Thursday, 27 June 2019

Suicide Rates Are Rising, But Nobody Really Knows Why

Suicide rates appear to be at all-time highs, with the latest research suggesting rates are one-third higher than they were in 1999.

Among people ages 16 through 64, the rate of suicide climbed from about 10 per 100,000 to 14 per 100,000 people. That’s a significant increase during a period of time where, by all outward measures, stigma about mental health issues and depression has been significantly decreasing. More than ever, it is safe and people are encouraged to talk about — and seek help for — a mental health concern.

So why this significant rise in the suicide rate?

Thoughts of suicide are usually a serious, often un-diagnosed symptom of clinical depression. For some, these thoughts turn into devising a plan and even making an attempt. People who die by suicide are usually suffering from depression and aren’t getting adequate — or in some cases, any — treatment for it. People who have been unsuccessful in dying by suicide say they usually immediately regretted having tried, because it really is a permanent solution to a transient emotional state.

According to the U.S. Centers for Disease Control and Prevention (CDC), however, 54% of Americans who died by suicide had no known mental disorder diagnosis. It could be that the person simply never saw a healthcare or mental health professional in order to be diagnosed. It could also be indicative that not all suicidal thoughts occur in the context of a mental illness.

Experts are hard-pressed for scientific data that could explain the rise. Instead, we have to turn to hypotheses and correlations. But these are really nothing more than educated guesses.

The latest data come from the CDC in a study released earlier this month. It built upon data from a similar CDC report released last year that showed rates for suicide had climbed 25% from 1999 to 2016.

In response to that study released last year, the BBC had this to say, suggesting that perhaps the lack of access to timely, adequate mental health care might explain some of the rise:

Prof Julie Cerel, president of the American Association of Suicidology, noted that having better reporting standards could account for some of the increase, but also pointed to a lack of adequate funding for mental health research and preventative care.

“Our mental health systems are just really struggling across the country,” Prof Cerel says. “In terms of training mental health professionals, we’re not doing a great job.”

As of 2018, only 10 states mandate suicide prevention training for health professionals.

Others have suggested that perhaps it’s also due to the economic downturn which began in 2008 and lasted through most of 2016. If true, however, such an explanation doesn’t really help us understand the rise in suicide rates during the period before the economic downturn.

A study in early 2019 of over 85,000 youths found an even more disturbing trend. Those researchers found that from 2007 through 2016, the increase in the rate of suicide for girls ages 10 to 14 was highest, rising by nearly 13% since 2007. The rate also rose for boys, but only by 7%.

The researchers concluded:

Following a downward trend in suicide rates for both sexes in the early 1990s, increasing rates of youth suicide since 2007 have been associated with an accelerated narrowing of the gap between male and female rates, with the largest percentage increase in younger female individuals. These trends were observed across all regions in the United States.

Tween and teenage girls are especially at risk. And this, to me, tells us something important.

Why Are Suicide Rates Going Up?

In this era of being able to talk far more freely about mental health issues than ever before in the history of humanity, it’s unimaginable that this openness hasn’t translated into more people seeking help for suicidal thoughts.

If I’d have to guess — since that seems all that we’re capable of doing right now — I’d say it was a combination of factors that has led to this increase. One factor is that while stigma has reduced around mental health issues, access to adequate mental health care has arguably actually declined since 1999. Despite laws trying to protect people’s access to such care, I believe the declining population of psychiatrists and others interested in going into the mental health profession has contributed to significant challenges in most parts of the country in actually obtaining care and services.

Second, the specific increase in young girls attempting suicide is concerning. Young girls are particularly vulnerable to social pressures during this age period (10 to 14 years old), as they are developing their own sense of self, worth, and self-identity. Combined with an increased use of social media compared to boys, technology may actually be playing a more harmful role in their lives than anyone has yet realized.

Third, political divisions in our country have never been more rancorous or stronger. Combined with a weak economy during much of this time period, we may not yet be seeing the positive effects of a recovering economy fully playing themselves out in families. The opioid epidemic may also be partially to blame for this increase in rates, since it was in full swing when data in 2016 and 2017 were collected.

In short, I wouldn’t be surprised that there is a complex multitude of factors that contribute to this increased rate of suicide among Americans. We can hope that many of these factors — such as the reduction of the opioid epidemic, a recovering economy, and efforts to increase recruitment of new mental health professionals — are heading in the right direction and may impact future suicide rates.

At least we can hope.

 

Suicidal? If you’re thinking of suicide, please call toll-free the National Suicide Prevention Lifeline at 800-273-8255 or text HOME to 741741 any time, day or night. Afraid that someone you know may be contemplating suicide? Talk to them — talking about it doesn’t increase the risk of it occurring.

 

References

National Center for Health Statistics. (2019). Suicide Rates for Females and Males by Race and Ethnicity: United States, 1999 and 2017.

Ruch DA, Sheftall AH, Schlagbaum P, Rausch J, Campo JV, Bridge JA. Trends in Suicide Among Youth Aged 10 to 19 Years in the United States, 1975 to 2016. JAMA Netw Open. Published online May 17, 20192(5):e193886. doi:10.1001/jamanetworkopen.2019.3886

Image: BBC



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