Suicide 101

Peter M. Gutierrez, Ph.D.VA VISN 19 MIRECC

Department of Psychiatry University of Colorado Denver School of Medicine

National Vital Statistics Reports, 56(10)

National Mortality Data - 2005

• 32,637 Suicide Deaths (11.0)

• 25,907 Male Suicide Deaths (17.7)

• 11th Leading Cause of Death

• Rate for 25-34 y/o 12.4

• Colorado 6th Highest Rate (17.1)

National Vital Statistics Reports, 56(10)

Estimated Attempts - 2005

• No Official National Data Compiled

• 816,000 (25:1)

• One Attempt Every 39 Seconds

• 3 Female Attempts for Every Male

VA Suicide Data Sources

• VA relies on multiple sources of information to identify deaths that are potentially due to suicide– VA 's own Beneficiary Identification and

Records Locator Subsystem– Records from the Social Security

Administration– Data compiled by the National Center for

Health Statistics in its National Death Index

National Death Index Matched to Service Members Separating

2002-2005 • VA examined OEF/OIF service

members who separated from service in that time period

• Male veterans 18-29 who used VA care died by suicide at a rate of 21.0/ 100,000, compared to veterans of that age who did not use VA for care (30.4)

NDI Findings Continued

• Male veterans aged 30-64 who used VA for care died of suicide at a rate of 17.5 compared to a rate of 22.8 for those who did not use VA for care (ns)

• only 3 women OEF/OIF veterans died of suicide through 2005, accurate rates within age groups cannot be calculated

VA Efforts to Track Suicide Attempts

• Suicide Prevention Coordinators now compiling data on suicide attempts, of which they are aware, at all 153 medical centers nationwide

• In place for past 22 months

Year of Death

Age Group Veteran Not a Veteran

Veteran Status

Unknown

Total

200410-17 * 34 * 3418-24 5 80 * 8525-44 45 264 * 30945-64 89 210 * 30165+ 55 34 * 89Total 194 622 * 818

200510-17 * 31 * 3118-24 8 112 * 12025-44 41 238 * 27945-64 73 194 * 26765+ 72 41 * 113Total 194 616 * 810

200610-17 * 21 * 2118-24 4 91 * 9525-44 29 247 * 27645-64 57 188 4 24965+ 55 28 * 83Total 145 575 4 724

Veteran Status for Suicide Deaths in ColoradoData from the Colorado Violent Death Reporting System

* Indicates fewer than 3 deaths; "Veteran" indicates only that the person served in the US Armed Services

Lessons Learned from OEF/OIF Veterans

• Qualitative study of combat veterans

• Impacts of deployment

• Coping strategies developed in theater don't work as well at home

• Role of burdensomeness, failed belongingness, and habituation to painful stimuli

Brenner et al., 2008

Gutierrez, Huggins & Brenner, 2008

Suicidality and Psychiatric Admission – VA TBI Survivors

• 22 Subjects

• Total Number of Admissions: 114– Median Number of Admissions: 3– Range of Admissions: 1-20

Gutierrez, Huggins & Brenner, 2008

Suicidal Ideation Assessed at Time of Admission

% Assessed87%

% Not Assessed13%

Gutierrez, Huggins & Brenner, 2008

Suicidal Ideation Present at Time of Admission

Present53%

Not Present47%

Gutierrez, Huggins & Brenner, 2008

Number of Admissions Secondary to a Suicide Attempt

0

20

40

60

80

100

120

140Total Number ofAdmissions = 122

Total Number ofAdmissionsSecondary to aSuicide Attempt =14 (6 patients)

11% of total admissionsNumber of attempts 1-5

Median - 2

Gutierrez, Huggins & Brenner, 2008

Attempt Method

0

1

2

3

4

5

6

7

Overdose - 7

Self Inflicted Wound- 6

Traumatic Injury - 1

National Suicide Crisis Line 1-800-273-TALK

• Press 1 for Veteran

• Partnership with the Lifeline Program of the Substance Abuse and Mental Health Services Administration

• Went live July, 2007

Impact of VA Crisis Line - Nationally

• As of April ‘09, more than 120,000 calls have come to the hotline from veterans, family members, or friends

• 3060 rescues involving emergency services