Suicide rates have been on the rise for years. Here’s what can help those in crisis

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• Judy Woodruff:

  And now some disturbing findings about suicides in this country and how the rate has continued to climb for more than 15 years.

  A new report highlights some of the reasons behind these patterns.

  And, as Amna Nawaz reports, it's issued at a moment when two notable deaths have drawn more attention to the problem.

• Amna Nawaz:

  The deaths of chef and TV host Anthony Bourdain and fashion designer Kate Spade this week underscored some grim numbers.

  Suicide is the 10th leading cause of death in the United States. In 2016 alone, nearly 45,000 Americans died by suicide. CNN announced today that Bourdain, who took viewers to locations around the world on his show, died at the age of 61.

  Spade, whose handbags and accessories made her a business mogul and a fashion icon, died Tuesday at the age of 55.

  The Centers for Disease Control and Prevention's latest report found suicide rates have increased in nearly every state in America since 2000. In half of all states, the rate rose more than 25 percent, and some of the largest increases were in Mountain States and the Midwest. That includes rural areas, where incomes can be stagnant, poverty can be high, and where financial stress can add to pressures in middle- and low-income American families.

  Experts in the field say there are almost always multiple causes of suicide. And, in fact, the CDC reported this week that 54 percent of people who died by suicide over the last two decades didn't have a known mental health condition.

  Some insight now about risks, treatment and the scope of the problem.

  Dr. Liza Gold has spent her career on trying to prevent suicide with proper treatment and interventions. She is a clinical professor of psychiatry at Georgetown University School of Medicine.

  Dr. Gold, welcome to the "NewsHour."

• Dr. Liza Gold:

  Thank you for having me.

• Amna Nawaz:

  Let me ask you. These numbers now are striking, 45,000 suicides last year alone. Just from a public health perspective, what do we know about why this is happening?

• Dr. Liza Gold:

  Well, I don't think we really have a very good handle on why the numbers are going up, but it's clear that they are going up.

  And out of the top 10 causes of death in the United States, leading cause, suicide is number 10, it's one of the three in the top 10 that's actually going up, instead of going down.

• Amna Nawaz:

  The one in three, as you mention, that continue to rise.

  Now, it's worth pointing out a couple of things we know from these multiyear studies. The age group with the highest vulnerability when it comes to suicide, Americans 45 to 64 years old.

  And something else we have learned recently, that gender gap that used to exist…

• Dr. Liza Gold:

  Yes.

• Amna Nawaz:

  … that men were more likely to take their lives than women, that seems to be shrinking, too.

• Dr. Liza Gold:

  Yes.

• Amna Nawaz:

  What do we know about that?

• Dr. Liza Gold:

  Well, what we know about that is that more — women have always made more attempts than men have made at suicide.

  The ratio has always been about 3-point-something to one in terms of attempts, but men have always been more likely to complete a suicide than women have been.

  I think the key factor in that shift has been increasing access to firearms, which is a highly lethal method of suicide. About 50 percent of all suicides are firearms. And women are becoming more comfortable over the past years, as accessibility and other programs have made women more likely to also buy firearms.

  It used to be that only men really — not only, but primarily men had firearms.

• Amna Nawaz:

  One of the other things we have learned now is every time there is a high-profile or celebrity suicide, the conversation shifts to mental health very, very quickly.

  And we know now from this multiyear study that 54 percent, more than half of the people who died by suicide in that study didn't have a mental health diagnosis at the time of their death.

  So what are we to understand about that number, about that 54 percent?

• Dr. Liza Gold:

  Well, I think that probably many of them probably did, but had not sought assessment or treatment. So, I think that number is very low.

  But another way of thinking about it is that suicide is a behavior, not a diagnosis, and it can be associated with life crises, as well as with mental health problems.

  And so, when we think about preventing suicide, we have to think about preventing a behavior, whether it's been associated with mental illness or not. With or without mental illness, we have to intervene. It's not just the mental illness that creates the crisis.

• Amna Nawaz:

  And some of those studies list there are a number of contributing factors. It's not just about mental health. Right? There's also relationship problems, substance abuse, physical health, financial problems.

  But you mentioned treatment in your answer there. Help me understand, what does that look like? What does that entail?

• Dr. Liza Gold:

  Well, it depends on what the problem is.

  But the most common diagnoses associated with suicide are substance abuse problems and mood disorders. And we have treatment for both of those problems, particularly for mood disorders. We do a pretty good job these days, between cognitive behavioral therapy and medication, in terms of helping people with mood disorders, so that — so that one of the two evidence-based interventions that will reduce rates of suicide, incidents of suicide are mental health treatment.

  And people who survive the — the other one is lethal means restriction, taking away the things that they use to kill themselves, so putting nets up on bridges, so they can't jump, removing firearms from someone who is in crisis, someone who has a stash of pills, holding on to those.

  So what we know about mental health treatment is that it does work, that it does decrease rates of suicide, and that people who have made a suicide attempt and who have survived it and who get into treatment are actually not likely to die by suicide.

  So they get better. And it's unfortunate that there's so much stigma attached both to mental health diagnoses and treatment and to suicide, still considered a very shameful thing in many places. Many people don't want to talk about it, don't want to acknowledge a family member who's committed suicide, et cetera.

  So, in order to get to treatment, you have to, A, increase the mental health resources upstream as far as possible, and, B, you have to destigmatize seeking treatment and receiving treatment.

• Amna Nawaz:

  For people who are worried about a loved one or someone that they may know, what are they looking for?

• Dr. Liza Gold:

  Looking for changes in behavior, really signs that someone might be in crisis, so, unusual behaviors, isolating themselves, becoming uncommunicative, not going in to work, withdrawing from relationships.

  Those are sort of warning signs, potentially, of depression or substance use, someone thinking about killing themselves.

• Amna Nawaz:

  If you see those things, you hear those things, what do you do, what do you say? And, also, what do you not do or say?

• Dr. Liza Gold:

  Reach out. That's the most important thing.

  And if you're really concerned, be persistent, and use the word suicide when — if you're really that concerned, because that gives people permission to talk about something they might be embarrassed or ashamed to bring up themselves.

• Amna Nawaz:

  Dr. Liza Gold, thank you for your time.

• Dr. Liza Gold:

  Thank you for having me.

• Amna Nawaz:

  Before we go, for anyone out there who needs help or knows someone who needs help, it is available to you 24/7 for free.

  Call the National Suicide Prevention Lifeline at 1-800-273-TALK. That is 1-800-273-TALK.

  Or text HOME to 741741.

  Or visit suicidepreventionlifeline.org.