September kicks off Suicide Awareness Month with Sept. 6 through Sept. 12 marking National Suicide Prevention Week and Sept. 10 being World Suicide Prevention Day.
The awareness and prevention reminders are needed. Suicide is the fourth leading cause of death for ages 35 to 54 and the second for ages 10 to 34, and the suicide rate increased 33 percent from 1999 through 2017, according to a March 2019 report by the American Psychological Association. Now with the COVID-19 pandemic affecting all aspects of our lives, it isn’t hard to imagine those numbers climbing.
“There's little data yet on the COVID-19 pandemic and its impact on the suicide rate,” the Mayo Clinic reports. “But clearly the pandemic has added intense emotional and mental stress to the lives of people around the world. Fear, anxiety, and depression can stem from a wide range of concerns and experiences, from personal and family issues to work-related stress.”
The American Association of Suicidology held its 2020 Suicide Prevention Summit in late August to discuss this concerning trend with breakout sessions that included “Suicide in Schools: Prevention and Intervention,” “Suicide: Why Are Older ‘White’ Men So Vulnerable?” and “Moving America’s Soul on Suicide: 988 and Integrated Crisis Response Services and Supports.”
Ten mental health professionals led the conversations, including Dr. Jonathan B. Singer from Loyola University Chicago, Dr. Silvia Sara Canetto from Colorado State University, and Dr. Stacey Freedenthal from the University of Denver.
“If we want a world where people feel like their lives are worth living, we can’t have a society that says that some lives are worth more than others,” Dr. Singer quoted in his presentation “Suicide in Schools: Prevention and Intervention.”
“The COVID-19 pandemic has exposed the enormous inequities in our society that put particularly black and brown folks at greater risks of health disparities than white folks,” he continued. “And one of the places where this is not often discussed is in the intersection of mental health and schools.
“It’s not that nobody talks about it. It is just in suicide prevention we tend to think about suicide risk assessment, prevention programs, intervention and postvention as being generic. And there have been some folks who have criticized this and they have criticized it and have been right.”
Dr. Singer set out to shine a light on how the COVID pandemic and the racial uprising have highlighted some of the most important issues related to suicide prevention as related to the intersection of health, suicide, and equity. He also set out to dispel myths and led with a quote by Jerry Reed before delving into data that painted a disturbing picture: “Behind every statistic is a tear.”
“This is particularly true when we’re thinking about youth who have died by suicide,” added Dr. Singer.
Dr. Singer pointed out that youth suicide rates among the ages 10 to 24 has gone up and down since 1999, but starting in 2007, they started a steady rise that increased fairly steeply in 2016. As far as 2018, which is the most recent stats available, that rate has risen to 10.3 per 100,000. Yet, this is an average number. If we look at suicide death among minority youth, the number can be lower but is often higher than the average.
For example, in 2018, the youth suicide rate for Black people between the ages of 10 and 24 was 7.5 per 100,000 compared to White people at 11 per 100,000, while Native Americans and Alaskan Natives topped 17.8 per 100,000, according to dates by the Centers for Disease Control Injury Control reports.
He claimed the myth is “suicide is a ‘White people problem.’” “The fact is,” he said, “suicide kills people of all races and ethnicities.”
Another myth he dispelled is “people who are suicidal are weak.” In fact, “people are suicidal despite enormous strength and courage.”
Dr. Singer highlighted 14 problems that occured with suicide death between the ages of 10 and 24. School problem, argument or conflict, intimate partner problem, and family relationship problem were the most often cited. Crisis preceding or upcoming in a two-week period topped the list.
A few tips for parents included:
- Restrict access to lethal means
- Technology isn’t bad but youth watching videos about self-harm or how to kill themselves isn’t good.
- If you see your child as the problem, keep in mind that family-based therapy is often a good solution.
Dr. Canetto delved into why older White men in the U.S. are so vulnerable to suicide. In the U.S., suicide rates are higher among older adults compared to other age groups. The dominant theory, she pointed out, is that it is higher due to a response to the losses and adversities of aging. She quoted Dr. Louis Dublin’s Ageist Theory of Older Adult Suicide: “With advancing years. . . . forced changes become more difficult and disturbing. Impairments are accumulated, particularly of chronic and painful diseases. Many older people suffer from . . . feelings of loneliness and futility as relations with family and friends and productive work drop off. Economic insecurity is often a serious problem.
“It is not strange that some old people wish to shake off the infirmities and the boredom of an unsatisfactory existence.”
But the fact that the suicide rate is higher among older White men creates what she called a “gender paradox” because they are the most socially and economically privileged as a group. They are also less exposed than women or ethnic minority men to the aging losses and adversities. Fewer older men suffer from chronic disease and disabilities compared to older women. They are less likely to live alone or experience poverty.
One dominant theory, she said, is that older adults’ high rate of suicide is a result of depression. Yet this creates a mental health paradox since older adults report more emotional well-being and stability than younger adults. Major depression is also less prevalent in older adults.
Dr. Canetto said to understand the high rate of suicide among older adult White men, you have to look at cultural factors. “A cultural perspective has been used to understand suicidal behavior in developing countries or among ethnic minorities in industrialized countries, but is rarely applied to examining suicidal behavior among dominant groups in industrialized countries.
“The failure to examine suicidal behavior in dominant groups (e.g., European-American men) from a cultural perspective implies that culture is something “others” have, and perpetuates the myth that the experience of European-American men is generic and universally generalizable.”
The Cultural Script Theory of Suicidal Behavior offers an answer. “The likelihood that someone responds to a life event or an adversity with suicidal behavior is related, among other things, to cultural factors, including the social meaning and permissibility of suicidal behavior, in relation to that event,” Dr. Canetto said.
Or in layman terms: In the U.S., White people believe that suicide by old people is more permissible than suicide by young people.
Sometimes, in fact, older White men who kill themselves are depicted as “macho.” Take, for example, gonzo journalist Hunter S. Thompson whose 2005 suicide went viral: “He was going to go out with a bang.” “He was going to go out on his own terms on his own time.” “He died… as he planned… with a single, courageous… gunshot.”
“Suicides in European-descent older men could be prevented by ‘challenging the indignities-of-aging suicide script, as well as the belief that suicide is a masculine response to aging,” Dr. Canetto said.
Suicide prevention based on this Script Theroy includes:
- Challening the normalization of older adult suicide
- Challenging the normlization of suicide under ill health conditions
- Challenging the normality of male suicide
Here are 5 steps to take, according to the National Institute of Mental Health, if you know someone in emotional pain:
- ASK: “Are you thinking about killing yourself?” It’s not an easy question but studies show that asking at-risk individuals if they are suicidal does not increase suicides or suicidal thoughts.
- KEEP THEM SAFE: Reducing a suicidal person’s access to highly lethal items or places is an important part of suicide prevention. While this is not always easy, asking if the at-risk person has a plan and removing or disabling the lethal means can make a difference.
- BE THERE: Listen carefully and learn what the individual is thinking and feeling. Research suggests acknowledging and talking about suicide may in fact reduce rather than increase suicidal thoughts.
- HELP THEM CONNECT: Save the National Suicide Prevention Lifeline number (1-800-273-TALK) and the Crisis Text Line (741741) in your phone so they’re there if you need them. You can also help make a connection with a trusted individual like a family member, friend, spiritual advisor, or mental health professional.
- STAY CONNECTED: Staying in touch after a crisis or after being discharged from care can make a difference. Studies have shown the number of suicide deaths goes down when someone follows up with the at-risk person.
For more information on suicide prevention, please visit nimh.nih.gov/health/topics/suicide-prevention.