US Suicide Rates Display Growing Geographic Disparity.

JAMA.
2017;317(16):1616. doi:10.1001/jama.2017.4076

As the overall US suicide rate increases, a CDC study showed that the trend toward higher rates in less populated parts of the country and lower rates in large urban areas has become more pronounced.

Using data from the National Vital Statistics System and the US Census Bureau, the researchers reported that from 1999 to 2015, the annual suicide rate increased by 14%, from 12.6 to 14.4 per 100, 000 US residents aged 10 years or older.

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Higher suicide rates in less urban areas could be linked with limited access to mental health care, the opioid overdose epidemic, and social isolation, the investigators suggested. The 2007-2009 economic recession may have caused the sharp upswing, they added, because rural areas and small towns were hardest hit.

The article is here

Why Suicide Keeps Rising for Middle-Aged Men

By Lisa Esposito
US News and World Report
Originally published Oct. 19, 2016

Suicide rates in the U.S. continue to rise, and working-age adults – particularly men – make up the largest increase, according to the Centers for Disease Control and Prevention. Middle-aged men in the 45 to 60 range experienced a 43 percent increase in suicide deaths from 1997 to 2014, and the rise has been even sharper since 2005. Untreated mental illness, the Great Recession, work-related issues and men's reluctance to reach out for help converge to put them at greater risk for taking their own lives. And because men are more likely than women to use a gun, their suicide attempts are more often fatal.

Historically, suicide rates have always been higher for men, says Dr. Alex Crosby, surveillance branch chief in the CDC's Division of Violence Prevention. "But what we've seen in these past few years is rates have been going up among males and females," he told journalists attending a National Press Foundation conference in September. "Still, rates are higher among males – about four times higher." For suicide attempts that don't prove fatal, the balance changes, with two to three times more females than males trying to take their own lives.

"In about half of the suicides in the United States, the mechanism or the method was a firearm," Crosby says. Males are more likely to use firearms, while poison is more common for females. However, he notes, "When you look at suicide in the military, females choose firearms almost as much as men."

The article is here.

With Guns, Suicide Is the Biggest Problem

By Sarah Wickline
MedPage Today
Originally posted April 11, 2014

Every day, 88 people die from firearm-related injury; two-thirds of those deaths are suicides, a high proportion of which are committed by seniors and individuals living in rural areas, researchers reported here.

"Mass shooting episodes are obviously horrible," Molly Cooke, MD, president of the American College of Physicians (ACP), told reporters in a press briefing. "But one of the points we make in the paper is that every day there are 88 firearms-related deaths."

The entire article is here.

Wall Street Is Not a Death Trap

By Sally L. Satel
Bloomberg News
Originally posted March 31, 2014

After the suicides of eight people in the global financial sector over six months, investment banks have come under pressure to pay more attention to the mental health of their employees. The high-stress, competitive environment -- with its unpredictably punishing workweeks -- are seen as creating the conditions for pushing some people over the edge.

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In answer to the question raised in a recent Fortune magazine article, no, there isn't a suicide contagion on Wall Street. Rather, the handful of suicides, tragic as each one is, involved the segment of the population most at risk: white men, particularly over 50.

The entire article is here.

Suicide prevention efforts grow in statehouses

By Maggie Clark

USA Today

Originally published September 13, 2013

Here are some excerpts:

Every day, more than 100 people commit suicide in the U.S. Suicide is the second-leading cause of death for people between the ages of 25 and 34, and the third-leading cause of death among those between 15 and 24. Between 2008 and 2010, there were twice as many suicides as homicides, according to the Suicide Prevention Resource Center. Still, in many areas of the country, suicide-prevention efforts are virtually nonexistent.

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Restricting access to guns for suicidal people may well help to reduce suicides, said Dr. Richard McKeon, chief of the suicide prevention branch of the U.S. Substance Abuse and Mental Health Services Administration, but it's not the only thing that can work.

"What's needed is a comprehensive approach to suicide prevention using multiple interventions, not just one," McKeon said. That could include restricting weapons access, training or building general awareness, he said.

The entire article is here.

Risk Factors Associated With Suicide in Current and Former US Military Personnel

Cynthia A. LeardMann, MPH, et al.
JAMA. 2013;310(5):496-506. doi:10.1001/jama.2013.65164.

Importance

Beginning in 2005, the incidence of suicide deaths in the US military began to sharply increase. Unique stressors, such as combat deployments, have been assumed to underlie the increasing incidence. Previous military suicide studies, however, have relied on case series and cross-sectional investigations and have not linked data during service with post service periods.

Objective  

To prospectively identify and quantify risk factors associated with suicide in current and former US military personnel including demographic, military, mental health, behavioral, and deployment characteristics.

Design, Setting, and Participants

Prospective longitudinal study with accrual and assessment of participants in 2001, 2004, and 2007. Questionnaire data were linked with the National Death Index and the Department of Defense Medical Mortality Registry through December 31, 2008. Participants were current and former US military personnel from all service branches, including active and Reserve/National Guard, who were included in the Millennium Cohort Study (N = 151 560).

One of the Conclusions

Despite universal access to health care services, mandatory suicide prevention training, and other preventive efforts, suicide has become one of the leading causes of death in the US military in recent years. Suicide rates across the population of active-duty US military personnel began to increase sharply in 2005 from a baseline rate of 10.3 to 11.3 per 100 000 persons to a rate of 16.3 per 100 000 persons in 2008, with the highest rates among Marine Corps and Army personnel (19.9 and 19.3 per 100 000 persons). Since 2009, suicide rates among those on active-duty status have stabilized at approximately 18 per 100 000.

The entire article is here.

A Simple Way to Reduce Suicides

By Ezekiel J. Emanuel
The New York Times - Opinionator
Originally published June 2, 2013

EVERY year about a million Americans attempt suicide. More than 38,000 succeed. In addition, each year there are around 33,000 unintentional deaths by poisonings. Taken together, that’s more than twice the number of people who die annually in car accidents.

The tragedy is that while motor vehicle deaths have been dropping, suicides and poisonings from medications have been steadily rising since 1999. About half of suicides are committed with firearms, and nearly 20 percent by poisoning. A good way to kill yourself is by overdosing on Tylenol or other pills. About 90 percent of the deaths from unintentional poisonings occur because of drugs, and not because of things like household cleaners or bleach.

There is a simple way to make medication less accessible for those who would deliberately or accidentally overdose — and that is packaging.

We need to make it harder to buy pills in bottles of 50 or 100 that can be easily dumped out and swallowed. We should not be selling big bottles of Tylenol and other drugs that are typically implicated in overdoses, like prescription painkillers and Valium-type drugs, called benzodiazepines. Pills should be packaged in blister packs of 16 or 25.

The entire opinion piece is here.

As Suicides Rise in U.S., Veterans Are Less of Total

By JAMES DAO
The New York Times
Published: February 1, 2013

Suicides among military veterans, though up slightly in recent years, account for a shrinking percentage of the nation’s total number of suicides — a result of steadily rising numbers of suicides in the general population, according to a report released on Friday by the Department of Veterans Affairs.

The report, based on the most extensive data the department has ever collected on suicide, found that the number of suicides among veterans reached 22 a day in 2010, the most recent year available.

That was up by 22 percent from 2007, when the daily number was 18. But it is only 10 percent higher than in 1999, according to the report. Department officials described the numbers as “relatively stable” over the decade.

In the same 12-year period, the total number of suicides in the country rose steadily to an estimated 105 a day in 2010, up from 80 in 1999, a 31 percent increase.

As a result, the percentage of the nation’s daily suicides committed by veterans declined to 21 percent in 2010, from 25 percent in 1999.

The entire story is here.

U.S. officials launch new strategy to prevent suicide

Reuters
Originally published September 10, 2012

A new nationwide strategy to prevent suicides, especially among U.S. military veterans and younger Americans, is tapping into Facebook, mobile apps and other technologies as part of a community-driven push to report concerns before someone takes his own life.

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The initiative includes $55.6 million in grant funding for suicide prevention programs.

Suicide is a growing concern and results in the deaths of more than twice as many people on average as homicide, officials said.

On average, about 100 Americans die each day from suicide, officials said. More than 8 million U.S. adults seriously thought about suicide in the last year, according to the Substance Abuse and Mental Health Services Administration.

The entire story is here.

Suicide: The fourth-leading cause of American deaths abroad

By Gary Stoller
USA Today
Originally published May 4, 2012

Tom Miller jumped from the eighth floor of a hotel in the Philippines in February, and Gerhard Habel hanged himself in his apartment in Thailand last April.

These incidents aren't entirely unrelated. Suicide by an American in a foreign country is a more common occurrence than might be thought. It's the fourth-leading cause of death abroad from non-natural causes after road accidents, homicides and drowning, according to the Centers for Disease Control and Prevention.

The deaths of Miller and Habel stand out, though, because they were reported to the media by local police, and some information about the tragedies was made public.

Though more than 125 American suicides abroad are reported annually to the State Department, there is no public profile of most who commit the tragic act. For privacy reasons, the State Department will not provide victim information such as name, age, gender or addresses abroad.

"The travel medicine community could take preventative steps if there was more knowledge about risk factors and circumstances of those individuals who are committing suicide abroad," says Stephen Hargarten, director of the Injury Research Center at the Medical College of Wisconsin.

The entire story is here.