Most Males Who Die by Suicide Have No Known Mental Health Conditions

The majority of boys and men who die by suicide have no known mental health conditions, a study in the American Journal of Preventive Medicine has found.

Katherine A. Fowler, Ph.D., of the National Center for Injury Prevention and Control at the Centers for Disease Control and Prevention (CDC) and colleagues analyzed data from the CDC’s National Violent Death Reporting System (NVDRS) for 70,376 males aged 10 years and older who died by suicide between 2016 and 2018. The researchers looked at data from four age groups: adolescents (aged 10 to 17 years), young adults (aged 18 to 34 years), middle-aged adults (aged 35 to 64 years), and older adults (aged 65 years and older). They used the NVDRS definition of a diagnosed mental health problem to determine if males who had died by suicide during the study period had any known mental health conditions. The NVDRS defines “diagnosed mental health problems” as diagnosed disorders and syndromes listed in DSM-5 except for alcohol and other substance use disorders. The definition also includes a history of treatment for a mental health problem, even if the nature of the problem is unclear in the person’s records (for example, the records say the person “was being treated for various psychiatric problems”).

Overall, 60% of males who died by suicide had no known mental health conditions. Across all age groups, firearm suicides were more common among males without known mental health conditions compared with males who had known mental health conditions. Between 32% and 40% of all young and middle-aged adults in the study had a history of problematic substance use. Between 43% and 48% of all young and middle-aged adults tested positive for alcohol at the time of their death.

Relationship problems were common among males who died by suicide, especially among adolescents, young adults, and middle-aged adults with no known mental health conditions. Intimate partner problems were significantly more common for young and middle-aged adults with no known mental health conditions, and family problems were the most common type of problem for adolescents with or without known mental health conditions. Arguments were common across age groups and were significantly more prevalent among young and middle-aged adults without known mental health conditions, particularly among those who died by suicide during an argument.

Fowler and colleagues wrote, “Suicide prevention initiatives for males might benefit from comprehensive approaches focusing on age-specific stressors reported in this study in addition to standard psychiatric markers.”

For related information, see the Psychiatric Services article “Preventing Suicide Through Better Firearm Safety Policy in the United States.”

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Many Older U.S. Adults Who Died By Suicide Did Not Have Known Mental Illness, Study Suggests

Many U.S. adults 65 and older who died of suicide between 2003 and 2016 did not have a known mental illness, according to a report in the American Journal of Preventive Medicine. The majority those who died of suicide were reported as having physical health problems—a precipitating circumstance that was more commonly documented for older adults without known mental illness.

“Suicide risk increases with age, and evidence exists for the underdiagnosis and undertreatment of suicide risk in older adults,” wrote Timothy J. Schmutte, Psy.D., and Samuel T. Wilkinson, M.D., both of Yale School of Medicine.

To better understand the similarities and differences between older adults with and without known mental illness who died of suicide, Schmutte and Wilkinson analyzed data from the National Violent Death Reporting System (NVDRS). This U.S. database contains extensive information on the characteristics of suicide decedents and the circumstances that precipitated their deaths. Known mental illness was defined as whether a decedent was identified as having a current mental health problem based on law enforcement or coroner/medical examiner reports.

Of the 26,884 suicide deaths recorded during the study period, 83.2% occurred in men. Most older men (69.1%) and women (50.2%) who died of suicide did not have a known mental illness.

Most suicide deaths involved firearms, which were disproportionately used by decedents without known mental illness (81.6% of men and 44.6% of women) compared with those with known mental illness (70.5% of men and 30.0% of women).

“[T]his study highlights a need for prevention efforts that address a broad range of risk factors for late-life suicide. ... Targeted community efforts to reduce stigma and improve help-seeking in older adults, particularly men, and other population-based strategies (for example, legislation that reduces access to handguns) may be effective at reaching vulnerable adults and reducing suicide rates,” Schmutte and Wilkinson wrote.

For related information, see the Psychiatric News article “Loss of Partner to Suicide Increases Risk of Mental Health Problems, Death.”

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