Special report: US men and suicide

Each year, about 31,000 Americans commit suicide, making it the eighth leading cause of death in the United States. Almost every American has a relative, friend, or acquaintance who has killed himself, according to a Men's Health America special report into The Continuing Tragedy of Male Suicide.

The number one risk factor for suicide is being male. In 1999, the suicide death rate was 18.2/100,000 among males, and 4.1 in females(1). This means that male suicides outnumbered female suicides by ratio of 4.4:1. Suicides have dropped slightly both among men and women since 1950.

Looking at age groups, suicide rates escalate rapidly during the 10-24 year age group. For White males, the rate then stabilizes until age 64, then again rises sharply. For Black males, the rate actually begins to drift down after age 24 (2).

Researchers have pinpointed a number of other risk factors for suicide, including suffering from depression, and being socially isolated, divorced, or widowed. According to one report that analyzed suicide among persons 65 years and older, "Sex- and marital status-specific suicide rates were highest for divorced/widowed men" (3).

Male suicide is also worrisome outside the United States. According to the World Health Organization, the international suicide rate is 24.0/100,000 among males, compared to just 6.8 in females, yielding a 3.5 male:female ratio (4). The sex disparity is especially high in the following countries, most of which are in Eastern Europe and Latin America(5). See table left.

It is true that women are more likely to engage in suicide attempts. But men who are contemplating suicide are far more likely to use firearms, and thus are more likely to be successful in their attempt. For women, a suicide attempt often represents a desperate plea for help. But for men, a suicide attempt represents an utter loss of hope.

Recent Milestones in Suicide Prevention

In 1999, former Surgeon General David Satcher released the ground-breaking report, "Call to Action to Prevent Suicide" (6). Fortunately, the report gives due attention to the problem of male suicide. Following his Call to Action, the Surgeon General formulated a National Strategy for Suicide Prevention, which coordinates the efforts of five federal agencies involved in the effort: the Centers for Disease Control, the Substance Abuse and Mental Health Services Administration (SAMHSA), Health Resources and Services Administration, the Indian Health Service, and the NIH National Institute of Mental Health.

The National Strategy includes research, surveys, conferences, suicide screening and prevention programs, and public information services. The National Strategy includes one female-specific program, which screens for depression among women around the time of pregnancy

(7). The National Strategy currently does not provide for any male-specific programs.

A number of private sector organizations complement the work of these five federal agencies. Those organizations include:

- American Association of Suicidology: www.suicidology.org

- American Foundation for Suicide Prevention: www.afsp.org

- Suicide Prevention Advocacy Network: www.spanusa.org

Suicide is a personal and social tragedy that can be prevented. But to be effective, prevention programs must be targeted at those persons at highest risk.

References

1. National Center for Health Statistics: Health, United States, 2002.

Hyattsville, MD, Table 30.

2. U.S. Suicide Rates by Age, Gender, and Racial Group, 1999.

www.nimh.nih.gov/research/suichart.cfm

3. Centers for Disease Control: Suicide among Older Persons, United

States, 1980-1992. Morbidity and Mortality Weekly Report, January 12,

1996.

4. World Health Organization: World Health Report 2001: Mental Health:

New Understanding, New Hope, Chapter 2.

5. Krug E: World Report on Violence and Health. Geneva, World Health

Organization, 2002. Table 7.1.

6. Surgeon General's Call to Action to Prevent Suicide.

www.mentalhealth.org/suicideprevention/calltoaction.asp

7. National Strategy for Suicide Prevention. www.mentalhealth.org/

suicideprevention/glance.asp

 Male:Female

  Ratios international

 Belarus

6.7 to 1

 Chile

8.1

 Estonia

5.7

 Kazakhstan 5.8

 Kyrgyzstan 5.1

 Lithuania 6.2

 Mexico

6.3

 Panama

5.7

 Poland

5.5

 Puerto Rico 10.4

 Moldova 6.0

 Romania 5.1

 Russian Federation 6.2

 Slovakia 6.5

 Ukraine

6.1

 Venezuela 5.0