County-level estimates of suicide mortality in the USA: A modelling study

Background Suicide is one of the leading causes of death in the USA and population risk prediction models can inform decisions on the type, location, and timing of public health interventions. We aimed to develop a prediction model to estimate county-level suicide risk in the USA using population characteristics. Methods We obtained data on all […]

Associations between natural language processing (NLP) enriched social determinants of health and suicide death among US veterans

Importance: Social determinants of health (SDOH) are known to be associated with increased risk of suicidal behaviors, but few studies utilized SDOH from unstructured electronic health record (EHR) notes. Objective: To investigate associations between suicide and recent SDOH, identified using structured and unstructured data. Design: Nested case-control study. Setting: EHR data from the US Veterans […]

Trends in suicide rates by race and ethnicity among members of the United States Army

Efforts were focused on identifying differences in suicide rates and time-dependent hazard rate trends, overall and within age groups, by race and ethnicity among United States Army members who returned from an index deployment (October 2007 to September 2014). This retrospective cohort study was conducted using an existing longitudinal database, the Substance Use and Psychological […]

Suicide risk among individuals diagnosed with cancer in the US, 2000-2016

Importance  Individuals diagnosed with cancer have elevated suicide risks compared with the general population. National estimates of suicide risks among individuals with cancer are lacking in the US, and knowledge about risk factors is limited. Objective  To provide contemporary estimates of suicide risks associated with cancer and to identify sociodemographic and clinical factors associated with suicide risks […]

Recent stressful experiences and suicide risk: Implications for suicide prevention and intervention in U.S. Army soldiers

Objectives To identify the extent to which the presence of recent stressful events are risk factors for suicide among active‐duty soldiers as reported by informants. Methods Next‐of‐kin (NOK) and supervisors (SUP) of active duty soldiers (n = 135) who died by suicide and two groups of living controls: propensity‐matched (n = 128) and soldiers who reported suicidal ideation in […]

Early first deployment and risk of suicide attempt among first-term enlisted soldiers in the U.S Army

Objective We examined early first deployment and subsequent suicide attempt among U.S. Army soldiers. Method Using 2004–2009 administrative data and person-month records of first-term, Regular Army, enlisted soldiers with one deployment (89.2% male), we identified 1,704 soldiers with a documented suicide attempt during or after first deployment and an equal-probability control sample (n = 25,861 person-months). Results […]

Suicide mortality and related behavior following calls to the Veterans Crisis Line by Veterans Health Administration patients

Objectives To assess outcomes for Veterans Health Administration (VHA) patients following calls to the Veterans Crisis Line (VCL). Methods 158,927 VHA patients had an initial VCL call in 2010–2015 with documented identifiers. Multivariable proportional hazards regressions assessed risks of suicide and suicide-related behavior through 12 months. Covariates included age, sex, region, mental health encounters in the […]

Time-series analyses of firearm-related Google searches and U.S. suicide rates 2004–2016

Objective The U.S. suicide rate has increased 35% since 1999. The role of the Internet has not been thoroughly investigated despite Internet use more than doubling from 1999 to present. The majority of U.S. suicide deaths are by firearm; however, there is no examination of the association between trends in firearm Internet searches and overall […]

A comparison of farming- and non-farming-related suicides from the United States’ National Violent Deaths Reporting System, 2003–2016

Farmers are at higher risk of suicide than other occupations and the general population. The complex suicide risk factors have not been examined in a large, population-wide study across a significant time period. This observational study draws on existing data from the United States’ National Violent Death Reporting System (NVDRS), including 140,523 farming- or non-farming-related suicide decedents […]

Financial costs to the U.S. Army for suicides by newly enlisted soldiers

Objective To estimate the financial burden to the U.S. Army of suicide by enlisted Soldiers during their first year of service. Methods This analysis included new Army enlisted Soldiers who started initial entry training from October 2012 through September 2016 and subsequently died by suicide within their first year of service. Outpatient and inpatient direct […]

Indirect standardization for rare events and a dynamic standard population rate: An analysis and simulation of U.S. military suicide mortality rates

Introduction Comparing suicide mortality rates between the U.S. military and U.S. general populations is common in lay and professional literature. Standardization is required for this comparison to account for differences in the population structure, but small event counts complicate the analysis. Methods We demonstrated the performance of direct, indirect, and reverse-direct standardization using U.S. military […]

Risk of suicide attempt in reserve versus active component soldiers during deployment to the wars in Iraq and Afghanistan

Introduction Little is known about the degree to which U.S. Army soldiers in the Reserve Components (Army National Guard and Army Reserve) and Active Component (Regular Army) differ with respect suicide attempt (SA) risk during high-stress times, such as deployment. Method Using administrative person-month records of enlisted soldiers on active duty during 2004–2009, we identified […]

When the United States says you do not belong: Suicide-related thoughts and behaviors among immigrant young adults varying in immigration legal status

Background The number of immigrants in the United States and the risk of suicide among minoritized individuals have increased. Little research has examined the impact of immigration legal status on suicide-related thoughts and behaviors (SRTB), despite theoretical and empirical work suggesting that feelings of burdensomeness and failure to belong (prominent among immigrants) are risk factors. […]

Notes from the field: Increases in firearm homicide and suicide rates United States, 2020–2021

The firearm homicide rate in the United States increased nearly 35% from 2019 to 2020, coinciding with the emergence of the COVID-19 pandemic (1). This increase affected all ages and most population groups, but not equally: existing disparities, including racial and ethnic disparities, widened. The firearm suicide rate was higher than the firearm homicide rate […]

Increasing suicide rates in early adolescent girls in the United States and the equalization of sex disparity in suicide: The need to investigate the role of social media

In the context of increasing rates of suicide in US youth, a recent report by the Centers for Disease Control and Prevention1 revealed that the largest percentage increases in the rates of suicide occurred in girls aged 10 to 14 years. In an unprecedented escalation, rates of suicide in this subgroup tripled between 1999 and […]

Three leading suicide methods in the United States, 2017–2019: Associations with decedents’ demographic and clinical characteristics

Background and aims: The U.S. suicide data show that use of lethal methods, specifically firearms and hanging/suffocation, has been increasing among young and middle-aged adults of both sexes over the past decades. In this study, we examined demographic and clinical correlates of use of firearms, hanging/suffocation, and poisoning as suicide methods among suicide decedents age 18+. […]

The Surgeon General’s call to action to implement the National Strategy for Suicide Prevention

A Report of the U.S. Surgeon General and of the National Action Alliance for Suicide Prevention The Surgeon General’s Call to Action to Implement the National Strategy for Suicide Prevention (Call to Action) seeks to advance progress toward full implementation of the National Strategy, while taking into account the unique challenges and  opportunities of our […]

Mental health and well-being in the construction industry: 2021 Pulse survey

Mental health and well-being are high priorities for organizations across industries. This was true before COVID-19, however, is even more so now. Growing mental health concerns exist in the  construction industry because it ranks second highest in suicide rates among major industries. Multiple factors likely contribute to higher suicide rates and mental health concerns in […]

Provisional numbers and rates of suicide by month and demographic characteristics: United States, 2021

Objectives—This report presents provisional numbers of deaths due to suicide by month and demographic characteristics (age and sex) for 2021 and compares them with final numbers for 2020. Age-adjusted and age-specific suicide rates are presented by sex and compared with final 2020 rates. Methods—Data are based on 99% of all 2021 death records received and […]

Public perception of mental health and suicide prevention survey results: August 2020

This report summarizes the results of a Harris Poll conducted in July 2020 about public knowledge, perceptions, attitudes, and experiences related to mental health, access to mental health care, and suicide prevention among adults in the United States. The poll was conducted on behalf of the National Action Alliance for Suicide Prevention, Suicide Prevention Resource Center, […]

Public perception of mental health and suicide prevention survey results: September 2022

This report summarizes the results of a Harris Poll conducted in July 2020 about public knowledge, perceptions, attitudes, and experiences related to mental health, access to mental health care, and suicide prevention among adults in the United States. The poll was conducted on behalf of the National Action Alliance for Suicide Prevention, Suicide Prevention Resource Center, […]

Suicides among incarcerated persons in 18 U.S. States: Findings from the National Violent Death Reporting System, 2003-2014

Using data from the National Violent Death Reporting System (2003–2014), this study examined the characteristics and contributing circumstances of suicides in correctional facilities. χ2 and logistic regression analyses revealed that, compared to nonincarcerated suicide decedents, incarcerated suicide decedents had significantly lower odds of positive toxicology for substances but significantly higher odds of substance abuse problems. Descriptive […]

A historical examination of military records of US Army suicide, 1819 to 2017

Importance:  Suicide rates among active-duty personnel in the US military have increased substantially since 2004, and numerous studies have attempted to contextualize and better understand this phenomenon. Placing contemporary examinations of suicides among active-duty personnel in the US Army in historical context provides opportunities for joint historical and epidemiological research to inform health care professionals […]