National Suicide Prevention Week takes place in September each year. It is an annual campaign dedicated to increasing awareness of the warning signs and prevention efforts amongst clinicians and the general public. This year, the conversation is more important than ever before. Suicide rates have been steadily increasing around the world, making suicide a global issue that can affect anyone.
While this issue impacts all demographics, some groups are more at risk than others. Understanding the common risks, warning signs, and available resources to help prevent this tragic act could help save a life and prevent long lasting effects on families and communities.
There is not a one size fits all approach to mental health, suicide prevention efforts must happen at an individual and global level. Check in with your loved ones and those close to you regularly, as the warning signs are not always apparent. It is vital that we take the time to understand what factors can create suicidal tendencies and who are amongst the most vulnerable populations.
Suicide Rates in the United States
Suicide rates in the United States have been steadily increasing over the last two decades1 making suicide two times more prevalent than homicide.2
- From 1999-2017, the age-adjusted suicide rate in the USA grew 33% from 10.5 deaths to 14.0 per 100,000 people.
- Over this period, the suicide rate for women increased 53% from 4.0 deaths in 1999 to 6.1 in 2017
- For men, the rate grew 26% from 17.8 deaths in 1999 to 22.4 in 20171
Common Risk Factors Associated with High Suicide Rates
It is incredibly important to understand the risk factors that make someone more likely to take their own life. The most prevalent risks are a previous suicide attempt and mental disorders like depression. Suicide statistics show that members of groups who experience discrimination such as minorities, LGBTQ, refugees, or prisoners are often at a higher risk due to feelings of conflict or a sense of isolation.
Potential risks that aren’t as easy to pinpoint include those in moments of crisis and extreme stress such as:
- Chronic pain
- Illness
- Financial problems
- Unemployment
- Economic recession3
Other lesser-known risk factors include:
- Alcohol use
- Gun prevalence
- Daylight patterns
- Countries without unilateral divorce4
- Media coverage of a suicide
Seasonal variations of suicide rates have been shown in many countries especially those that do not experience regular daylight patterns, and contrary to popular belief, the rates do not peak in times when the nights are longest.
In countries that experience seasonal variations of daylight patterns, suicide rates peaked in the spring and summer months during the periods of constant light.5
For example, in North Greenland, 48% of suicides occurred during the period of constant light in the year.5
Over the years, several studies have found a phenomenon of an increase in suicides following media reports of a suicide, a relationship referred to as ‘copycat’ behavior.6 Research shows that suicide appears to be “contagious” with clusters of suicides following specific media content creating a substantial increase, approximately 14.3 times higher, in the likelihood of a suicide.7
A 2010 study found that continuous reporting of the same suicide and reporting of suicide myths were positively associated with an increase in suicide rates, while coverage of suicide coping mechanisms was negatively associated with suicide rates.8 Based on these findings the World Health Organization (WHO) has developed guidelines for reporting of suicides in the media including instructions to avoid using language that sensationalizes or normalizes suicides.9
Suicide Rates Increase Following a Pandemic
Following the Spanish Flu pandemic the world saw an increase in suicide rates, experts concluded that the fear associated with the virus combined with the decreased social integration led to an uptick in suicides.12 The events surrounding the COVID-19 pandemic have caused concern for an increase in suicide rates within the US and internationally, with potential for adverse outcomes on suicide risk being high.10
Experts have pointed to the pandemic as a perfect storm of suicidal risk factors combining economic stress, unemployment, social isolation, barriers to mental health treatment, and an increase in anxiety seen across the nation. Additionally, the unprecedented surge in firearm sales over the past several months makes experts particularly concerned, as this is the most common method of suicide in the United States.10
Social distancing measures during COVID-19 have significantly decreased access to community and religious support, removing a source of purpose and connection for many people, a large component of preventing suicides. A 2016 study showed that weekly attendance at religious services has been associated with a 5-fold lower suicide rate compared with those who do not attend.11
Given the severity of the virus, one study investigated whether COVID-19 survivors are at an increased risk for suicide. Experts examined how the stress of a diagnosis, fear of infecting others, combined with the trauma of experiencing severe symptoms may affect this demographic during and after recovery.
The study concluded that these factors place survivors at a high risk of developing post-traumatic stress disorder (PTSD), depression, anxiety, and other mental health disorders, especially if they were admitted to an ICU. Ultimately, COVID-19 survivors should be regarded as individuals at elevated risk for suicide and that specific prevention and intervention strategies should be put in place.13
Global Suicide Statistics
Globally, close to 800,000 people die from suicide every year making up about 1.4% of all deaths.14 While suicide is a worldwide issue, there is at least a ten-fold difference or greater between each country’s share of total deaths by suicide.2 Among the highest are:
- Greenland at 7.21% suicide deaths
- South Korea at 5.08%
- Qatar at 5.08%
- The countries with the lowest rates are Greece at 0.4% and Indonesia at 0.5%2
Suicide Rates by Gender, Age, and Income Level
Suicide is an issue that affects people of all demographics; however it is more prevalent amongst some groups of people based upon age, gender, and income level.
Suicide Rates by Gender
The most recent suicide statistics show that in all countries suicide was more common in men (13.9 deaths per 100,000), with rates just over twice as high than those for women (6.3 deaths per 100,000).2 However, this stark contrast is not seen uniformly around the world, the suicide rate for men in Ghana was as great as 10.52 times higher than women, while there is almost difference between genders in Pakistan and Bangladesh.2
According to a study on men and depression, men are often at a higher risk of suicide because they are not socialized to talk about their emotions and therefore may hide their emotional pain rather than seek out help.15
Suicide Rates by Age
Suicide occurs in people throughout the lifespan, but it does not affect all age groups equally. Today, suicide is one of the leading causes of death among younger age groups. In 2019, it was the third leading cause of death in people aged 15-19 years old,3 however, this does not mean this age group has the highest rate of suicide. People 70 years of age and older have the highest rate of suicide, but it is not the leading cause of death as they are more likely to die from other causes.2
Suicide Rates by Income Level
A person’s income and a country’s economic status also play a role in the number of suicides in each population. According to the WHO, in 2016 approximately 79% of the world’s suicides occurred in low and middle-income countries.3 While definitive evidence of the association between suicide and poverty in low and middle-income countries is scarce, a study revealed that there is a consistent trend at the individual level indicating that poverty, diminished wealth, and unemployment is associated with suicidal ideations and behaviors.16
Suicide Rates Within Minority Groups
For the past decade, suicide rates across all races and ethnicities have been on the rise:
- In 2018 the suicide rate amongst American Indian and Alaska Native (AI/AN) populations was at 22.1 deaths per 100,000, higher than the overall US suicide rate of 14.2 per 100,00017
- It is important to note that according to available data, suicide rates peak during adolescence and young adulthood within the AI/AN population and then decline. This is a different pattern than is seen in the overall U.S. population, where suicide rates peak in midlife17
- In 2018, the age-adjusted suicide rate amongst Hispanic populations (7.4 deaths per 100,000)
- Asian or Pacific Islander populations (7.0 deaths per 100,000) were about half of what the overall suicide rate was for the United States (14.2 deaths per 100,000)17
Suicide Rates by Sexual Orientation & Gender Identity
As previously stated, people among minorities groups are often at a higher risk of suicidal behaviors. Individuals who identify as lesbian, gay, bisexual, and/or transgender (LGBTQ) often fall within these elevated risk factors, as they may experience discrimination and feelings of isolation.
Research shows that mental health problems, misuse of alcohol and drugs, suicidal thoughts and behaviors are more common amongst this group than in the general population.18 While studies show suicidal tendencies are more common among the LGBTQ community, there is no official or generally reliable way to determine rates of completed suicide in LGBTQ people.18
Risk factors include:
- Depression and other mental health problems
- Alcohol or drug use
- Stress from prejudice and discrimination (family rejection, harassment, bullying, violence)
- Feelings of social isolation
Protective factors include:
- Family acceptance
- Connections to friends and others who care about them
- Sense of safety
Suicide Rates of People with Mental Health Diagnoses
While there are many elements that make a person susceptible to suicidal behavior, mental health and mood disorders are cited as the largest attributing risk factor. The results of a 2002 systematic review of 31 published studies by Bertolote and Fleischmann revealed that 98% of people who died by suicide had a diagnosable mental health disorder.19 Their review separated individuals who had previously been admitted to a mental hospital and those who had not.
Their findings showed that suicide is associated with a variety of mental disorders, but mood disorder accounted for most of the diagnoses and were the leading cause for both individuals in the general population as well as those who had previously been admitted. The second highest amongst the general population were those with substance-related disorders, while schizophrenia was the second highest cause for patients who had been admitted.19
Suicides by Method
Globally, firearms, ingestion of pesticide, and hanging are among the most common methods of suicide.3
The WHO estimates that around 20% of suicides around the world are due to pesticide self-poisoning, a majority of them occurring in rural agricultural areas in low- and middle-income countries.9 A 2019 study estimates that the total number of lives lost to self-poisoning by pesticides to be 14-15 million between 1960-2018.21
Suicide by firearm accounts for about 8% of suicide deaths globally.22 The Center for Disease Control and Prevention (CDC) estimates that 23,854 people died by firearm in suicide in the United States in 2017, while in that same year 14,452 homicides by firearm occurred, meaning that ~60% of firearm deaths in the US were from suicides in 2017.22
Suicide Statistics Over Time
Data from the National Vital Statistics System, Mortality showed that from 1999 through 2018 in the United States:
- The suicide rate increased 35%, from 10.5 deaths per 100,000 to 14.2, increasing on average ~1% per year from 1999 to 2006 and by 2% per year from 2006 through 201823
- Over the years US veterans have seen an alarming increase in suicides, increasing by 129 from 2016 to 2017 alone24
- However, since 1990, most European and Asian countries have seen a decline in suicide rates2
Resources for a Crisis
If you or someone you know is exhibiting signs of a crisis, seek out help.
Please see below for crisis resources:
- Suicide hotline National Suicide Prevention Lifeline 1-800-273-8255 (1-800-273-TALK)
- Crisis Text Line: Text START to 741-741
- Crisis Text Line is free, 24/7 support for those in crisis. Text from anywhere in the USA to text with a trained Crisis Counselor
Note: The FCC has designated 9-8-8 as the National Suicide Prevention Lifeline, but this number will not take effect until July of 2022.
Veterans Crisis Line Resources
- https://www.veteranscrisisline.net
- Call: 1-800-273-8255 and Press 1
- Text: 838255
- Connect online
- Support for deaf and hard of hearing: 1-800-799-4889
- This free support is confidential, available 24/7, and serves all veterans, service members, and their family members and friends
LGBTQ Crisis Resources
- The Gay, Lesbian, Bisexual and Transgender National Hotline: (888) 843-4564
- The GLBT National Youth Talkline (youth serving youth through age 25): (800) 246-7743
- The Trevor Project
- Call: 1-866-488-7386
- Text START to 678-678
- TrevorText is a confidential and secure resource that provides live help for LGBTQ youth with a trained specialist, over text messages.
Suicide Prevention Resources
Suicide prevention efforts must take place at a global and an individual level. As the pandemic measures are still in place in the United States, it’s more important than ever to check in on your loved ones and be aware of any signs of distress. During these challenging times it is critical to increase access to mental health care through in person or telehealth resources. Another great way to increase the feeling of connectedness is to physically distance rather than socially distance during the pandemic.
The following sites can help with finding mental healthcare:
- American Psychiatric Association
- American Psychological Association
- National Association of Social Workers
- SAMHSA Mental Health Provider Locator
- Veterans Affairs
For additional resources visit the American Foundation For Suicide Prevention’s website to view mental health resources by condition, or the WHO’s suicide prevention site to view and download the World Health Organization’s literature on suicide prevention. This report outlines steps to increase awareness and prevention on suicides and suicide attempts.
