The Problem

* Suicide took the lives of 29,350 Americans in 2000.1

* More people die from suicide than from homicide. In 2000, there were 1.7 times as many suicides as homicides.1

* Overall, suicide is the 11th leading cause of death for all Americans, and is the third leading cause of death for young people aged 15-24.1

* Males are more than four times more likely to die from suicide than are females.1 However, females are more likely to attempt suicide than are males.2

* 1999, white males accounted for 72% of all suicides. Together, white males and white females accounted for over 90% of all suicides.1 However, during the period from 1979-1992, suicide rates for Native Americans (a category that includes American Indians and Alaska Natives) were about 1.5 times the national rates. There was a disproportionate number of suicides among young male Native Americans during this period, as males 15-24 accounted for 64% of all suicides by Native Americans.3

* Suicide rates are generally higher than the national average in the western states and lower in the eastern and midwestern states.4

* 57% of suicides in 2000 were committed with a firearm.1

Suicide Among the Elderly

* Suicide rates increase with age and are highest among Americans aged 65 years and older. The ten year period, 1980-1990, was the first decade since the 1940s that the suicide rate for older residents rose instead of declined.5

* Men accounted for 84% of suicides among persons aged 65 years and older in 2000.1

* From 1980-1998, the largest relative increases in suicide rates occurred among those 80-84 years of age. The rate for men in this age group increased 17% (from 43.5 per 100,000 to 52.0).1,6

* Firearms were the most common method of suicide by both males and females, 65 years and older, in 2000, accounting for 79.5% of male and 37% of female suicides in that age group.1

* Suicide rates among the elderly are highest for those who are divorced or widowed. In 1992, the rate for divorced or widowed men in this age group was 2.7 times that for married men, 1.4 times that for never-married men, and over 17 times that for married women. The rate for divorced or widowed women was 1.8 times that for married women and 1.4 times that for never-married women.6

* Risk factors for suicide among older persons differ from those among the young. Older persons have a higher prevalence of depression, a greater use of highly lethal methods and social isolation. They also make fewer attempts per completed suicide, have a higher-male-to-female ratio than other groups, have often visited a health-care provider before their suicide, and have more physical illnesses.7

Suicide Among the Young

* Persons under age 25 accounted for 15% of all suicides in 2000.1 From 1952-1995, the incidence of suicide among adolescents and young adults nearly tripled. From 1980-1997, the rate of suicide among persons aged 15-19 years increased by 11% and among persons aged 10-14 years by 109%. From 1980-1996, the rate increased 105% for African-American males aged 15-19.1,8

* For young people 15-24 years old, suicide is the third leading cause of death, behind unintentional injury and homicide. In 1999, more teenagers and young adults died from suicide than from cancer, heart disease, AIDS, birth defects, stroke, and chronic lung disease combined.1

* Among persons aged 15-19 years, firearm-related suicides accounted for more than 60% of the increase in the overall rate of suicide from 1980-1997.1

* The risk for suicide among young people is greatest among young white males; however, from 1980 through 1995, suicide rates increased most rapidly among young black males.9 Although suicide among young children is a rare event, the dramatic increase in the rate among persons aged 10-14 years underscores the urgent need for intensifying efforts to prevent suicide among persons in this age group.

CDC's Efforts in Suicide Prevention

The National Center for Injury Prevention and Control (NCIPC) is working to raise awareness of suicide as a serious public health problem and is focusing on science-based prevention strategies to reduce injuries and deaths due to suicide. Current activities include the following:

* The Surgeon General's Call To Action introduces a blueprint for addressing suicide - Awareness, Intervention, and Methodology (AIM), an approach derived from the collaborative deliberations of the 1st National Suicide Prevention Conference participants. As a framework for suicide prevention, AIM includes 15 key recommendations that were refined from consensus and evidence-based findings presented at the Reno conference.

* The Institute of Medicine released a report entitled Reducing Suicide: A National Imperative. The report contains four recommendations from The Committee on Pathophysiology and Prevention of Adolescent and Adult Suicide which examined the state of the science base, gaps in our knowledge, strategies for prevention, and research designs for the study of suicide. The report reflects different perspectives and levels of analysis, and is precisely what policy makers need to do to advance the science and improve health and social perspectives. The project was funded by the Centers for Disease Control and Prevention, the National Institute of Mental Health, the National Institute on Drug Abuse, the National Institute on Alcohol Abuse and Alcoholism, the Substance Abuse and Mental Health Services Administration, and the Veterans Administration. Views in this report are those of the Institute of Medicine Committee on Pathophysiology and Prevention of Adolescent and Adult Suicide and are not necessarily those of the funding agencies. The report is available for viewing or purchase on the National Academy Press website.

* National Strategy for Suicide Prevention: Goals and Objectives for Action
www.mentalhealth.org/suicideprevention/
The National Strategy for Suicide Prevention creates a framework for suicide prevention for the Nation. The Goals and Objectives for Action articulate a set of 11 goals and 68 objectives, and provides a blueprint for action.

* Reporting on Suicide: Recommendations for the Media
www.afsp.org/education/newrecommendations.htm.
The media play a powerful role in educating the public about suicide prevention. Stories about suicide inform readers and/or viewers about the likely causes of suicide, warning signs, trends in suicide rates, and recent advances in treatment. Media are able to reach multiple audiences about ways to prevent suicide. These recommendations will help guide the media to educate readers and viewers about the steps they can take to prevent suicide.

* Participating in national conferences to exchange information about research and prevention strategies (including the Suicide Prevention Advocacy Network conference held in Washington, DC in July 2002).

* Supporting extramural research that will examine risk factors for suicide in the general population.

* Developing the Suicide Prevention Research Center at the Trauma Institute, University of Nevada School of Medicine.

* Continuing support for a Native American suicide prevention center.

* Evaluating the effectiveness of current suicide prevention programs, including two interventions, one with youth in New York and one with older persons in South Carolina.

Suicide Prevention Materials Published by CDC

* Anderson MA; Kaufman K; Simon TR; et al. School-Associated Violent Deaths in the United States, 1994-1999 JAMA. 2001;286:2695-2702.
Study finds school-associated violent deaths rare, fewer events but more deaths per event Although school-associated violent deaths remain rare events, they have occurred often enough for public health experts to begin to detect patterns and identify potential risk factors according to a new study conducted by the Centers for Disease Control and Prevention (CDC) in conjunction with the U.S. Departments of Education and Justice.

* Centers for Disease Control and Prevention. Emergency Medical System Responses to Suicide-Related Calls - Maine, November 1999 - October 2000. MMWR 2002; 51 (03); 56-59.
Suicide is devastating for individuals, families, schools and communities. This study conducted in Maine reveals that response by emergency medical system (EMS) to suicide calls may be useful in early prevention efforts by increasing the understanding of the nature and characteristics associated with suicidal behavior. It also provides evidence for the importance of establishing statewide and national suicidal behavior surveillance systems.

* Centers for Disease Control and Prevention. Nonfatal Self-Inflicted Injuries Treated in Hospital Emergency Departments --- United States, 2000. MMWR 2002; 51(20); 436-8.
In 2000, more than 264,000 persons were treated for nonfatal self-inflicted injuries in hospital Emergency Departments (EDs) according to a CDC MMWR released today. Most of the injuries were either poisonings or lacerations; 60% were probable suicide attempts. This study provides national estimates and the characteristics of these self-inflicted injuries, which can be used to help monitor trends and evaluate prevention programs and policies.

* Centers for Disease Control and Prevention. Programs for the prevention of suicide among adolescents and young adults; and suicide contagion and the reporting of suicide: recommendations from a national workshop. MMWR 1994; 43 (No.RR-6).

* Centers for Disease Control and Prevention. Regional Variations in Suicide Rates -- United States, 1990-1994. 1997; 46(34); 789-793.

* Centers for Disease Control and Prevention. Suicide Prevention Evaluation in a Western Athabaskan American Indian Tribe--New Mexico, 1988-1997. MMWR 1998;47 (No. 13);257-261.
* Centers for Disease Control and Prevention. Suicide Prevention Among Active Duty Air Force Personnel-United States, 1990-1999. MMWR 1999; 48 (No. 46); 1053-1057.

* Centers for Disease Control and Prevention. Suicide among Black Youths--United States, 1980-1995. MMWR 1998;47(No.10);193-196.Centers for Disease Control and Prevention.

* Centers for Disease Control and Prevention. Suicide among children, adolescents, and young adults--United States, 1980-1992. MMWR 1995; 44:289-291.

* Centers for Disease Control and Prevention. Surveillance for Injuries and Violence Among Older Adults. MMWR 1999; 48 (No. SS-8); 27-34.

* Centers for Disease Control and Prevention. Temporal Variations in School-Associated Student Homicide and Suicide Events -- United States, 1992-1999 MMWR 2001; 50(31); 657-660.

New information from a CDC study may help school administrators in better planning and implementing violence prevention programs. In analyzing school-associated violent deaths since the beginning of the 1992 school year, CDC researchers found that student homicide rates are typically highest near the start of the fall and spring semesters. Student suicide rates were higher during the spring semester. Over the seven-year study, CDC confirmed 209 school-associated violent deaths. The latter equates to an average of 1 student homicide event every 7 school days, and 1 student suicide event every 31 school days.

* Centers for Disease Control and Prevention. Youth Suicide Prevention Programs: A Resource Guide. Atlanta: Centers for Disease Control, 1992.

* Crosby AE, Cheltenham MP, Sacks JJ. Incidence of Suicidal Ideation and Behavior in the United States, 1994. Suicide and Life-Threatening Behavior. 1999; 29(2):131-140.

* Kachur SP, Potter LB, James SP, Powell KE. Suicide in the United States, 1980-1992. Atlanta: Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, 1995. Violence Surveillance Summary, No.1.

* Potter LB, Powell KP, Kachur SP. Suicide prevention from a public health perspective. Suicide and Life-Threatening Behavior. 1995; 25(1):82-91.

* Rosenberg ML, Mercy JA, Potter LB. Firearms and Suicide. [Editorial]. NEJM 1999;341(21):1609-1611.

* Silverman MM and Simon TR, editors. Supplement to Suicide and Life-Threatening Behavior: The Houston Case-Control Study of Nearly Lethal Suicide Attempts December, 2001 Suicide and Life Threatening Behavior Volume 32(1) 1-86.

CDC releases study on non-traditional risk factors for nearly lethal suicide attempts. Employing an innovative approach to studying suicide attempters who either used a highly lethal method or would have died without medical help, researchers at the Centers for Disease Control and Prevention (CDC) have identified several non-traditional health risk factors that have rarely been included in suicide research. These non-traditional health associated risk factors include: acute alcohol use, changing residences, existing medical conditions, and characteristics of impulsive suicide behavior. The findings are published in a special supplement to the spring edition of Suicide and Life-Threatening Behavior (SLTB). SLTB is the official Journal of the American Association of Suicidology.

* Wallace LJD, Calhoun AD, Powell KE, O'Neil J, James, SP. Homicide and Suicide among Native Americans, 1979-1992. Atlanta, GA: Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, 1996. Violence Surveillance Summary Series, No. 2.

Resources

*American Association of Suicidology
www.suicidology.org or call 1-202-237-2280

*American Foundation for Suicide Prevention
www.afsp.org

*National Institute of Mental Health (NIMH)
www.nimh.nih.gov

*National Strategy for Suicide Prevention
Goals and Objectives for Action
www.mentalhealth.org/suicideprevention/

*National Suicide Prevention Strategy
www.sg.gov/library/calltoaction/

*National Youth Violence Prevention
ResearchCenter www.safeyouth.org
The National Youth Violence Prevention Resource Center (NYVPRC) was established as a central source of information on prevention and intervention programs, publications, research, and statistics on violence committed by and against children and teens. The resource center is a collaboration between the Centers for Disease Control and Prevention and other federal agencies. Together, the NYVPRC Web site, www.safeyouth.org, and call center, 1-866-SAFEYOUTH (723-3968), serve as a user-friendly, single point of access to federal information on youth violence prevention and suicide.

*Reporting on Suicide: Recommendations for the Media
www.afsp.org/education/newrecommendations.htm
The media play a powerful role in educating the public about suicide prevention. Stories about suicide inform readers and/or viewers about the likely causes of suicide, warning signs, trends in suicide rates, and recent advances in treatment. Media are able to reach multiple audiences about ways to prevent suicide. These recommendations will help guide the media to educate readers and viewers about the steps they can take to prevent suicide.

*Substance Abuse and Mental Health
Administration(SAMHSA)www.samhsa.gov

*Suicide Prevention Advocacy Network (SPAN)
www.spanusa.org

References

1. Centers for Disease Control and Prevention. Web-based Injury Statistics Query and Reporting System (WISQARS) [Online]. (2002). National Center for Injury Prevention and Control, Centers for Disease Control and Prevention (producer). Available from: URL: www.cdc.gov/ncipc/wisqars. [2003 March 27].

2. Suicide & Life Threatening Behavior 28(1):1-23, 1998.

3. CDC, Violence Surveillance Summary Series, No. 2. 1996.

4. MMWR 46(34):789-792, 1997.

5. Am J Public Health 81:1198-1200, 1991.

6. MMWR 45(1):3-6, 1996.

7. Aging & Mental Health 1(2):107-111, 1997.

8. MMWR 44(15):289-291, 1995.

9. MMWR 47(10):193-196, 1998.

Disclaimer
Links to organizations found at this site are provided solely as a service. These links do not constitute an endorsement of these organizations or their programs by the Centers for Disease Control Prevention (CDC), the National Center for Injury Prevention and Control (NCIPC), or the Federal government, and none should be inferred. CDC and NCIPC are not responsible for the content of the individual organizations' web pages found at these links.