(June 13, 2018) Suicide is the 10th leading cause of death across all age-groups, with suicide rates increasing 30% since 1999 and half of states experiencing an increase in suicide of more than 30% during that time period. There were 44,965 deaths by suicide in the United States in 2016, almost 20% of all injury-related deaths, according to new data released from the Centers for Disease Control and Prevention (CDC) last week.
Factors contributing to suicide risk are extremely complex and can include mental illness as well as a host of other factors including substance misuse or financial instability. New data from the CDC indicates that more than half of people who died by suicide in 2016 had no known mental health disorder at the time of death. As the CDC so rightly states, however, "it is possible that mental health conditions or other circumstances could have been present and not diagnosed, known, or reported."
Of the total suicide deaths in 2016, 10.3% of individuals had a diagnosed serious mental illness, according to a 27-state sample analysis conducted by the CDC. Extrapolated to the entire United States, this indicates that approximately 4,649 individuals with schizophrenia or bipolar disorder died by suicide in 2016.
Suicide risk by firearms or other means
A new research article published in Psychiatric Services this month supports the CDC data while highlighting the importance of caution when drawing broad conclusions from any one-time results.
Jennifer Boggs and authors analyzed 2,674 non-adolescent suicides and 267,000 controls of patients of health care systems that are part of the Mental Health Research Network, a network of health care systems that provide both general medical and mental health care to more than three million Americans. Through a complex statistical analysis of matching suicide cases to controls, Boggs and authors were able to determine different risk factors for suicide, including the risk for suicide by firearms or other means.
Individuals with schizophrenia had significantly higher rates of suicide compared to the general population by the largest magnitude than any other mental or physical health condition. The odds varied by means, individuals with schizophrenia had much higher odds of suicide by other means as compared to firearms. The following is a sample of the findings from the study:
- The odds of suicide by other means is 24-times higher for individuals with schizophrenia; 10-times higher for suicide by firearms.
- The odds of suicide by other means is 23-times higher for individuals with bipolar disorder; 8-times higher for suicide by firearms.
- The odds of suicide by other means is 12-times higher for individuals with depression; 8-times higher for suicide by firearms.
- The odds of suicide by other means is 3-times higher for individuals with epilepsy; 3-times higher for suicide by firearms.
The authors found that the odds of having a mental illness or substance use disorder is significantly less among suicide cases with firearms when compared to suicide cases by other means. This is despite the fact that approximately 50% of all suicides occur by firearms and that 63% of all firearm injuries in the United States are self-inflicted. However, this does not imply that the contribution of mental illness to suicide risk in the United States is insignificant. Rather, the results show that individuals with serious mental illness have more than a 20-times higher risk of suicide compared to the general population.
Conclusions
The results from these two studies indicate that untreated severe mental illness is a significant factor contributing to the rising rates of suicide in the United States. Steps need to be taken to reverse this trend that include ensuring access to timely and effective treatment for individuals with the most severe psychiatric disorders.
Elizabeth Sinclair
Director of Research
References:
- Boggs, J. et al. (2018, June). General medical, mental health, and demographic risk factors associated with suicide by firearm compared with other means. Psychiatric Services.
- Stone, D. M. et al. (2018, June). Vital signs: Trends in state suicide rates —United States, 1999–2016 and circumstances contributing to suicide —27 states, 2015. Centers for Disease Control and Prevention.