Suicide - Ages 65+

Suicide - Ages 65+ in Alabama

Alabama

Suicide is a troubling public health issue that leaves a lasting impact on families and communities. Between 2000 and 2018, the suicide rate increased 30%, then decreased in 2019 and 2020. The suicide rate increased again in 2021, with more than 48,000 deaths by suicide. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), that same year, 12.3 million adults seriously thought about suicide, 3.5 million made a plan and 1.7 million actually attempted suicide.

Suicide attempts among older adults are usually more lethal than those among younger age groups. In 2020, suicide deaths involving a firearm were highest among adults ages 65 and older. Older adults may exhibit passive self-harm behaviors that can result in death, such as refusing food, medications or liquids; these are rarely recorded as suicide attempts or as deaths by suicide. 

Suicide among adults ages 65 years and older cost the United States more than $1.8 billion in combined medical and work-loss-related expenses in 2013, averaging between $66,218 and $243,883 per death.

The suicide rate is higher among:

• Older men compared with older women. 
• Those ages 85 and older compared with those ages 65-84. 
• White older adults compared with American Indian, Asian, multiracial and Black older adults.
• LGBTQ adults compared with straight adults. Lifetime discrimination and victimization based on sexual orientation may contribute to this higher suicide rate.

Suicide is often preventable. Preventing suicide among older adults may require the use of multiple and aggressive interventions. 

Risk factors for suicide among older adults include mental illness, depression, previous suicide attempts, substance use problems, chronic pain, physical illness, declining function, disability, family discord or loss, family history of suicide and social isolation. Dementia and other forms of impaired cognitive ability have also been linked to suicidal behavior in older adults. Some doctors and researchers are urging caregivers of older adults with dementia to secure or eliminate firearms from their environment, in part because firearms are the most common method of suicide among older adults. 

Several interventions have proven effective at preventing suicide and reducing risk factors among older adults, including:

• Primary care interventions using care coordinators.
• Telephone counseling (primarily effective among women).
• Education and community activities to improve resilience.
• Clinical treatments. 

SAMHSA has published a brief with the Administration on Aging to help health care and social services organizations prevent suicide among older adults. Additionally:

• The Suicide Prevention Resource Center provides comprehensive materials and training on preventing suicide at all levels, as well as programs and contacts specific to each state. 
• SAGE is an organization that advocates for older LGBTQ+ adults and has a 24-hour LGBTQ+ Elder Hotline certified in crisis response. 
• The 988 Suicide & Crisis Lifeline provides free, confidential support for people in distress 24/7, everywhere in the U.S. Their website offers additional forms of crisis support, and the previous National Suicide Prevention Lifeline number (1-800-273-TALK(8255)) is still active and usable.

Reducing the suicide rate is a Healthy People 2030 leading health indicator.

Betz, Marian E., Alexander D. McCourt, Jon S. Vernick, Megan L. Ranney, Donovan T. Maust, and Garen J. Wintemute. 2018. “Firearms and Dementia: Clinical Considerations.” Annals of Internal Medicine 169 (1): 47. https://doi.org/10.7326/M18-0140.

Conwell, Yeates, Kimberly Van Orden, and Eric D. Caine. 2011. “Suicide in Older Adults.” Psychiatric Clinics of North America, Geriatric Psychiatry: Advances and Directions, 34 (2): 451–68. https://doi.org/10.1016/j.psc.2011.02.002.

Fredriksen-Goldsen, Karen I., and Anna Muraco. 2010. “Aging and Sexual Orientation: A 25-Year Review of the Literature.” Research on Aging 32 (3): 372–413. https://doi.org/10.1177/0164027509360355.

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National Academies of Sciences, Engineering, and Medicine. 2020. Social Isolation and Loneliness in Older Adults: Opportunities for the Health Care System. Washington, D.C.: National Academies Press. https://doi.org/10.17226/25663.

“Older Americans Behavioral Health Issue Brief 4: Preventing Suicide in Older Adults.” 2012. Substance Abuse and Mental Health Services Administration (SAMHSA), Administration on Aging. https://acl.gov/sites/default/files/programs/2016-11/Issue%20Brief%204%20Preventing%20Suicide.pdf.

Ramchand, Rajeev, Megan S. Schuler, Michael Schoenbaum, Lisa Colpe, and Lynsay Ayer. 2022. “Suicidality Among Sexual Minority Adults: Gender, Age, and Race/Ethnicity Differences.” American Journal of Preventive Medicine 62 (2): 193–202. https://doi.org/10.1016/j.amepre.2021.07.012.

Shepard, Donald S., Deborah Gurewich, Aung K. Lwin, Gerald A. Reed, and Morton M. Silverman. 2016. “Suicide and Suicidal Attempts in the United States: Costs and Policy Implications.” Suicide and Life-Threatening Behavior 46 (3): 352–62. https://doi.org/10.1111/sltb.12225.

Snow, Caitlin E., and Robert C. Abrams. 2016. “The Indirect Costs of Late-Life Depression in the United States: A Literature Review and Perspective.” Geriatrics 1 (4): 30. https://doi.org/10.3390/geriatrics1040030.

Stone, Deborah M. 2023. “Notes from the Field: Recent Changes in Suicide Rates, by Race and Ethnicity and Age Group — United States, 2021.” MMWR. Morbidity and Mortality Weekly Report 72. https://doi.org/10.15585/mmwr.mm7206a4.