Suicide The Silent Epidemic Kevin Thompson Director of Health Promotion Weber-Morgan Health Department

National Suicide Facts §Suicide took the lives of 30,622 Americans in §Suicide is the 11th leading cause of death in the United States. §For year olds, suicide is the third leading cause of death, 86% male, 14% female. §Suicide rates are higher than the national average in the intermountain states, including Utah, lower in the eastern and midwestern states.

National Suicide Facts §Suicide by firearms is the most common method for both men and women, accounting for 55% of all suicides. §Males are four times more likely to die from suicide than females. §72% of all suicides are committed by white men. §79% of all firearm suicides are committed by white men.

Attempted Suicides §In 2001, 132,353 individuals were hospitalized following suicide attempts, 116,639 were treated in emergency rooms and released. §There are an estimated 8-25 attempted suicides to one completion. §Women report attempting suicide during the lifetime about three times as often as men.

Youth Suicide in Perspective §Suicide is the third leading cause of death for adolescents and young adults. §Since peaking in the early 1990s, suicide rates have fallen sharply for most adolescents. §Within the past 12 months: l One in five adolescents seriously considered attempting suicide l One in six made a specific suicide plan l One in 12 attempted suicide §A typical U.S. high school classroom includes one boy and two girls who attempted suicide in the past year.

Suicide Among the Elderly §The highest suicide rates of any age group occur among persons aged 65 and older. §The elderly have a higher prevalence of depression, are more socially isolated, more frequently use highly lethal methods, make fewer attempts per completed suicide, have a higher male-to-female ration, have often visited a health- care provider before their suicide, and have more physical illnesses.

Suicide Among the Elderly §It is estimated that 20% of elderly persons who commit suicide visited a physician within 24 hours of their act, 41% within a week, and 75% within a month. §Firearms account for 71% of elderly suicide followed by overdose (11%) and suffocation (11%) §In 1998, men accounted for 84% of elderly suicides. Among males aged 75 years+ the rate for divorced men was 3.4 times and widowed men was 2.6 times that for married men.

Utah Suicide Facts §Utah has the 10th highest overall suicide rate in the U.S., 30% higher than U.S. rate. §Suicide is now the leading cause of death for males age in Utah. §Demographically similar to U.S., 88% occur among males, 64% by firearm. §While Nevada has the highest overall suicide rate, Utah, Montana and Wyoming have the highest youth suicide rates.

Risk Factors §Previous suicide attempts §Family history of suicide §History of mental disorders, particularly depression §History of alcohol and/or substance abuse §Family history of child maltreatment §Physical illness

Risk Factors §Loss of interest in once-pleasurable activities §Giving away cherished possessions §Morbid ideation §Feelings of hopelessness, helplessness and/or isolation §Unwillingness to seek help because of stigma §Cultural and religious beliefs

Risk Factors §Recent loss (relational, social, work, or financial) §Easy access to lethal methods §Local epidemics of suicide §Impulsive or aggressive tendencies §Barriers to accessing mental health services

Utah Youth Suicide Study Utah Dept. of Health, University of Utah College of Medicine, Primary Children’s Medical Center, Utah Suicide Prevention Task Force §“Psychological Autopsies” of 131 youth suicides cases l 65% had contact with the juvenile justice system l 41% had contact with DCFS l 21% had contact with Child Protective Services l 73% had contact with any agency l 47% had a past history of school suspension or expulsion l 39% had received a special education evaluation l 28% of school-age youth had dropped out of school

Utah Youth Suicide Study §Risk factors identified l Males are at higher risk l Contact with juvenile justice system increases risk 5 times l Behavioral problems in school increases risk l Intervention through DHS allows for earlier contact and possible prevention l High rate of co-morbid mental disorders among males (mood disorders, substance and/or alcohol abuse, conduct disorder)

Verbal Warning Signs “I am going to kill myself.” “I want to die.” “I can’t stand living anymore.” “Don’t worry about me, I won’t be around much longer “My family would be better without me.” “I’ve had enough; I am ending it all.”

Protective Factors §Effective clinical care for mental, physical, and substance abuse disorders. §Easy access to a variety of clinical interventions and support for help seeking. §Family and community support. §Skills in problem solving, conflict resolution and nonviolent handling of disputes. §Cultural and religious beliefs that discourage and support self-preservation instincts.

What to Do §Be direct. Talk openly and matter-of-factly about suicide. §Be willing to listen. Allow expressions of feelings. Accept the feelings. §Be non-judgmental. Don’t debate whether suicide is right or wrong, or feelings are good or bad. Don’t lecture on the value of life. Source: American Association of Suicidology

What to Do §Get involved. Become available. Show interest and support. §Don’t dare him or her to do it. §Don’t act shocked. This will put distance between you. §Don’t be sworn to secrecy. Seek support. Source: American Association of Suicidology

What to Do §Offer hope that alternatives are available but do not offer glib reassurance. §Take action. Remove means, such as guns or stockpiles pills. §Get help from persons or agencies specializing in crisis intervention and suicide prevention. Source: American Association of Suicidology