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Suicide in the Southwest Health Planning Region, 2003-2008

Suicide in the Southwest Health Planning Region, 2003-2008. Marc E. Leslie Coordinator, Virginia Violent Death Reporting System Office of the Chief Medical Examiner, Virginia Department of Health The Southwest Health Planning Region Suicide Prevention Summits May 10, 2011 Abingdon, VA

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Suicide in the Southwest Health Planning Region, 2003-2008

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  1. Suicide in the Southwest Health Planning Region, 2003-2008 Marc E. Leslie Coordinator, Virginia Violent Death Reporting System Office of the Chief Medical Examiner, Virginia Department of Health The Southwest Health Planning Region Suicide Prevention Summits May 10, 2011 Abingdon, VA May 11, 2011 Roanoke, VA

  2. Map of the Southwest Health Planning Region (HPR)

  3. Pop Quiz In the Southwest Health Planning Region: • Average number of suicides per year? (Hint: average of 60 homicides per year). • Percentage of suicide victims who are White males? • Median age of a suicide victim? • Percentage of male and female suicides by firearm?

  4. Suicide in the Southwest HPR, 2003-2008 Overview of the Problem

  5. Suicide in the Southwest HPR, 2003-2008

  6. Suicide in the Southwest HPR, 2003-2008

  7. Suicide in the Southwest HPR, 2003-2008 Suicide vs. Homicide (2003-2008) • 1,263 suicides; rate of 16.0 • 357 homicides; rate of 4.5 • Suicide occurs 3.6 times more often than homicide

  8. Suicide in the Southwest HPR, 2003-2008

  9. Suicide in the Southwest HPR, 2003-2008

  10. Suicide in the Southwest HPR, 2003-2008 Who is at Risk?

  11. Suicide in the Southwest HPR, 2003-2008 Selected Demographic Elements • Gender • Race • Age

  12. Suicide in the Southwest HPR, 2003-2008 Race and Gender • Male (81%, rate of 26.6) • White (94%, rate of 17.4) • White male (76%, rate of 28.7) (remember, overall rate for Southwest HPR is 16.0)

  13. Suicide in the Southwest HPR, 2003-2008 Age • Median age is 46 • Ages 35-44 most common age group (20%) and highest rate (23.7) • Next highest rates for those 75-84 (rate of 22.2) and 45-54 (rate of 21.8)

  14. Suicide in the Southwest HPR, 2003-2008

  15. Suicide in the Southwest HPR, 2003-2008 Race and Gender: Non-Fatal Attempts • Most commonly by females (59%, rate of 96.1) • Whites still most common and highest risk; but Black risk level rises notably (from rate of 7.3 to 57.5)

  16. Suicide in the Southwest HPR, 2003-2008

  17. Suicide in the Southwest HPR, 2003-2008 Age: Non-Fatal Attempts • Median age is 35 • Risk increases greatly for most age groups, especially those under age 64 • 15 times increase for those ages 15-19 • Rate for those 35-44 years old is 163.4 • In general, non-fatal attempt rate decreases with age

  18. Suicide in the Southwest HPR, 2003-2008 At ages 65-74, the fatal rate surpasses the non-fatal rate

  19. Suicide in the Southwest HPR, 2003-2008 Veterans

  20. Suicide in the Southwest HPR, 2003-2008 • Veterans • 22% of all suicide victims (18 years and older) • 22% of males; <1% of all females • Unknown if veterans served in combat, but can generally tell if they are currently in the military

  21. Suicide in the Southwest HPR, 2003-2008 • Veterans • Male veterans older than male non-veterans (median ages of 62 and 43, respectively) • Median age suggests that those who are combat veterans generally not in the most recent conflicts • 58% of males ages 65 and over are veterans compared to 19% of males ages 18-64

  22. Suicide in the Southwest HPR, 2003-2008 Method of Fatal Injury

  23. Suicide in the Southwest HPR, 2003-2008 Method of Fatal Injury • More than one method of fatal injury can be used per suicide (e.g., combining poison and drowning) • Firearm, poison, and hanging/suffocation account for 96% of suicides • Most poisons are prescribed medications, primarily mental health medications and pain medications

  24. Suicide in the Southwest HPR, 2003-2008

  25. Suicide in the Southwest HPR, 2003-2008 Method of Fatal Injury: Non-Fatal Attempts • Most common method for non-fatal attempts is poison (85%) • Poison use is defining method difference between fatal and non-fatal attempts

  26. Suicide in the Southwest HPR, 2003-2008 Geography

  27. Suicide in the Southwest HPR, 2003-2008 Geography • Southwest HPR has 40 localities (29 counties and 11 cities) • 36 of these localities (90%) have a suicide rate exceeding the rate for Virginia (11.3) • In general smaller locality = lower number and higher rate

  28. Suicide in the Southwest HPR, 2003-2008

  29. Suicide in the Southwest HPR, 2003-2008

  30. Suicide in the Southwest HPR, 2003-2008

  31. Suicide in the Southwest HPR, 2003-2008 Selected Circumstances

  32. Suicide in the Southwest HPR, 2003-2008 Most Common Circumstances • Mental health problem (44%) • Crisis in past two weeks (42%) • Intimate partner problem (33%) • Problem with alcohol and/or other substances (23%) • Physical health problem (23%)

  33. Suicide in the Southwest HPR, 2003-2008 Circumstances: Mental Health • Females (62%) more than males (40%) • Most prevalent in ages 45-54 (50%); 20% or more of every age group • 78% treated in past two months and/or prior • 56% known to take mental health medications currently or in the past* *2007-2008 data

  34. Suicide in the Southwest HPR, 2003-2008 Circumstances: Crisis in Past 2 Weeks • 42% of all persons; 43% of males, 39% of females • Most crises (63%) occurred in the past 24 hours* • Indicator of reactive suicides • 50% or more for every age group through ages 25-34 *2007-2008 data

  35. Suicide in the Southwest HPR, 2003-2008 Circumstances: Intimate Partner Problems • 33% having problems with current/former intimate partner at time of suicide • Similar for males and females • 76% also having a recent life crisis • Shows volatility of intimate partner conflict

  36. Suicide in the Southwest HPR, 2003-2008

  37. Suicide in the Southwest HPR, 2003-2008 Circumstances: Alcohol and Other Substance Problems • 23% of all persons • Peaks at ages 25-34 (36%) • 61% of those with alcohol problems had elevated levels of alcohol in their system (compared to 14% of those without alcohol problems)

  38. Suicide in the Southwest HPR, 2003-2008 Circumstances: Physical Health Problems • 23% of all suicide victims; 23% of males, 20% of females • Median age of 64 compared to 43 for those without a physical health problem • 50% or more of those age 65 and older

  39. Suicide in the Southwest HPR, 2003-2008 Circumstances: Physical Health Problems • Explains majority of elder suicides • Problems range from treatable (diabetes, mild pain) to severe (loss of vision, amputations) to terminal diseases and conditions

  40. Suicide in the Southwest HPR, 2003-2008 Circumstances: Warning Signs • 43% disclosed intent and/or had prior attempts • Most commonly disclosed to family (49%), intimate partners (37%), or friends/acquaintances (16%)* *2007-2008 data

  41. Suicide in the Southwest HPR, 2007-2008 Actions Taken to Prevent Suicide* • Limited access to firearms/ammunition (42%) • Tried to persuade victim to not commit suicide (33%) • Called 911/law enforcement (17%) • Sought/encouraged mental health treatment (13%) • Checked in on victim (4%) *2007-2008 data (entire slide)

  42. Suicide in the Southwest HPR, 2007-2008 Efforts to Limit Access to Firearms and/or Ammunition* • 13 persons had friends or family members who restricted access to firearms or ammunition • Includes 3 persons not known to disclose intent, but loved ones acted out of concern • Variety of techniques used to restrict (hiding, removing, disassembling) • Of these persons, 11 (85%) used a firearm to commit suicide • *2007-2008 data (entire slide)

  43. Suicide in the Southwest HPR, 2003-2008 In the fatal suicide, those with prior attempts used less lethal methods than those without prior attempts

  44. Suicide in the Southwest HPR, 2007-2008 Other Warning Signs of Suicide* • Taking prescribed pain medication (11%) • Sleeping too little (4%) • Unusual behavior, past two weeks (4%) • Family history of suicide (3%) • Family/friends expected suicide (1%) *2007-2008 data (entire slide)

  45. Suicide in the Southwest HPR, 2003-2008 Conclusions • Suicide rates are highest among Whites, males, and middle-aged adults • Most suicides involve use of a firearm to inflict fatal injury • A large proportion of suicide victims have a mental health problem, and most of these persons were being treated

  46. Suicide in the Southwest HPR, 2003-2008 Conclusions • 43% of suicide victims talk about plans or desire to commit suicide and/or have a history of suicide attempt(s) • Fatal suicide and non-fatal suicide attempts present different pictures of risk and methods of fatal injury

  47. Questions, Data Requests, Further Information Marc Leslie, VVDRS Coordinator 737 N. 5th Street, Suite 301 Richmond, VA 23219 804-205-3855 marc.leslie@vdh.virginia.gov http://www.vdh.virginia.gov/medExam/NVDRS.htm Our goal is to provide data and information that can be used for prevention and education; please let me know how I can help

  48. Appendix: Additional Information and Complete Tables

  49. Suicide in the Southwest HPR, 2003-2008 Index: Fatal Suicide

  50. Suicide in the Southwest HPR, 2003-2008 Index: Non-Fatal Suicide

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