Suicide in Missouri: Where We Stand Liz Sale, PhD Missouri - - PowerPoint PPT Presentation

Suicide in Missouri: Where We Stand

Liz Sale, PhD Missouri Institute of Mental Health University of Missouri-St. Louis August 2017

Outline

• Prevalence of suicide

– World, U.S., Missouri comparisons – Trends over time

• Means of suicide
• Suicidal ideation and intentional self-injury
• Vulnerable populations

Worldwide Suicide Rates

• 800,000 people die each year to suicide worldwide
• 17th leading cause of death

National Suicide Rates

• 121 suicide per day nationally
• 44,000 suicides in 2015, 1 million attempts (1:25)
• 10th leading cause of death
• In 2015, Missouri’s suicide rate was 17th highest (16.98 per 100,000)

CDC WISQARS, 2015

Age Groups

Rank 10-14 15-24 25-34 35-44 45-54

1

Unintentional Injury Unintentional Injury Unintentional Injury Unintentional Injury Malignant Neoplasms

2

Malignant Neoplasms Homicide

Suicide

Heart Disease Heart Disease

3

Suicide Suicide

Homicide Malignant Neoplasms Unintentional Injury

4

Homicide Malignant Neoplasms Heart Disease Suicide Suicide

5

Benign Neoplasms Heart Disease Malignant Neoplasms Homicide Diabetes

Five Leading Causes of Death Missouri, 2015, Ages 10-54

• 10th leading cause of death for all age groups

CDC, 2015

Suicide Rates by County (1990-2014)

• Rates highest in rural counties

DHSS, MICA, 2014

Comparisons with Other Fatal Injuries: (2015)

1,052 936 547

Suicide Motor Vehicle Accidents Homicide

Suicide in Missouri

• 73% of those who die by suicide in Missouri

are white males.

– Males: 49% of MO population; 78% of those who die by suicide are male – Whites: 83% of MO population 93% of those who die by suicide are white – Rates highest among white males 45-54 and 75+

Missouri Suicide Rates by Race, Age and Gender (2015)

CDC, WISQARS, 2015

10 20 30 40 50 60

10-14 15-17 18-19 20-24 25-34 35-44 45-54 55-64 65-74 75-84 85+

Rates Per 100,000

White Males Black Males White Females Black Females

Trends

Missouri and U.S. Suicide Rates (2005-2015)

CDC, WISQARS, 2015

5 10 15 20 25 30 2005 2007 2009 2011 2013 2015 Rate Per 100,000 Missouri United States

Missouri Suicide Rates by Gender (2005-2015)

CDC, WISQARS, 2015 5 10 15 20 25 30

2005 2007 2009 2011 2013 2015 Rate Per 100,000 Males Females

Missouri Suicide Rates: Youth and Adults (2005-2015)

CDC, WISQARS, 2015

5 10 15 20 25 30 2005 2010 2015

Rate Per 100,000

Youth 15-24 Adults 25+

Missouri Suicide Rates by Gender: All Ages and 45-64 Year Olds (2005-2015)

5 10 15 20 25 30 35 40 45 2005 2007 2009 2011 2013 2015 Rate Per 100,000 All Males All Females 45-64 Year Old Males 45-64 Year Old Females

Missouri Suicide Rates Whites and African Americans (2005-2015)

2 4 6 8 10 12 14 16 18 20

2005 2007 2009 2011 2013 2015 Rate Per 100,000

Whites Blacks

Missouri and U.S. Rates 75 and Older (2005-2015)

10 20 30 40 50 60 70 2005 2007 2009 2011 2013 2015 Rate Per 100,000 White Males 75+

Lethal Means

Means of Suicide (All Ages) 2011-2015

0% 20% 40% 60% 80% 100% Firearms Hanging Poisoning Jumping Sharp

• bjects

Gases and vapors Other

Means of Suicide: Males and Females (2011-2015)

38% 31% 26% 5%

Poisoning Firearms Suffocation Other

Males Females

9% 65% 21% 5%

Poisoning Firearms Suffocation Other

Means of Suicide: Youth and Adults (2011-2015)

Under 18 18 and Older

15% 58% 22% 5% Poisoning Firearms Suffocation Other

7% 43% 48% 2%

Poisoning Firearms Suffocation Other

Means by Age, Race and Region (2011-2015)

• 75+ year olds more likely to use firearms (82%)

than any other means in 2015.

• Caucasians more likely to use firearms than

African Americans.

• Slightly higher use of firearms in non-

metropolitan areas.

MO Department of Health and Senior Services, Missouri Public Health Information Management System (MOPHIMS)

Firearm-related Suicides (2000-2015)

0% 20% 40% 60% 80% 100% 2000 2002 2004 2006 2008 2010 2012 2014

Intentional Self-Injury

• Around 7,000 Missourians were treated in

emergency rooms or were hospitalized for intentional self-injury in 2014.

• Poison or drug/alcohol overdose accounted

for 84% of all intentional self-injuries.

• Highest among females 15-19.
• Rose steadily from 2001 to 2011; declined

steadily since then.

MO DHSS MICA database, 2012

Missouri Intentional Self-Injury Rate by Age and Gender (2014)

Missouri Department of Health and Senior Services, 2014

100 200 300 400 500 600 Rate Per 100,000 Males Females

Youth Suicidal Ideation (2016)

• One of 8 middle school students seriously

considered suicide in the past year.

• One in 6 high school students
• Almost 1 in 5 college students
• Ideation rates higher for females than males
• On average, suicidal thoughts highest in 8th – 9th

grade

Middle and high school data: Missouri Student Survey, 2016 College data: Missouri Assessment of College Health Behaviors, 2016

Suicidal Ideation: Students who “Seriously Considered Suicide” in Past Year (2016)

Missouri Student Survey, 2016; Missouri Assessment of College Health Behaviors, 2016

0% 4% 8% 12% 16% 20% Middle School Students High School Students College Students

% “Seriously Considered Suicide”: Middle, High School and College Students (2016)

Missouri Student Survey, 2016; Missouri Assessment of College Behaviors Survey, 2016

Grade in Middle/High School Age in College

0% 5% 10% 15% 20% 25% 30% 6 8 10 12

0% 5% 10% 15% 20% 25% 18 20 22 24

Populations at High Risk

LGBTQ Community

• LGB youth are at least 3-4 times more likely to

attempt suicide

• Attempts by LGBTQ youth are 4-6 times more likely

to require treatment from a health professional.

• Missouri LGBTQ college students are more than 3

times more likely to have had suicidal thoughts than their peers.

• Nationally, 40% of transgender adults have

attempted suicide. 92% attempted before the age

• f 25.

U.S. Active Military

• Primarily white males under 30
• 68% used firearms; 92% were not military issued
• Rates highest in the Army and National Guard
• Failed relationships number one stressor
• Rates in military similar to civilian rates (adjusting for

age)

Veteran Suicides

• In 2010, it was estimated that 22 U.S. veterans die by

suicide every day.

• Almost all Missouri veteran suicides are male.
• Rates highest among older veterans.
• MO suicide rates stable over time, similar to national

rates

• Among veterans under 25, around 25% of those who

died, died by suicide.

U.S. Veterans Affairs, 2010; MO DHSS, 2014

Questions?