Middle-aged suicide sees rapid rise

PHOTOGRAPHER: Sara Foss

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Traditionally, suicide prevention efforts have focused on youths and elderly people.

But sobering new statistics from the U.S. Centers for Disease Control and Prevention suggest suicide prevention measures aimed at middle-aged people are needed.

According to the CDC, the suicide rate among adults ages 35-64 rose 28 percent from 1999 to 2010. Among adults ages 50-54, the suicide rate jumped 48 percent, and among adults ages 55-59, it jumped 49 percent.

New York saw one of the biggest percentage increases in suicide among people 35-64 — nearly 42 percent. Despite this leap, the state’s suicide rate remained among the nation’s lowest at 11.7 per 100,000 population, according to the CDC.

Nationwide, the suicide rate for middle-aged adults was 17.6 per 100,000 in 2010, up from 13.7 per 100,000 in 1999.

“This data is quite concerning,” said Dr. James Kelleher, chief medical officer at Four Winds Saratoga, which provides inpatient and outpatient mental health treatment for children, adolescents and adults. “It gives us another area to focus on. We can target services to this demographic.”

Duane Miller, director of behavioral health outpatient services for St. Mary’s Healthcare in Amsterdam, agreed.

“We can’t ignore this information,” he said. “We need to figure out ways we can target and reach this population.”

Mental health and suicide prevention experts in the Capital Region pointed to several factors that might be driving the increase in the state’s suicide rate. They said the lousy economy has added stress to people’s lives and contributed to feelings of helplessness, and the increasing abuse of prescription drugs might also be a factor. They also noted that the baby-boomer generation had an unusually high suicide rate during its adolescent years.

Miller said the CDC data mirrors what he sees at St. Mary’s, where he oversees a clinic that assists people who have attempted suicide or are struggling with suicidal thoughts.

“The people we’ve been treating are between 35 and 64,” he said. “Certainly, this is a generation that’s going to be more sensitive to an economic downturn. They’re well into their productive years. They have families and mortgages and obligations that can’t be overlooked.”

Miller said Fulton and Montgomery counties are poorer than much of the state, and “even when things were going well, we worked with a lot people in the two counties who struggled. Our area has lagged behind with jobs.”

He added that Fulton and Montgomery counties have been hit hard by two emerging drug problems: the abuse of synthetic drugs, such as bath salts, and prescription painkillers such as hydrocodone. Historically, people struggling with substance abuse have been more likely to die by suicide.

Statistics from the state Department of Health indicate more New Yorkers are dying by suicide. In 2011, 1,625 New Yorkers died by suicide, up from 1,391 in 2005, a 16 percent increase.

Last year, 24 Schenectady County residents died by suicide, up from seven in 2008, while 25 Saratoga County residents died by suicide, up from 15 in 2008. In Montgomery County, eight people died by suicide in 2011, up from six in 2008, while six people died by suicide in Schoharie County in 2011, up from three in 2008. The number of people dying by suicide fell in Fulton County, from 11 in 2008 to five in 2011.

Robert Hubbell, a psychologist in Albany Medical Center’s psychiatry department, said his department isn’t necessarily seeing a big jump in patients ages 35-64. But he added that the mental health system is overburdened, due to budget cuts, and there aren’t enough resources for people in need.

“A huge number of people in the community have thoughts of suicide, but they don’t have access to health care, or they don’t have the support they need to access health care,” Hubbell said. “We see the people who get here and get help.”

Hubbell said the economy has been a big source of stress for a number of years now.

“We hear from people who are feeling overwhelmed, because they’re feeling trapped in a job or more anxious about entering the economy,” he said.

Finding a new job or entering the workplace is “that much harder because right now it’s such a challenge,” he said.

Mental health problems such as bipolar disorder, depression and schizophrenia are risk factors for suicide, said Donald Capone, executive director of the New York chapter of the National Alliance on Mental Illness.

“Suicide is something the mental health community is very familiar with, unfortunately,” Capone said.

Capone said many people with mental illnesses are not being diagnosed and treated quickly enough and there’s still a stigma attached to mental health problems, which often makes people less likely to seek the help they need.

“The longer the delay in getting treatment, the worse things get,” he said.

In addition, not everyone has access to quality mental health services.

“The mental health infrastructure is not equivalent in all parts of the state,” Capone said. “Once you get into the more rural areas, it’s harder to find services. There are some parts of the state where people can’t find a child psychologist.”

Miller echoed this, noting many of the people who arrive at his clinic because they’ve attempted suicide have not been receiving mental health treatment or services of any kind.

“If someone attempts suicide and ends up at our hospital, they’ll likely end up in our care,” he said. “A lot of times, when people are in the acute stages of suicidality, we see them in the emergency room. … We’re seeing more health needs here, but there are fewer services.”

Laura Marx, director of the American Foundation for Suicide Prevention’s Capital Region chapter, noted New York’s suicide rate remains relatively low and suggested education and awareness campaigns organized by advocacy groups and public health officials have made a difference.

“We do a lot of prevention,” Marx said, “but certainly there’s more work to be done when so many people are dying by suicide.”

According to the CDC, the suicide rate among U.S. men ages 35-64 rose 27 percent between 1999 and 2010. Among women in that demographic, it increased 31.5 percent. The greatest percentage increase in suicide rate — 59.7 percent — was observed in women ages 60-64.

The agency recommends more suicide research and prevention efforts focused on middle-aged people.

“Prevention efforts are particularly important for this cohort because of its size, history of elevated suicide rates and movement toward older adulthood, the period of life that has traditionally been associated with the highest suicide rates,” the CDC noted in a recent Morbidity and Mortality Weekly report.