Daily Briefing Blog

Why are suicides rising—and how can hospitals help?


Dan Diamond, Managing Editor

Robin Williams' death on Monday put a spotlight on depression—how it can strike anyone, anywhere, anytime. Even one of the world's funniest, most successful men.

And it also underscores an awful fact: The nation's death rate may be falling, but the suicide rate is only going up.

Between 2006 and 2011, the all-cause death rate declined by more than 6%, according to CDC data. But deaths attributable to suicide rose by more than 11%, which means that more than 100 people commit suicide every day. (A figure that experts suggest may be undercounted.)

Researchers have been concerned, if a bit confused by the rise in the suicide rate. But they've flagged a few drivers that likely have played a role in this growing public health problem.

    The aging of the baby boomers. There's data that the rising suicide rate reflects a spike in middle-aged suicides; for example, CDC found that the increase in suicides among men ages 50 to 59 rose by almost 50%.

    And as baby boomers age, they may be especially susceptible to depression, one sociologist warns.

    "The boomers had great expectations for what their life might look like, but I think perhaps it hasn’t panned out that way," Rutgers sociologist Julie Phillips told the New York Times last year.

    The suffering of military veterans. Studies suggest that as many as 22 suicides per day are from veterans struggling with a range of risk factors, like PTSD, problems reintegrating to non-combat life, and difficulty accessing care. (See related coverage: "For every soldier killed in combat, 25 are dying by suicide.")

    The pain of the Great Recession. Financial troubles have frequently been a driver for depression, and researchers have unearthed a strong link between the economic downturn and the rising suicide rate; some older Americans who lost their jobs were particularly at risk.

Related: Physicians have the highest suicide rate of any profession. So why haven't you heard about it?

Experts stress that many suicides are ultimately preventable—90% of Americans who commit suicide had a untreated mental health disorder at the time of death.

And that means providers can play a key role in saving lives: Proactive hospitals, doctors, nurses, and other staff can do more to spot and care for the patients who are most at-risk.

For instance, my colleagues at the Care Transformation Center flagged essential tactics to screen and connect patients to behavioral health resources at every step in the care delivery process, beginning with the initial visit.

And there are strategies for the outpatient care process too, such as training PCPs to screen for behavioral health disorders and better integration with non-hospital staff (like community social workers).

Given that so many patients with behavioral health problems don't know where to go—or are worried about the stigma of mental illness—a doctor's role is essential here.

"The primary care office is usually the patient’s first and central point of contact with the health system. It’s also a major triage point," my colleague Kelsey Mahler points out. That means that adding behavioral health care support to the primary care setting has a dual benefit, she writes: It meets patients' immediate needs, and "increases the likelihood that patients will get timely access to ongoing care."

More resources on addressing mental health

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See our study on how hospitals can be proactive at managing behavioral health, and this accompanying video on why that matters so much—not just for patients' mental state, but for their physical health too.

The Daily Briefing also has covered how some hospitals are redesigning their facilities as they try to prevent patient suicides.

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Physicians have the highest suicide rate of any profession. So why haven't you heard about it?

Nearly 400 physicians commit suicide each year—likely an underestimate, say experts—but the subject still remains taboo in the medical community and physicians' cries for help often fall on deaf ears, writes Pamela Wible for the Washington Post.