Suicide is one of life’s final common denominators and it does not discriminate. People in every demographic category are impacted by this tragedy be they rich, poor, young, old, gay, straight, college educated or a high school drop-out. Suicide impacts individuals of every race and every religion, everywhere. Sadly, in recent years, Americans are taking their own lives in record numbers.
The Centers for Disease Control (CDC) defines suicide as “death caused by self-directed injurious behavior with an intent to die as a result of the behavior.” The agency has also recorded suicide as the tenth leading cause of death in the United States.
Since at least 2013, and once again this year, California has trended above the national average in the number of suicides experienced among adults aged 65 and older. California ranks 26th in the nation regarding the number of suicides among older adults, with 17.2 suicides per 100,000 seniors compared to the national average of 16.6 suicides among adults aged 65 and older. Although adults beyond the age of 65 experience high rates of suicide, those over the age of 85, take their own lives at an even higher rate.
Seniors represent only 13 percent of the nation’s population and the high suicide rate among them is not only cause for alarm among those who love them, but among health care professionals as well.
Depression is a key driver among those who commit suicide and according to the National Institute of Health, physical illness, that becomes more common with age, can increase the risk of developing depression and depression can lead to suicide.
According to the to the World Health Organization, “suicide rates tend to rise as a function of age for both men and women to a peak in old, old age.”
The National Institute of Health has noted that depression is not a natural part of aging and the rates of depression among older adults does vary based on the population screened. In three separate reports, the rate of depression ranged from 6 percent to 9 percent among primary care patients, to higher rates among those who receive homecare services and home-delivered meals—the rates of depression in these groups ranged from 13 percent to 15 percent. The highest rate of depression, 34 percent, was found among seniors who were abused.
For years, depression has been well documented as a predictor of suicide, yet it is still not recognized and treated consistently by health care professionals. One expert on aging and mental health, Dr. Jo Anne Sirey, noted last year that in older adults, depression is not well detected because its mistaken as a natural part of aging. It is not.
The CDC has identified common risk factors that can help individuals identify and seek help for themselves and those they love. Those risk factors include a family history of suicide or child maltreatment, previous suicide attempts, a history of alcohol or substance abuse, a history of mental disorders, feelings of isolation and/or hopelessness, loss (including personal, social, work, or financial) and an unwillingness to consider mental health treatment.
Psychiatric experts have also reported on other factors that contribute to feelings of depression and suicide among older adults. They include the loss of one’s ability to function independently, feelings of isolation and/or the fear of becoming a burden to others.
California and the nation must do more to assist seniors suffering from depression—just as attention is paid to their physical well- being, the nation must get re-focused on their mental health as well.
In September, the Huffington Post reported two facts that should help drive attention to this issue. First, although 18 to 25 percent of elderly people need some type of mental health care service—data indicates only three percent of all Medicare reimbursements are for psychiatric treatment. Secondly, seniors make up only six percent of community mental health services, yet they account for 15 percent of the population.
Currently, California legislators are considering an amendment to Proposition 63, the Mental Health Services Act (MHSA) approved by California voters in November 2004, which provides funding for mental health services. The proposed amendment, SB 1004, is shifting the legislation’s focus toward the state’s youth because research has shown 75 percent of mental illness begins by age 14. New language in the measure is focused on the Adverse Childhood Experiences Study and its highlight on the relationship between early trauma adverse experiences and lifelong problems in mental health.
The California Commission on Aging (CCoA) has offered other language to SB 1004 and stressed the importance of making the amendment work for everyone, including the elderly. You can track the progress of SB 1004 and leave comments for the legislation’s author at this link: https://leginfo.legislature.ca.gov/faces/billStatusClient.xhtml?bill_id=201720180SB1004.
California’s seniors are committing suicide at a rate higher than the national average. This may be partly because they do not get the help they need. The National Suicide Prevention Lifeline provides support 24 hours a day, seven days a week and can connect callers with a local crisis center. If you or someone you know needs assistance, help is available onlineat https://suicidepreventionlifeline.org/ or by calling (800) 273-8255. Unfortunately, only a small percentage of older adults ever call the National Suicide Prevention Lifeline.