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Suicide in the Eastern Health Planning Region, 2003-2008

Suicide in the Eastern Health Planning Region, 2003-2008. Marc E. Leslie Coordinator, Virginia Violent Death Reporting System Office of the Chief Medical Examiner, Virginia Department of Health The Eastern Health Planning Region Suicide Prevention Summit June 15, 2011 Hampton, VA.

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Suicide in the Eastern Health Planning Region, 2003-2008

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  1. Suicide in the Eastern Health Planning Region, 2003-2008 Marc E. Leslie Coordinator, Virginia Violent Death Reporting System Office of the Chief Medical Examiner, Virginia Department of Health The Eastern Health Planning Region Suicide Prevention Summit June 15, 2011 Hampton, VA

  2. Map of the Eastern Health Planning Region (HPR)

  3. Pop Quiz In the Eastern Health Planning Region: • Average number of suicides per year? (Hint: average of 139 homicides per year). • Percentage of suicide victims who are White males? • Median age of a suicide victim? • Percentage of male and female suicides by firearm?

  4. Suicide in the Eastern HPR, 2003-2008 Overview of the Problem

  5. Suicide in the Eastern HPR, 2003-2008

  6. Suicide in the Eastern HPR, 2003-2008

  7. Suicide in the Eastern HPR, 2003-2008 Suicide vs. Homicide (2003-2008) • 1,143 suicides; rate of 10.6 • 832 homicides; rate of 7.7 • Suicide 1.4 times more common than homicide

  8. Suicide in the Eastern HPR, 2003-2008

  9. Suicide in the Eastern HPR, 2003-2008

  10. Suicide in the Eastern HPR, 2003-2008 Who is at Risk?

  11. Suicide in the Eastern HPR, 2003-2008 Selected Demographic Elements • Gender • Race • Age

  12. Suicide in the Eastern HPR, 2003-2008 Race and Gender • Male (76%, rate of 16.5) • White (81%, rate of 13.6) • White males (61%, rate of 20.4), White females (20%, rate of 6.8), and Black males (14%, rate of 9.7) comprise 95% of all suicide victims (remember, overall rate for Eastern HPR is 10.6)

  13. Suicide in the Eastern HPR, 2003-2008 Age • Median age is 45 • Ages 45-54 most common age group (22%) • Highest rate for those 85 and over (21.8)

  14. Suicide in the Eastern HPR, 2003-2008

  15. Suicide in the Eastern HPR, 2003-2008 Race and Gender: Non-Fatal Attempts • Most commonly by females (59%, rate of 48.3) • Whites still most common and highest risk • Black risk level rises notably (from rate of 5.5 to 31.1) • Asian risk level doubles

  16. Suicide in the Eastern HPR, 2003-2008

  17. Suicide in the Eastern HPR, 2003-2008 Age: Non-Fatal Attempts • Median age is 36 • Risk increases for all age groups except 75-84 and 85 and over • Rate for those ages 15-19 increases 9 times (from 6.5 to 59.7) • In general, non-fatal attempt rate decreases with age

  18. Suicide in the Eastern HPR, 2003-2008 At ages 75-84, the fatal rate surpasses the non-fatal rate

  19. Suicide in the Eastern HPR, 2003-2008 Veterans

  20. Suicide in the Eastern HPR, 2003-2008

  21. Suicide in the Eastern HPR, 2003-2008 • Veterans • 32% of all suicide victims (18 years and older) • 40% of males; 7% of females • Unknown if veterans served in combat, but can generally tell if they are currently in the military

  22. Suicide in the Eastern HPR, 2003-2008 • Veterans • Male veterans older than male non-veterans (median ages of 55 and 40, respectively) • Median age suggests that those who are combat veterans generally not in the most recent conflicts • 71% of males ages 65 and over are veterans compared to 33% of males ages 18-64

  23. Suicide in the Eastern HPR, 2003-2008 Method of Fatal Injury

  24. Suicide in the Eastern HPR, 2003-2008 Method of Fatal Injury • More than one method of fatal injury can be used per suicide (e.g., combining poison and drowning) • Firearm, poison, and hanging/suffocation account for 94% of suicides • Most poisons are prescribed medications, primarily mental health medications and pain medications

  25. Suicide in the Eastern HPR, 2003-2008

  26. Suicide in the Eastern HPR, 2003-2008 Method of Fatal Injury: Non-Fatal Attempts • Most common method for non-fatal attempts is poison (84%) • Poison use is defining method difference between fatal and non-fatal attempts

  27. Suicide in the Eastern HPR, 2003-2008 Geography

  28. Suicide in the Eastern HPR, 2003-2008 Geography • Eastern HPR has 26 localities (16 counties and 10 cities) • 12 of these localities (46%) have a suicide rate exceeding the rate for Virginia (11.3) • In general smaller locality = lower number and higher rate

  29. Suicide in the Eastern HPR, 2003-2008

  30. Suicide in the Eastern HPR, 2003-2008

  31. Suicide in the Eastern HPR, 2003-2008

  32. Suicide in the Eastern HPR, 2003-2008 Selected Circumstances

  33. Suicide in the Eastern HPR, 2003-2008 Most Common Circumstances • Mental health problem (50%) • Crisis in past two weeks (34%) • Intimate partner problem (34%) • Problem with alcohol and/or other substances (26%) • Physical health problem (18%)

  34. Suicide in the Eastern HPR, 2003-2008 Circumstances: Mental Health • Females (71%) more than males (44%) • Most prevalent in ages 55-64 (60%); 30% or more of every age group • 83% treated in past two months and/or prior • 56% known to take mental health medications currently or in the past* * 2007-2008 data

  35. Suicide in the Eastern HPR, 2003-2008 Circumstances: Crisis in Past 2 Weeks • 34% of all persons; 35% of males, 31% of females • Most crises (73%) occurred in the past 24 hours* • Indicator of reactive suicides • 38% or more for age groups 15-19, 20-24, 25-34, and 35-44 *2007-2008 data

  36. Suicide in the Eastern HPR, 2003-2008 Circumstances: Intimate Partner Problems • 34% having problems with current/former intimate partner at time of suicide • 34% of males and females • 61% also having a recent life crisis • Shows volatility of intimate partner conflict

  37. Suicide in the Eastern HPR, 2003-2008

  38. Suicide in the Eastern HPR, 2003-2008 Circumstances: Alcohol and Other Substance Problems • 26% of all persons • Peaks at ages 35-44 (38%) • 50% of those with alcohol problems had elevated levels of alcohol in their system at death (compared to 15% of those without alcohol problems)

  39. Suicide in the Eastern HPR, 2003-2008 Circumstances: Physical Health Problems • 18% of all suicide victims; 19% of males, 15% of females • Median age of 65 compared to 41 for those without a physical health problem • 45% or more of those ages 65 and older

  40. Suicide in the Eastern HPR, 2003-2008 Circumstances: Physical Health Problems • Explains majority of elder suicides • Problems range from treatable (diabetes, mild pain) to severe (loss of vision, amputations) to terminal diseases and conditions

  41. Suicide in the Eastern HPR, 2003-2008 Circumstances: Warning Signs • 41% disclosed intent and/or had prior attempts • Most commonly disclosed to family (54%), intimate partners (35%), friends/acquaintances (17%), medical/mental health professionals (4% each)* • Disclosure of intent similar for males (31%) and females (30%) • Prior attempts more common for females (31%) than for males (16%) *2007-2008 data

  42. Suicide in the Eastern HPR, 2007-2008 Actions Taken to Prevent Suicide* • Sought/encouraged mental health treatment (35%) • Called 911/law enforcement (25%) • Tried to persuade victim to not commit suicide (25%) • Checked in on victim (5%) *2007-2008 data (entire slide)

  43. Suicide in the Eastern HPR, 2003-2008 In the fatal suicide, those with prior attempts used less lethal methods than those without prior attempts

  44. Suicide in the Eastern HPR, 2007-2008 Other Warning Signs of Suicide* • Sleeping too little (10%) • Taking prescribed pain medication (10%) • Unusual behavior, past two weeks (4%) • Family history of suicide (2%) • Family/friends expected suicide (1%) *2007-2008 data (entire slide)

  45. Suicide in the Eastern HPR, 2003-2008 Conclusions • Suicide rates are highest among Whites, males, and older adults • Most suicides involve use of a firearm to inflict fatal injury • Half of suicide victims have a mental health problem, and most of these persons were being treated

  46. Suicide in the Eastern HPR, 2003-2008 Conclusions • 41% of suicide victims are known to talk about plans or desire to commit suicide and/or have a history of suicide attempt(s) • Fatal suicide and non-fatal suicide attempts present different pictures of risk and methods of fatal injury

  47. Questions, Data Requests, Further Information Marc Leslie, VVDRS Coordinator 737 N. 5th Street, Suite 301 Richmond, VA 23219 804-205-3855 marc.leslie@vdh.virginia.gov http://www.vdh.virginia.gov/medExam/NVDRS.htm Our goal is to provide data and information that can be used for prevention and education; please let me know how I can help

  48. Appendix: Additional Information and Complete Tables

  49. Suicide in the Eastern HPR, 2003-2008 Index: Fatal Suicide

  50. Suicide in the Eastern HPR, 2003-2008 Index: Non-Fatal Suicide

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