Suicide is preventable: Here's how to stop it

The recent deaths of Kate Spade and Anthony Bourdain are a stark reminder that suicide takes far too many lives prema...

Posted: Jun 15, 2018 6:05 AM
Updated: Jun 15, 2018 6:05 AM

The recent deaths of Kate Spade and Anthony Bourdain are a stark reminder that suicide takes far too many lives prematurely and unnecessarily.

The 10th leading cause of death in the United States and the second-leading cause of death in people age 10-34, suicide claimed nearly 45,000 American lives in 2016 alone. Unlike other major threats to public health such as heart disease, smoking-related conditions, infectious diseases and cancer, whose death rates have declined in the last few decades, suicide rates have dramatically increased.

According to the Centers for Disease Control and Prevention, death by suicide has risen 25% in the United States since 1999 -- and risen by 30% in half of all US states -- despite falling over the same period in most of the rest of the world.

A number of myths surrounding suicide continue to persist. Most serious is the belief that people take their own lives abruptly, with no warning. They usually don't. In more than 90% of cases, suicide is an outcome of a pre-existing mental disorder and associated risk factors.

While a recent CDC report suggested that only half of those who die by suicide have a mental illness, we know from many other systematic reviews of suicide deaths that this is vastly underestimated, and it is closer to 90% of cases in which people who take their own lives have prior conditions, whether they have been diagnosed and treated by a mental health professional or not.

We also know that in the United States only about 25% of those who died by suicide were in psychiatric treatment at the time, suggesting that most suicides occur because their illness has gone untreated.

Another common myth is that the mere mention of the word suicide by friends and loved ones leads individuals to take their lives. But in reality, those harboring suicidal thoughts actually benefit from talking openly about their feelings. If you are concerned about someone's emotional state, and wonder if they might be at risk for suicide, you should engage them and inquire.

Think of someone's worrisome behavior (social withdrawal, lack of interest, taking risks, frequent intoxication) or ominous statements (I'd be better off dead, life isn't worth living, taking stock of what they have done) as if they have a fever. You don't know if it's due to a common cold or flu, or due to a more serious infection that needs immediate treatment. So, you ask them and if needed, encourage them to go or take them to see a doctor.

The first source of help if they are not already in psychiatric treatment is their primary care provider. There are also suicide help lines (The National Suicide Prevention Lifeline number is 1-800-273-8255). If the situation is dire, then you should call 911 or take them to the emergency room of a hospital where they can be fully assessed and advised of the best course of action.

Suicide should not be an acceptable outcome for mental disorders. Proper treatment can reduce the risk of suicide. But ensuring that those who are at risk receive care will require a sustained effort both at the micro and macro levels.

We can slow and reverse the escalating suicide trends by applying proven methods of prevention and providing better mental health care. Like heart disease risk calculators used to monitor those vulnerable to heart attacks, suicide risk assessments and risk reduction strategies should be employed to reduce suicide threat levels. The Columbia Suicide Severity Rating Scale was developed for just this purpose. (Full disclosure: Mann receives royalties for the commercial use of the Columbia Suicide Severity Rating Scale.) It is used to assess risk by first responders, in emergency rooms and by schools to assess risk. The FDA recommends the use of questionnaires like the Columbia Suicide Severity Rating Scale to assess risk and outcomes in clinical trials testing new psychiatric medications.

In addition to a pre-existing mental disorder, other factors influence one's risk of suicide, including, but not limited to: a family history of suicide, substance abuse, and stressful life events, such as marital discord or losing one's job. Men die by suicide at more than three times the rate of women and men are not as good as women at seeking help. And older males and middle-age females are at the greatest risk of suicide, demographics that include both Kate Spade and Anthony Bourdain.

Media coverage of prominent suicides can also play a role. Latent suicidal thoughts can wax and wane until pushed over the threshold to carry out the ultimate act. In this context, media coverage that glamorizes suicide can tip the scales for people who are thinking about suicide and vulnerable to social messages. While many media outlets are sensitive to this issue and make attempts to highlight the mental illnesses that resulted in suicide and its preventability, too much coverage tilts the story in the wrong direction.

Stopping needless deaths will also require greater policy efforts. Federal support for suicide prevention and treatment has chronically been underfunded, even while incident rates have continued to climb. A 2012 National Strategy for Suicide Prevention led by the US surgeon general called for, among other things, greater training for mental health professionals in assessing suicidal thoughts and behaviors.

Yet the number of trained professionals remains inadequate. In addition, the capacity for assessment and screening must extend beyond hospitals, clinics and doctors' offices to engage people in community settings such as schools, place of employment settings and religious organizations.

Not everyone who is depressed takes their own life, but most who do suffer from depression or one of the other mental disorders associated with higher suicide risk. However, the more effectively their mental disorder is treated, the lower the risk for suicide. Through risk assessment, public education, better diagnosis and more widely available treatment, we can stem the rising suicidal tide and prevent people from carrying out this most tragic and irreversible act.

Mississippi Coronavirus Cases

Data is updated nightly.

Cases: 259117

Reported Deaths: 5668
CountyCasesDeaths
DeSoto17331186
Hinds16373328
Harrison13731199
Rankin10854217
Jackson10557187
Lee8922141
Madison8335166
Jones6483112
Forrest6038120
Lauderdale5965187
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Lamar490865
Washington4826124
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Monroe3591105
Warren3569100
Union348063
Marshall347769
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Leflore3059107
Lincoln299386
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Hancock282559
Tate274362
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Itawamba265260
Pike264679
Scott250847
Prentiss248252
Yazoo247356
Tippah244450
Copiah243949
Coahoma242254
Simpson238368
Leake232966
Grenada220671
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Marion215073
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Wayne203232
Winston202667
George201939
Newton195044
Attala194659
Tishomingo191661
Chickasaw185744
Jasper174438
Holmes169168
Clay161335
Tallahatchie148235
Stone145921
Clarke141762
Calhoun137621
Smith122725
Yalobusha119134
Walthall112836
Noxubee111423
Greene111029
Montgomery110136
Carroll105321
Lawrence103217
Perry102831
Amite98826
Webster93924
Tunica87421
Claiborne86625
Jefferson Davis85827
Benton83323
Humphreys83324
Kemper78420
Quitman6969
Franklin67115
Choctaw61213
Wilkinson58825
Jefferson55419
Sharkey44017
Issaquena1596
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Alabama Coronavirus Cases

Cases: 429655

Reported Deaths: 6283
CountyCasesDeaths
Jefferson63040956
Mobile30794557
Madison27486201
Tuscaloosa20996268
Montgomery19352315
Shelby18833120
Baldwin16653184
Lee12749102
Morgan12389119
Etowah11861176
Calhoun11292201
Marshall10290113
Houston8746156
Limestone813276
Cullman8125106
Elmore7999104
DeKalb776599
Lauderdale768698
St. Clair7651121
Talladega6309108
Walker5954174
Jackson586341
Colbert539873
Blount537683
Autauga525755
Coffee450456
Dale402981
Franklin369948
Russell340711
Chilton338966
Covington332668
Escambia326043
Dallas308896
Chambers293170
Clarke287833
Tallapoosa2641107
Pike255230
Marion248953
Lawrence246649
Winston229535
Bibb218847
Geneva205446
Marengo202829
Pickens197531
Hale179542
Barbour176036
Fayette172928
Butler170858
Cherokee161930
Henry156523
Monroe149818
Randolph142135
Washington139126
Clay127645
Crenshaw121544
Cleburne119023
Lamar119021
Macon118637
Lowndes112036
Wilcox105121
Bullock101128
Perry99019
Conecuh95720
Sumter89626
Greene76623
Coosa61015
Choctaw51624
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