
Targeting Suicide
The recent tragedy with the Germanwings crash in the Alps has started a worldwide discussion about mental illness and suicide. NIMH Director Thomas Insel reflects on the larger issues we continue to face.
FROM THE NIMH
The recent tragedy with the Germanwings crash in the Alps has started a worldwide discussion about mental illness and suicide. We don’t yet know what happened on this flight and we certainly don’t have access to the medical history of the copilot who is now the focus of the investigation, but this heartbreaking news from France, and the debate that it has spawned, illustrates the difficulties of understanding suicidal behavior, much less predicting it.
While much attention has focused on this tragedy, it is important to remember that 41,000 people in America died by suicide in 2013.1 Suicide is the tenth leading cause of death in our country. Most of the other top-ten causes of mortality, such as heart disease, cancer, stroke, Alzheimer disease, and diabetes are rightly the targets of visible and productive research efforts. For cause number four, accidents (which include automobile crashes), research has led to measures (both devices and law enforcement) that have substantially reduced mortality. Effective vaccines have been developed for the eighth leading cause of death, influenza and pneumonia.
If research on these conditions has shown anything, it is that research investments can, eventually, make a large and life-saving difference, even for issues that at first seem intractable. The
Unlike many of the leading causes of death, the suicide rate has shown no appreciable decline over the last 50 years; indeed, the rate among middle-aged Americans is increasing, and for young people ages 15-34, it is not the tenth, but the second leading cause of death. Because of this significant burden, suicide is among the top conditions for DALYs-disability-adjusted life years (an aggregate of the number of years lost to premature mortality and years lost to disability). A few weeks ago I released a
Last year, a
Research with multiple psychotherapies has shown that adult suicide attempters can be prevented from reattempting. This point was reinforced in a report from Denmark just published; over 5000 people who attempted suicide were treated with a psychosocial intervention and followed for 20 years. Relative to 17,000 attempters who did not receive psychotherapy, the treated population had fewer subsequent acts of self-harm, fewer suicides, and fewer deaths from any cause. The results were stunning: in this population, it appeared that psychosocial therapy prevented 153 deaths, including 30 suicides.2
Perhaps the most important point brought home by the efforts of the Action Alliance and the
Soon, the crash of the Germanwings airliner in France will begin to fade from the headlines and our own consciousness. When will we change our national habit of paying brief attention to suicide when circumstances make it newsworthy and start viewing it as the major public health problem it is: one to be addressed by marshalling-and sustaining-research, as we have for other health issues, with the clear goal of saving lives?
Disclosures:
Dr Insel is Director of the National Institute of Mental Health (NIMH).
Note: This article, originally published on April 2, 2015, is posted here courtesy of NIMH.
References:
1. National Center for Injury Prevention and Control, Centers for Disease Control and Prevention. Web-based Injury Statistics Query and Reporting System, Fatal Injury Reports, National and Regional, 1999-2013.
2. Erlangsen A, Lind BD, Stuart EA, et al. Short-term and long-term effects of psychosocial therapy for people after deliberate self-harm: a register-based, nationwide multicentre study using propensity score matching. Lancet Psychiatry. 2015;2:49-58.
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