The first response most of us have to news of a suicide is: Why? While of course each instance of suicide is different, and while the reasons that people choose to take their own life are complex and individual, we should also broaden the question. Why tens of thousands of people? What is happening that so many people make this irrevocable choice? What are we missing in our culture? How can we open up the conversation on this issue to make other choices seem more realistic and appealing? In fact, we know more about suicide than our diminished national conversation about it would indicate. Front and center is that, even as many other causes of death are in decline, the rate of suicide is rising. This is especially true among the middle-aged. According to the American Foundation for Suicide Prevention (AFSP) in 2017, the highest suicide rate (20.2) was among adults between 45 and 54 years of age. The second highest rate (20.1) occurred in those 85 years or older. Younger groups have had consistently lower suicide rates than middle-aged and older adults. In 2017, adolescents and young adults aged 15 to 24 had a suicide rate of 14.46.

 

A few other numbers:

In 2017, the highest U.S. age-adjusted suicide rate was among Whites (15.85) and the second highest rate was among American Indians and Alaska Natives (13.42). Much lower and roughly similar rates were found among Black or African Americans (6.61) and Asians and Pacific Islanders (6.59).

 

In 2017, firearms were the most common method of death by suicide, accounting for a little more than half (50.57%) of all suicide deaths. The next most common methods were suffocation (including hangings) at 27.72% and poisoning at 13.89%.

 

In the U.S., no complete count of suicide attempt data is available. The CDC gathers data from hospitals on non-fatal injuries from self-harm as well as survey data.

In 2015, (the most recent year for which data are available), approximately 575,000 people visited a hospital for injuries due to self-harm.

Based on the 2017 National Survey of Drug Use and Mental Health it is estimated that 0.6 percent of the adults aged 18 or older made at least one suicide attempt. This translates to approximately 1.4 million adults. Adult females reported a suicide attempt 1.4 times as often as males. Further breakdown by gender and race are not available.

Based on the 2017 Youth Risk Behaviors Survey, 7.4 percent of youth in grades 9-12 reported that they had made at least one suicide attempt in the past 12 months. Female students attempted almost twice as often as male students (9.3% vs. 5.1%). Black students reported the highest rate of attempt (9.8%) with white students at 6.1 percent. Approximately 2.4 percent of all students reported making a suicide attempt that required treatment by a doctor or nurse. For those requiring treatment, rates were highest for Black students (3.4%).

 

 

We also know a great deal about the strong connection between suicide and mental illness. In fact, around 90 percent of those who commit suicide suffer from a mental illness of some kind at the time of their death — quite often an untreated one. The connection between suicide and substance abuse is also quite strong. Of those who die by suicide, more than one in three is found to be intoxicated from drugs or alcohol at the time. In one study, among adults who’d had a major depressive episode in the past year, those who had also binged on drugs or alcohol were more likely to have had thoughts of suicide and make attempts than those who hadn’t. Unfortunately, even though we know depression and mental illness are deeply intertwined with suicide, we still don’t treat them as the public-health issues that they are. Since 1986 spending for mental health, while increasing in raw terms, has still remained only 1 percent of the economy, even as overall health spending has risen.  So the need is there, but it’s not being met. As the Washington Post‘s Sarah Kliff reported, it’s harder to get access to a mental-health provider than it is for any other kind of medical doctor, with over 89 million Americans living in what the federal government considers a “Mental Health Professional Shortage Area.” One of the primary reasons for this is the stigma still surrounding both mental illness and suicide. This is a very costly silence, and one that has a daily body count attached to it. Only 25 percent of adults with mental-health issues believe people are generally caring and sympathetic to those with mental-health problems. So one thing we can do — in addition to demanding increased funding and access for mental-health services — is to try to find ways to increase real connection and engage with those who may feel isolated, cut loose and hopeless. And one way to do that is to put the spotlight on mental-health issues.

 

NOTE:  Losing someone to suicide or struggling with a mental illness can feel like no one understands what you are going through. Unlike other illnesses, it is difficult to look at someone and know their connection. The Out of the Darkness Community Walk is a journey of remembrance and a walk that unites a community – a time to acknowledge the ways in which suicide and mental illness have affected our lives and our loved ones. Bost C.A.R.E.S. is a proud sponsor of the 2019 River Valley Out of the Darkness Walk taking place in Fort Smith on Saturday, October 12. For more information regarding the Out of the Darkness Walk visit: https://afsp.donordrive.com.

 

AFSP’s latest data on suicide are taken from the Centers for Disease Control and Prevention (CDC) Data & Statistics Fatal Injury Report for 2017. Suicide rates listed are Age-Adjusted Rates.