Healthy Skepticism Library item: 1587

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Publication type: Journal Article

Msnbc .
U.S. suicides decline, but thoughts remain: Vulnerable patients need better treatment, experts say
Reuters 2005 May 24;

Full text:

The proportion of U.S. adults contemplating or attempting suicide stayed about the same over the last decade, while the availability of treatment increased and the actual suicide rate fell, a study said on Tuesday.

The finding raises questions about whether effective help reaches the neediest people in time, said the report published in the Journal of the American Medical Association.

It also renews concerns about adverse reactions to heavily prescribed antidepressant drugs that some say can initially trigger suicidal thoughts in some patients, particularly the young.

Twin surveys covering nearly 10,000 American adults aged 18 to 54 taken from 1990 to 1992 and 2001 to 2003 showed 3 percent reported thoughts of suicide over the previous year, 1 percent hatched suicide plans, 0.6 percent attempted suicide, and 0.2 percent made a suicide attempt or “gesture” they knew would not succeed.

All categories except the last increased marginally over the decade, the report said.

Suicidal thoughts remain steady
In an apparent contradiction, completed U.S. suicides declined 6 percent to 14 out of 100,000 people during the decade. In contrast, the latest figures showed 3,000 out of 100,000 people had thoughts of killing themselves and 500 out of 100,000 attempted suicide.

“If increased treatment did play a part in the decrease in the suicide rate, then why did we not see a comparable decrease in suicide-related behaviors?” study author Ronald Kessler of Harvard Medical School asked.

He drew three possible conclusions: that suicidal behavior would have increased except for the rise in treatment options, that people only got help after attempting suicide, or that the increase in available treatment was so poor as not to affect suicidal behavior.

The most vulnerable subgroups – the young, women, the uneducated, the unemployed and those lacking stable relationships – also are often likely to be at a disadvantage in gaining access to treatment.

“Because the dramatic increase in treatment in the last decade failed to reduce sociodemographic disparities in suicidal behaviors considered here, programs specifically targeting high-risk populations are needed,” Kessler wrote.