Disconnect Found Between Increased Suicide Attempts and People Getting Behavioral Health Services

• From 2008 to 2019, the suicide attempt rate per 100,000 people jumped from 481.2 to 563.9.
• The rates of suicide attempts increased significantly for young adults aged 18 to 25 (adjusted odds ratio 1.81), women (adjusted odds ratio 1.33), the unemployed (adjusted odds ratio 2.22), those who were never married (adjusted odds ratio 1.60), and people who used substances (adjusted odds ratio 1.44).
• Three clinical subgroups were associated with relatively high odds of attempting suicide: individuals with serious psychological distress (adjusted odds ratio 7.51), individuals with major depressive episodes (adjusted odds ratio 2.90), and individuals with alcohol use disorder (adjusted odds ratio 1.81).
• From 2008 to 2019, the only sub-group that experienced a significant decrease in suicide attempts was individuals aged 50 to 64 years old.
• From 2008 to 2019, 34.8% to 45.5% of adults who attempted suicide reported needing behavioral health services but not receiving them. “Specifically, there were no significant changes in the likelihood of having any outpatient, inpatient, or medication services for mental health reasons and no changes in the use of treatment services for substance use,” the study’s co-authors wrote.
• The most common reason cited for not receiving behavioral health treatment was being unable to afford the cost, although those citing this reason did not increase significantly during the study period.
• Two reasons for not seeking behavioral health treatment increased significantly during the study period: individuals who said they did not know where to go for treatment (adjusted odds ratio 1.96) and individuals who either lacked transportation or said services were too far away (adjusted odds ratio 5.15)

Interpreting the data

There has been an “alarming increase in suicide attempts,” and there is a disconnect between suicide attempts and people seeking behavioral health treatment, the study’s co-authors wrote.

“Despite an increase in suicide attempts, we did not find a corresponding increase in use of services among those who attempted suicide, and a large percentage of those reporting suicide attempts indicated that they had needed mental health services but did not receive them in the year of their attempt. Because prior suicide attempts are the single most important risk factor associated with future suicide, suicide prevention strategies must rely on use of services after an attempt. However, this study suggests that many individuals who need help are not receiving these potentially life-saving services,” they wrote.

There is a need for suicide prevention efforts beyond formal treatment settings, the study’s co-authors wrote. “Our finding that less than half of suicide attempters had clinical contact around the time of their attempt suggest that it is not only important to expand initiatives for high-risk individuals with clinical contact, but also to implement public health-oriented strategies outside the formal treatment system.”

The study’s results indicate where suicide prevention efforts should be targeted, the study’s co-authors wrote. “Our findings identify subgroups with rising rates of suicide attempts among whom targeted interventions may be especially needed, including young adults, individuals who are unemployed or never married, and individuals who use substances. These findings highlight the potential importance of social media interventions, media-reporting guidelines, and initiatives on college campuses to target the rising rates of suicide attempts among young people.”