In Harm’s Way: Suicide in America
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(Source NIMH website 1/04)
Suicide is a tragic and
potentially preventable public health problem. In 2000, suicide was the 11th
leading cause of death in the U.S. Specifically, 10.6 out of every 100,000
persons died by suicide. The total number of suicides was 29,350, or 1.2
percent of all deaths. Suicide deaths outnumber homicide deaths by five to
three. It has been estimated that there may be from eight to 25 attempted
suicides per every one suicide death. The alarming numbers of suicide deaths
and attempts emphasize the need for carefully designed prevention efforts.
Suicidal behavior is complex.
Some risk factors vary with age, gender and ethnic group and may even change
over time. The risk factors for suicide frequently occur in combination.
Research has shown that more than 90 percent of people who kill themselves have
depression or another diagnosable mental or substance abuse disorder, often in
combination with other mental disorders. Also, research indicates that
alterations in neurotransmitters such as serotonin are associated with the risk
for suicide. Diminished levels of this brain chemical have been found in
patients with depression, impulsive disorders, a history of violent suicide
attempts, and also in postmortem brains of suicide victims.
Adverse life events in combination with other risk factors such as depression may lead to suicide. However, suicide and suicidal behavior are not normal responses to stress. Many people have one or more risk factors and are not suicidal. Other risk factors include: prior suicide attempt; family history of mental disorder or substance abuse; family history of suicide; family violence, including physical or sexual abuse; firearms in the home; incarceration; and exposure to the suicidal
behavior of others, including
family members, peers, or even in the media.
Gender Differences
Suicide was the 8th
leading cause of death for males and the 19th leading cause of death for
females in 2000. More than four times as many men as women die by suicide,
although women report attempting suicide during their lifetime about
three times as often as men. Suicide by firearm is the most common method for
both men and women, accounting for 57 percent of all suicides in 2000. White
men accounted for 73 percent of all suicides and 80 percent of all firearm
suicides.
Children, Adolescents, and Young Adults
In 2000, suicide was the 3rd
leading cause of death among 15- to 24-year-olds—10.4 of every 100,000 persons
in this age group—following unintentional injuries and homicide. Suicide was
also the 3rd leading cause of death among children ages 10 to 14,
with a rate of 1.5 per 100,000 children in this age group. The suicide rate for
adolescents ages 15 to 19 was 8.2 deaths per 100,000 teenagers, including five
times as many males as females. Among people 20 to 24 years of age, the suicide
rate was 12.8 per 100,000 young adults, with seven times as many deaths among
men as among women.
Older Adults
Older adults are
disproportionately likely to die by suicide. Comprising only 13 percent of the
Attempted Suicides
Overall, there may be between eight and 25 attempted suicides for every suicide death; the ratio is higher in women and youth and lower in men and the elderly. Risk factors for attempted suicide in adults include depression, alcohol abuse, cocaine use, and separation or divorce. Risk factors for attempted suicide in youth include depression, alcohol or other drug use disorder, physical or sexual abuse, and disruptive behavior. As with people who die by suicide, many people who make serious suicide attempts have co-occurring mental or substance abuse disorders. The majority of suicide attempts are expressions of extreme distress and not just harmless bids for attention. A suicidal person should not be left alone and needs immediate mental health treatment.
Prevention
Preventive efforts to reduce
suicide should be based on research that shows which risk and protective
factors can be modified, as well as which groups of people are appropriate for
the intervention. In addition, prevention programs must be carefully tested to
determine if they are safe, truly effective, and worth the considerable cost
and effort needed to implement and sustain them.
Many interventions designed to
reduce suicidality also include the treatment of mental and substance abuse
disorders. Because older adults, as well as women who die by suicide, are
likely to have seen a primary care provider in the year prior to their suicide,
improving the recognition and treatment of mental disorders and other suicide
risk factors in primary care settings may be one avenue to prevent suicides
among these groups. Improving outreach to men
at risk for suicide is a major challenge in need of
investigation.
Recently, the manufacturer of the medication clozapine received the first ever Food and Drug Administration indication for effectiveness in preventing suicide attempts among persons with schizophrenia. Additional promising pharmacologic and psychosocial treatments for suicidal individuals are currently being tested.
If someone is
suicidal, he or she must not be left alone. Try to get the person to seek help
immediately from his or her doctor or the nearest hospital emergency room, or
call 911. It is also important to limit the person's access to firearms,
medications, or other lethal methods for suicide.
For More Information about Mental Illnesses- Contact
The
NAMI of Greater
Phone: 312-563-0445
Document created: TP
1/04