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US economic downturn has produced sharp uptick in suicide

Robin Wulffson MD's picture
suicide, economic crisis, Barack Obama, Mitt Romnye, presidential election

Arguably, the most significant issue in the imminent presidential election is the economy. President Obama and Governor Mitt Romney have expressed their differing viewpoints on how best to spur the economy. In addition to the flagging US economy, many European nations are experiencing financial problems. Evidence from European countries indicates a significant rise in suicides from the economic recession, totaling more than 1,000 excess deaths in the United Kingdom alone. Among the worst affected economies in Europe, such as Greece, suicides have risen by more than 60% since 2007.

Researchers affiliated with the University of Cambridge in the UK noted that to date, there has been little or no analysis of US mental health data, primarily due to delays in data availability. Thus, they conducted a study to extend their previous analyses of recessions and suicides in Europe to assess trends in all 50 US states. They published their findings online on November 5 in The Lancet.

The researchers accessed data on suicide mortality rates from 1999 to 2010 from the Centers for Disease Control and Prevention (CDC). Unemployment data was obtained from the Bureau of Labor Statistics. They evaluated excess suicides occurring during the economic crisis (i.e., deaths over and above the level that would be expected if historical trends continued). They noted that concerns exist that suicide data are under-reported in the US; however, these biases are likely to have been consistent over this relatively short period. Thus, they might lead to a conservative estimate of the mental health effects of the crisis.

“In the run-up to the US presidential election, President Obama and Mitt Romney are debating how best to spur economic recovery. Missing from this discussion is consideration of how to protect Americans’ health during these hard times,” noted lead author Aaron Reeves, PhD. He added, “Suicide is a rare outcome of mental illness, but this means that these data are likely the most visible indicator of major depression and anxiety disorders among people living through the financial crisis, as revealed by recent research in Spain and Greece.”

The investigators found that between 1999 to 2008, the annual suicide rate was rising by 0.12 deaths per 100,000 population. However, coinciding with the onset of the recession, the suicide rate accelerated, and an additional 0.51 deaths by suicide per 100,000 population from 2008 to 2010 occurred. The researchers report that this increase corresponds to an additional 1,580 suicides per year. They noted, “Thus, during the recessionary period after 2007, there were an estimated 4,750 excess suicide deaths.”

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They next examined the relationship between rising unemployment and suicide mortality rates and found that a 1 percentage point rise in unemployment was associated with a 0.99% increase in the suicide rate. During 2007-2010, the US unemployment rate increased from 5.8% to 9.6%. The researchers report that the rise in unemployment was associated with a 3.8% increase in the suicide rate, corresponding to approximately 1,330 suicides. They wrote, “In other words, rising unemployment could account for about a quarter of the excess suicides noted in the USA during this time,” they write.

On a brighter note, the authors proposed that it is possible to avoid increased rates of suicide in tough economic times. They explained that some countries, such as Sweden, have avoided an increase despite a major economic downturn. They wrote, “Active labour market programmes, projects that immediately help the unemployed find social support and new work opportunities (even part time), and mental health prevention programmes seem to mitigate significantly the negative mental health effects of recessions. The fact that countries such as Sweden have been able to prevent suicide rises despite major recessions reveals opportunities to protect Americans from further risk of suicide during the continued economic downturn.

Beyond civilian suicide in the US is a soaring suicide rate in the its military personnel. For example, in August, the US Army confirmed that 26 active-duty soldiers and 12 reservists died by suicide in July; this marks the highest number in one month ever recorded among this group of individuals. From January through July of 2012, a total of 116 active-duty military personnel and 71 reservists are believed to have committed suicide. In comparison, 165 active-duty soldiers and 118 reservists killed themselves for all of 2011. Not only are many military personnel committing suicide but also many are suffering from psychiatric illnesses such as post-traumatic stress disorder (PTSD) and severe depression. Due to this alarming increase, members of the US Congress and even the President are taking action.

On August 31, President Obama signed an executive order directing the US Department of Veterans Affairs (VA) to hire 1,600 new mental health professionals and 800 peer-support counselors; the goal was to facilitate prompt attention by a healthcare professional within 24 hours. A task force is being implemented that will develop strategies for improving diagnosis and treatment of PTSD and traumatic brain injury (TBI). Furthermore, the US Department of Defense (DoD) has created a “Real Warriors” campaign and Web site to offer support and to inspire these individuals to come forward for help.

Since 2001, more than 2 million service members have been deployed to Iraq or Afghanistan since 2001; many of these individuals have been deployed multiple times. The most common reason for hospitalization of Army personnel is now admission for some type of psychiatric illness, including PTSD, depression, other anxiety disorders, or substance abuse. Approximately 15% of US infantry personnel experience some sort of PTSD symptoms post deployment. The most common reason for hospitalization of Army personnel is now admission for some type of psychiatric illness, including PTSD, depression, other anxiety disorders, or substance abuse.

Reference: The Lancet