• Between 2001 and 2006 there were 333 reported suicides among black Tennesseans, at a rate of 5.55 per 100,000.  This is slightly higher than the national black rate of 5.15 per 100.000, which itself is roughly half of the overall U.S rate of 10.98 per 100,000.
• During this period, suicide was the sixteenth-leading cause of death among blacks in Tennessee, consistent with national statistics. Suicide was the fifth-leading cause of death within the 10-24 age group (as compared to the third-leading cause nationally).
• Firearms were the most common means of death employed by black suicide victims in Tennessee, used in 68.1% of the deaths.
• Suicide is the third-leading cause of death among African-Americans aged 10-24 after homicides and accidents. Available statistics suggest that before 1965, the African-American suicide rate was only a quarter that of whites, but in only a few years had risen to half the white rate.
• While Caucasians are twice as likely as African-Americans to die by suicide, the rate of suicide among black teens aged 15-19 more than doubled between 1980 and 1995 and tripled among black youth aged 10-14, far surpassing the rate of increase among white teens. The latest statistics show that rates have decreased, with roughly 5.5 per 100,000 African-American deaths ruled as suicide in 2005. But this still translates to a rate of five per day, and given the tendency of medical examiners to obscure causes of death and the stigma suicide carries in the black community, this rate is likely much higher in reality.
• African-American females are more likely to attempt suicide, but African-American males are more likely to complete suicide.
• According to the adolescent component of the National Survey of American Life, which reviews aspects of mental illness and treatment within African Americans and Afro-Caribbean Americans, 4 percent of black teen males and about 7 percent of black teen females attempt suicide by age 17.  Children from middle-class backgrounds ($32,000 to $54,999 annual household income) were more likely to attempt suicide than those from lower-income homes ($18,000 to $31,999).
• The lifetime prevalence of suicide attempts black men of Caribbean-American extraction (as opposed to those of black African descent) is almost twice as high as the overall black rate.
• Firearms are the predominant method of suicide completion among African Americans.  Nationally, firearms are involved in 74% of all suicides among black teens aged 10-14 age group, 61% of all suicides among 15-24 year olds and 54% of all suicides among 25-34 year olds.
• A recent study reported that over 25% of African American youth exposed to violence met diagnostic criteria for post-traumatic stress disorder (PTSD). Black veterans are also more prone to PTSD than their white counterparts.
• Although the behavioral components of depression are typically more pronounced among African-Americans, some victims express little suicide intent or depressive symptoms prior to the act. Additionally, they are less likely to use drugs; firearms are the predominant method.
• Common suicide risk factors for black Americans include being under the age of 35, substance abuse (especially use of cocaine), presence of a firearm in the home, and a history of violent threats against others.
• The prevalence of several myths about suicide and African-Americans complicate prevention efforts. Often these communities regard depression as a constitutional weakness rather than a medical condition, and communities of faith condemn suicide as a sin. Suicide is regarded as a problem of middle-class whites, and there are tendencies within the black community to idealize their men as too strong to take their own lives and their women as too resilient to crack under pressure. While these beliefs may offer some degree of a protective factor, they may also dissuade troubled individuals and their loved ones from seeking needed interventions and compromise community mental health outreach efforts.
• While current surveys put the rate of mental illness among black Americans at roughly equal to that of whites, a report from the Office of the U.S. Surgeon General suggests higher rates might be evident if researchers were more inclined to include psychiatric hospitals, prisons, and poor rural communities in their analyses.
• A 2007 study published in the Archives of General Psychiatry found that less than half of African-Americans and less than a quarter of Caribbean black American with major depression receive treatment and generally receive poorer quality care than white Americans.

Sources: Tennessee Department of Health, American Association of Suicidology, National Organization for People of Color Against Suicide, Substance Abuse and Mental Health Services Administration, Journal of the American Medical Association, U.S. Department of Health and Human Services, Archives of General Psychology, Deviant Behavior, Suicide and Life-Threatening Behavior.

• Between 1999 and 2004 there were 40 reported suicides among Hispanics in Tennessee, at a rate of 4.8 per 100,000, slightly lower than the national Hispanic rate of 5.09 per 100.000, which itself is roughly half of the overall U.S rate of10.75 per 100,000.
• During this period, suicide was the eighth-leading cause of death among Hispanics in the state (as compared to the eleventh-leading cause nationally) and the third-leading cause of death within the 10-24 age group (same as the national ranking).
• Firearms were the most common means of death employed by Hispanic suicide victims in Tennessee, used in 65% of the deaths. Nationally, firearms are a factor in only 43.1% of Hispanic suicide deaths.
• The highest rate occurs among males over the age of 85, at 30.7 per 100,000.
• Hispanic suicide victims in the United States are five-and-a-half times more likely to be male than female.
• Numerous studies suggest that Hispanic children and adolescents experience more mental health problems than non-Hispanic Caucasian youth. This finding is supported by the 2005 Youth Risk Behavior Survey, which suggests young Hispanics are at greater suicide risk than their non-Hispanic counterparts. They are 6% more likely to have seriously considered making a suicide attempt within a 12-month period, 11.5% more likely to have made a suicide plan, and 34.5% more likely to have made a suicide attempt.
• Additionally, the Tennessee Department of Education’s 2007 Tennessee Youth Risk Behavior Survey (YRBS), found that the rates of suicidal ideation and attempts among Hispanic high-school age children were far above the general population. Nearly twice as many Hispanic respondents reported feeling a period of sadness or hopelessness for twoweeks or more severe enough to pull them away from their usual activities during a twelve-month period, compared with Tennessee youth overall (43.9% vs. 26.8%). They were twice as likely to consider suicide as a legitimate solution to their problems (27.4% vs. 14.1%) and develop a suicide plan (21.3% vs. 10.2%), three times more likely to attempt suicide (24% vs. 7.4%), and nearly five times more likely to require medical attention for a suicide attempt (10% versus 2.2%).
• A 2001 Surgeon General’s report observed that few than 1 in 5 individuals of Hispanic origin informs a general healthcare provider. Less than 1 in 11 contacts a mental health professional.
• Population studies have found that American-born Hispanics have higher rates of mental illness than immigrants of Hispanic origin. However, recent immigrants may be at increased risk for depression and suicidal ideation due to cultural adaptation stresses.
• Certain aspects of Hispanic cultures may serve as protective factors against suicide and suicide attempts. These include social support provided by an extended family unit, religious prohibitions against suicide, and a fatalistic life orientation that may condition people to accept and adapt to adverse events. However, these factors may also dissuade troubled individuals and their loved ones from seeking needed interventions and compromise community mental health outreach efforts.

Sources: Tennessee Department of Health, US Department of Health and Human Services, Cultural Diversity and Ethnic Minority Psychology, Aggression and Violent Behavior.

• The 1999 Surgeon General’s Call to Action to Prevent Suicide, the formative document for the modern suicide prevention movement, listed gay, lesbian, bisexual, and transgendered (GLBT) youth as a high-risk population, citing a lack of research and data on suicidal behavior within this group, a lack of suicide prevention programs tailored to their concerns, an insufficient awareness of suicide prevention within GLBT youth organizations and settings, and lack of opportunity to develop and adapt culturally effective suicide prevention and intervention programs. Since the publication of this report, research in this area has expanded considerably.
• To date, no empirical national studies have recorded the frequency of suicide among GLBT individuals, and community based studies suggest this subgroup overall is not at increased suicide risk. However, studies are finding associations between suicide risk and bisexuality or homosexuality in youths, particularly males.
• Precise numbers vary, but studies suggest gay and bisexual teenage males are 55% more prone to suicidal ideation than their heterosexual counterparts, and that lesbian and bisexual teenage females are 38% more disposed to suicidal ideation than heterosexuals. In a 2001 study, GLBT youths surveyed estimated that roughly half their suicide thoughts are connected to their sexual orientation.
• Statistics regarding suicide attempts are also inconsistent, but preliminary reports suggest GLBT youth are between three and five times more likely to attempt suicide than heterosexual teens. Some estimates suggest that teenage homosexual and bisexual males are at seven times the risk for a suicide attempt.
• Studies on GLBT youth suicide have found that attempts within this subgroup are more likely to be fatal and more likely to involve serious injury. Additionally, it has been that many suicide attempts among GLBT youth occur within one year of disclosure of sexual orientation to parents.
• There exist numerous obstacles to research in the field of GLBT youth suicide risk. These include stigma surrounding both the subjects of suicide and homosexuality, lack of consistently applied and accepted terminology, lack of racial/ethnic minority representation in existing studies, and the possibility that individuals who are willing to reveal their sexual orientation may be more likely to disclose suicidal tendencies as well. Additionally, death records and hospital data do not record sexual orientation and/or gender identity.
• Generally speaking, the suicide risk factors and warning signs for GLBT youth are largely the same for other young adults, but the GLBT adolescent is subject to several unique risk factors. An early, forced, mistimed, or forestalled coming-out process puts such an individual at increased risk.
• Understanding the family and school background is crucial to assessing suicide risk; depending on the support they offer and their overall safety, these environments can become major protective facts or the GLBT youth’s greatest threat.
• Many mental health providers, physicians, and school faculty have not received accurate information about GLBT suicide risk; consequently their response to troubled and/or suicidal youth may be ineffective, cause further psychological damage, and/or discourage further disclosure attempts.
• Tennessee was one of 42 states which received a grade of “F” in the 2004 State of the States report issued by the Gay, Lesbian and Straight Education Network (GLSEN). The report cited a lack of a state non-discrimination law and substandard safe-schools policies at the local level.

Sources: Gay, Lesbian and Straight Education Network, Suicide Prevention Resource Center. The Network wishes to recognize Effie Malley, Senior Prevention Specialist with SPRC who presented most of these findings at the 2007 American Association ofSuicidology Conference.

• While the elderly make up only 12.6% of the population, they account for 18.1% of the suicides.
• Each day 14 people over the age of 65 are lost to suicide–one every 101 minutes.
• The suicide rate for the elderly rose 9% between 1980 and 1992. However, rates have declined sincethat time.
• In 2003, suicide rates ranged from 12.7 per 100,000 among persons aged 65 to 74, to 16.4 per 100,000 persons aged 75 to 84–52% higher than the overall U.S. rate.
• White men over the age of 85 are at the greatest risk of all demographic groups. In 2003, the suicide rate for these men was 51.6 per 100,000, more than four times the current overall rate.
• 84% of elderly suicides are men. The rate of suicide among men in late life is almost eight times that for women (overall, men’s rates were 4.1 times those of women as of 2003).
• Although older adults attempt suicide less often than those in other age groups, they have a higher completion rate. For all ages combined, there is 1 suicide for every 20 attempts. Among the young (15-24 years) there is 1 suicide for every 100-200 attempts. Over the age of 65, there is 1 suicide for every 4 attempts.
• Firearms are the most common means of completing suicide among the elderly, with men (78%) usingfirearms more than twice as often as women (35%).
• Alcohol or substance abuse plays a diminishing role in later life suicides.
• Contrary to popular opinion, only a fraction (2-4%) of suicide victims have been diagnosed with a terminal illness at the time of their death. Two-thirds of older adult suicide victims were in relatively good physical health at the time. 80% of elderly suicides over 75 have seen a primary care physician within 6 months of their suicide. 75% have seen a physician within a month of their deaths; 35% within a week; 20% within 24 hours.
• The vast majority of elderly suicide victims have at least one psychiatric diagnosis. Two-thirds of these diagnoses are for late-onset, single-episode clinical depression.
• As many as 75% of depressed older Americans are not receiving the treatment they need.
• Elderly persons are less likely to reach out by calling a crisis line than their younger counterparts.

Common Myths About Suicide And Older Adults

• Depression among the elderly is a normal consequence of aging and associated problems.
• Depression among the elderly cannot be treated.
• Most older adults who die by suicide are terminally ill.
• Elders who complete suicide do not have close family members.
• Only elderly persons who live alone are at risk for suicide.
• Suicide and suicidal behavior are normal responses to stresses experienced by most people.
• There is nothing that can be done to stop an elderly suicide.
• Most suicidal elders will self-refer to obtain mental health care.
• Suicidal elderly do not exhibit warning signs of their suicidal ideation or intent.
• Adverse living conditions are not significant risk factors in elderly suicide.

In this fact sheet, elderly refers to persons over the age of 65. Information presented refers to the latest available data (i.e., 2000 data unless otherwise cited).

Sources: Tennessee Department of Health, American Association of Suicidology.

• As of 2005, suicide ranks as the third-leading cause of death for people aged 10-24, behind accidents and homicides. Approximately twelve young people between the ages of 15 and 24 die every day by suicide in the United States, or one every 125 minutes.
• In 2003, 32,637 people completed suicide. 12.9% of these suicides were committed by persons under the age of 25.
• Suicide rates for 15-24 year olds have tripled since the 1950s and remained largely stable at these higher levels since the late 1970s.
• Suicide rates for those 15 to 19 years old increased 11% between 1980 and 1997. Suicide rates for those between the ages of 10-14, however, nearly doubled during this same period. Both age groups have shown small declines in rates in the years since then.
• Firearms remain the most common suicide method among youth, regardless of race or gender, nearly accounting for almost three of five completed suicides. Research shows that the access to and the availability of firearms is a significant factor in the increase of youth suicide.
• In 2005, the male-to-female ratio of completed suicides was 3:1 among 10-14 year olds, 4.2:1 among15-19 year olds, and 5.4:1 among 20-24 year olds.
• The typical profile of an adolescent nonfatal suicide attempter is a female who ingests pills; while the profile of the typical fatal suicide attempter is a male who dies from a gunshot wound.
• Between 1980 and 2000, black male youths aged 10-14 showed the largest increase in suicide rates relative to sex and ethnicity, increasing by 180%. Among 15-19 year old black males, rates have increased 80%.
• Most adolescent suicides occur in the afternoon or early evening and in the teen’s home.
• According to the 2005 Youth Risk Behavior Surveillance Study published by the Centers for Disease Control and Prevention, nearly one in five high school students stated on a self-report survey that they had seriously considered attempting suicide during the preceding 12 months. Within a typical high school classroom, it is likely that three students (one boy and two girls) have made a suicide attempt in the past year.
• Not all adolescent attempters may admit their intent. Therefore, any deliberate self-harming behaviors should be considered serious and in need of further evaluation.
• Most adolescent suicide attempts are precipitated by interpersonal conflicts. The intent of the behavior appears to be to effect change in the behaviors or attitudes of others.
• Repeat attempters use their behavior as a means of coping with stress and tend to exhibit more chronic symptomology, poorer coping histories, and a higher presence of suicidal and substance abusive behaviors in their family histories.

Common Risk Factors for Youth Suicide

• Presence of a psychiatric or conduct disorder
• The expression/communication of thoughts of suicide, death, dying or the ?????
• Impulsive and aggressive behavior; frequent expressions of rage.
• Previous exposure to other’s suicidiality.
• Recent severe stressors (e.g., difficulties in dealing with sexual orientation; unplanned pregnancy or other significant real or impending loss).
• Family loss or instability; significant family conflict.

Sources: Tennessee Department of Health, American Association of Suicidology.