An in-depth look at suicide statistics in the United States

Before you can truly solve a problem, you have to have a better idea of what that problem is.

In my policy-making career, I’ve taken a long look at suicide reduction.  I’ve come to the conclusion that there is no one-size fits all approach; different demographics require different solutions.  We know there are certain groups more likely to commit suicide, and those groups require different interventions.

First, here’s a look at what the American Foundation for Suicide Prevention has found.  The basic statistics are tragic:

  • Suicide is the 10th leading cause of death in the United States.
  • 44,193 Americans die by suicide.  That’s an increase of 25% since 1999.
  • For every completed suicide, there are 25 attempts (Note: Terminology matters – “committed” or “successful” suicide have negative connotations, and “completed” suicide is a much more appropriate term).

Now, this is a broad overview.  Let’s take a closer look at these numbers in-depth.

Gender

According to the CDC:

Males take their own lives at nearly four times the rate of females and represent 77.9% of all suicides.

One of the reasons for this: Men are more likely to attempt suicide via a firearm, which is much less survivable than other suicide methods.  This is also despite the fact that women attempt suicide three times as often as men.

Race

In most mental health related fields, it is members of the minority community who are on the wrong end of the statistics.  That being said, for race, the reverse is true: Whites have the highest suicide rates of any ethnicity, followed by American Indians.  African Americans, Hispanics and Asians are well behind.

More research certainly needs to be done in this realm, but at least one researcher suggests that, “White older men, however, may be less psychologically equipped to deal with the normal challenges of aging, likely because of their privilege up until late adulthood.”

Age

While suicides have been increasing across all age groups, those of middle age (45-64) have the highest rates of suicide, followed by those 85 or older.

What is particularly striking and tragic is where suicide falls in terms of leading causes of death.  It is the 3rd highest cause of death for those 10-14 and 2nd for those between the ages of 15-24 and 25-34.

Method – and gun ownership

49.8% of all completed suicides result from firearms, with suffocation (26.8%) and poisoning (18.4%) as the next most used method.  It is important to note that there is a strong link between gun ownership and suicides.  Suicide rates are higher in states where there are high levels of gun ownership, and lower where there are low rates of gun ownership:

The lesson? Many lives would likely be saved if people disposed of their firearms, kept them locked away, or stored them outside the home. Says HSPH Professor of Health Policy David Hemenway, the ICRC’s director: “Studies show that most attempters act on impulse, in moments of panic or despair. Once the acute feelings ease, 90 percent do not go on to die by suicide.”

But few can survive a gun blast. That’s why the ICRC’s Catherine Barber has launched Means Matter, a campaign that asks the public to help prevent suicide deaths by adopting practices and policies that keep guns out of the hands of vulnerable adults and children. For details, visit www.meansmatter.org.

As I hope this entry has demonstrated, “suicide” should not be viewed as a monolithic disease or condition.  It varies from person to person, group to group.  We have to treat is as such, and ensure that any treatment effort addresses the many various demographics that suffer from suicidal idealization or attempts.

Google launches depression screening tool

I caught this over the weekend and found it to be very interesting: Apparently, Google has launched a tool that serves as a brief depression screening.

First, about the screening.  It is the PHQ-9, which is only nine statements.  It asks users to select the level of agreement with nine statements, ranging from “Not at all” to “Nearly every day.”  They include items like, “Little interest or pleasure in doing things” and “Feeling tired or having little energy.” The information can then be shared with the user’s health care provider and used to seek treatment.

This is noteworthy for many reasons.  The screening will pop up in the event that “depression related searches” are made, similar to the way that the number for the National Suicide Prevention Lifeline (1-800-273-8255) pops up for suicide related searches.  Given the prevalence of Google in modern life, this can, hopefully, help make people more aware of mental illness and steer them to treatment options.  This is also particularly important, given the spike in suicide-related Google searches.  That spike, incidentally, is tied to 13 Reasons Why on Netflix, a show I suspect I will be writing about in the future.

Indeed, I’d argue that the most significant reason that the availability of the depression questionnaire is important is because of the major rate of spikes in suicide that we are seeing.  Suicides are rising across the board, but particularly for young girls aged 15-24, who have seen suicide rates increase to 40 year highs.  Obviously, this is the generation that is the most technologically dependent, so increasing their awareness about mental illness and treatment options can be a very, very good and healthy thing.

As good of a thing as this is – and it really, really is a good thing – depression screenings are not without their problems.  There are some studies which report that versions of the PHQ can demonstrate “poor specificity in detecting major depression” or false positives.

That being said, for the sake of argument, let’s assume the absolute worst about the PHQ-9: That it leads to an unacceptably high amount of false positives for depression.  Google’s use of it is still a great:

  • First, false positives is very different than false negatives.  A single accurate, positive test about the PHQ-9 can steer people into treatment and give them the help that they so desperately need.
  • Second, it can help move positive views of mental illness in a positive direction.  Too many people still view mental illness as a weakness or something that can simply be conquered by willpower.  That, of course, isn’t the case anymore than a broken arm can be healed by well-wishes.  Having a source viewed as positively as Google advertise depression screenings can, hopefully, convince people of the importance of seeking treatment for mental health.

As always, I’d love to hear your thoughts.  Let us know in the comments!