Suicide and Mental Illness: A New Public Health Crisis

By Randy Ihara

Suicide and mental illness, particularly depression, are inextricably linked.

Most suicides are brought on by unbearable psychological pain where the person ending his or her life is convinced that there is no other way out. This link was recently brought to the fore by an alarming article entitled, “Sweeping Pain as Suicides Hit a 30-Year High” published in The New York Times (April 22). The article was a report on the findings of a study released by the National Center for Health Statistics, which found that suicides in America have increased dramatically among “middle-aged Americans [45-64 years of age], sending a signal of deep anguish from a group whose suicide rates had been stable or falling since the 1950s.”

During the study period, 1999-2014, suicides for middle-aged women, 45-64, increased sharply by 63 percent, while men in the same age group exhibited a rise of 43 percent, “the sharpest increase for males of any age.” Over the study period, the Center reported, the overall suicide rate increased by 24 percent. Almost 43,000 people committed suicide in 2014; this is significantly more than the 33,000 Americans who died as a result of gun violence that year. At that level, suicide is the second leading cause of death after traffic fatalities. This is compared with just over 29,000 suicides in 1999. The increase in suicides was so broad, “affecting virtually every age group,” that the nation’s suicide rate increased to 13 per 100,000 people, the highest rate since 1986.

This data “provided fresh evidence of suffering among white Americans,” supplementing recently reported evidence of less-educated, lower-income whites who exhibit greater death rates from drug overdoses, suicide, liver disease and alcohol poisoning.

An analysis of the data by the Center and by health researchers at the Robert Wood Johnson Foundation “identified a link between suicides in middle age and rising rates of distress about jobs and personal finances.“ In addition, increases in social isolation as a result of rapidly rising divorce rates may play a role. According to one study “unmarried middle aged-men were 3.5 times more likely than married men to die from suicide,” while women were 2.8 times more likely to commit suicide. Finally, worsening economic conditions among lower-income whites have eroded the prospects of families, which may represent preconditions for suicide for this group. One study by the Centers for Disease Control and Prevention, found that suicide rates were highest during periods of economic downturn going back to the 1920s. During the Great Depression the national suicide rate was 22.1 per 100,000, about 70 percent higher than the rate in 2014.

In the face of these statistics, efforts to prevent suicide have been spotty at best. Funding for research into suicide prevention by The National Institute of Mental Health’s Suicide Research Consortium has been relatively flat, and represents “a small fraction for research of mental illnesses, including mood disorders like depression,” according to the study.

Against this national backdrop, Virginia is not immune.

According to a 2013 report of Virginia’s Chief Medical Examiner, suicide in the commonwealth is more common than homicide: For every homicide there were more than three suicides. Between 2000 and 2012, the suicide rate increased every year from 10.5 per 100,000 in 2000, to 12.9 per 100,000 in 2012. Eighty-five percent of those suicides were white men.  In Loudoun County the suicide rate in that year was 9.2 per 100,000 population, higher than the rate of 3.7 for traffic deaths in the county.

Unfortunately, youth suicide in Virginia is a significant issue. According to the Virginia Violent Death Reporting System, suicide is the third leading cause of death for those in the 10-24-year age bracket, representing 13.4 percent of all Virginia suicides.  Between 1996 and 2005, the Virginia youth suicide rate was 7.2 per 100,000, while in Loudoun County the Office of the Chief Medical Examiner reported a rate in 2013 of 9.2 per 100,000.  According to the National Institute of Mental Health, 9 out of 10 who die by suicide have a treatable mental illness.

Yet resources for the treatment of mental illness in Virginia and Loudoun County have not kept up with the need. According to the National Alliance on Mental Illness, Virginia’s mental health system provides services to only 19 percent of adults with mental illness. Expansion of Medicaid in Virginia would increase access to health services, including mental health, for an estimated 400,000 Virginians. Modest improvements in funding were achieved in the General Assembly in Virginia this past session, but the need for additional resources remains, as evidenced by the growth of the state’s suicide rate and population. Per capita spending for mental health has fallen from about $105 per capita to $69. At the county level, funding for mental health services has remained level at around $32 million from FY12 to FY14 while the county’s population has grown significantly. As a result, on a per capita basis, funding has fallen from $94 in constant dollars, to $90 per capita.

The recent death of several of our young people reminds us of the cost of the insufficiency of resources available for mental health services. We can and must do better.


[Randy Ihara is a past president of Friends of Loudoun Mental Health.]

2 thoughts on “Suicide and Mental Illness: A New Public Health Crisis

  • 2016-04-29 at 12:47 am

    Mr. Ihara, and Rob Jones, thank you so much for your very enlightening comments. As someone who has suffered with mental illness for years, I appreciate your efforts to raise more awareness about this topic. If people understood more about mental illness, they’d know that we are not stupid, nor are we lazy, and most of us would never use our condition to excuse our behavior. None of us ever asked to be this way, and hurtful comments from others only make us feel worse about ourselves. Like someone with diabetes, COPD or multiple sclerosis, we must accept the fact that we will have this disease for the rest of our lives. But unlike the other conditions, mental illness cannot be diagnosed with blood tests or x-rays. It can’t be seen by others, like a physical handicap or blindness. I agree with the effects of today’s stressors on mental health. I’ve known three people who committed suicide. I’ve often asked myself how I could have missed the signs, or if there was something I could or should have done to help. Two of them were sad most of the time, and their deaths were not totally surprising. However, the other individual was the opposite: she was way too happy. I know now that this happiness was really a façade. Deep inside, she was in so much pain. My therapist explained to me that trying to hide depression for a long time can physically and emotionally exhaust someone to the point that they become too tired to live anymore. They feel that the only way to finally get some rest is to end their lives. I agree about the reluctance and/or refusal of insurance companies to provide coverage for those of us with mental health issues. I know first-hand how much I pay out-of-pocket for my sessions and medications. I’ll close this with one observation: why is it that I’ve never read comments from mental health specialists?

  • 2016-04-27 at 5:23 pm

    I could not agree more. But it will take more than funding studies. Look at the stressors in everyday life, most notably joblessness, lack of hope for advancement, poverty. With the cost of basic amenities such as housing and transportation, health care, higher education, even razor blades and lightbulbs, the key driver for a lot of despair is simply not being able to afford the life we thought we should have. Include the issue of violence at school and at the workplace, and do the math: someone who is suffering from a mental disorder or from externally induced stress places everyone at risk for a major catastrophic event. And yet, if you look at how insurance companies treat mental health as a benefit, and see how the Veteran’s Administration has dragged its feet for years on addressing PTSD and other combat-related trauma, the finger of blame gets pointed squarely at the Federal Government. Giving money to some non-profit to release a report that results in little more than hand-wringing and lip service does nothing except waste the money. Look at what has happened in Flint, MI. Who in their right mind would consider the Flint river water safe, even after treatment? The problem of lead poisoning is only just beginning to surface, if you consider how many communities and cities in the country have similar lead pipe carrying their drinking water? And the number one cause for concern? Children with adverse mental health effects. I ask you to consider whether or not a young person on the edge of suicide has any assurance that the insurance industry bankers or the legislative budgeteers actually care. Because the cost of treatment is not seen as beneficial in the face of the cost of suicide? Ask the parents of Columbine, Sandy Hook, Virginia Tech victims of mass murder what they think about the people who committed murder? Perhaps it would have been better if these people had been recognized as having a mental illness before they acquired an arsenal? So the crazy thing is that guns are easier to get than treatment. Insurance will pay for doctors to prescribe opiates by the pound, but when it comes to referring patients to mental health specialists, who gets to pick up the tab?

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