Classifying death as suicide is probably the easiest for medical investigators and coroners in the western United States, which officially reports the highest suicide rates. Suicide with a firearm is the main method there, and is usually obvious in terms of evidence.
In contrast, drug-induced suicide, motivated mainly by the opioid epilepsy in the rest of the country, is less obvious to researchers.
But a new study on mortality led by the University of West Virginia combines the majority of drug-related deaths with all suicides in an expanded self-harm category. Reflecting a mental health crisis that has erupted across the United States over the past two decades, survey data has a direct impact on suicide prevention efforts.
Ian Rockett, emeritus professor of epidemiology at the WVU School of Public Health, led the study that studied fatal suicide in the United States from 1999 to 2018. Measuring suicide mortality (SIM) -; suicide in addition to the “non-suicide” estimate of drug-alcohol-related deaths; going around suicidal miscarriage and more definitively reporting lethal suicide.
“By extending the definition of SIM to cover the majority of drug overdose deaths, even if they do not meet the standards set by medical examiners and drugstores used to classify them as suicide, the whole country is plagued by a mental health crisis, “Rockett said.” On the other hand, if we do not represent SIM but with registered suicide, the This crisis is showing falsehood in western states. “
Rockett, who was also an associate professor in the Department of Psychology, University of Rochester Medical Center, analyzed differences in suicide classification between departments.
“Suicide seems to be the easiest way to find in the west because arson is the main method and it is very deadly,” he said. “Opioid addiction has had the worst impact on the rest of the country during the opening decades of the 21st century.
As a result of our previous research showing that there was too much to do with more latent suicide disease, I was led to develop a SIM in collaboration with a very talented group of multidisciplinary researchers and users around on six or seven years ago. That suicide was more prevalent in the west and opioid epilepsy elsewhere in the country -; West Virginia stands out -; encouraged us to look at SIM levels against suicide across the country as a whole and over time. “
The findings appear in EClinicalMedicine Lancet. Other WVU researchers who joined Rockett on the study were Brian Hendricks, research professor of epidemiology, and James Berry, chair of the Department of Behavioral Medicine and Psychology.
The research team tapped into cause-of-death data for all 50 states and Washington, DC from the Centers for Disease Control and Prevention’s extensive online Data for Epidemiologic Research.
After expanding the SIM definition, they found that the average annual percentage change in the SIM rate was 4.3% versus 1.8% for the suicide rate. By 2017-2018, all states except Nebraska had imposed a SIM rate of at least 21 deaths per 100,000 population. All located in the west, only five states had such a high rate in 1999-2000.
“Despite the fact that victims share many common risk factors, suicide deaths and drug overdose tend to be treated separately in the scientific literature, the media, the health care system, and by funding agencies. and prevention programs, “Rockett said.” These risk factors include unemployment, family disorder, uncontrolled and uncontrolled physical pain, and various psychosocial disorders involving alcohol. strong and other substance use disorders.
“While most people who died with overeating may not have expected to die, they were engaging in repetitive, deliberate behavior, which they themselves had ‘injury they perceived greatly increases the chance of premature death. By calling these fatal accidents (the most commonly used forensic classification in the US) or’ unconscious’ (the a term used by the CDC) abuses what happened, even if it met the classification criteria used by medical examiners and coroners. “
Early data show that COVID-19 pandemic disease exacerbates the national mental health crisis.
“Opioid and other drug-related deaths continue to rise despite medical efforts to provide patients and communities with life-saving medicines for opioid use disorders,” said co-author Hilary Connery , from McLean Hospital and Harvard Medical School. “Many people who suffer from drug use disorders become hopeless-; they recur frequently, continue to suffer relationship loss, health effects, and economic instability, and often suffer from other mental health problems, such as depression, disorder post-traumatic stress, and other anxiety disorders. . We know that people with addiction have 10 times the level of suicide compared to those without addiction. “
Another Rockett co-researcher, Eric Caine, a professor of psychiatry at the University of Rochester Medical Center, confirmed that this work has a major impact on future suicide prevention efforts. It is particularly important to implement “upstream” programs where organizations and individuals can help with underlying problems of concern long before they become suicidal, he said. Recognition of a patient’s whole story – risk factors, long-term health history, socioeconomic experiences – is critical in providing life-saving, holistic care.
“Ultimately it is less about ‘suicide classification’ and more about realizing that suicide and premature death reflect social and psychological risk factors that were present long before death, “said Caine.
“There are large groups of people in our country who have suffered bad experiences of early life, family and social unrest, economic hardship and life frustration, as well as chronic illnesses; many die prematurely. The aim of eliminating or reducing these conditions is that these organizations do not use misguided or misleading postmortem leaflets to do little to prevent it.We need to focus on the lives of people in these groups long before they are near death if we are to recover from these great losses of life. “
Source:
Magazine Reference:
Rockett, IRH, et al. (2021) Fatal Suicide in the United States, 1999–2018: Ending a national mental health crisis. EClinicalMedicine. doi.org/10.1016/j.eclinm.2021.100741.