The suicide deaths of fashion designer Kate Spade and celebrity chef Anthony Bourdain this week have heightened public awareness of what experts describe as a growing, and often overlooked, public health issue in the U.S.
The news Friday of Bourdain’s death prompted tributes from President Trump and former President Obama, and cries of grief and surprise on social media.
Statistically, the rates of suicide in the United States are increasing, meaning that while Bourdain’s and Spade’s passings can be a shock to millions, they are not as unusual as they may seem.
{mosads}
“These prominent deaths remind us that this is the 10th leading cause of death in America,” said Dr. Jerry Reed, a national suicide prevention expert and executive committee member of the National Action Alliance for Suicide Prevention.
In reality, he said “this happens every day to people all across the country. It’s a reminder we have a long way to go.”
An analysis released by the Centers for Disease Control and Prevention (CDC) Thursday showed suicide rates have increased in 49 states since 1999 — with half of those states seeing an increase of 30 percent.
In 2016, 45,000 people died from suicide.
“These findings are disturbing. Suicide is a public health problem that can be prevented,” said CDC Principal Deputy Director Anne Schuchat.
Not all suicide deaths are associated with mental illness
One important point from the CDC study, experts say, is that more than half of people who died from suicide during the study period did not have any known mental health issues, though some could have been undiagnosed.
“Many people who die by suicide do not have standard markers of suicidal behavior,” said Mark Kaplan, professor of social welfare at the UCLA Luskin School of Public Affairs.
Relationship problems, a traumatic event, physical health problems, problematic substance use and issues with work or finances are some factors that can contribute to suicide among those with and without known mental health conditions, the CDC said in its report.
“For a long, long time we looked at suicide simply through the lens of mental health,” Reed said.
“While that is an appropriate lens to look through … there are also circumstances and situations, whether marital, monetary, that are also salient in the conversation.”
More research is needed
Suicide rates began ticking upward during the Great Recession, especially in more rural areas of the country.
While 49 states have seen increases in suicide rates since 1999, rural states like Montana, Idaho, Wyoming, North Dakota and South Dakota saw increases between 38 percent and 58 percent, according to the CDC.
But most experts agree more research and funds need to be dedicated to the issue.
While suicide is the 10th leading cause of death — and some experts think it might be higher than that — it doesn’t get the same amount of attention or resources that other leading causes of death do.
There is a national strategy for suicide prevention, developed by the U.S. Surgeon General and the National Action Alliance for Suicide Prevention, that’s intended to guide suicide prevention actions in the U.S.
The problem is funding.
“The strategy is great, but there’s no funding behind it,” said Colleen Creighton, executive director of the American Association of Suicidology.
“That’s one of the biggest problems we have. A lot of money is earmarked for specific agencies for specific programs, but not really enough to research to get the root of what is going wrong, where are we falling short.”
She noted that the deadly opioid crisis has captivated the attention of Congress over the past few years, with new, dedicated funding to fight the epidemic, several hearings and a national ad campaign recently launched by the White House.
While both issues kill thousands of people every year — 45,000 deaths from suicide in 2016 and 64,000 from opioids in the same year — the opioid epidemic, while also a serious health crisis facing the country, has received much more public support and attention.
“I’d love to see whatever we can do. A lot of representatives and senators on [Capitol Hill] are losing their constituents,” she said.
Reed noted that there is only one major federal grant directed toward suicide prevention, and it focuses on young people.
But suicide rates are increasing for middle-aged men and women, like Bourdain and Spade.
Suicide is increasing among all demographics, but there was a 43 percent increase in deaths of men aged 45-64 between 1999 and 2016, according to the CDC.
More research also needs to be done on firearms and suicide, experts say.
Of those with known mental health conditions who died by suicide, 41 percent used a firearm. For those without known mental health conditions, 55 percent used firearms.
For this reason, the CDC recommends reducing access to “lethal means,” such as medications and firearms, for people at risk of suicide.
A comprehensive approach
Leading public health experts say suicide prevention needs to focus on a comprehensive approach that involves every sector of society: government, health care, employers, education and community organizations like churches.
Employers and churches are most likely to notice changes in behavior that can be a sign something is wrong, experts say.
The CDC recommends providing financial support to individuals in need to prevent factors that can contribute to suicide, like unemployment or homelessness.
Employers can enact policies that reduce stigma about seeking help, and communities can offer programs and events to create a sense of belonging among residents.
Many individuals who die by suicide feel isolated from society, experts note.
“As a society, we need to do more to understand and prevent suicide,” said Dr. Liza Gold, a clinical professor of psychiatry at Georgetown University School of Medicine.
“You don’t have to be a doctor. You just have to understand that none of us are immune, be it our spouse, parent, child, our friends, boss or coworkers.”
The National Suicide Prevention Hotline is available at 1-800-237-8255.