In Harms Way: Suicide in America

Suicide is a tragic and potentially preventable publicyoung adults, with seven times as many deaths
health problem. In 2000, suicide was the 11th leadingamong men as among women.
cause of death in the U.S. Specifically, 10.6 out ofOlder Adults
every 100,000 persons died by suicide. The totalOlder adults are disproportionately likely to die by
number of suicides was 29,350, or 1.2 percent of allsuicide. Comprising only 13 percent of the U.S.
deaths. Suicide deaths outnumber homicide deaths bypopulation, individuals age 65 and older accounted for
five to three. It has been estimated that there may18 percent of all suicide deaths in 2000. Among the
be from 8 to 25 attempted suicides per every suicidehighest rates (when categorized by gender and race)
death. The alarming numbers of suicide deaths andwere white men age 85 and older: 59 deaths per
attempts emphasize the need for carefully designed100,000 persons, more than five times the national
prevention efforts.U.S. rate of 10.6 per 100,000.
Suicidal behavior is complex. Some risk factors varyAttempted Suicides
with age, gender, and ethnic group and may evenOverall, there may be between 8 and 25 attempted
change over time. The risk factors for suicidesuicides for every suicide death; the ratio is higher in
frequently occur in combination. Research has shownwomen and youth and lower in men and the elderly.2
that more than 90 percent of people who killRisk factors for attempted suicide in adults include
themselves have depression or another diagnosabledepression, alcohol abuse, cocaine use, and separation
mental or substance abuse disorder, often inor divorce. Risk factors for attempted suicide in
combination with other mental disorders. Also,youth include depression, alcohol or other drug use
research indicates that alterations indisorder, physical or sexual abuse, and disruptive
neurotransmitters such as serotonin are associatedbehavior. As with people who die by suicide, many
with the risk for suicide. Diminished levels of this brainpeople who make serious suicide attempts have
chemical have been found in patients with depression,co-occurring mental or substance abuse disorders.
impulsive disorders, a history of violent suicideThe majority of suicide attempts are expressions of
attempts, and also in postmortem brains of suicideextreme distress and not just harmless bids for
victims.attention. A suicidal person should not be left alone
Adverse life events in combination with other riskand needs immediate mental health treatment.
factors such as depression may lead to suicide.Prevention
However, suicide and suicidal behavior are not normalPreventive efforts to reduce suicide should be based
responses to stress. Many people have one or moreon research that shows which risk and protective
risk factors and are not suicidal. Other risk factorsfactors can be modified, as well as which groups of
include: prior suicide attempt; family history of mentalpeople are appropriate for the intervention. In
disorder or substance abuse; family history of suicide;addition, prevention programs must be carefully
family violence, including physical or sexual abuse;tested to determine if they are safe, truly effective,
firearms in the home; incarceration; and exposure toand worth the considerable cost and effort needed
the suicidal behavior of others, including familyto implement and sustain them.
members, peers, or even in the media.Many interventions designed to reduce suicidality also
Gender Differencesinclude the treatment of mental and substance abuse
Suicide was the eighth leading cause of death fordisorders. Because older adults, as well as women
males and the 19th leading cause of death forwho die by suicide, are likely to have seen a primary
females in 2000. More than four times as many mencare provider in the year prior to their suicide,
as women die by suicide, although women reportimproving the recognition and treatment of mental
attempting suicide during their lifetime about threedisorders and other suicide risk factors in primary
times as often as men. Suicide by firearm is the mostcare settings may be one avenue to prevent suicides
common method for both men and women,among these groups.
accounting for 57 percent of all suicides in 2000.Recently, the manufacturer of the medication
White men accounted for 73 percent of all suicidesclozapine received the first ever Food and Drug
and 80 percent of all firearm suicides.Administration indication for effectiveness in
Children, Adolescents, and Young Adultspreventing suicide attempts among persons with
In 2000, suicide was the third leading cause of deathschizophrenia. Additional promising pharmacologic and
among 15- to 24-year-olds-10.4 of every 100,000psychosocial treatments for suicidal individuals are
persons in this age group-following unintentionalcurrently being tested.
injuries and homicide. Suicide was also the 3rd leadingIf someone is suicidal, he or she must not be left
cause of death among children ages 10 to 14, with aalone. Try to get the person to seek help
rate of 1.5 per 100,000 children in this age group. Theimmediately from his or her doctor or the nearest
suicide rate for adolescents ages 15 to 19 was 8.2hospital emergency room, or call 911. It is also
deaths per 100,000 teenagers, including five times asimportant to limit the person's access to firearms,
many males as females. Among people 20 to 24medications, or other lethal methods for suicide.
years of age, the suicide rate was 12.8 per 100,000