{"id":180515,"date":"2020-10-28T14:20:31","date_gmt":"2020-10-28T18:20:31","guid":{"rendered":"https:\/\/www.bu.edu\/sph\/?post_type=bu-article&p=180515"},"modified":"2021-03-02T14:41:10","modified_gmt":"2021-03-02T19:41:10","slug":"on-suicide-we-must-address-failures-at-a-system-level","status":"publish","type":"bu-article","link":"https:\/\/www.bu.edu\/sph\/news\/articles\/2020\/on-suicide-we-must-address-failures-at-a-system-level\/","title":{"rendered":"On Suicide, ‘We Must Address Failures at a System Level’"},"content":{"rendered":"\n
\"Stopping<\/figure><\/div>\n\n\n\n

While the global suicide rate has declined steadily since 1990, suicide mortality in America reflects a starkly different trend.<\/p>\n\n\n\n

Between 1990 and 2016, the age-adjusted global suicide rate decreased by 33 percent, but in the US, the suicide rate<\/a> since 1999 has increased by 35 percent, placing suicide as the 10th<\/sup>-leading cause of death in the nation.<\/p>\n\n\n\n

On Thursday, October 1, the School of Public Health will hold the first of a three-part Dean’s Symposium to examine this complex, multifaceted issue. \u201cStopping Suicide: A Population Health Approach to Preventing Suicide\u201d<\/a> will convene mental health experts from academia and government to discuss the causes and challenges of suicide, potential solutions, and ways to promote mental health and well-being.<\/p>\n\n\n\n

The first session, which will take place from 4:30 p.m. to 6 p.m., will feature panel presentations by scholars on the challenges of suicide prevention and a discussion moderated by Lynn Jolicoeur<\/a>, producer and reporter for WBUR. The second event, on October 8 from 1 to 2:30 p.m., will feature keynotes by D\u00e9vora Kestel<\/a>, director of the WHO Department of Mental Health and Substance Abuse, and Joshua Gordon<\/a>, director of the National Institute of Mental Health. In the concluding session, on October 15 from 4:30 to 6 p.m., scholars will explore ways to mitigate suicide risk and deaths.<\/p>\n\n\n\n

Several SPH faculty members played an integral role in planning the symposium, including Carol Dolan<\/a>, clinical associate professor of community health sciences; Sarah Lipson<\/a>, assistant professor of health law, policy & management, Jaimie Gradus<\/a> (SPH\u201904\u201909); associate professor of epidemiology; and Julia Raifman<\/a>, assistant professor of health law, policy & management.<\/p>\n\n\n\n

The faculty members designed the program in early January, well before COVID-19 surged in the US. But the need for suicide prevention is even more urgent today as the mental health impact of the pandemic continues to unfold. A first-of-its-kind School of Public Health study<\/a> recently found that the pandemic has likely tripled the prevalence of depression symptoms in the US.<\/p>\n\n\n\n

\u201cPrior to the pandemic, rates of mental health concerns, including suicidality, were alarming,\u201d says Dolan, who studies trauma-informed care<\/a> and is the director of the MPH mental health and substance use certificate<\/a>. \u201cWith the challenges of social isolation, anxiety, fear of contagion, uncertainty, chronic stress, and economic difficulties, it is not surprising that we are seeing further increases in mood and substance use disorders that are associated with suicidal behavior.\u201d<\/p>\n\n\n\n

Based on outcomes from past collectively experienced traumatic events, \u201cthe mental health consequences of the pandemic are likely to be present for a long time and peak after the pandemic ends,\u201d she says.<\/p>\n\n\n\n

Lipson will present and participate in the panel discussion on October 1, and she says she hopes that the event imparts that suicide is preventable.<\/p>\n\n\n\n

\u201cSuicide is not an individual problem, but rather a societal problem,\u201d says Lipson. \u201cThere are failures at a system level that we must address, for these are the drivers that hold the most potential for large-scale prevention. I hope that folks gain a better understanding of the system-level drivers of suicide, as well as the ways in which discriminatory environments and policies shape inequalities and suicide risk.\u201d<\/p>\n\n\n\n

According to the Centers for Disease Control and Prevention, the 2018 national suicide rate<\/a> for males was 3.7 times the rate for females, and suicide rates were higher in the most rural counties compared with the most urban counties. Suicide is also the second-leading cause of death among people ages 15 to 34. A JAMA Pediatrics<\/a> <\/em>study found that sexual minority youth are 3.5 times as likely to attempt suicide as their heterosexual peers.<\/p>\n\n\n\n

Lipson also coleads The Healthy Minds Study<\/a>, the most comprehensive national survey on mental health among college student populations, and she says that annual survey results have shown an increase in rates of depression and suicidality over the past five years.<\/p>\n\n\n\n

\u201cIt\u2019s important to note that similar trends are seen in adolescent and young adult populations more broadly, meaning that this problem is not unique to campus environments,\u201d Lipson says. \u201cThese trends are deeply troubling and likely result from a confluence of factors, ranging from the impact of social media and mobile technology, to sociopolitical events and resultant hopelessness about the future, to systemic oppression, to rising rates of food and housing insecurity.\u201d<\/p>\n\n\n\n

In 2018, almost half<\/a> of the 48,344 US suicide deaths involved a firearm. Raifman was the lead author of a recent study<\/a> that examined the relationship between the minimum age of US handgun purchases and suicide among adolescents. She found that hundreds of suicides could be prevented each year in the US if the 33 states where 18-year-olds are allowed to buy handguns raised the age limit to 21 years old.<\/p>\n\n\n\n

\u201cThis study demonstrates the important role that policies can play in reducing suicide, particularly for populations at high risk, such as young adults,\u201d says Raifman, who will expand on this topic as a presenter and panelist on October 15. \u201cThe US has, by far, the highest level of firearm ownership in the world. This study contributes to a broad body of evidence that means restriction of firearms is effective for reducing suicide.\u201d<\/p>\n\n\n\n

Raifman is particularly concerned about the economic impact of the pandemic on mental health. \u201cAll of the data I have seen in the wake of COVID suggests both that everyone is suffering and that people living in low-income households are suffering the most,\u201d she says. \u201cPeople living in low-income households have been the most likely to lose work, the least likely to have economic reserves, and the most likely to quickly face housing and food insecurity for themselves and their families.<\/p>\n\n\n\n

\u201cI am very concerned about suicide now that the federal supplement to unemployment insurance has expired and the Senate is not voting on a relief package for people in dire circumstances through no fault of their own,\u201d she says. In March, Raifman and a team of SPH students developed the COVID-19 US State Policy Database<\/a> to track social safety net policies and help facilitate research on suicide, mental health, and other pandemic-related outcomes.<\/p>\n\n\n\n

Gradus, who studies trauma-related disorders<\/a> and the associated impacts on suicide outcomes, will moderate the panel discussion on October 15. She says that suicide as a critical public health issue deserves more attention from the field than it has received.<\/p>\n\n\n\n

\u201cIn all of our decades of studying suicide, we have gotten no better at predicting and preventing it,\u201d she says. \u201cIn contrast, we have gotten much better at predicting and treating other causes of death, such as cardiovascular disease and cancer, and as a result, deaths due to these causes have decreased.<\/p>\n\n\n\n

\u201cI think understanding this nuance is critically important to our thinking with regard to how we address suicide as public health practitioners and researchers.\u201d<\/p>\n\n\n\n

To continue the conversation after the Dean’s Symposium, students in the Mental Health Public Health Connections<\/a> student organization and Mental Health and Substance Use certificate will hold a virtual student-led discussion from 5 to 6 p.m. on October 22.<\/em><\/p>\n\n\n\n

If you\u2019re thinking about suicide, are worried about a friend or loved one, or would like emotional support, the Lifeline network is available 24\/7 across the United States. Contact the National Suicide Prevention Lifeline at 1-800-273-8255 (Espa\u00f1ol: 1-888-628-9454; deaf and hard of hearing: 1-800-799-4889) or the Crisis Text Line by texting HOME to 741741, or visit <\/em>https:\/\/suicidepreventionlifeline.org\/talk-to-someone-now\/<\/a><\/em>. <\/em><\/p>\n\n\n\n

\u2014Jillian McKoy<\/a><\/em><\/p>\n","protected":false},"excerpt":{"rendered":"

While the global suicide rate has declined steadily since 1990, suicide mortality in America reflects a starkly different trend. Between 1990 and 2016, the age-adjusted global suicide rate decreased by 33 percent, but in the US, the suicide rate since 1999 has increased by 35 percent, placing suicide as the 10th-leading cause of death in […]<\/p>\n","protected":false},"author":14430,"featured_media":180517,"comment_status":"closed","ping_status":"closed","template":"","meta":{"bu_prepress_billboard":"","_bu_prepress_primary_term":"Signature Programs","_bu_prepress_primary_term_manual":"Signature Programs"},"tags":[3434,2178,1976,2847,2330,1871,1793,3380,1996,3055,2191],"bu-publication":[3516],"sphnews-article-category":[3519,3520,3526,3528,3530,3531,3540,3541],"sphnews-topic":[],"bu_edition":[],"media_type":[],"profile_tax":[466,2825,2473,2834],"_links":{"self":[{"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/bu-article\/180515"}],"collection":[{"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/bu-article"}],"about":[{"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/types\/bu-article"}],"author":[{"embeddable":true,"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/users\/14430"}],"replies":[{"embeddable":true,"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/comments?post=180515"}],"version-history":[{"count":2,"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/bu-article\/180515\/revisions"}],"predecessor-version":[{"id":192692,"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/bu-article\/180515\/revisions\/192692"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/media\/180517"}],"wp:attachment":[{"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/media?parent=180515"}],"wp:term":[{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/tags?post=180515"},{"taxonomy":"bu-publication","embeddable":true,"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/bu-publication?post=180515"},{"taxonomy":"sphnews-article-category","embeddable":true,"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/sphnews-article-category?post=180515"},{"taxonomy":"sphnews-topic","embeddable":true,"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/sphnews-topic?post=180515"},{"taxonomy":"bu_edition","embeddable":true,"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/bu_edition?post=180515"},{"taxonomy":"media_type","embeddable":true,"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/media_type?post=180515"},{"taxonomy":"profile_tax","embeddable":true,"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/profile_tax?post=180515"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}