According to the US Census Bureau, seniors (age 65 and older) accounted for 16 percent of the total US population in 2019. And in 2020, seniors aged 50 to 85+ accounted for 19,968 deaths for a crude rate of 16.86 per 100,000 in the Centers for Disease Control and Prevention’s (CDC) Internet-based Injury Statistics Query and Reporting System. Recognizing that this population is disproportionately affected, it is important to address suicide prevention in this group of Americans.
Baby boomers, those born between 1946 and 1964, had a relatively higher suicide rate at any given age than older or later birth cohorts. Demographers estimate that by the year 2030, more than 71 million Americans will be age 65 or older, or 20 percent of the US population. Baby Boomers are a group with historically high suicide rates, and as they enter adulthood, the suicide rate for both men and women is expected to rise again. Older adulthood is a time of greater risk and could lead to significant increases in the number of older adults dying by their own hands (Conwell, et al., 2011). Collectively, caregivers of older adults, the health community, government and non-government agencies, and the general public can change this trajectory.
To intervene, health care providers and caregivers must be able to recognize the warning signs of suicide in older adults. Being aware of certain behaviors that may indicate thoughts of self-harm can help save a life. The SAMHSA website has published warning signs that may indicate someone is at risk of suicide:
- Talking about wanting to die or kill himself.
- He is looking for a way to kill himself.
- Speaking of being a burden to others.
- Increased use of alcohol or drugs.
- Acting restless or agitated, behaving recklessly.
- Sleeping too little or too much.
- Withdrawal or feeling isolated.
- Showing anger or talking about revenge.
- Experiencing extreme mood swings.
Mental health providers should have early career training in suicide prevention, behavioral suicide interventions, and suicide prevention. Graduate students in social work, psychology, counseling, and even gerontology often do not receive adequate skills training. As a result, many providers with master’s degree preparation are learning on the ground how to support people with suicidal ideation and/or suicide attempts.
An example of a prevention strategy that can help reduce suicide attempts among older adults is to increase health care providers’ awareness of substance use and mental health conditions in older adults. To achieve this, evidence-based screening tools can be used in clinical settings to screen for suicidal risk.
A critical national resource for those experiencing crisis is the 988 Suicide and Crisis Lifeline. Lifeline is available 24/7 and connects mental health professionals with those in crisis. Safety planning is another important tool for prioritizing coping strategies and sources of support for individuals. These tools offer broad guidance on older adults and suicide prevention, substance use, program best practices, and clinical support.
While the observation of a single warning sign may not indicate suicidal thoughts, the observation of multiple signs and other risk behaviors, major life events, medical prognosis, and/or mental health diagnosis may indicate suicidal risk. There are many strategies that can be used to prevent a death by suicide among the elderly.
Finally, providers in all mental health disciplines can refer to resources that reinforce best practices, including SAMHSA Promoting Emotional Health and Suicide Prevention: A Toolkit for Senior Centers and the CDC resource, Suicide prevention: A technical package of policies, programs and practices (PDF | 6.1 MB).
bibliographical references
- Centers for Disease Control and Prevention, National Center for Health Statistics. Web-Based Injury Statistics Question and Report System (WISQARS) [online]. Report 2022, September 27.
- Conwell, Y., Van Orden, K., & Caine, ED (2011). Suicide in the elderly. Psychiatric Clinics, 34(2), 451-468.
- Schini, K. (h). What you need to know about suicide rates in the elderly. WebMD. Retrieved 17 August 2022.
- Stone, DM, Holland, KM, Bartholow, B., Crosby, AE, Davis, S., and Wilkins, N. (2017). Suicide prevention: A technical package of policies, programs and practices. Atlanta, GA: National Center for Injury Prevention and Control, Centers for Disease Control and Prevention.
- Substance Abuse and Mental Health Services Administration. (2015). Promoting Emotional Health and Preventing Suicide: A Toolkit for Senior Centers. HHS Publication No. SMA-15-4416. Rockville, MD: Center for Mental Health Services, Substance Abuse and Mental Health Services Administration, 2015.
