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Speaking at a press conference in Washington, D.C., last month, Surgeon General David Satcher, M.D., helped launch a suicide prevention initiative and announced that the federal Centers for Disease Control and Prevention would support development of a national suicide prevention research center.
Joined by the friends and families of people who had killed themselves, Satcher said that suicide, which results in more than 31,000 deaths each year, has not yet received the attention it deserves as a leading cause of mortality in the United States.
"Life is full of golden opportunities carefully disguised as irresolvable problems," remarked Satcher. The advent of effective therapies for depression and other serious mental illnesses that contribute to suicide presents us with such an opportunity, he said. The public health problem of suicide "is now being recognized, and action to address the problem is emerging," he observed. "I'm sure that if we work together, we can overcome the unfortunate attitudes of so many Americans toward [mental illness] and the problem of suicide."
Suicide is the ninth leading cause of death in the U.S., and the third leading cause of death for people aged 15 to 24, according to Satcher. More people kill themselves each year than are murdered.
Senator Harry Reid (D-Nev.) spoke via live television from his home state. Reid, whose father killed himself, alluded to the stigma surrounding suicide and mental illness.
"I speak from experience when I say there is nothing more devastating than losing a loved one to suicide," said Reid. "After my father killed himself, my family had to bear the burden of that tragic experience in secret. At that time no one talked publicly about suicide, and there were no support groups to help us cope with our feelings."
A room-sized suicide quilt containing verses, embroidery, and, in some cases, photographs of the dead was held up for the duration of the hour-long press conference. At the conclusion, the quilt was flipped over, leaving the blank side to the audience as a symbol of the absence of the dead.
The briefing was sponsored by the Suicide Prevention Advocacy Network (SPAN), a group started by people who had lost family members to suicide. SPAN has received a research grant from the Center for Mental Health Services (CMHS) to identify the best suicide prevention practices.
Although Americans kill themselves in a variety of ways, most shoot themselves, observed APA President Herbert Sacks, M.D. The increase in the U.S. suicide rate over the past 30 years is due in part to the ready availability of firearms, particularly handguns, said Sacks.
"States with very strict gun control laws have low suicide rates," he said. It is unlikely, however, that the use of guns in suicide will be a factor in any legislative decision to limit their availability, "since suicide is not high on the list of America's political concerns," he added.
A Norwegian study recently published in the Journal of Child and Adolescent Psychiatry revealed that self-inflicted gunshot wounds from handguns are the primary cause of death among Norwegian teenagers 15 years old and older, Sacks noted. These suicides are often associated with alcohol use and depression. Children under the age of 15 more often kill themselves by hanging, according to Sacks. Child suicide and attempted suicide "have been associated with serious mental disorders, especially unrecognized bipolar disorder, in my experience," Sacks noted.
In 1995, the most recent year for which there are complete data, more than 90 percent of all suicides in the U.S. were among whites, with males accounting for 73 percent and females 18 percent. Minority suicides, however, are a growing problem, Satcher observed. Suicide rates for native Americans are about 1.5 times the national rate. Although white teenagers have a higher suicide rate than black youths, the suicide rate for black teens aged 15 to 19 more than doubled from 3.6 per 100,000 to 8.1 per 100,000 between 1980 and 1995, according to Satcher.
Another at-risk group are the elderly, who have a suicide rate 50 percent higher than the national average.
A national consensus development conference to support the goal of reduced suicide will be held October 15 through 19 in Las Vegas. The conference is cosponsored by the National Center for Injury Prevention and Control of the Centers for Disease Control and Prevention. Additional federal agency support is being provided by the Center for Mental Health Services and the Substance Abuse and Mental Health Services Administration. Nevada was chosen as the site in part because it is the state with the highest suicide rate.