Specific Populations

Veterans

Veterans account for 11.5% of New York State suicides.1 The rate of suicide among this population continues to increase, reaching 29.1 per 100,000 population in 2014, with the highest rate among young veterans 18-34 years old (64.5 per 100,000 population).2  Some of the factors that contribute to higher risk include deployment, co-occurring mental health conditions, alcohol or other drug use, and time away from family.  

Nationally, suicide rates are higher among those who do not access services within the Veterans Health Administration (VHA).3   While many receive services within the New York State VHA, some are not eligible or choose not to access these services.

If you are a veteran in crisis, please call the Veterans Crisis Line at 1-800-273-8255 (PRESS #1).

 

 

 

Resources

Middle-aged Men

Middle-aged men are one of the highest risk groups in New York State and nationally.  The suicide rate among men 50-59 is approximately 21 per 100,000 population in New York, almost three times the state average.  The rate jumps to approximately 26 per 100,000 population among White middle-aged men.4

Reasons for increased risk include:5

  • The use of firearms, the most lethal means for suicide
  • Employment, financial, and/or legal problems – especially among those approaching retirement – are more common among this group
  • Men are less likely to seek out and utilize behavioral health treatment.  Reasons for this may include reluctance to acknowledge a behavioral health problem, failure of clinicians to recognize depression among men, perception that services are not effective, and perceived stigma.

Resources

Seniors

The suicide rate among New Yorkers 75 and older is 8.6 per 100,000 population; it is 19.5 per 100,000 population among men in this age group.  The highest risk age group in New York State and nationally is men 85 and older, at 24 per 100,000 population.4

Suicide attempts by older adults are much more likely to result in death, as older adults plan more carefully and use more deadly methods, are frailer and less likely to recover from an attempt, and are less likely to be discovered and rescued.6

For more information and resources, visit the Suicide Prevention Resource Center’s Older Adult resource page.  Click here for your local Office for the Aging.

American Indians/Alaskan Natives

Nationally, American Indians/Alaska Natives (AI/AN) have the second highest age-adjusted suicide rate of all racial/ethnic groups at 13.4 per 100,000 population, only slightly lower than the rate among Whites (15.9 per 100,000 population).  AI/AN youth and younger adults ages 15-34 have the highest suicide rate of all racial ethnic youth and young adult groups, soaring to 25.9 per 100,000 population for 25-34 year olds. 4 

Risk in AI/AN populations may stem from high rates of alcohol or other drug misuse, mental health problems, intergenerational trauma, low socioeconomic status, lack of resources, and issues within native communities.  Factors which reduce risk include a strong tribal/spiritual bond, social support, and a sense of cultural belonging.7

Resources

LGBTQ

According to the 2017 Centers for Disease Control and Prevention (CDC) Youth Risk Behavior Survey, 59.2% of New York State LGB high school students felt sad or hopeless, 40.8% seriously considered suicide, 25.8% attempted suicide, and 10.1% made a suicide attempt that required medical attention in the 12 months prior to the survey.  These self-reported numbers are statistically significantly greater than those reported by their heterosexual peers.8  New York City LGB youth who have experienced rejection by their families are 8.4 times more likely to have attempted suicide than those with no or low levels of rejection.9 One in three transgender youth in New York City have seriously considered suicide, and two in five report having attempted suicide in the past 12 months.

Individuals identifying as LGBTQ are at elevated risk for a variety of reasons:10

  • Undue stress and internalization of anti-LGBTQ sentiments resulting from residual stigma
  • Harassment, discrimination, and bias among peers, family, colleagues, schools, workplaces, health care, and the community
  • A history of depression, anxiety, and/or alcohol or drug misuse
  • Victimization including bullying and abuse

If you’re in crisis, call the Trevor Project’s free, 24/7 LGBTQ crisis intervention phone line at 1-866-488-7386 or use TrevorText by texting ‘START” to 678-678. You may also call the 24/7 National Suicide Prevention Lifeline at 1-800-273-TALK (8255) or text ‘Got5’ to 741-741 for the 24/7 Crisis Text Line. In New York City, you may call 1-888-NYC-WELL (1-888-692-9355).

Other Resources

Individuals with Justice System Involvement

Suicide is a leading cause of death within jails, prisons, and juvenile facilities.  Between 2000 and 2012, the average suicide rate was 41 per 100,000 population for adult inmates in jails.  The rate increased to 80 per 100,000 for White inmates and 86 per 100,000 for inmates not yet convicted.

Youth who have had contact with the juvenile justice system, even those with “light touches” who remain in the community, are at increased risk for suicide.  Screening and early interventions for suicide risk and upstream risk factors such as depression and alcohol and other drug misuse, as well as diversion to behavioral health settings delivering suicide safer care, are critical for this population.  The risk becomes much more severe once incarcerated. Among incarcerated youth age 17 and younger, the rate of death by suicide was 49 per 100,000.11

For more information and resources on suicide prevention for the criminal and juvenile justice systems, visit the Suicide Prevention Resource Center and the National Action Alliance for Suicide Prevention dedicated justice system webpages.  Visit the National Center for Mental Health and Juvenile Justice, located in the New York State Capital Region, for more information about addressing mental health, substance use, and suicide within juvenile justice populations.  

Postpartum Mothers and Fathers

Suicide is the second leading cause of death among postpartum women, accounting for one in five postpartum deaths.  Nationally, one in nine women experience postpartum depression.12  Fathers may also experience depression following the birth of their child.  Approximately 4% experience it within the first year after their child’s birth, and 20% will have experienced at least one episode by a child’s 12th birthday.  Younger fathers with a history of depression who have financial difficulties are at greatest risk.13

For more information, visit the New York State Office of Mental Health maternal depression page, the Postpartum Resource Center of New York, or Mom’s Mental Health Matters.  If you’re in crisis, call the Parental Stress Hotline at 1-800-632-8188. You may also call the Postpartum Support International (PSI) HelpLine at 1-800-944-4773 or text 503-894-9453.

Multicultural Considerations

As a state with great cultural and ethnic diversity, it is important to understand unique factors that may increase risk among minority cultures.  Factors may include:14,15 

  • Trying to assimilate to a new culture
  • Challenges accessing and receiving quality care
  • Higher levels of stigma
  • Cultural beliefs regarding suicide, mental health, and help-seeking
  • A culturally insensitive health care system
  • Language barriers
  • Lack of health insurance
  • Being a victim of or witnessing a hate crime, or a crime that is motivated by the offender’s bias against a race, ethnicity, religion, sexual orientation, or disability
  • Experiencing discrimination, or the unlawful and intentional act of unfair treatment of a person based on race, ethnicity, gender, religion, national origin, physical or mental disability, or age
  • Being a victim of microaggressions, or intentional or unintentional daily forms of disrespect including snubs and put-downs

Consequently, individuals from minority cultures who may be exhibiting multiple feelings and emotions including stress, sadness, fear, and violence, may cope by avoiding others different from themselves. As such, those experiencing suicidal thoughts may not seek out services, particularly those delivered by professionals who are different from them.  Therefore, as a state and a nation, we must train a more diverse workforce that understands and respects the cultural values and needs of our patients, clients, and communities when conducting outreach and delivering mental health and suicide prevention programs. Click here for more information on culturally competent approaches to suicide prevention.

 

References

  1. New York State Department of Health. Health connector: Suicide and self-harm. Retrieved from https://nyshc.health.ny.gov/web/nyapd/suicides-in-new-york.
  2. U.S. Department of Veterans Affairs. New York: Veteran suicide data sheet. Retrieved from https://www.mentalhealth.va.gov/docs/data-sheets/2014/Suicide-Data-Sheet-New-York.pdf.
  3. Hoffmire CA, Kemp JE, Bossarte RM. Changes in suicide mortality for veterans and nonveterans by gender and history of VHA service use, 2000-2010. Psychiatr Serv. 2015;66:9 33. 959-965.
  4. Centers for Disease Control and Prevention. Web-Based Injury Statistics Query and Reporting System. Fatal injury data. Retrieved from https://www.cdc.gov/injury/wisqars/fatal.html.
  5. Suicide Prevention Resource Center. Preventing suicide among men in the middle years: Recommendations for suicide prevention programs. 2016. Waltham, MA: Education Development Center, Inc. Retrieved from https://www.sprc.org/sites/default/files/resource-program/SPRC_MiMYReportFinal_0.pdf.
  6. Suicide Prevention Resources Center. Older adults. Retrieved from https://www.sprc.org/populations/older-adults.
  7. Indian Health Service. Suicide prevention and care program. Retrieved from https://www.ihs.gov/suicideprevention/.
  8. Centers for Disease Control and Prevention. Youth risk behavior survey. 2017. Retrieved from https://www.cdc.gov/healthyyouth/data/yrbs/results.htm.
  9. New York City Department of Health and Mental Hygiene. LGBTQ youth and suicide. Retrieved from https://www1.nyc.gov/site/doh/health/health-topics/lgbtq-youth-suicide.page.
  10.   Fenway Institute. Suicide risk and prevention for LGBTQ people. September 2018. Retrieved from https://www.lgbthealtheducation.org/wp-content/uploads/2018/10/Suicide-Risk-and-Prevention-for-LGBTQ-Patients-Brief.pdf.
  11.   New York State Office of Mental Health. 1700 Too Many: New York State’s Suicide Prevention Plan 2016-17. 2016. Retrieved from https://www.omh.ny.gov/omhweb/resources/publications/suicde-prevention-plan.pdf.
  12.   Centers for Disease Control and Prevention. Trends in postpartum depressive symptoms – 27 states, 2004, 2008, and 2012. MMWR. February 17, 2017;66:6 153-158. Retrieved from https://www.cdc.gov/mmwr/volumes/66/wr/mm6606a1.htm?s_cid=mm6606a1_w.
  13.   Dave S, Petersen I, Sherr L, Nazareth I. Incidence of maternal and paternal depression in primary care: A cohort study using a primary care database. Pediatrics, 2010;164:11 1038-44.
  14.   Shadick R. Multicultural suicide prevention: Saving lives in our diverse communities. Texas Suicide Prevention Symposium. Retrieved from https://texassuicideprevention.org/wp-content/uploads/2013/06/Multicultural_Suicide_Prevention_-_Texas_Suicide_Prevention_Conference_Web_Version.pdf.
  15.   National Alliance on Mental Illness. Mental health facts: Multicultural. Retrieved       from https://www.nami.org/NAMI/media/NAMI-Media/Infographics/MulticulturalMHFacts10-23-15.pdf