Suicide

Epidemiology: Suicide Morbidity and Mortality

Suicide rates can be examined from many perspectives—internationally, nationally, regionally, temporally, racially, by gender or age cohorts. More than 30,000 suicides occur every year in the United States and more than 80 suicides each day, or approximately 1 suicide every 16.7 minutes. In 2004, suicide was the 11th leading cause of death, while homicide was 15th. The rates are highest in persons over 80, and suicide is the third leading cause of death for youth ages 15–25 years. The rates are increasing for youth ages 10–14 years. Males and Caucasians are more likely to die by suicide than are females and other races. Firearms are the major method (50 percent) for completed suicide (hanging is second). In fact, each year there are more firearm suicides than firearm homicides. And sadly, U.S. soldiers involved in the Iraqi Freedom conflict are dying by suicide in increasing numbers, beyond average rates for military persons.

The Surgeon General's Report on ethnicity, race, and mental health underscored the significance of suicide in the major racial and ethnicity groups, including Asian, black, Caucasian, and Hispanic persons. The suicide rate for Native Americans is the highest next to whites, and suicide was the second leading cause of death for American Indians/Alaskan Natives in 1999–2004. Suicide is the eighth leading cause of death for Asian Americans/Pacific Islanders, in particular the elderly. The highest rates for blacks are among young males ages 20–24.

Somewhere between 8 and 25 suicide attempts occur for every death by suicide. The ratio of attempts to suicide deaths in adolescents is approximately 1 to 100–200. Females have the highest rate of suicide attempts, and the ratio of attempts by females versus males is 3:1. Approximately 650,000 persons receive treatment following an attempt each year. The most common method for attempts is overdose. The rates of attempts increase in the elderly. The risk for attempting suicide in blacks is highest among 15- to 24-year-olds. The Centers for Disease Control and Prevention 2005 Youth Risk Behavior Surveillance System surveyed high school students and determined the rates of suicidal behavior were highest in Hispanic youth, particularly Hispanic females.

Risk and Protective Factors Framework

The risk and protective factors framework helps explain, assess, and intervene with suicidal behavior. Risk or protective factors are characteristics or conditions that, when present, increase or decrease respectively the likelihood that persons will develop suicidal behavior. Risk and protective factors include individual, familial, psychological, or environmental domains. [Page 914]Examples of common suicide risk factors include the following: individual factors, such as gender, genetic vulnerability, chronic physical illness, and poor coping skills; family factors, such as severe marital discord, psychiatric disorders, suicide of a family member, and abuse and neglect; psychiatric factors, such as depression, substance use or abuse, and limited access to mental health services; and environmental factors, such as violence, poverty, racism, lack of social support, and access to highly lethal means of suicide. Protective factors include resilience, family ties, cultural and religious beliefs that discourage suicide and support self-preservation, culturally sensitive programs that strengthen family ties, tribal spiritual orientation, and specialized mental health and addictions treatment.

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