Older-adult patients more likely to disclose suicidal thoughts as they age

Depression and health problems in older adults are linked to willingness to disclose suicide intent, according to a new study in the American Journal of Preventive Medicine.


Ann Arbor, MI, October 4, 2017

Suicide among older adults is a growing public health issue. Conditions associated with aging — chronic pain, diagnosed or perceived terminal illness, social isolation, and the death of friends and family — can push older Americans towards ending their own lives. A new study in the American Journal of Preventive Medicine shows that 23% of individuals aged 50 and older who died by suicide had disclosed their suicide intent.

Using 10 years of data from the National Violent Death Reporting System (NVDRS), researchers were able to identify key trends about older suicide decedents. They found the older the decedents were, the more likely they were to have disclosed their intent to die by suicide. Decedents who had depressed mood or health problems were more likely to have disclosed, as well as those who had recently received mental health care or undergone substance abuse treatment.

“Findings that depressed mood, health problems, and other stressors were associated with increased odds of disclosure indicate that suicide may have been prevented by providing the services needed to alleviate these problems,” explained lead investigator Namkee Choi, PhD, Louis and Ann Wolens Centennial Chair in Gerontology, Steve Hicks School of Social Work at the University of Texas, Austin, TX. “Healthcare providers need better preparation to screen and aid those in need to prevent suicide.”

The study also looked at other aspects of older-adult suicide. The data revealed that disclosure was most often to an intimate partner or other family member, with only a small number talking about suicide to a healthcare professional. In terms of methods of suicide, researchers found that the use of firearms and hanging/suffocation were associated with lower overall disclosure odds. Among firearm users, however, men were more likely to have disclosed than females.

“Because disclosing suicide intent provides an opportunity to prevent suicide and offer assistance in coping with stressors, the study findings have important clinical implications for increasing disclosure and preventing suicide among older adults,” said Dr. Choi. Investigators pinpoint four important interventions that may help prevent suicide by the elderly:

  • Healthcare providers, especially primary care physicians who work closely with older adults, should routinely assess suicide risk and inquire about access to guns and other means of suicide. Evidence-based prevention training programs such as Applied Suicide Intervention Skills Training should be considered.
  • Public health campaigns aimed at families and other social support systems for elderly patients should discuss suicide warning signs and give information on how to seek help after a disclosure.
  • Healthcare and social service systems need to ensure that older adults have access to services that address their mental and physical health needs, such as therapy for ongoing emotional turmoil and crisis counseling, palliative care for chronic pain, and affordable and accessible long-term care services for chronic illness and disabling conditions.
  • Older adults suffering from depression, mental illness, or substance abuse need tailored treatment services made to suit their specific needs. These services can be integrated into the primary car setting to ease access and reduce the stigma of getting mental health help.

As suicide rates for older Americans continue to climb, it is crucial to take a close look at this issue and find opportunities for intervention. “High late-life suicide rates in a rapidly aging society call for more effective ways to identify older adults at risk and provide prevention and intervention services,” concluded Dr. Choi.

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Notes for Editors
The article is “Older Suicide Decedents: Intent Disclosure, Mental and Physical Health, and Suicide Means,” by Namkee G. Choi, PhD, Diana M. DiNitto, PhD, C. Nathan Marti, PhD, and Mark S. Kaplan, DrPH (https://doi.org/10.1016/j.amepre.2017.07.021). It appears in the American Journal of Preventive Medicine, volume 53, issue 6 (December 2017) published by Elsevier.

Full text of this article is available to credentialed journalists upon request; contact Jillian B. Morgan at +1 734-936-1590 or ajpmmedia@elsevier.com. Journalists wishing to interview the authors should contact Andrea Campetella at +1 512-471-1458 or campetella@austin.utexas.edu.

About the American Journal of Preventive Medicine
The American Journal of Preventive Medicine is the official journal of the American College of Preventive Medicine and the Association for Prevention Teaching and Research. It publishes articles in the areas of prevention research, teaching, practice and policy. Original research is published on interventions aimed at the prevention of chronic and acute disease and the promotion of individual and community health. The journal features papers that address the primary and secondary prevention of important clinical, behavioral and public health issues such as injury and violence, infectious disease, women's health, smoking, sedentary behaviors and physical activity, nutrition, diabetes, obesity, and alcohol and drug abuse. Papers also address educational initiatives aimed at improving the ability of health professionals to provide effective clinical prevention and public health services. The journal also publishes official policy statements from the two co-sponsoring organizations, health services research pertinent to prevention and public health, review articles, media reviews, and editorials.

About Elsevier
Elsevier is a global information analytics business that helps institutions and professionals progress science, advance healthcare and improve performance for the benefit of humanity. Elsevier provides digital solutions and tools in the areas of strategic research management, R&D performance, clinical decision support, and professional education; including ScienceDirect, Scopus, SciVal, ClinicalKey and Sherpath. Elsevier publishes over 2,500 digitized journals, including The Lancet and Cell, more than 35,000 e-book titles and many iconic reference works, including Gray's Anatomy. Elsevier is part of RELX Group, a global provider of information and analytics for professionals and business customers across industries. www.elsevier.com

Jillian B. Morgan, MPH
Managing Editor, AJPM
+1 734-936-1590
ajpmmedia@elsevier.com