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2. The Language of Suicidology Contemplator thoughts of self harm intended to end own life.
Attemptor acts on thoughts and injures self.
Completor ends own life.
Survivor close personal relationship with a completor.
3. Classifying Intentional Injuries
4. Magnitude of Problem Over 30,000 deaths annually in the U.S., over 1 million worldwide
25 times as many people attempt suicide
63% of intentional deaths
1.7 times as many deaths as homicide
#3 cause of death in 1st 4 decades of life
The CDC maintains a database of suicide data for each state in the U.S. In 2001, there were over 30,000 deaths due to suicide.
There were more than 1.7 times as many deaths from suicide than from homicide. Males are four times as likely to die from their suicide attempt, while females overall are more likely to attempt suicide. 57% of suicides deaths use firearms.The CDC maintains a database of suicide data for each state in the U.S. In 2001, there were over 30,000 deaths due to suicide.
There were more than 1.7 times as many deaths from suicide than from homicide. Males are four times as likely to die from their suicide attempt, while females overall are more likely to attempt suicide. 57% of suicides deaths use firearms.
5. Age Adjusted Rates, 2000 CDC Injury-Related Deaths in the U.S.
6. 2000 Age-Adjusted Rates, CDC Spectrum of Suicide
7. Worldwide, Eastern Europe, the Soviet Republic and China have rates that exceed those of the U.S.
Canada and Australia and portions of western Europe are roughly equivalent to the USWorldwide, Eastern Europe, the Soviet Republic and China have rates that exceed those of the U.S.
Canada and Australia and portions of western Europe are roughly equivalent to the US
8. Examining suicide death rates in the U.S., the red states on this map have the highest suicide rates and are, with the exception of Florida, largely Western States
Blue states have the next highest death rates from suicide, followed by grey, and
the white states have the lowest suicide rates; Generally, rural areas have higher suicide rates than Metropolitan areas.Examining suicide death rates in the U.S., the red states on this map have the highest suicide rates and are, with the exception of Florida, largely Western States
Blue states have the next highest death rates from suicide, followed by grey, and
the white states have the lowest suicide rates; Generally, rural areas have higher suicide rates than Metropolitan areas.
9. Demographics Males 4 x more likely to die than females
Native American, Caucasian highest rates
In youth, less racial or ethnic variation
Elderly at high risk
The CDC maintains a database of suicide data for each state in the U.S. In 2001, there were over 30,000 deaths due to suicide.
There were more than 1.7 times as many deaths from suicide than from homicide. Males are four times as likely to die from their suicide attempt, while females overall are more likely to attempt suicide. 57% of suicides deaths use firearms.The CDC maintains a database of suicide data for each state in the U.S. In 2001, there were over 30,000 deaths due to suicide.
There were more than 1.7 times as many deaths from suicide than from homicide. Males are four times as likely to die from their suicide attempt, while females overall are more likely to attempt suicide. 57% of suicides deaths use firearms.
10. 2000 CDC Data Death Rates High Across Ages Actual death rates per 100,000 population change remain quite high throughout life and in fact increase in the geriatric population. Actual death rates per 100,000 population change remain quite high throughout life and in fact increase in the geriatric population.
11. Mechanism of Suicide Deaths Both Genders, All Ages
12. Gender Differences Males use firearms more than females
Suffocation used by males more than females
Poisoning used by females more than males
Males attempts more likely to result in death
13. Age-Adjusted Rates per 100,000 Population, 2000 CDC Data Male GenderSuicide Deaths & Attempts However, if we examine attempts separately from deaths, we see that the proportion of attempts, shown in light yellow compared with suicide deaths is large, especially in the younger years. However the proportion of deaths to attempts increases significantly with age. We can see that although the rates per 100,000 of suicide deaths is high, the number of attempts is staggering. There are over 23,000 male deaths per yearHowever, if we examine attempts separately from deaths, we see that the proportion of attempts, shown in light yellow compared with suicide deaths is large, especially in the younger years. However the proportion of deaths to attempts increases significantly with age. We can see that although the rates per 100,000 of suicide deaths is high, the number of attempts is staggering. There are over 23,000 male deaths per year
14. Age-Adjusted Rates per 100,000 Population, 2000 CDC Data Female GenderSuicide Deaths and Attempts Switching to females, we can see that females have a much lower death rate than do males, but it important to remember that there are 5,800 deaths per yearSwitching to females, we can see that females have a much lower death rate than do males, but it important to remember that there are 5,800 deaths per year
15. Age-Adjusted Rates per 100,000 Population, 2000 CDC Data Suicide Deaths Plus Suicide AttemptsBy Gender and Age If we look at total attempts, lethal and non-lethal, we see that the total rate for males and females differs little, and in fact there are some categories where females exceed malesIf we look at total attempts, lethal and non-lethal, we see that the total rate for males and females differs little, and in fact there are some categories where females exceed males
16. Summary Demographics Male death rate > Female
Native American > White > African American > Hispanics
Suicide is 3rd most common cause of death 10-34, 4th 35-44, 5th 45-54.
Adolescent suicide represents fastest growing segment of suicide attempts.
Rates for 65+ are greatest
17. Risk Factors
18. Depression and Hopelessness:Major Risk Factors 1 of 16 people with depression commit suicide
2/3 of people who commit suicide are depressed, higher for adolescents
Depression plus alcohol increases risk
Hopelessness, anxiety increases risk
19. Other Risk Factors Family member committed suicide (survivor)
Childhood trauma, especially abuse
Intimate Partner Violence
Divorce
Recent move, especially for adolescents
Firearms
Alcohol
Education
Chemical low levels of serotonin
20. Adolescents and Young Adults High rate of depression, hopelessness
Impulsivity, Alcohol Use important
Recent move of household a risk factor
Many seek help from family/friends.
Need community-based training for prevention
Need to remove the stigma of suicide
A surprising result was that even if situations that looked like impulsive suicide attempts, the majority of adolescents and young adults had in fact sought help prior to their attempt. More sought help from family and friends than for all professionals combined.A surprising result was that even if situations that looked like impulsive suicide attempts, the majority of adolescents and young adults had in fact sought help prior to their attempt. More sought help from family and friends than for all professionals combined.
21. Barnes LS, Suicide and Life-Threatening Behavior, 2001 Help-Seeking Behavior Adults:
Medical community often contacted prior to attempt
Adolescents:
Few have recent medical contact
Often seek help from family or friends
Less than 10% use Hotlines
22. Suicides Impact OnTrauma Centers National Trauma Data Bank
23. National Trauma Data Bank (NTDB) Voluntary reporting by trauma centers to central database maintained by the American College of Surgeons.
Suicide identified by E-codes.
24. Intentionality of Trauma Patients in NTDB The data I am presenting is based upon a preliminary analysis of NTDB data, after permission was obtained from the NTDB. An analysis of an even larger number of patients in the NTDB will be presented at the Western Trauma Meeting next month.
If we look at intentionality, 15% of patients in the NTDB represent intentional injuries, and only 2% represent injury to self.The data I am presenting is based upon a preliminary analysis of NTDB data, after permission was obtained from the NTDB. An analysis of an even larger number of patients in the NTDB will be presented at the Western Trauma Meeting next month.
If we look at intentionality, 15% of patients in the NTDB represent intentional injuries, and only 2% represent injury to self.
25. Suicide in Trauma Centers 2% of all admissions
77% male, average age 40 years
80% are penetrating injuries
24% mortality (higher than other types of trauma)
75% require OR or are admitted to ICU
26. Suicide in Trauma Centers Many have known mental health problems
Longer hospital and ICU stays than other injuries
Few are discharged to psychiatric facility
27. Trauma Patients at Future Risk of Suicide
28. Traumatic Brain Injury Patients Traumatic Brain Injury patients are at risk of subsequent suicide attempts*
35% hopeless
23% suicidal ideation
17% have attempted suicide
Higher risk with substance abuse
Repeated suicide attempts
Move to Risk factors specific to trauma patients.Move to Risk factors specific to trauma patients.
29. Other Trauma Patients Depression in other patients following trauma?
Those with ongoing somatic complaints have higher incidence of depression.
Associated with ongoing alcohol use? Move to Risk factors specific to trauma patients.Move to Risk factors specific to trauma patients.
30. Interventions Treat depression
SSRIs, others
Individual cognitive therapy decreases repeat attempts
Group Therapy
Family Counseling
Physician Speaking with patient and family may make a difference
31. Recommendations Suggestions for Trauma Centers
32. Recommendations Participate in NTDB
National, regional, state suicide burden to Trauma Centers
Suicide Education
Surgery Residents
Trauma Fellows
Practicing Surgeons
Primary Care Physicians
Other medical personnel
Medical Students
33. Recommendations Develop A Suicide Prevention Plan for your Community.
Demographics
Identify hospital and community resources
Educate medical staff
Injury Prevention partner with community groups
Rural locations
34. Resources www.cdc.gov
www.suicidology.org
www.sprc.org
www.surgeongeneral.org
www.aas.org
www.afsp.org
Reducing Suicide: A National Imperative. 2002. Institute of Medicine. National Academy of Sciences