1. Carol Moss, MS - Mental Health Epidemiologist
Suicide in New Mexico New Mexico Public Health Association Annual Meeting Las Cruces, NM April 2, New Mexico Department of Health Epidemiology & Response Division
Jacalyn Dougherty, RN, PhD - Suicide Prevention Program Coordinator
Carol Moss, MS - Mental Health Epidemiologist

2. Topic Overview
Suicide and suicidal behaviors definitions & terminology
State suicide trend data
NMDOH’s Suicide Prevention Program
Resources

3. Definitions
Suicide: Death caused by self-directed injurious behavior with an intent to die as a result of the behavior.
Suicide attempt: Non-fatal, self-directed, potentially injurious behavior with an intent to die as a result of the behavior; might not result in injury.
Suicidal ideation: Thinking about, considering, or planning suicide.
Suicide-related behaviors: Thoughts and activities that may contribute or lead to suicide.
Source:
Consistent Definition is Important…
A large body of literature about suicide and suicide prevention exists, however, the usefulness of this information and the ability to interpret it is often questionable when definitions vary. Consistent data definitions allow researchers to better gauge the scope of the problem, identify high-risk groups, and monitor the effects of prevention programs and policies.

4. Pyramid of Suicidal Behaviors
Death by Intentional
Self-injury
Self-inflicted
injuries resulting in
hospitalizations or ED visits
Self-inflicted injuries resulting in
visits to primary care facilities
Self-inflicted injuries treated outside the
health system, not treated or not reported
Suicidal ideation and attempts that do not lead to injury
The suicide indicator is based on deaths, but this pyramid of suicidal behaviors shows other points along the way that we gather data and could potentially intervene prior to death. For e.g., a previous suicide attempt is an important risk factor for suicide, so we also have started to conduct surveillance of suicide attempts as well.

5. Terminology
Use “died by suicide” or “suicide death” rather than “committed” suicide
Avoid referring to people as their disease  use instead “person with depression” vs. “depressive”

6. Suicide Death Rates by Year, NM & U.S., 2008-2017
Suicide rates have been increasing in New Mexico and the U.S. over the past decade. New Mexico’s rate has consistently been more than 50% higher than the U.S. rate. In 2017, 491 New Mexicans died by suicide, an age-adjusted rate of 23.2 deaths/100,000 residents. Suicide was the 9th leading cause of death among New Mexico residents in Suicide accounted for 8.7% of all years of potential life lost before 75 years in NM. New Mexico had the fourth highest suicide rate in the U.S. in 2017.
Significant upward trend since 2009 for NM (‘15-’17 signif greater compared to ‘09). New Mexico suicide rates increased by 28.2% from
Sources: Centers for Disease Control and Prevention. Detailed Mortality data, Available at Accessed March 26, 2019; New Mexico Department of Health. Bureau of Vital Records and Health Statistics death data, New Mexico’s Indicator-Based Information System. Available at Accessed March 26, 2019.

7. U.S. Suicide Death Rates by State, 2017
Top 10 states are in most saturated red (rate= /100,000 pop., age-adjusted): 1. Montana (n=311); 2. Alaska (200); 3. Wyoming (157); 4. New Mexico (491); 5. Idaho (392); 6. Utah (663); 7. South Dakota (191); 8. West Virginia (393); 9. Arkansas (631); 9. Colorado (1,181)
¹The number of deaths per 100,000 total population. Source: Centers for Disease Control and Prevention. Suicide mortality by state. Available at Accessed March 26, 2019.

8. Suicide Death Rates by NM Counties, 2013-2017
(5-year rates for stability.) The suicide rate in those counties in the two darkest colors was at least 50% higher than the state’s average over this five-year period.
Source: New Mexico Department of Health. Bureau of Vital Records and Health Statistics death data, New Mexico’s Indicator-Based Information System. Available at Accessed March 26, 2019.

9. Suicide Death Rates by NM Public Health Region, 2017
The highest suicide rates in 2017 were in the Northeast (25.4 per 100,000 population) and Northwest (24.2 per 100,000 population) Public Health Regions. The Northeast Region had significantly higher suicide rates compared to the Metro Region.
Source: New Mexico Department of Health. Bureau of Vital Records and Health Statistics death data, New Mexico’s Indicator-Based Information System. Available at Accessed March 26, 2019.

10. Suicide Death Rates by NM Urban/Rural Counties, 2017
Rural counties (darkest red) had significantly higher suicide rates compared to metropolitan and small metro counties in 2017.
Darkest color (red) = Rural Counties (age-adjusted rate=31.0/100,000 pop.; n=29); dark orange = Mixed Urban/Rural Counties (rate=23.8/100,000); light orange = Small Metro Counties (rate=23.0/100,000); yellow = Metropolitan Counties (rate=22.1/100,000).
Source: New Mexico Department of Health. Bureau of Vital Records and Health Statistics death data, New Mexico’s Indicator-Based Information System. Available at Accessed March 26, 2019

11. Suicide Death Counts by Selected NM Counties, 2017
San Juan
n=37
Taos
n=14
McKinley
n=19
Santa Fe
n=42
Sandoval
n=22
Valencia
n=18
Bernalillo
n=161
Counts
Dona Ana
n=37
Eddy
n=16
Otero
n=24
Source: New Mexico Department of Health. Bureau of Vital Records and Health Statistics death data, New Mexico’s Indicator-Based Information System. Available at Accessed March 26, 2019

12. Suicide Death Rates by Year & Sex, NM, 2008-2017
M: signif upward trend since ’09 (compared to ‘15 and ’17); F: ns. In 2017, the suicide rate for men was more than three and one-half times that for women (M: n=382; F: n=109).
This was particularly true for Whites and AI/AN. For Hispanics, the male rate was more than 4½ times that of females. (A/PI: only 1 female; for AA: 6 males). The rate was highest for males 85 years and older and for females years old.
Source: New Mexico Department of Health. Bureau of Vital Records and Health Statistics death data, New Mexico’s Indicator-Based Information System. Available at Accessed March 26, 2019.

13. Suicide Death Rates by 3-year Moving Time Period & Race/Ethnicity, NM, 2008-2017
(3-year moving time periods for stability) Whites and American Indians continue to have the highest rates of suicide. (2017: Whites: n=266; Hispanic: n=175; AI/AN: n=41; A/PI: n=1; AA: n=6). From , rates among Whites increased 35% and rates among Hispanics increased 28.7%.
For Whites, the suicide rate was highest among those 45 years and older. For American Indians, the rate was highest among those years. Unstable rates: A/PI (all but ‘10-’12 and ‘11-’13); Black (‘09-’11 and ‘10-’12).
Source: New Mexico Department of Health. Bureau of Vital Records and Health Statistics death data, New Mexico’s Indicator-Based Information System. Available at Accessed March 26, 2019.

14. Suicide Death Rates by Year & Age Group, NM, 2008-2017
From , rates among those 65+ years increased significantly – by 60.9% – while rates among those years increased by 37.9%.
(2017: : n=99; 25-44: n=151; 45-64: n=136; 65+: n=105 [65-74: n=63; 75-84: n=27; 85+: n=15)
Source: New Mexico Department of Health. Bureau of Vital Records and Health Statistics death data, New Mexico’s Indicator-Based Information System. Available at Accessed March 26, 2019.

15. Suicide Deaths by Mechanism, NM, 2017
53% of those who died by suicide in 2017 used a firearm. Suicide rates by firearm have increased by 28.6% over the past decade.
The male firearm suicide rate in 2017 was more than six times higher than the female firearm suicide rate. The leading causes of suicide death among males were firearm, followed by suffocation and poisoning. The leading causes of suicide death among females were poisoning, followed by firearm and suffocation. The leading cause of suicide death among American Indians was suffocation, whereas firearm was the leading cause of death in all other racial/ethnic groups.
Firearm was the leading cause of suicide death across all age groups except among those years for which suffocation was the leading cause. Suffocation was the second leading cause of death among persons 15-54, whereas poisoning was the second leading cause of death among persons 55 years and older.
Source: New Mexico Department of Health. Bureau of Vital Records and Health Statistics death data, New Mexico’s Indicator-Based Information System. Available at Accessed March 26, 2019.

16. Suicide Death Rates by Year & Age Group, NM, 2008-2017
(Going back to a previous slide) focus on youth suicide rates: Rates among residents years showed the largest increase among age groups from
Source: New Mexico Department of Health. Bureau of Vital Records and Health Statistics death data, New Mexico’s Indicator-Based Information System. Available at Accessed March 26, 2019.

17. Youth Suicide Death Rates by Year & Age Group, NM, 2015-2017
10-14 yrs.: n=7; yrs.: n=41; yrs.: n= yr. rate: unstable.
Source: New Mexico Department of Health. Bureau of Vital Records and Health Statistics death data, New Mexico’s Indicator-Based Information System. Available at Accessed March 26, 2019.

18. Youth Suicide Death Rates by Year & Age Group, NM, 2015-2017
The rate of suicide death increased among youth from among all three age groups. The greatest increase was seen among those under 20. The rate in 2017 was 3½ times compared to 2016 among year olds and more than double among those years. The rate of increase among year olds was nearly 1½ times. (?13 Reasons Why debuted 3/31/17)
Source: New Mexico Department of Health. Bureau of Vital Records and Health Statistics death data, New Mexico’s Indicator-Based Information System. Available at Accessed March 26, 2019.

19. Youth Suicide Death Counts by Age Group & Sex, NM, 2017
Over all ages, many more males die by suicide compared with females, but this is not reflected in the youngest age group here.
77 males/22 females yrs.: n=7; yrs.: n=41; yrs.: n= yr. rate: unstable.
(Instability? 13 Reasons Why? debuted 3/31/17)
Source: New Mexico Department of Health. Bureau of Vital Records and Health Statistics death data, New Mexico’s Indicator-Based Information System. Available at Accessed March 27, 2019.

20. Youth Suicide Death Counts by Age Group & Race/Ethnicity, NM, 2017
Over all ages, many more Whites die by suicide, but this is not reflected in the two young adult age groups here.
15 AI/AN; 1 A/PI; 3 AA; 53 Hisp; 27 White. [10-14 yrs.: n=7; yrs.: n=41; yrs.: n=51.]
Source: New Mexico Department of Health. Bureau of Vital Records and Health Statistics death data, New Mexico’s Indicator-Based Information System. Available at Accessed March 27, 2019.

21. Youth Suicide Death Counts by Age Group & Mechanism, NM, 2017
Compared to all ages, many more youth suicide deaths are by suffocation (42% compared to 29% over all ages), while fewer deaths are by poisoning (6% compared to 13%) and firearm (47% compared to 53%) . (Jackie next)
Poisoning = 6; Suffocation = 42; Firearm = 46; Other = 5.
Source: New Mexico Department of Health. Bureau of Vital Records and Health Statistics death data, New Mexico’s Indicator-Based Information System. Available at Accessed March 27, 2019.

22. Mental Health Data Resource

23. Planning & Gatekeeper Training Resources
Question, Persuade, Refer Gatekeeper Trainings (for individuals and organizations)
DOH follows evidence-based strategies and recommendations published in 2017 by CDC.

24. DOH’s Suicide Prevention Program
Survey suicide and prevention efforts around the state
Promote evidence-based approaches consistent with principles of wise stewardship of funds and efforts
Establish and support a statewide Suicide Prevention Coalition
Develop a Strategic Plan for Suicide Prevention
Participate with Child Fatality Review Suicide Panel and id. suggestions to address system failures with prevention in mind
Promote and support policy initiatives related to suicide
Expand capacity to prevent suicide with partnerships

25. In summary, suicide …
is a multi-faceted, complex public health issue with various biopsychosocial components and
requires data to direct interventions and a comprehensive, evidence-based approach.
The primary goal of suicide prevention efforts is to …

26. Our most important message … Suicide is preventable!

27. Please call if you have any questions or comments.
Thank you!
Please call if you have any questions or comments.