According to the U.S. Census Bureau, older adults (age 65 and over) represented 16 percent of the total U.S. population in 2019. And in 2020, older adults ages 50 to 85+ accounted for 19,968 deaths for a crude rate of 16.86 per 100,000 according to the Centers for Disease Control and Prevention (CDC) Web-based Injury Statistics Query and Reporting System. Recognizing this population is disproportionately affected, it’s critical that we address suicide prevention in this group of Americans.
Baby boomers, those born between 1946 and 1964, have had a relatively higher suicide rate at any given age than earlier or subsequent birth cohorts. Demographers estimate that by the year 2030, over 71 million Americans will be age 65 or older, or 20 percent of the U.S. population. Baby boomers are a group with historically high rates of suicide and as they enter older adulthood, it is anticipated the rate of suicide in men and women will rise again. Older adulthood is a time of greatest risk and could result in substantial increases in the number of senior citizens dying by their own hands (Conwell, et al., 2011). Collectively, older adult caregivers, the health community, government and non-government stakeholders, and the general public alike can change that trajectory.
In order to intervene, health care providers and caregivers must be able to recognize the warning signs of suicide in older adults. Being aware of certain behaviors that can indicate thoughts of self-harm may help save a life. The SAMHSA website has published warning signs that may indicate someone is at risk of suicide:
- Talking about wanting to die or kill oneself.
- Looking for a way to kill oneself.
- Talking about being a burden to others.
- Increasing the use of alcohol or drugs.
- Acting anxious or agitated, behaving recklessly.
- Sleeping too little or too much.
- Withdrawing or feeling isolated.
- Showing rage or talking about seeking revenge.
- Displaying extreme mood swings.
Mental health providers should have early-career training in suicide prevention, suicide behavioral interventions, and suicide postvention. Graduate students in social work, psychology, counseling, and even gerontology often do not receive adequate skills training. As a result, too many providers with graduate degree preparation are learning on-the-job how to support individuals with suicidal ideation and/or post suicide attempts.
One example of a prevention strategy that can help reduce suicide attempts among older adults is to increase health care provider awareness of substance use and mental health conditions in older adults. To achieve this, evidence-based screening tools can be used in clinical settings to screen for suicide risk.
A critical national resource for those experiencing crisis is the 988 Suicide and Crisis Lifeline. The Lifeline is available 24/7 and connects mental health professionals to those in crisis. Safety planning is another important tool to prioritize coping strategies and sources of support for individuals. These tools offer wide ranging guidance on older adults and suicide prevention, substance use, program best practices, and clinical support.
While observing a single warning sign may not indicate thoughts of suicide, noting multiple signs and other risk behaviors, major life events, medical prognosis, and/or mental health diagnosis could indicate suicide risk. There are many strategies that can be used to prevent a suicide death among older adults.
Lastly, providers across mental health disciplines can refer to resources that reinforce best practices, including SAMHSA’s Promoting Emotional Health and Preventing Suicide: A Toolkit for Senior Centers and the CDC’s resource, Preventing Suicide: A Technical Package of Policy, Programs, and Practices (PDF | 6.1 MB).
References
- Centers for Disease Control and Prevention, National Center for Health Statistics. Web-based Injury Statistics Query and Reporting System (WISQARS) [online]. Cited 2022, September 27.
- Conwell, Y., Van Orden, K., & Caine, E. D. (2011). Suicide in older adults. Psychiatric Clinics, 34(2), 451-468.
- Rope, K. (n.d.). What to know about suicide rates in older adults. WebMD. Retrieved August 17, 2022.
- Stone, D.M., Holland, K.M., Bartholow, B., Crosby, A.E., Davis, S., and Wilkins, N. (2017). Preventing Suicide: A Technical Package of Policies, Programs, and Practices. Atlanta, GA: National Center for Injury Prevention and Control, Centers for Disease Control and Prevention.
- Substance Abuse and Mental Health Services Administration. (2015). Promoting Emotional Health and Preventing Suicide: A Toolkit for Senior Centers. HHS Publication No. SMA-15-4416. Rockville, MD: Center for Mental Health Services, Substance Abuse and Mental Health Services Administration, 2015.