In its May 3, 2013 Morbidity and Mortality Weekly Report, the Centers for Disease Control and Prevention (CDC) announced that more people now die of suicide than motor vehicle accidents. In 2010 there were 33,687 deaths from motor vehicle crashes and 38,364 suicides. From 1999 to 2010, the suicide rate among Americans ages 35 to 64 rose by nearly 30 percent, to 17.6 deaths per 100,000 people, up from 13.7. Although suicide rates are growing among both middle-aged men and women, far more men take their own lives. The suicide rate for middle-aged men was 27.3 deaths per 100,000, while for women it was 8.1 deaths per 100,000. The largest increases were seen among men in their 50s, a group in which suicide rates jumped by nearly 50 percent, to about 30 per 100,000. For women, the largest increase was seen in those ages 60 to 64, among whom rates increased by nearly 60 percent, to 7.0 per 100,000.
This is an alarming increase. In the early 1950’s, when little was known about suicide prevalence and education on suicide was sparse, the CDC (Communicable Disease Center, now known as the Centers for Disease Control and Prevention) began tracking suicide trends in the United States based on autopsy reports by coroners and medical examiners. Stigma and lack of reporting mandates likely led to an under-reporting of prevalence. Still—at an average of 17.7/100,000— the reported rates in 1950 were the highest on record.
Throughout the last four decades suicide rates in the U.S. declined dramatically. By the year 2000, suicide levels were at the lowest in reported history at 13.1/100,000. A focus on educating mental health providers and the public, increased access to treatment, and campaigns focused on de-stigmatizing mental illness may have led to this decline. Research also indicates that a decline in suicide reporting due to decreased autopsy rates may have resulted in misclassification of suicides, thus lowering the rate. Even taking all of this into account, suicide rates have begun to increase in recent years.
Here are some sobering facts:
- Among 15- to 24-year olds, suicide accounts for 20% of all deaths annually.
- Suicide rates for females are highest among those aged 45-54 (rate 9 per 100,000).
- Suicide rates for males are highest among those aged 75 and older (rate 36 per 100,000).
- The rate of suicide for adults aged 75 years and older was 16.3 per 100,000.
- The prevalence of suicidal thoughts, suicide planning, and suicide attempts is significantly higher among young adults aged 18-29 years than among adults aged ≥30 years.
- Suicide is the third leading cause of death among persons aged 15-24 years, the second among persons aged 25-34 years, the fourth among person aged 35-54 years, and the eighth among person 55-64 years.
- 12.8% of students in grades 9-12 reported that they made a plan about how they would attempt suicide during the 12 months preceding the survey;
- 7.8% of students reported that they had attempted suicide one or more times during the 12 months preceding the survey.
- 2.4% of students reported that they had made a suicide attempt that resulted in an injury, poisoning, or an overdose that required medical attention
- Of students in grades 9-12, significantly more Hispanic female students (13.5%) reported attempting suicide in the last year than Black, non-Hispanic female students (8.8%) and White, non-Hispanic female students (7.9%).
Several factors may be leading to the increase in suicide rates, with economic factors being among the most likely. As people find themselves with mounting debt and facing the loss of jobs and/or housing, a sense of hopelessness may increase.. In many cases, alcohol or drug use increases as a short term (and ineffective) coping mechanism. The combination of depression and hopelessness mixed with substance abuse can prove deadly. In fact, in nearly 90% of all suicides, the individual has a diagnosis of a mental illness and was using alcohol or other drugs or both.
As mental health providers, we need to be concerned about this change. There’s more education about mental health, more access to treatment – and yet more people are choosing to take their own lives. It’s critical we educate ourselves on how to accurately assess for suicide risk, and know what to do when we detect that the risk is high.
In future blogs, we will discuss ways clinicians can more accurately assess for suicide risk and what families can do if they’re worried about a loved one.
Contributed by Kirk Woodring, LICSW Vice President of Clinical Services