New CDC Study Shows Large Increase in Suicides Since 1999

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The CDC deemed suicide to be a public health crisis in 1999. Every state save Nevada has seen an increase in the suicide rate since then.

plumbs some of the dimensions of this development:

Suicide has become the second highest cause of death for the 18 to 34 year old age group

The female rate of suicide, which historically has been lower than that of men, has risen to approach the male level. But white males showed the biggest increase of any gender or racial cohort

Gunshot is far and away the most common method

In the states that track the data, more than half the suicides were of people who has not been diagnosed with a mental health issue

The Washington Post report on the CDC study awkwardly acknowledged that t:

“Research for many years and across social and health science fields has demonstrated a strong relationship between economic downturns and an increase in deaths due to suicide,” Sarah Burgard an associate professor of sociology at the University of Michigan, explained in an email on Thursday.

The dramatic rise in opioid addiction also can’t be overlooked, experts say, though untangling accidental from intentional deaths by overdose can be difficult. The CDC has calculated that suicides from opioid overdoses nearly doubled between 1999 and 2014, and data from a 2014 national survey showed that individuals addicted to prescription opioids had a 40 percent to 60 percent higher risk of suicidal ideation. Habitual users of opioids were twice as likely to attempt suicide as people who did not use them…

The problems most frequently associated with suicide, according to the study, are strained relationships; life stressors, often involving work or finances; substance use problems; physical health conditions; and recent or impending crises. The most important takeaway, mental health professionals say, is that suicide is an issue not only for the mentally ill but for anyone struggling with serious lifestyle problems.

“Lifestyle problems”? Being broke or having serious physical problems (which then can create serious financial problems) are “lifestyle problems”? The CDC’s little graphic shows financial or health issues playing a role in over 40% of suicides:

Even though suicide is almost always an individual act, the researchers seem to have difficulty seeing the increase not simply as (at least in part) due to financial stress, but in large measure to the way society has been restructured under neoliberalism, with most people having smaller and shallower personal networks, job tenures being shorter, community organizations being hollowed out, and social safety needs shredding. And as we’ve written virtually from the inception of this website, highly unequal societies are unhappy and unhealthy. If you lose your position on the social/economic ladder, the fall is sharp. Even people at the top recognize how a big loss could upend how they live.

Some comments to the Washington Post article acknowledged these issues. For instance, from desertbloom:

There’s no therapy cure for a chronic pain patient re-assigned from being a supervisor to unloading heavy boxes on the dock.

He then loses his job, defaults on his mortgage, gets left by his wife and kids, then gets denied visitation and loses his insurance.

Can you find an extended family member somewhere to take in someone broken by the system – a boss who wants to see someone fail?

Those of us who see dignity and courage in those who see everything they worked for disappearing cannot even provide treatment for a reduced fee or run a tab that we know will never be paid.

There is no tax write-off for this sort of charity provided by individual doctors for the uninsured. There are no rehabilitation residential treatment programs for body, mind and soul….

As a first-year doctor there were 28 of us in the emergency room in the poorest hospital in one of the poorest states of the nation. Everyone who came in the door was seen within five minutes.

Now people who are suffering wait 24 hours to be seen and are often sent out without any treatment at all.

The message is clear: mental suffering and pain is no longer the responsibility of the health system.

Now a Stoic or a Buddhist would probably see attachment to one’s social position as flaw in one’s perception that needed to be addressed. But how many people have the energy and intestinal fortitude to restructure their life after a major setback? And worse, in America, being social seems to require money: driving in a car to see other people, being expected to be able to pay for a drink or a meal. One of the amenities I recall in Italy was that a hillside town had a social center for older people where they could hang out. It had a little library and games tables and I assume a TV. America is poor in that sort of thing.

I wish there were better answers. The CDC stresses more access to mental health treatment, and while that would help in many cases, it strikes me as addressing only the most extreme symptoms of increased alienation and desperation.

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40 comments

  1. Colonel Smithers

    Thank you, Yves.

    It’s the same in the UK as per .

    According to one of dad’s friends and former colleagues, still working as a pathologist in the UK and overseas, the authorities in the UK often attribute the cause of death to reasons other than suicide. This to spare the loved ones more pain and, in the case of a well-known singer, protect his reputation and his BF, the suspected supplier of the drugs that led to the massive overdose.

    Clive, I think, has also mentioned this change of cause of death.

    1. Clive

      Yes, coroners have a lot of latitude in recording verdicts. Several what appear to be reliable studies (such as ) suggest that classifications — especially for suicide — should be treated with caution and under-reporting I suppose isn’t unheard of.

      Accurate statistics would help understand the scale of the suicide problem, but I can totally appreciate the wish to not distress the bereaved relatives further.

    2. PlutoniumKun

      This has been a long term problem, certainly in Britain and Ireland it was common practice to ascribe a death to ‘misadventure’ when there was even the slightest possibility it wasn’t a suicide – this was supposedly to spare the families feelings. The exception was with auto-erotic asphyxiation, where suicide was sometimes considered a less embarrassing verdict. I’ve been told that this is sometimes still the case with female deaths.

      There was a move to more ‘honest’ verdicts in Coroners Courts could perhaps have been reversed in more recent years because of justified concern about copy-cat suicides, especially with young people.

      So I think all figures on suicide have to be treated with some healthy scepticism. That said, I think there is very little doubt that there have been rising trends in both the US and UK.

  2. Nameful

    Perhaps a link to the original thing would have been nice – it hardly seems much of a but it does have one more graphic with splits across mental problems, sex and type of demise. Honestly, the male-to-female ratio is worrisome, if it were inverted there would be plenty of women’s suicide help groups springing across the country. Problems and symptoms, it seems.

      1. tegnost

        well to be fair they couldn’t say much of substance in this regard (causes of anomie) because the system is the problem and bezos et al certainly don’t care if a citizen with low purchasing capacity offs themselves, but considering the neolib dream is to have the gov pay the bill for the boots over the threshold of the institution, in this case the “health” industry, the article stumbles to the point in the end, which as always is “more treatment”…
        “It is no measure of health to be well adjusted to a profoundly sick society”
        krishnmurti .

  3. Eudora Welty

    I’ve worked in a regional trauma center in an urban core, offering pastoral care, for more than 10 years. The number of incoming gsw’s (gun-shot wounds) has risen dramatically, especially self-inflicted. However, gang-related gsw’s are routine now, too. Not to be gross, but I’ve seen several people shoot themselves in the face/ mouth (you’d think surely fatal) and survive. The elderly & super-elderly instances are most disturbing. I’ve seen all classes, stations of life, & ages. Suicide seems more internally acceptable.

  4. voteforno6

    We had a small get together of people from my high school class last year – we reckoned that, of all our classmates who have passed away, half of them were from suicides. These are all individual tragedies, but it’s not until you step back and look at the whole picture that you realize that something is wrong.

  5. Louis Fyne

    —. Not to be gross, but I’ve seen several people shoot themselves in the face/ mouth (you’d think surely fatal) and survive. —

    Suicide isn’t like how it’s often portrayed in the movies/TV (obviously).

    Many people have a misapprehension that a person can somehow manage a (less) painless exit. remember the theme to MASH–“Suicide is painless”?

    every single method commonly available to a layman can be excruciatingly painful.

    Suicide is not euthanasia. And sadly the rise in suicide points to a total breakdown in optimism, social bonds, hope.

    1. Alex Cox

      “every single method commonly available to a layman can be excruciatingly painful.”

      Not necessarily. I won’t go into lots of details, but just mention one: in Oregon a friend’s husband decided his dementia was wrecking his quality of life. Fortunately this is one of the states were assisted suicide is available.

      His Oregon MD gave him a bottle of valiums and told him to eat them all. This proved impossible, so he and the misses crushed them all, mixed them with water, and he drank it like a milkshake.

      He died without pain.

  6. David

    From a quick scan, I can’t see any figures for attempted suicides, although intuitively one imagines those figures would be rising as fast, if not faster, than successes. This is because suicide is actually quite difficult, and it’s not the kind of thing, to put it mildly, that you can practice. Thus, as any medical professional will tell you, suicides in their area, which are distressingly common now in most advanced countries, are usually done with drugs that those individuals know how to use. By contrast, a common method of attempted suicide in the UK is ingestion of enormous numbers of Paracetamol, which can kill you from liver failure, but has horrible side-effects if you don’t succeed – notably having your legs amputated.
    The list of proposed mitigations in the report is pitiful, and perpetuates the myth that suicide is the result of mental problems, whereas for quite lot of people it’s actually a rational choice. At some point, it’s going to have to be said that our (neo)liberal social and economic system is actually closer to a disease than a school of political philosophy. Poverty, inequality, insecurity, loneliness, and the death of community and culture literally kill people. It’s unsurprising if increasing numbers decide to choose the point at which they will check out.

    1. aliteralmind

      “Suicide is the tenth leading cause of death and is one of just three leading causes that are increasing (1,4). In addition, rates of emergency department visits for nonfatal self-harm, a main risk factor for suicide, increased 42% from 2001 to 2016 (1). Together, suicides and self-harm injuries cost the nation approximately $70 billion per year in direct medical and work loss costs (1).”

      Neoliberalism is a four-decade long Ponzi scheme, and it’s taking increasingly desperate steps to keep it going.

  7. Livius Drusus

    In America you are judged by your job and how much money you make so that does have an impact on your social life especially if your friends are in a much higher economic class than you are. All Americans talk about are their jobs, their homes, their families (a decent family life now becoming a luxury good thanks to the destruction of the middle class), their relationships, their cars or their new gadgets.

    If you are poor or even working-class many of those things are likely beyond your reach so you just sit there like a bump on a log and don’t contribute to the discussion. You end up declining invitations to get-togethers to avoid the embarrassment. As mentioned in this post, you might not be able to afford eating and drinking out. This contributes to social isolation and in extreme cases depression and even suicide.

    Social media has just enhanced Keeping up with the Joneses. The vast majority of social media posts consist of bragging whether outright or of the “humble brag” variety. Of course you are seeing a person’s good side and not their bad side and there is likely a good amount of fake stuff being posted but the “compare and despair” aspect of social media is real and probably contributes to much misery. People also seem to be less open and friendly now that they are staring into screens all of the time,

    American values are now almost entirely materialistic and status-oriented. In the past you could still fulfill certain roles and have respect even if you were not affluent. You could be a good father/mother/spouse or a good friend. You could be a good Christian/Jew/Muslim/humanitarian. Now these things are increasingly luxuries (friends and families) or no longer respected.

    Religion is in decline and many forms of religion in America have adopted the hustling dogma such as the prosperity gospel. Humanitarianism and politics are increasingly dominated by the same affluent people that dominate other social settings and there is a tremendous cynicism about politics today so many people do not even bother. I don’t think Stoicism or similar philosophies can help most people. Most of us need social interaction to survive much less thrive.

    Unfortunately because everything under neoliberalism is seen as a problem for individuals only there is a tendency to write struggling people off as losers or whiners. That is why self-help gurus are so popular and successful. Some people might benefit from their advice but others won’t and they will go on to the next guru or just give up eventually. Self-help gurus can always claim that their disciples are just not following their program correctly or they just didn’t try hard enough or whatever. So no matter what you are all alone, on your own and you better not mess up because nobody will help you and they will spit on you when you are down. No wonder suicide rates are increasing.

    1. MyLessThanPrimeBeef

      It all starts in school.

      Today, we over-value the brain, and ignore the heart.

      Be smart and you will succeed materially. Students strategically calculate their extracurricular activities to maximize self-benefits.

    2. Lambert Strether

      > Unfortunately because everything under neoliberalism is seen as a problem for individuals only there is a tendency to write struggling people off as losers or whiners

      Suicide because TINA.

    3. Jeremy Grimm

      You assert “In America you are judged by your job and how much money you make so that does have an impact on your social life especially if your friends are in a much higher economic class than you are.”

      As a movies lover I recall the movie “About a Boy” which is situated in England. Recalling that movie I cannot but wonder what strange values we place on work, and it is much more than just a matter of keeping up with the Jones although that is not a factor I would diminish. So I agree with everything in your comment but would take it even further. Our societies place a strange value on the place of work in our lives and the jobs — indeed even many of the jobs that pay six-figures — fail to satisfy these strange values beyond just money. We all live live as strangers in a strange land. In the realms of Neoliberalism even the successful feel lost, friendless, remote from their families, and alien from their work, their spouses and children, and their unhappy lives.

  8. Petter

    Thomas Joiner is a renowned expert on suicide and – clipped right from Wikipedia – In Why People Die by Suicide, Joiner posits the interpersonal theory of suicide, a three-part explanation of suicide which focuses on ability and desire. The desire to die by suicide comes from a sense of disconnection from others and lack of belonging, combined with a belief that one is a burden on others. The ability to die by suicide comes from a gradual desensitization to violence and a decreased fear of pain, combined with technical competence in one or more suicide methods. Under this model, a combination of desire and ability will precede most serious suicide attempts.

    His paper Why People Die By Suicide: Further Development and Tests of the Interpersonal-Psychological Theory of Suicidal Behavior offers a good summary:

    An interesting but contentious read is Sarah Perry’s Every Cradle is a Grave: Rethinking the Ethics of Birth and Suicide. Perry is an anti-natalist.

    1. freedomny

      I absolutely love Anthony Bourdain’s shows and am completely blown away by his suicide. It’s unbearably sad.

  9. Wukchumni

    The world of 1999 was already in your face from an internet perspective, but only a few years prior if you wanted privacy in your life, all you had to do really, was have an unlisted phone number, or only give your name, with no address, in the phone book.

    It was as simple as that, poof, you hardly existed in that world, and face time was the order of the day, not sharing with the world on .

    I think this loss of privacy is the driving factor in so many suicides.

    1. Livius Drusus

      I agree with you. In my earlier post I mentioned the “compare and despair” aspect of social media. Most people live in a pressure cooker today and social media is a big part of that. The 1990s were already materialistic and depressing in some respects but at least you could escape into your own private world with your family and friends.

      Today you are expected to curate your life online. You have to manufacture a perfect online image not only for friends and family but for co-workers, employers (and potential employers) and potential friends/romantic partners. If want to opt out of this game you are seen as a weirdo at best and maybe even dangerous because you “must be hiding something.”

      I often wonder what happens when inevitably some of the perfect online lives fall apart, like when a couple that paraded how perfect and happy they were gets divorced. It must be even worse now that everyone on your social media can see that something bad happened. It takes gossip and busybody behavior to another level. This is not even getting into things like cyberbullying which has made bullying even worse now that it doesn’t end at the schoolyard or workplace but continues 24/7 online.

      Most people don’t want to admit it because we worship technology but a lot of the new tech, particularly smartphones and social media, have more downsides than upsides. Sure it makes it easier to stay in touch with people but do you really need to stay in touch will hundreds of people most of whom you will never deal with in person and who really don’t care about you? We have traded a relatively small number of strong, deep face-to-face relationships for hundreds of shallow, weak ones online.

      1. Arizona Slim

        I have been cyberbullied. The worst of it happened on Facebook and I’m still dealing with the consequences.

      2. jrs

        “The 1990s were already materialistic and depressing in some respects but at least you could escape into your own private world with your family and friends.”

        at least the economy was better also

        “Sure it makes it easier to stay in touch with people but do you really need to stay in touch will hundreds of people most of whom you will never deal with in person and who really don’t care about you?”

        I am told this is what you need to do to network for a job these days

    1. flora

      adding: to highlight WaPo article commentor desertbloom’s comment:

      “Those of us who see dignity and courage in those who see everything they worked for disappearing cannot even provide treatment for a reduced fee or run a tab that we know will never be paid.

      There is no tax write-off for this sort of charity provided by individual doctors for the uninsured. There are no rehabilitation residential treatment programs for body, mind and soul….”

  10. Wukchumni

    Suicides are almost always a cry out for attention, few do themselves in by leaping into deep icy crevices where they’ll never be found, or jumping into the ocean laden in heavy chain link.

    It’s one last see me-dig me, why i’m not sure.

    How we die is interesting.

    A couple of years ago in our cabin community in the National Park, a quite fit fellow cabin owner in her 60’s went off for a 10 mile dayhike, which is a common thing to do, and she went missing, and a search and rescue ensued and they found her body 4 days later, she had a fatal heart attack and fell off the trail, down about 60 feet below, and the next day, the newspapers headline was “Woman Hiker Dies In Sequoia National Park”, but if she had a heart attack @ the Sequoia Mall in Visalia, would anybody have ever read about it?

    1. tegnost

      A problem I have with your your attention theory re why not go jump off a mountain, actually going to the mountains may give people perspective about life and feel uplifted by nature and not do themselves in, but then go into their cave and see only their demons and the unarguable hopelessness that permeates working class life. I know from your comments that you have a reasonably stable and generally prosperous life, you travel a fair amount,go skiing etc…all things that cost money, and to visit friends you actually need to have some and our atomized society pretty much expels anyone marginal and justifies our cruel society by saying things like suicide is one last dig..No, suicide is someone feels really awful and see’s no way out, and has no feeling of place or belonging that counteracts the despondence.I have a costly marginal in my life and have been told to give her $50 and a gun (yes, hillary or buster, yes advocate of gun control) Earlier in life she made a good living as a gardener, but something happened to those jobs…needless to say I usually just stop talking to people who reveal themselves in this way. (50 and a gun). When I really want to lose faith I go to any article on the homeless crisis in any major newspaper and read the comments. Americans are mean, we cultivate mean, and we reap what we sow.

      1. Lambert Strether

        > I have a costly marginal in my life and have been told to give her $50 and a gun (yes, hillary or buster, yes advocate of gun control)

        Yikes.

        Adding, I’m confused about what the $50 is for. A motel room?

  11. Roland Chrisjohn

    I wrote a book about indigenous suicide 4 years ago and called attention to these phenomena (which I’d been gathering for a decade or longer). My co-author and I account for it entirely in materialist terms (even though I’m an ex-psychologist who worked in suicide direct services for years). It’s received no play (the publishers decided they wanted nothing to do with it, since pie-in-the-sky therapy-buttressing piffle is the norm in Indian Country these days), but it’s a coherent account of why this is happening most everywhere. I’ve been giving it away free since 2014, and if anyone is interested:

    1. JacobiteInTraining

      Thanks for the link – at work now, but it looks like something I’ll want to read from end to end. A proud Tlingit, my best friend for decades…fell into such a trap and wasn’t able to escape. :(

      “…In such situations the feeling that you failed a friend is impossible to shake…”

      Ain’t that the truth…

    2. JSo

      I had similar findings from developing country research. Unsurprisingly, when the poor cannot pay their micro credit loans back they will take desperate measures to escape debt (the most recent example was 200+ suicides by mostly women debtors in Andhra Pradesh — 200 may be low bc in reality nobody cared, but the MFIs who caused the over indebtedness were allowed to do fast track bankruptcy restructuring).

      Also, not surprisingly, same findings when consumers are victims of financial frauds, like ponzis. I interviewed a woman who lost her life savings in a ponzi scheme and she told me she went to the chemist/pharmacist to buy poison, but could not afford the full bottle. Too broke to commit suicide.

      1. Lambert Strether

        > Unsurprisingly, when the poor cannot pay their micro credit loans back they will take desperate measures to escape debt

        One reason Thomas Frank’s is so nauseating, besides the sycophancy.

      1. flora

        You can read the paper online at the link, just can’t download it without logging in to F or G.

  12. Jeremy Grimm

    Have you ever tried to get help for a relative you fear might intend suicide? Have you ever tried to get help for a relative with obvious — even to this untrained layman — need for psychiatric help? Good luck! And when help comes, usually following a lengthy legal proceedings that promise time in the penal system for a relative with mental illness — unless you their responsible relative spend a not inconsiderable amount time searching for and a considerable amount of money obtaining an attorney to defend them — the usual remedy is a lengthy sentence to a state prison where whatever mental illness they have can be amplified, if they are able to survive their sentence. [Try to find an attorney to defend a client involved in a felony case. You can find any number of criminal attorneys to defend DUI and petty shoplifting cases but very few experienced or skilled at criminal defense.]

    I look at our society and the jobs we have on offer, the schooling and expense required to train for those jobs, and the ‘long-term’ those jobs offer, and I wonder why we don’t have even more suicide and mental illness. I am especially concerned for the fate of young men. After all the hoopla around women’s liberation — all I have noticed is management directives to promote women in favor of similarly or better qualified men to the low-level management positions which are the best many men and women without the ‘right’ qualifications might hope for. The now endless campaigns to constrain ‘sexual harassment’ reduces in practical terms to a constraint on lower level men hitting on the women in their office-place. [Men at higher levels seem strangely immune.] If you argue that women’s liberation has benefited men too just tell me what percent of the men who motion for it obtain child custody in a divorce or even decent [and enforced] visitation rights. Which is not to say women have benefited especially from receiving their seats at desks serving the American workplace. If not at work, where is a young guy supposed to find a mate — on-line?

    Take a closer look at the nature of the jobs and required schooling for the 21st Century American workplace. What sane person would want to grind through some of the incredibly dull textbooks and lectures at school, and the mindkilling work, that characterizes the ‘better’ and ‘better-paid’ jobs of the modern workplace? What person sane at the onset will remain sane for a decade? And what about our blue-collar workplace — such as remains of it? This is the age of Taylorism’s wet-dreams. Any instincts of workmanship are quashed with books of billable hours and pressure to sell the unnecessary. And friends and families are scattered over time and space to accommodate the Capitalist’s dreams of a “flexible-workforce” — although we can always reach out and touch someone — at a distance — if we subscribe to the right mobile phone service provider.

    Our society does not fit humankind. I wonder at the sanity of those who are not depressed by our present world and the world our likely future holds.

  13. AstoriaBlowin

    I suspect our built environment has a role to play too, our sprawled out “communities” and car dependency results in social isolation. You can’t just walk out your door and see people, there’s no where to walk to and not even a sidewalk in many cases. There’s no room for spontaneous interactions if you are trapped in a car everywhere you go. In how many towns could you take a stroll after dinner and see your neighbors or family?

  14. Scott1

    James Jones believed young men suffering heartbreak would run off to the Army where they got their throats cut for them. The older man sick of war jumped off the ship in the night. There was the woman who self diagnosed her disease that brought on shame making her feel as though she did not deserve to live.
    “What happened to Ron?”
    “Lisa broke up with him and he killed himself.”
    The Parkland mass murderer murdered the girl who didn’t want him.
    Arthur Koestler was sick and not to get better. He got his younger wife to help him and kill herself as well.
    Bourdain’s younger girlfriend stepped out on him with a younger man and he killed himself.

    In regions of Eastern Europe there were suicides because where they lived was given to Stalin.
    I do not know of another animal that kills themselves other than dolphins.
    Drug addicts and alcoholics are warned against the conditional life. When the conditions of life become intolerable, intelligent beings will either murder others to change those conditions, or kill themselves.

    When your life is all you have you may well be less inclined to willingly give it up.
    Dolphin suicides are protest suicides. As a category of suicides it is the protest suicide rate that indicates the illness of the conditions of a population’s true society and the population’s culture created by artificial systems of human civilizations.
    Our job is to help each other live. Life is more beautiful than death. We can’t make it on our own, and we all need help living.
    In the current financial system the rich get more help from the system living than the working classes.
    Is not this the essence of Class Warfare? We can march, occupy & burn.
    The burning of those running the system so all of the majority are made depressed, miserable, murderous and suicidal, In Effigy is not a common practice in the US, though I recommend it.

    I did somewhat well with my message rocket program as a pro active civil demonstration.
    Bombing adversaries, like say the DPRK with popcorn and flowers is something I’d like to see tried by my all so militarized government and its equipment.

    I’m angry and have been deeply suicidal but I value my life and have done what I can to protect my personal liberty.
    Thinking up things to do to protest that will not land me in jail, is something I do with my anger.
    So far I have not killed myself.

  15. LS

    That CDC report gave countless Media outlets a way to highlight the exponentially rising deaths from economic hopelessness, but no (I won’t even link to the pathetic New York Times piece I read on June 7th which referenced Financial Setbacks versus a reality of Can’t Afford To Live, for so many thousands, then quickly moved on to totally obscure that increasing reality), that did not happen at all.

    I can’t help but wonder how many bipartisan politicians ed mucketys at newspapers and major networks behind the scenes and demanded that they focus on the two very unfortunate famous people which preceded and succeeded that report – within about 4 days time – versus informing their constituents that people are killing themselves because they can no longer afford to live anything but a nightmare, despite the fact that they are not terminally ill or in their late nineties, many of them are under retirement age, many under thirty.

    Previously I wasn’t familiar with either of them. From what’s been noted about Kate Spade, I can’t say, though suspect she would be outraged; and from what I’ve now read about Anthony Bourdain, it definitely seems to me that he would be outraged that his death is being used to obscure a National Crime of epic proportions.

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