I'd never heard of the Aokigahara Forest near the base of Mt. Fuji, and none of the psychiatrists I’d met on my professional visits to Japan had ever mentioned it to me. I’d guess most of you hadn’t heard of it either. Until maybe recently, that is.
This forest is the place made infamous in a YouTube video (now removed) by a fellow named Logan Paul, one of the most widely watched bloggers on YouTube. The video caused a major international outcry of condemnation, because the video contained a view of a person who committed suicide hanging from a tree in the Aokigahara Forest, which is known in Japan as a frequently used site for suicide.1 The frequency of suicides there is so high that authorities have placed signage geared to direct those considering suicide to seek help. And, the number of park employees at the site have been increased.
My thinking about the Aokigahara Forest and of Japan’s concerns about the effect of social contagion on suicide barely preceded the release of the CDC annual report on suicide rates and trends. Unfortunately, unlike YouTube videos which can be removed, this report and the reality that underlies it are here to stay.
The American Foundation for Suicide Prevention (AFSP) has analyzed and summarized some of the key findings in the CDC report and posted them on its website.2 Nearly 50,000 people commit suicide in the US every year. In spite of improved understanding of risk factors and increased vigilance for suicide risk among mental health and other medical practitioners and families of those at risk, the suicide rate in the US continues to go up.
Because of the lag in data collection and analysis, the CDC report covers data with a year’s delay. What is seen, though, is that between 2006 and 2016 the overall US suicide rate went up from 10.97 to 13.26 per 100,000 people. Those numbers may seem small, but they reflect an increase of just over 20% in these 10 years. And, the trend lines don’t look much different going back to 2000.
For reasons that are unclear, the suicide rates are much higher among white people, although the rates in those identifying as Native American are close. White males accounted for 70% of suicides in 2016. And, although there has been a small uptick in rates in the last few years for African American or Asian heritage people, those rates are much lower than for white and Native Americans. The AFSP notes that data for those of Hispanic origin are not reported in the same way, since individuals in any of the other groups may be Hispanic.
Another interesting demographic finding is that the states that have the lowest population densities have the 10 highest per capita suicide rates. These states are, in order of suicide rates (highest to lowest): Wyoming, Alaska, Montana, New Mexico, Utah, Idaho, South Dakota, Oklahoma, Colorado, and Arkansas.
The CDC also, as you know, segregates rate data by age groups. The recent data show that the highest suicide rates are in those aged 45 years and older, clustering around 15 per 100,000. And, the rate of increases in the suicide rate in the 45 to 54 and 65 to 74 age brackets are especially steep. The most concerning finding to many, however, is the fact that the suicide rate for those 15 to 24 is now 12.5, the highest since 1995.
In 1970, the suicide rate for 15- to 24-year-olds was 8.8 per 100,000, which rose to 13.8 by 1994.3 This phenomenon led then US Surgeon General David Satcher, a pediatrician, to declare that adolescent suicide prevention was his top public health priority. While it is unclear whether federal attention was the major factor, the suicide rate in this age group fell to 9.9 by 2002. This nearly 33% drop was by far the greatest change of any age group, although other age groups also dropped by small or moderate amounts. It is, thus, distressing to see that since 2002, not only have suicide rates increased for nearly every age group aged younger than 75 years, but that the adolescent suicide rate is nearly back to a 5-decade high.
1. Rich M. Long Before Video, Japanese Fought Suicide in the ‘Sea of Trees.’ New York Times. January 6, 2018. https://www.nytimes.com/2018/01/05/world/asia/suicide-forest-japan-logan-paul.html. Accessed January 9, 2018.
2. American Foundation for Suicide Prevention. https://afsp.org/. Accessed January 9, 2018.
3. McKeown RE, Cuffe SP, Schulz RM. US suicide rates by age group, 1970-2002: an examination of recent trends. Am J Public Health. 2006;96:1744-1751.
4. Olfson M, Blanco C, Wall M, et al. National trends in suicide attempts among adults in the United States. JAMA Psychiatry. 2017;74:1095-1103.