there are aspects of religion that are now recognized as potentially representing a risk factor for increased suicide risk for some followers. Results identified the varying influence of religions on suicide ideation, attempts, and deaths across sociodemographic (e.g., gender, race/ethnicity) and clinical groups (e.g., psychiatric disorders). In addition, the identified risk or protective nature of religiosity varies by characteristics (e.g., age, diagnoses, etc.) across the dominant religions. However, it is important to recognize that these dominant religions are not homogenous groups, but comprise a multitude of sects and sub-groups, each with some shared central tenets but also with distinct interpretations and unique and differing religious customs.

Conclusion and Implications:

The relationship between an individual’s religiosity and suicidality is often minimized or ignored in clinical assessments. Despite the increase in attention that the role of religiosity has received over the last decade as a risk and/or protective factor for suicide, formal guidelines for including religious information in a suicide risk assessment have yet to be established.  A six-point general practice recommendation guideline is presented to guide clinicians in assessing and understanding the influence and impact of clients’ religiosity on their suicide risk. Also recommendations of further research is presented in the area of religion and suicidality to better understand the relationship between religiosity and gender, age, culture, and ethnicity.