The State of Suicide and its Survivors

One person providing comfort to another.

By Cori McMahon, PsyD, NCCE
VP of Clinical Services, Tridiuum

Suicide, always a tragic outcome of advanced mental illness, is quickly becoming an even more formidable threat in the United States. According to Suicide Awareness Voices of Education (SAVE), 2020 saw almost 46,000 Americans die from suicide in the U.S., making it now the 12th leading cause of death in our country. With one death every 11.5 minutes, there are approximately 125 Americans dying by suicide every day. These numbers are astounding, and when we consider those most impacted, suicide is the third leading cause of death among 15–24-year-olds.

Highest Risk
The highest rates are among white males (25.4 per 100,000) followed by Native American/Alaska Natives (14.6) and Black males (12.6). While those data represent individuals who have died, it is estimated that there is one attempt every 27.5 seconds for a total of almost 1.15 million attempts annually in the U.S.

Broadening the scope to include worldwide data, it is estimated that nearly 800,000 people die from suicide each year, representing roughly one death every 40 seconds. Suicide is the 2nd leading cause of death globally for those aged 15–24 and depression is the leading cause of disability.

Vulnerable Populations
Lesbian, gay and bisexual kids are three times more likely than those who identify as straight to attempt suicide at some point in their lifetime (di Giacomo et al, 2018) . Those who come from families who reject them are over eight times more likely to attempt suicide than those who are accepted by their families (American Foundation for Suicide Prevention). In addition, in 2019, the suicide rate in U.S. veterans aged 18-34 was 44.4 per 100,000. While this rate decreased for both male and female veterans from 2018 to 2019, it remains much higher than the general population. (National Veteran Suicide Prevention Annual report)

Surviving an Attempt
When interviewed, those who have attempted suicide describe being stuck in a state of transition. They had moved beyond experiencing suicidal thoughts and made a serious attempt to stop living, yet they survived and are now attempting to cope with the aftereffects.

“Most clinicians are trained to just stick the client in an inpatient unit as soon as possible,” said Jacqueline Elder, a retired therapist and suicide attempt survivor who runs a Facebook support group for fellow survivors.

This is a major fear for those who suffer from suicidality. Attempt survivors also describe the importance of family involvement in one’s recovery. However, family members might be uncertain about what to say, how to behave, or experience compassion fatigue after hearing a loved one talk about suicide or make multiple attempts. There are various common and evidence-based interventions that can effectively address suicidal thoughts, like cognitive behavioral therapy, medication when appropriate, and mindfulness techniques. According to the literature, while those who have attempted suicide are more likely to have subsequent attempts, the majority of those who have attempted do not die from a subsequent attempt and go on to live their full lives.

Effect on Loved Ones
The devastating loss of a life by suicide causes a ripple effect on everyone that person touched. According to Frontiers in Psychiatry, every suicide effects between five and eighty individuals, who are known as suicide survivors. Not surprisingly, suicide survivors are at increased risk for depression, anxiety, and suicidal behaviors of their own. They also have an increased likelihood to experience suicide grief—the rate of complicated grief, or an ongoing, heightened state of mourning that prevents healing, reaches 40% in this population. When it comes to seeking mental health support, this group can experience barriers related to guilt, shame, and social stigma. In a survey study completed by McMenamy, Jordan, and Mitchell, 2008, four areas of natural coping were examined:

  1. Practical, psychological, and social difficulties
  2. Formal and informal sources of support
  3. Resources utilized in healing
  4. Barriers to finding support since the loss

Survey results indicated that survivors experienced high levels of psychological distress, including symptoms of depression, guilt, anxiety, and trauma. Survivors had difficulty talking with others about the suicide. Most of the group viewed professional help as beneficial, while barriers to receiving care included depression and lack of information about where to find help. Those who reported higher levels of functional impairment also reported higher levels of distress, social isolation, and barriers to seeking help.

Improving Care
Barriers to seeking help, both for suicide survivors and suicide attempt survivors, have improved in the recent past and have been impacted greatly by healthcare technology. With ease and reach of access, those in need of immediate care can connect with support when it is critically needed.

Over the past few years, almost 200,000 suicide alerts have been triggered within the Tridiuum ONE system. This information is used to connect individuals to real-time clinical support by providers who can tailor interventions to meet patient needs more effectively.

While warning signs for suicide may or may not be apparent, we know that depression affects 20–25% of American adults annually and only half of those experiencing an episode receive treatment (CDC, NAMI). If we connect patients to care efficiently, 80–90% of those who do seek treatment for depression are treated successfully using therapy and/or medication (TADS study).

Read more about suicide and access to firearms.

 

National Suicide Prevention Lifeline: Dial 988 or 800-273-8255