Date: May 1st, 2009
Every age group is at risk for suicide, but the most vulnerable group may surprise you. Older adults—particularly white men—experience the highest rate of suicide in the U.S. In 2005, the elderly comprised 12 percent of the population yet accounted for 17 percent of all suicides—more than 7,000 older Americans committed suicide that year.
Despite these frightening statistics, seniors remain underserved by prevention and treatment programs and resources. Fortunately a number of groups and organizations are working to bring attention to the need for increased suicide prevention in the elderly. An important Capitol Hill briefing was hosted in June 2008 by the Suicide Prevention Action Network USA (SPAN USA), along with Senate Majority Leader Harry Reid (D-NV) and Representatives Darlene Hooley (D-OR) and Tim Murphy (R-PA).
One of the speakers at the briefing talked about the enormity of the problem. “It’s important for us to acknowledge the magnitude of this problem because there’s so much that our communities and our health care system can do to prevent these deaths,” said Mel Kohn, MD, MPH. Dr. Kohn is a state epidemiologist with the Public Health Division of the Oregon Department of Human Services.
Critical Prevention Efforts
Dr. Yeates Conwell, co-director of the University of Rochester Center for the Study and Prevention of Suicide, also spoke at the briefing and recommended three strategies to prevent senior suicide:
- 1. Optimize function and reduce isolation,
- 2. Restrict access to lethal means, and
- 3. Diagnose and prevent depression.
These strategies help combat three of the most common factors that place older adults at higher risk for suicide.
Research has found that older adults who live alone are more likely to commit suicide, particularly if they are divorced or widowed. People considering suicide often withdraw from their normal social engagements, but staying active can improve moods and decrease the likelihood of depression. Exercising, spending time with loved ones, developing a new hobby, and joining a support group are good ways for older people to avoid depression and suicide. Family and community members can serve as strong support systems and encourage behavior that keeps them active and connected.
Easy access to handguns can also place seniors at a greater risk of suicide. Statistics show that older people with handguns in their households are more than twice as likely to commit suicide as those without access to firearms. Lethal weapons are the most common method of suicide by the elderly and result in a very high completion rate. By being aware of handguns in the home of an older loved one, family and friends may be able to prevent an imminent suicide.
It is also critical to recognize the signs of depression in the elderly. Sixty to 75 percent of suicide victims age 75 and older have diagnosable clinical depression. Older adults may experience slightly different symptoms than younger depression patients—typical symptoms include anxiety, fatigue, loss of interest in hobbies, isolation, unexplained weight loss, and suicidal thoughts.
“I had been happily married to my husband for 30 years when he took his life…at age 67,” shared Sue Pitkin in a brochure recently published by SPAN USA. “I always remember Bill saying, ‘There is nothing that can happen to you that is worth taking your life over.’ Yet, his brain totally gave up. The public needs to be informed that people can die from depression.”
Unfortunately, depression often goes unrecognized. Physicians can play a significant role in preventing elderly suicide if they routinely screen for and treat signs of depression. Seventy percent of older suicide victims visited a physician within a month of their death, and 20 percent saw their physician on the day of their suicide. Studies show that a collaborative treatment method where general physicians work with care managers and psychiatrists to treat elderly patients, greatly reduces the occurrence of depression and suicide.
While researchers continue to investigate methods of prevention, policymakers are working to change federal guidelines. Senator Reid introduced the Stop Senior Suicide Act (S.1854/H.R.4897) in the previous Congress, which—if reintroduced in the current Congress and passed—would amend the Public Health Act to require the formation of an Interagency Geriatric Mental Health Planning Council. The council would establish mental health services—including suicide prevention—for the elderly. The changes would also lower Medicare co-payment rates for outpatient mental health services to the same rate as outpatient physical health services. Medicare patients currently pay 50 percent of outpatient mental health care, but only 20 percent of physical health care.
Professional help is available if you or someone you know is experiencing depression. The Institute on Aging’s Friendship Line offers counseling, support, crisis intervention, referrals, and other information specifically for older adults and their loved ones. Anyone in crisis can call the hotline at (800) 971-0016—24-hours a day, 365 days a year. For non-crisis support, information, and referrals the hotline is available from 8:00 AM to 11:00 PM PT. A state-by-state guide to local prevention and treatment resources is also helpful and can be found at www.spanusa.org/states.
For more information about suicide prevention, visit the following websites: