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 • 17 th leading cause of death •

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

Five Leading Causes of Death Missouri, 2015, Ages 10-54 Age Groups Rank 10-14 15-24 25-34 35-44 45-54 Unintentional Unintentional Unintentional Unintentional Malignant 1 Injury Injury Injury Injury Neoplasms Malignant Suicide 2 Homicide Heart Disease Heart Disease Neoplasms Malignant Unintentional Suicide Suicide 3 Homicide Neoplasms Injury Malignant Heart Disease Suicide Suicide 4 Homicide Neoplasms Benign Malignant 5 Heart Disease Homicide Diabetes Neoplasms Neoplasms • 10 th 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) Homicide 547 Motor Vehicle Accidents 936 1,052 Suicide

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) White Males Black Males White Females Black Females 60 50 Rates Per 100,000 40 30 20 10 0 10-14 15-17 18-19 20-24 25-34 35-44 45-54 55-64 65-74 75-84 85+ CDC, WISQARS, 2015

Trends

Missouri and U.S. Suicide Rates (2005-2015) Missouri United States 30 25 20 Rate Per 100,000 15 10 5 0 2005 2007 2009 2011 2013 2015 CDC, WISQARS, 2015

Missouri Suicide Rates by Gender (2005-2015) Males Females 30 25 Rate Per 100,000 20 15 10 5 0 2005 2007 2009 2011 2013 2015 CDC, WISQARS, 2015

Missouri Suicide Rates: Youth and Adults (2005-2015) Youth 15-24 Adults 25+ 30 25 Rate Per 100,000 20 15 10 5 0 2005 2010 2015 CDC, WISQARS, 2015

Missouri Suicide Rates by Gender: All Ages and 45-64 Year Olds (2005-2015) 45 40 35 30 Rate Per 100,000 All Males 25 All Females 20 45-64 Year Old Males 45-64 Year Old Females 15 10 5 0 2005 2007 2009 2011 2013 2015

Missouri Suicide Rates Whites and African Americans (2005-2015) 20 18 16 14 Rate Per 100,000 12 10 Whites Blacks 8 6 4 2 0 2005 2007 2009 2011 2013 2015

Missouri and U.S. Rates 75 and Older (2005-2015) White Males 75+ 70 60 50 Rate Per 100,000 40 30 20 10 0 2005 2007 2009 2011 2013 2015

Lethal Means

Means of Suicide (All Ages) 2011-2015 100% 80% 60% 40% 20% 0% Firearms Hanging Poisoning Jumping Sharp Gases and Other objects vapors

Means of Suicide: Males and Females (2011-2015) Males Females Poisoning Firearms Suffocation Other Poisoning Firearms Suffocation Other 5% 5% 9% 21% 38% 26% 65% 31%

Means of Suicide: Youth and Adults (2011-2015) 18 and Older Under 18 Poisoning Firearms Suffocation Other Poisoning Firearms Suffocation Other 2% 5% 15% 7% 22% 48% 43% 58%

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) 100% 80% 60% 40% 20% 0% 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) 600 500 400 Rate Per 100,000 300 Males Females 200 100 0 Missouri Department of Health and Senior Services, 2014

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 8 th – 9 th 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) 20% 16% 12% 8% 4% 0% Middle School Students High School Students College Students Missouri Student Survey, 2016; Missouri Assessment of College Health Behaviors, 2016

% “Seriously Considered Suicide”: Middle, High School and College Students (2016) Grade in Middle/High School Age in College 30% 25% 25% 20% 20% 15% 15% 10% 10% 5% 5% 0% 0% 6 8 10 12 18 20 22 24 Missouri Student Survey, 2016; Missouri Assessment of College Behaviors Survey, 2016

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 of 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

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