April 10, 2006

Who Died?

Here is a suicide statistic:

"Suicide is the eighth leading cause of death in men."

That's useless, because there is no context. Other useless statements are: the risk is higher in psychiatric illness; the risk is higher the more previous attempts; men have higher rates of sucide than women, etc.

Here are some statistics (1999, 2001 and 2003-- they're all the same) which may help you.

In the US in 2001, 30,622 people died from suicide.   Yes.  That few.

24,672 were men. 5950 were women. (That's 80/20). In the whole world (WHO 2000), it was about 815,000.

5395 were over 65. (85/15 males to females)
3971 were 15-24. (85/15 males to females)

So 70% of all suicides are adults.
73% of all suicides are white males (20,000+). To put it in perspective, in 2003, the number of black women who suicided was 358.
Guns were involved in 55% of all suicides; 60% of the men's, and 73% of the elderly's, and 54% of youth's.

In other words, mostly white adult males die.

White men over 85 have the highest rate given their popualtion (54/100,000), vs. an overall rate of 10.7/100,000 (.01%) But this number of suicides is so small that the statistic doesn't help you.

So the real risk factors are white males with a gun.

I should also point out that 30,622 is a really small number of people-- even though it is almost as many as homicides (20k) and AIDS deaths (14k) combined.

How about suicide attempts that don't result in death?

Well, there are a lot: in 2002, 132,353 were hospitalized for a suicide attempt, and 116,639 were seen in an ER and released. But here's the thing: they didn't die.

The problem with our suicide assessment is that it screens for attempts, not death. And while non-psychiatrists might be surprised to hear this, a whole lot of people commit impulsive suicidal acts with no or little interest in actually dying. Psychiatry cannot do much to stop these acts, nor should it be responsible to do so. A psychiatrist should be no more responsible to prevent these parasuicidal acts than an endocrinologist is to guarantee that the patient takes their insulin. If psychiatric illness-- that's major Axis I-- so impairs their reason that they don't know what they're doing, can't stop, etc-- then it's our responsibility, just like, given that same patient, it's the endocrinologist's.  Otherwise, it is not.

We spend a lot, a lot, of money and time hospitalizing people who are not going to die. A not insignificant portion are outright malingerers, and everyone knows it. The rest may be at risk, but they may not be best served in a hospital.

So we can either spend our time and resources on preventing suicide attempts, or on preventing the 30k actual suicide deaths. It's not the same thing.







Comments

Excellent post. I linked t... (Below threshold)

June 6, 2006 9:07 PM | Posted by spiritual_recovery: | Reply

Excellent post. I linked to you via this quote on my own site: Many psychiatrists try to frighten families into keeping the person on medications by saying 10% of people with schizophrenia commit suicide. If you are told that, ask to see evidence proving that the statistic is accurate. The truth is, national statistics on suicide disprove that statement. There is no documented evidence supporting the assertion that 10% of people with schizophrenia commit suicide. If that was true, there would be over 250,000 suicides recorded in the United States every year instead of the 30,000 reported for all causes.

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I want to address this last... (Below threshold)

October 21, 2007 11:17 AM | Posted by Nate: | Reply

I want to address this last statement:

"We spend a lot, a lot, of money and time hospitalizing people who are not going to die. A not insignificant portion are outright malingerers, and everyone knows it. The rest may be at risk, but they may not be best served in a hospital."

I think it's kind of complicated. No, these people are not the best way to use hospital resources; but unfortunately, hospitals are really the only acceptable institutions to give these people what they need (or rather want, if you feel like differentiating).

Two hundred years ago, you could spend six months in a monastery. Fifty years ago, a short institutionalization for a "nervous breakdown" was acceptable. From what I've seen, people with non-lethal suicide attempts are not without problems, and they've reached the end of their rope. No, they don't really want to die, but they need a socially acceptable respite. They need a week during which they're loved, a week away from their job, a week where they carefully inspect their own hearts.

It's easy to scoff and call it nonsense, to say toughen up, but you could say the same thing about a patient getting pain medication during the setting of a fracture. Hospitalization (nope, that "bottle" of Vicodin still didn't kill them) and inpatient psych don't fix the problem, but they palliate for a variable length of time-- and the goal isn't to live forever anyways, the goal is to have your life be enjoyable, or at least tolerable. Sometimes that requires a never-ending series of very expensive band-aids.

Besides, this is America. Admit to all the beds you want-- we'll make more! (and expand admission criteria so long as a bed lies empty....)

I agree that there isn't really a better way. But the reason there isn't a better way is because psychiatry isn't set up for cure, it's set up for management. Admission to a hospital is really a pause in your life; nothing actually happens there, there isn't any advancement. For example, you don't spend five hours a day in coping skills training, modified CBT style skills, insight therapy, etc. You just wait. So leaving aside the malingerers, the others aren't actually getting a service in the hospital, they're just waiting out their suicidality.

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Sadly no one knows the pain... (Below threshold)

August 29, 2008 3:00 PM | Posted by Animous: | Reply

Sadly no one knows the pain someone who committs suicide was experiencing,its not as simple as suck it up and move on or being condemned to a lifetime of meds which only put you in worse positions as far as extensive depression and dibilitating circumstances. I resent those who feel that these people are cowards, believe me there is nothing cowardly in taking one's life...especially if this means that they will find the peace they seek. Yes, many people are concerned about cleaning up the mess and the politeness of how to phrase what happened, but let me ask you this. That person should be forced to live an unhappy life based on the convienence of others? So then this isn't selfish of those who have opposed a person's right to die?

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One knows that men's life i... (Below threshold)

July 2, 2010 2:24 PM | Posted by WeaverConcetta33: | Reply

One knows that men's life is not very cheap, however we require money for various issues and not every man gets enough cash. Thus to receive quick lowest-rate-loans.com and just short term loan would be a correct way out.

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Of course, Alone, as you po... (Below threshold)

November 3, 2013 6:26 PM | Posted by Me: | Reply

Of course, Alone, as you point out, it's men who are the most likely to actully kill themselves. But who's the most likely to attempt suicide? "Society" spends money on women; men (especially white men) can go kill themselves.

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~30,000/year sounds small, ... (Below threshold) That person should... (Below threshold)

May 12, 2014 12:44 PM | Posted, in reply to Animous's comment, by jonny: | Reply

That person should be forced to live an unhappy life based on the convenience of others? So [this is] selfish of those who have opposed a person's right to die?

Selfless of them (the Selfish don't need to impose), but yes. They've never had the Right to impose on anyone, but TDGAF. What possible logical, moral, ethical or reasoned argument can be made for suffering to please those who are pleased by suffering?

many people are concerned about cleaning up the mess

A mess is made, not by the suicide victims, but by the plantation whores whose measures prevent Their Own slaves from escaping with dignity. Objectified women need a world of pain to sell their pain 'relief'. Revealing their evil culpability, they block all humane exits, fully aware that if slaves could choose to leave in peace, they'd tell the leeches to fuck themselves, literally. The humanity! Trauma is needed to make slaves afraid to leave, ergo logic dictates all slaves have an ethical duty to go. Enabling evil is evil.

This trick of stigmatising humane behaviour by declaring it to be socially undesirable conduct in need of criminalisation, with the explicit intent of holding up the contrived trauma as 'justification' for continued prohibition, is the dumbest if not the oldest trick in The Book. The War on Drugs is obviously a war for toxic drugs against [medicinal pain relief]. Field junkies get confused but a good BOY should only be addicted to a plantation whore's love.

There would be no reason to traumatise children with fear of the Unknown, were they not slaves born into slavery. They stigmatise suicide, euthanasia, abortion, humane termination of pain. Jesus didn't die for those 'sins'. "Don't you touch yourself." Martyrdom, murder, violence, self-sacrifice in war are glorified. Jesus only died to save kiddie fiddlers, serial killers, violent rapists, mothers, etc.

"...the dread of something after death,
The undiscover'd country from whose bourn
No traveller returns, puzzles the will
And makes us rather bear those ills we have
Than fly to others that we know not of?
Thus conscience does make cowards of us all."
- Shakespeare (Hamlet)

A slave's conscience. Mothers and priests made cowards of us all.

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In case my links are broken... (Below threshold)

May 13, 2014 12:33 AM | Posted, in reply to johnnycoconut's comment, by johnnycoconut: | Reply

In case my links are broken (in the comment above last), here's another source (from one of the same sites Alone cited) that says that from 1986-2010, 796,672 people in the US are known to have completed suicide:

http://www.suicidology.org/c/document_library/get_file?folderId=1045&name=2003datapgb.pdf

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