New CDC Report Finds Stunning Suicide Increases Among Middle-Aged Americans | PBS NewsHour | May 3, 2013

JUDY WOODRUFF: There's been a stunning increase in the suicide rate among middle-aged Americans. The finding is part of a new study by the Centers for Disease Control and Prevention that spells out how much suicide is a growing public health concern in the U.S.

Ray Suarez has more.

RAY SUAREZ: The analysis looked at data compiled over a little more than a decade, a period ending in 2010 that included the financial crisis and the great recession. In 2010, there were more suicides in the U.S., 38,000-plus, than there were fatal motor vehicle accidents.

Most disturbing, that spike among the middle-aged, a 28 percent rise overall, a 40 percent jump among white Americans, and among men in their 50s, suicides increased by more than 48 percent. Guns remained the leading method used in all suicides, followed by poisoning, overdoses and suffocation.

Some perspective on all this from Dr. Thomas Frieden, the director of the CDC.

And, Dr. Frieden, the Morbidity and Mortality Report is a pretty technical document. But, from reading it, can you tease out what stressors might explain this tremendous spike in the number of people taking their own lives?

DR. THOMAS FRIEDEN, Centers for Disease Control and Prevention: We don't know what specifically is causing it, but the trend has been consistent, and if anything our numbers would underestimate the gravity of the problem.

And, of course, even one death from suicide is a terrible tragedy and many of them are preventable. We know that in times of financial stress, there's generally an increase in suicides. We also know that this is a generation that grew up at a time when they expected more than some have been able to achieve in their lives, and also that they're stressed with what their kids are going through and what their parents are going through, so in some ways, the sandwiched generation.

And, furthermore, they have access to things like prescription opiates that can be so deadly and that are a big part of an increase like this.

RAY SUAREZ: So does this trend happen to coincide with higher use and abuse of prescription medication?

THOMAS FRIEDEN: We have seen an increase of almost 500 percent in deaths from prescription opiates. Some of those are unintentional overdoses and some of those are suicides.

As more prescription opiates have been prescribed, more of them have been abused and more people have died, either intentionally or unintentionally, from prescription opiates.


RAY SUAREZ: And what about abuse of non-prescription drugs, illegal or illicit drugs? Have we seen -- do we know whether those deaths are intentional from things like cocaine, heroin, methamphetamine?

THOMAS FRIEDEN: Well, one thing that's quite striking is that, today, there are more people who die from prescription opiates than from heroin and cocaine combined, so a major problem.

And one thing that also isn't always recognized is that alcohol is a significant contributor to depression and to mental health problems. That binge drinking and problem drinking can really exacerbate mental health problems. So for people to cut down, never more than four for men, never more than three for women at one sitting, makes a big difference.

There's a lot that people can do to take care of themselves and to take care of their families and friends to reduce the risk of suicide. But we know that this is a challenging problem, and for the families dealing with suicide of a family member, it's devastating.

RAY SUAREZ: A big part of the CDC brief, Doctor, is prevention. And I'm wondering how you craft a response to these numbers when you see in certain groups that the problem is acute, among more elderly women, among white men of a certain age. You see a number that pops out like that, what do you do in return?

THOMAS FRIEDEN: We think about what works, what really makes a difference.

Now we put things into two broad categories. The first is social connectedness, being involved, whether it's book clubs or walking clubs or with family or friends or teams or sports. Being involved with others, it makes a big difference. And the second are caring for your mental health.

And I would highlight three particular areas: treatment, physical activity, and avoiding excess alcohol and drugs. For each of those things, there is something that everyone can do to be healthy or help others being healthier in terms of their mental status.

RAY SUAREZ: But can people in the health care professions be warned by these numbers to be on the lookout for people who may be entering a stage where they may have suicidal thoughts, where they may have the means or the access to the kind of things they might use to end their lives?

THOMAS FRIEDEN: It's very important that doctors and other health care workers are aware of the risk of suicide and are attentive to clues or hints that patients can give.

Study after study shows that many patients who commit suicide had seen a health care professional in the preceding month. And often there was a warning sign. So it's important for doctors and others to ask about depression, to ask about thoughts of suicide, and to refer people or provide treatment right away, because treatment does make a difference.

RAY SUAREZ: Well, Dr. Frieden, I hear what you're suggesting, but at the same time, this is the sort of thing that someone does often in a way to mask things that are going on in their lives.

For a clinician, aren't these things kind of hard to root out? Aren't these things kind of hard to watch for, these precursors to an attempt of suicide?

THOMAS FRIEDEN: Actually, there are important things that doctors can do and other health professionals can do to open the dialogue.

Often, patients want to talk, asking about depression, asking about feelings of hopelessness, asking, frankly, if patients have had thoughts of hurting themselves. It's been shown that asking that doesn't increase the likelihood that patients will hurt themselves, but it greatly increases the likelihood that doctors will be able to help the patient.

RAY SUAREZ: And we can do that in a way that doesn't seem intrusive or, let's say, is appropriate for a medical professional to do?

THOMAS FRIEDEN: It's very important that all health care professionals become more comfortable with mental health issues. Addressing mental health issues just as naturally as we address physical health issues is really important.

We say that someone has a broken leg, but they are depressed. There's something about mental health issues, mental health problems that create attitudes that often lead us to make it more difficult to talk about those conditions. But mental health problems are health problems, and health care workers need to address them.

RAY SUAREZ: Dr. Thomas Frieden is the director of the Centers for Disease Control.

Thanks for joining us.

THOMAS FRIEDEN: Thank you for putting attention to this important issue.

JUDY WOODRUFF: There is a national suicide prevention hot line if you know someone who is in distress. That number is 1-800-273-TALK.

And, online, we have more on the CDC's report, including charts that break down the numbers.