Suicide is a tragic and potentially
preventable public health problem. In 2000, suicide was the 11th
leading cause of death in the U.S.1
Specifically, 10.6 out of every 100,000 persons died by suicide. The
total number of suicides was 29,350, or 1.2 percent of all deaths.
Suicide deaths outnumber homicide deaths by five to three. It has
been estimated that there may be from 8 to 25 attempted suicides per
every suicide death.2
The alarming numbers of suicide deaths and attempts emphasize the
need for carefully designed prevention efforts.
Suicidal behavior is complex. Some
risk factors vary with age, gender, and ethnic group and may even
change over time. The risk factors for suicide frequently occur in
combination. Research has shown that more than 90 percent of people
who kill themselves have depression or another diagnosable mental or
substance abuse disorder, often in combination with other mental
Also, research indicates that alterations in neurotransmitters such
as serotonin are associated with the risk for suicide.4
Diminished levels of this brain chemical have been found in patients
with depression, impulsive disorders, a history of violent suicide
attempts, and also in postmortem brains of suicide victims.
Adverse life events in combination
with other risk factors such as depression may lead to suicide.
However, suicide and suicidal behavior are not normal responses to
stress. Many people have one or more risk factors and are not
suicidal. Other risk factors include: prior suicide attempt; family
history of mental disorder or substance abuse; family history of
suicide; family violence, including physical or sexual abuse;
firearms in the home; incarceration; and exposure to the suicidal
behavior of others, including family members, peers, or even in the
Suicide was the eighth leading cause
of death for males and the 19th leading cause of death for females
More than four times as many men as women die by suicide,1
although women report attempting suicide during their
lifetime about three times as often as men.5
Suicide by firearm is the most common method for both men and women,
accounting for 57 percent of all suicides in 2000. White men
accounted for 73 percent of all suicides and 80 percent of all
Children, Adolescents, and Young
In 2000, suicide was the third leading
cause of death among 15- to 24-year-olds—10.4 of every 100,000
persons in this age group—following unintentional injuries and
homicide. Suicide was also the 3rd leading cause of death among
children ages 10 to 14, with a rate of 1.5 per 100,000 children in
this age group. The suicide rate for adolescents ages 15 to 19 was
8.2 deaths per 100,000 teenagers, including five times as many males
as females. Among people 20 to 24 years of age, the suicide rate was
12.8 per 100,000 young adults, with seven times as many deaths among
men as among women.1,6
Older adults are disproportionately
likely to die by suicide. Comprising only 13 percent of the U.S.
population, individuals age 65 and older accounted for 18 percent of
all suicide deaths in 2000. Among the highest rates (when
categorized by gender and race) were white men age 85 and older: 59
deaths per 100,000 persons, more than five times the national U.S.
rate of 10.6 per 100,000.1,6
Overall, there may be between 8 and 25
attempted suicides for every suicide death; the ratio is higher in
women and youth and lower in men and the elderly.2
Risk factors for attempted suicide in adults include
depression, alcohol abuse, cocaine use, and separation or divorce.7,8
Risk factors for attempted suicide in youth include
depression, alcohol or other drug use disorder, physical or sexual
abuse, and disruptive behavior.8,9
As with people who die by suicide, many people who make serious
suicide attempts have co-occurring mental or substance abuse
disorders. The majority of suicide attempts are expressions of
extreme distress and not just harmless bids for attention. A
suicidal person should not be left alone and needs immediate mental
U.S. Suicide Rates by Age, Gender,
and Racial Group
Preventive efforts to reduce suicide
should be based on research that shows which risk and protective
factors can be modified, as well as which groups of people are
appropriate for the intervention. In addition, prevention programs
must be carefully tested to determine if they are safe, truly
effective, and worth the considerable cost and effort needed to
implement and sustain them.10
Many interventions designed to reduce
suicidality also include the treatment of mental and substance abuse
disorders. Because older adults, as well as women who die by
suicide, are likely to have seen a primary care provider in the year
prior to their suicide, improving the recognition and treatment of
mental disorders and other suicide risk factors in primary care
settings may be one avenue to prevent suicides among these groups.11
Improving outreach to
men at risk for suicide is a major challenge in need of
Recently, the manufacturer of the
medication clozapine received the first ever Food and Drug
Administration indication for effectiveness in preventing suicide
attempts among persons with schizophrenia.12
Additional promising pharmacologic and psychosocial treatments for
suicidal individuals are currently being tested.
If someone is suicidal,
he or she must not be left alone. Try to get the person to seek help
immediately from his or her doctor or the nearest hospital emergency
room, or call 911. It is also important to limit the person's access
to firearms, medications, or other lethal methods for suicide.
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All material in this fact
sheet is in the public domain and may be copied or reproduced
without permission from the Institute. Citation of the source is
NIH Publication No. 03-4594
Printed January 2001; Revised April 2003
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