Suicide The Silent Epidemic

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

2. National Suicide Facts • Suicide took the lives of 30,622 Americans in 2001. • Suicide is the 11th leading cause of death in the United States. • For 15-24 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.

3. 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.

4. 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.

5. 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: • One in five adolescents seriously considered attempting suicide • One in six made a specific suicide plan • 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.

6. 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.

7. 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.

8. Utah Suicide Facts • Utah has the 10th highest overall suicide rate in the U.S., 30% higher than U.S. rate. • Suicide is now theleading cause of death for males age 15-44 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.

9. 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

10. 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

11. 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

12. Utah Youth Suicide StudyUtah 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 • 65% had contact with the juvenile justice system • 41% had contact with DCFS • 21% had contact with Child Protective Services • 73% had contact with any agency • 47% had a past history of school suspension or expulsion • 39% had received a special education evaluation • 28% of school-age youth had dropped out of school

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

14. 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.”

15. 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.

16. 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

17. 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

18. 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