What is causing the alarming increase in suicides in the United States, and what can psychiatrists do to help?
The Centers for Disease Control and Prevention recently reported that the suicide rate in 2014 was 13/100,000, a 24% increase from the 1999 rate of 10.5/100,000. Every age group from 10 to 74 had an increase in suicides; people over age 75 had a decrease. The suicide rate increased by 1% yearly from 1999 through 2006 and then by 2% per year from 2006 through 2014.
Dr. Marcia Morris
It’s hard to find a single explanation for the increased suicide rates, since so many events have rocked our country since 1999. You could talk about 9/11 and the wars that followed, you could mention the Great Recession of 2007-2009 and its anemic recovery, and you could note the growing disparity between the rich and the poor as placing immeasurable stress on this country.
The economy and war do not explain the most startling statistic: The suicide rate for girls aged 10-14 tripled from 1999 to 2014. I can only speculate on the cause of this rise, but I believe social media play a role. Facebook was launched in 2004, and there are now dozens of social media sites that adolescent girls use, despite age restrictions. The bullying and sexual harassment that have always been part of the adolescent years now can be amplified when a message or post goes viral. Cyberbullying has been linked to some high-profile adolescent suicides. While researching this topic, I learned about a book, “American Girls: Social Media and the Secret Lives of Teenagers” (New York: Knopf, 2016) by Nancy Jo Sales, which highlights the harm of unmonitored social media use on girls’ psyches.
While women had a larger increase than men in suicide rates, men’s rates continue to exceed women’s rates. The ratio of male to female suicides was 3.6 in 2014, a decrease from a rate of 4.5 in 1999. Possible explanations for men’s continued higher suicide rates include their decreased likelihood of seeking help for mental health issues and increased likelihood of using more lethal means (firearms) in suicide attempts.
Most psychiatrists may not be surprised to learn that suicide rates have steadily risen from 1999 to 2014. In my own work as a university counseling center psychiatrist, I see a student population with increased rates of anxiety, depression, and suicidal thoughts and behaviors. Suicide is now the second-leading cause of death for people aged 15-24.
Whenever I hear about a suicide, I lament that the individual either did not seek treatment or lost faith in the treatment they were in. Tragically, it is estimated that 2 out of 3 of people who killed themselves suffered from depression, and the majority of them were not receiving treatment. If they only knew what we have seen as psychiatrists – amazing recoveries in people who had nearly given up hope.
How do we engage people who are depressed and suicidal into believing they can get help and feel good again?
We have to start young, by educating parents about the warning signs of depression and suicide in their children. For the last few years, I have written parenting articles, given talks, and done radio shows on mental health. Psychiatrists can teach parents through writing and speaking in their local communities. Parents should be encouraged to monitor their child’s social media use. Parents should urge both girls and boys to talk openly about their feelings and not be afraid to ask for help.
We have to encourage people of all ages to recognize and get early treatment for mental health problems. We need to get the word out that there is strength in seeking help. We have to fight the stigma that continues to accompany mental health treatment.
We also need to loudly support more funding for mental health. Too many of my patients who need intensive levels of treatment for psychosis, severe depression, or borderline personality disorder lack access to care; some have no insurance or insurance with limited coverage. Write your congressman, senator, or local representative to support bills that increase mental health coverage. Promote groups like NAMI, National Alliance on Mental Illness, and the Depression and Bipolar Support Alliance that provide support and advocacy.
Over the next few months, there may be explanations for the increased suicide rates and a public health approach to this problem. There is one fact we know: Many people with mental health issues are not getting treatment. Now more than ever, psychiatrists need to go beyond the walls of their office to educate the public about the benefits of treatment, and to advocate for greater access to care.