The problem of suicide in the United States remains a key concern of public health authorities, but new statistics unveiled by the CDC show that the problem is getting worse. In a teleconference with reporters on June 7, Anne Schuchat, MD, the CDC’s principal deputy director, noted that in 2016 alone, 45,000 people committed suicide, and that suicide is one of only three leading causes of death that are increasing (Alzheimer’s disease and drug overdoses are the other two).

Specifically, according to data from the National Vital Statistics System and the CDC’s National Violent Death Reporting System, between 1999 and 2016, suicide rates increased among all age groups younger than 75 years of age, although the problem was most apparent among middle-aged adults.

“We’re seeing middle-aged adults have higher rates of drug overdoses, and we’re also seeing the so-called deaths of despair emerging in some of the social sciences literature,” Schuchat said. “I can say that increases in suicide tend to correlate with economic downturns, and some of the economic downturns may have left some middle-aged populations really hard hit, but there are probably many factors that feed into the findings.”

Schuchat also noted that nearly all states had increasing suicide rates between 1999 and 2016, and 25 states saw rate increases of more than 30%. Among the leading methods of suicide, the most common was firearms, followed by hanging, suffocation, and poisoning, which includes opioids, Schuchat explained.

“Opioids were present in 31% of the individuals who died by suicide and were considered the means of death,” she said. “Firearms have shown up as [the method] for nearly half [of suicides] consistently over time.”

While there may be some under-recognition of mental health conditions in the data regarding suicide, Schuchat stressed that it is clear that this is more than a mental health issue.

“We know we need improved access and treatment for mental health conditions and better recognition and diagnostics because there are still stigmas and still reasons that people don’t present for care, but we think that a comprehensive approach to suicide is what’s needed to ensure that we can prevent suicide and identify concerns earlier,” she said. “If we only look at this as a mental health condition, or mental health issue, we won’t make the proper diagnosis that we need.”

Schuchat urged healthcare providers to be particularly attuned to significant transitions in their patients’ lives. Whether this involves career changes, moving in or out of the military, or moving from one healthcare setting to another, such moves can be the source of considerable stress, she said.

“We think high-quality, ongoing care focused on patient safety and suicide prevention is important for health systems to build into their approaches, and [they need to] train providers in adopting proven treatments for patients at risk for suicide,” Schuchat said.

To prioritize prevention, the CDC has developed Preventing Suicide: A Technical Package of Policy, Programs, and Practices that states and communities can use to strengthen their efforts in this area. (Editor’s Note: Readers can learn more information about this program online at: https://bit.ly/2AnZWRU).

Schuchat noted that health and behavioral healthcare providers play an important role to ensure that people at risk of suicide are identified and provided with appropriate interventions. “Policies and protocols that prioritize patient safety and that help get people into ongoing care, especially during care transitions, can help prevent suicide,” she said.