Suicide in Missouri: Where We Stand Liz Sale Missouri Ins6tute of - PowerPoint PPT Presentation

Suicide in Missouri: Where We Stand Liz Sale Missouri Ins6tute of Mental Health University of Missouri-St. Louis June 2016

Outline • Prevalence of suicide – World, U.S., Missouri comparisons – Trends over 6me • Means of suicide • Suicidal idea6on and inten6onal self-injury • Vulnerable popula6ons

Worldwide Suicide Rates 800,000 people die each year to suicide worldwide • 15 th leading cause of death • (World Health Organiza6on, 2014)

Na6onal Suicide Rates • In 2010, Missouri’s suicide rate was the 22 nd highest in the na6on. • In 2014, Missouri’s suicide rate was 20 th highest

Suicide Rates by County (1990-2014) • Rates highest in rural coun0es (DHSS, MICA, 2014)

Five Leading Causes of Death Missouri, 2014, Ages 10-54 Age Groups Rank 10-14 15-24 25-34 35-44 45-54 Uninten6on Uninten6onal Uninten6onal Uninten6onal al Malignant 1 Injury Injury Injury Injury Neoplasms Heart Homicide Heart Disease Suicide Suicide 2 Disease Malignant Uninten6onal Malignant Suicide 3 Homicide Neoplasms Injury Neoplasms Malignant Heart Disease Suicide Suicide 4 Homicide Neoplasms Malignant 5 Homicide Benign Heart Disease Diabetes Neoplasms Neoplasms • 10 th leading cause of death for all age groups (CDC, 2014)

Comparisons with Other Fatal Injuries: 2014 Number of Rate Deaths (per 100,000) Suicide 1,017 16.77 Motor Vehicles 801 13.21 Accidents Homicide 441 7.27

Missouri 2014 • Largely a white male issue: – 80% males – 95% Whites – 76% White males • Highest rates among those 35-59 and 75+ • 58% firearms

# of Suicides (2014) by Age Group: Males and Females 250 200 150 Females Males 100 50 0 0-14 15-24 25-34 35-44 45-54 55-64 65-74 75-84 85+

2014 Suicide Rates by Age Group 40 35 30 Rate per 100,000 25 20 15 10 5 0 15-24 25-34 35-44 45-54 55-64 65-74 75-84 85+

Male Suicide Rate by Age (2014) 80 70 60 50 40 30 20 10 0 15-24 25-34 35-44 45-54 55-64 65-74 75-84 85+

2014 Suicide Rates by Race and Ethnicity 40 35 30 Rate per 100,000 25 20 15 10 5 0 Caucasian African American Hispanic

2010-2014 Suicide Rates by Gender and Race* 40 35 30 Rate per 100,000 25 20 15 10 5 0 Caucasian African Caucasian African Asian Males Males American Female American Males Females * Data aggregated to allow for greater race/gender comparisons

Trends

Missouri and U.S. Suicide Rates (1999-2014) 50 45 40 Rate per 100,000 35 30 MO 25 U.S. 20 15 10 5 0 1999 2004 2009 2014

Missouri Suicide Rates (1999-2014) Males and Females 50 45 40 Rate per 100,000 35 30 Males 25 Females 20 15 10 5 0 1999 2004 2009 2014 CDC, Wisqars, 2016

Missouri Suicide Rates (1999-2014) Caucasians and African Americans Chart Title 50 45 40 Rate per 100,000 35 30 Caucasian 25 20 African American 15 10 5 0 1999 2004 2009 2014

Missouri and U.S. Rates (1999-2014) 45-54 Year Old Caucasian Males 50 45 40 35 30 25 U.S. 20 MO 15 10 5 0 • Resistance to help seeking, job loss, divorce, decline in physical health, addic6on

Missouri and U.S. Rates (1999-2014) Caucasian Males 75 and Older 70 60 50 40 MO 30 U.S. 20 10 0 1999 2004 2009 2014

Lethal Means

Means of Suicide (All Ages) 2010-2014 100% 80% 60% 40% 20% 0% Firearms Hanging Drugs Jumping Sharp Gases Other objects and vapors

Means of Suicide: Males and Females 2010-2014 100% 80% 60% 40% Males Females 20% 0%

Means by Age, Race and Region (2010-2014) • 75+ more likely to use firearms than any other age group (80%) • African Americans more likely to use firearms than Caucasians (65% vs. 58%) • Slightly more likely to use firearms in rural areas

% Firearms by Region in Missouri 100% Large Central 80% Large Fringe Medium metro 60% Small Metro Micropolitan Non-core 40% 20% 0% • Trend for firearm use to be higher in more rural areas though in all areas, firearms are primary means

Missouri and U.S. Rates (1999-2014) % Suicides by Firearms 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% 1999 2004 2009 2014

Suicidal Idea6on in Youth • 11.7% of Missouri middle and high school students reported seriously considering suicide in 2014. • Rates higher for females than males (16% vs. 7%). • Suicidal thoughts highest in 8 th – 9 th grade • 15% of Missouri college students experienced suicidal thoughts in 2014. Middle and high school data: Missouri Student Survey, 2014 College data: Missouri College hHealth Behavioral Survey

Inten6onal Self-Injury • Over 8,000 Missourians are treated in emergency rooms for inten6onal self-injury every year. • Females 15-24 have highest rates: double the rate for all Missourians (141.5 per 100,000). • Poison or drug/alcohol overdose accounted for around 80% of all inten6onal self-injuries. • Rate of inten6onal self-injury declines with age regardless of race or gender. MO DHSS MICA database, 2012)

Popula6ons at High Risk

LGBTQ Community • LGBTQ youth are at least 3 to 4 6mes more likely to alempt suicide. • Alempts by LGBTQ youth are 4 to 6 6mes more likely to require treatment from a health professional. • LGBTQ college students three 6mes more likely to have had suicidal thoughts than their peers. • Gay men 6 6mes more likely to alempt suicide • Around one-third of transgender youth have alempted suicide

U.S. Ac6ve 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 • Rates slightly lower in 2014 compared to 2012; much lower for National Guard

Veteran Suicides • In 2010, it was es6mated 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 6me, similar to na6onal rates • Among veterans under 25, around 25% of those who died, died by suicide. (U.S. Veterans Affairs, 2010; MO DHSS, 2014)

Other Vulnerable Popula6ons • People with a mental illness, par6cularly untreated depression • People with substance use disorders • People who are bullied and those who bully • People with disabili6es • People with terminal illnesses • Individuals in juvenile and criminal jus6ce system • Homeless

Ques6ons?