Montefiore in the News

Rate of suicide in the U.S. peaks among older men, a hard demographic to reach

Eduardo Cuevas USA TODAY December 13, 2023

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The hardest group for Dennis Gillan to get to talk about suicide is older men. They also happen to have the highest rate of suicide in the United States.

Gillan, 60, is from Greenville, South Carolina, and he has been a front-row observer to the crisis. He's a self-trained suicide expert who speaks on college campuses and at corporate training offices about mental health awareness. He draws on his personal experience after the deaths, about a decade apart, of his brothers Mark and Matthew by suicide. Both men were in their early 20s.

Of all the groups he has worked with, older men are among the trickiest demographic to reach. Getting them in the room and speaking candidly has been one of the toughest challenges.

“As men, we’re supposed to have all the answers,” he told USA TODAY. "We’re really not good at saying, ‘I don’t have a clue what happens in life.”

Gillan is among a contingent in the mental health community trying to connect older people with mental health resources to avert tragedies that are becoming increasingly commonplace.

The geography and backgrounds of their lives vary. Recent deaths by suicide include an 83-year-old military veteran from Oklahoma, a retired Teamsters driver from New York, and a 65-year-old actor who first voiced Charlie Brown on the “Peanuts" TV show.

Highest rate since 1941, data shows

Recent data shows suicide among older people has risen precipitously. The U.S. suicide rates reached an 80-year high in 2022 of nearly 50,000 people, according to provisional data from the National Center for Health Statistics (NCHS).

The rate of 14.3 suicides per 100,000 people is the highest it has been since 1941. There have been periodic spikes in U.S. suicide rate dating back more than a century, with peaks during World War I, the Great Depression and the Great Recession.

Deaths among people younger than 25 have declined from 2021, however, and suicides among people older than 35 have risen. Men tend to have higher suicide rates as they age. The most salient rate is among men 75 and older: It's nearly 44 deaths per 100,000 people. Non-Hispanic white men tend to have the highest rates of suicide at older ages, said Sally Curtin, an NCHS statistician and lead author of the report.

The rates among older Americans had begun to decline, but the latest increase in deaths began in 2020, Curtin said. Experts attribute these deaths to the fallout from the COVID-19 pandemic, in part because of losses in social connection, the lack of health access during the pandemic, and the availability of firearms in the U.S., which are a factor in half of all suicides. Among elderly people, 70% of suicide deaths involve firearms.

What's causing it?

The impetus for each suicide varies, but psychologists have identified some leading triggers among elderly people, which they sum up as "the five Ds": depression; disability because of functional impairment; disease, with illness and pain; disconnectedness from others; and access to deadly weapons.

Understanding these risk factors is essential for health professionals so they can intervene.

People assume it's normal to become depressed and isolated as you become older, but that's just ageism rearing its head, said Kathleen Cameron, a senior director at the nonprofit National Council on Aging.

“Everyone deserves to have a healthy, well-rounded, good life as they age,” she said. “No matter what health conditions they may have.”

Peter Franz, a clinical assistant professor at the Psychiatry Research Institute of Montefiore Einstein in New York, said stressful life events, such as the loss of a spouse or friend, contribute to depression, as does social isolation. That may explain why older people have suicidal thoughts that contribute to a rising suicide rate, he said. Experts say it's also important to note that older people who attempt suicide are also far more likely to succeed than younger people.

Health care leaders confronting these numbers have taken strategic steps to reduce suicide rates among the elderly. At the Michael E. DeBakey Department of Veterans Affairs Medical Center in Houston, staff psychologist Elizabeth Conti has identified safety plans to help older people identify warning signs, develop coping strategies, find resources and safely store weapons if or when they experience suicidal thoughts.

The suicide rate among veterans is higher than the overall average, according to a recent VA report. Deaths by suicide rose 11.6% from 2020 to 2021.

It's important for people who are feeling suicidal to learn to reach out for help, which can be difficult for older adults, who may be used to being independent. Reaching out can be as simple as finding a person who is willing to listen. For families with loved ones who are showing suicidal thoughts or feelings of loneliness or hopelessness, it can mean reaching out to the person’s primary care doctor to connect with mental health professionals.

“We want to emphasize reaching out first, that they don't have to wait,” said Conti, who is also an assistant professor of psychiatry and behavioral sciences at Baylor College of Medicine. “There's no expectation that they wait until things get really bad, or they wait until they've tried to solve it on their own. Go ahead and reach out. Increasing social connection overall is going to decrease their suicide risk."

Kevin Briggs, 61, a retired California Highway Patrol sergeant and Army veteran, has talked hundreds of people out of jumping off of the Golden Gate Bridge. Since he retired a decade ago, he has become a speaker and advocate for mental health awareness and suicide prevention.

He has helped older people engage with others and access support systems. He also has encouraged family members to call or visit them.

“We all have a part in this,” he said. “Seniors have earned the right to have a happy part of their old age. And the rest of us can contribute to that greatly.”

'How's everybody's mental health?'

On Thursday, Gillan, the South Carolina mental health advocate, ate breakfast at Maple Street Biscuit Company with other men from the apartment building he lived in after he was divorced. Five years ago, Gillan felt the small apartment's walls closing in on him after moving from his suburban house. He found other men in the building also had gone through tough times.

The group formed the Camo Hat Club, Gillan said, for how men camouflage their feelings. They've continued since 2018 with monthly breakfasts.

At the end of each meal, they end with a simple question: “How’s everybody’s mental health?”

Whether people say they're down or feeling chipper, Gillan is just glad when they open up and say so.

Eduardo Cuevas covers health and breaking news for USA TODAY. He can be reached at EMCuevas1@usatoday.com