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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

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

pop quiz
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?
suicide in the eastern hpr 2003 20087
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
suicide in the eastern hpr 2003 200811
Suicide in the Eastern HPR, 2003-2008

Selected Demographic Elements

  • Gender
  • Race
  • Age
suicide in the eastern hpr 2003 200812
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)

suicide in the eastern hpr 2003 200813
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)
suicide in the eastern hpr 2003 200815
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
suicide in the eastern hpr 2003 200817
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
suicide in the eastern hpr 2003 200818
Suicide in the Eastern HPR, 2003-2008

At ages 75-84, the fatal rate surpasses the non-fatal rate

suicide in the eastern hpr 2003 200821
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
suicide in the eastern hpr 2003 200822
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
suicide in the eastern hpr 2003 200824
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
suicide in the eastern hpr 2003 200826
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
suicide in the eastern hpr 2003 200828
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
suicide in the eastern hpr 2003 200833
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%)
suicide in the eastern hpr 2003 200834
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

suicide in the eastern hpr 2003 200835
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

suicide in the eastern hpr 2003 200836
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
suicide in the eastern hpr 2003 200838
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)
suicide in the eastern hpr 2003 200839
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
suicide in the eastern hpr 2003 200840
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
suicide in the eastern hpr 2003 200841
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

suicide in the eastern hpr 2007 2008
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)

suicide in the eastern hpr 2003 200843
Suicide in the Eastern HPR, 2003-2008

In the fatal suicide, those with prior attempts

used less lethal methods than those without prior attempts

suicide in the eastern hpr 2007 200844
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)

suicide in the eastern hpr 2003 200845
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
suicide in the eastern hpr 2003 200846
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
questions data requests further information
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

slide48
Appendix:

Additional Information

and Complete Tables

suicide in the eastern hpr 2003 200852
Suicide in the Eastern HPR, 2003-2008

The White male suicide rate is 3 times the rate for White females, more than twice the rate for Black males, and 12 times the rate for Black females.

suicide in the eastern hpr 2003 200853
Suicide in the Eastern HPR, 2003-2008

Largest percentage of victims: ages 45-54

Highest risk: ages 85 and older

non fatal suicide attempts in the eastern hpr 2003 200855
Non-Fatal Suicide Attempts in the Eastern HPR, 2003-2008

Greatest risk: ages 25-34

Largest percentage: ages 35-44

suicide in the eastern hpr 2003 200860
Suicide in the Eastern HPR, 2003-2008

* Commonly prescribed for

mental health treatment

** Commonly prescribed for pain management

suicide in the eastern hpr 2003 200862
Suicide in the Eastern HPR, 2003-2008

Number and Rate (per 100,000) of

Suicides by Locality of Residence

suicide in the eastern hpr 2003 200863
Suicide in the Eastern HPR, 2003-2008
  • Number and Rate (per 100,000) of
  • Suicides by Locality of Residence (continued)
suicide in the eastern hpr 2003 200864
Suicide in the Eastern HPR, 2003-2008
  • Number and Rate (per 100,000) of
  • Suicides by Locality of Residence (continued)
suicide in the eastern hpr 2007 200871
Suicide in the Eastern HPR, 2007-2008

Some victims had family, friends, or others who reacted

to the disclosed intent and tried to prevent the suicide