Did some digging I’ve not done before.

Looking at the original article the CDC got this information from: Vital Signs: Trends in State Suicide Rates — United States, 1999–2016 and Circumstances Contributing to Suicide — 27 States, 2015

https://www.cdc.gov/mmwr/volumes/67/wr/mm6722a1.htm?s_cid=mm6722a1_w https://twitter.com/deseraestage/status/1318607185140715520

Some interesting things in here.

Can confirm my hunch from earlier: the statistic that says 54% of those who died by suicide did not have a mental health history did, in fact, come from documentation from LEO/coroner reports, rather than attempts at postmortem diagnosis.

The data is pulled from the 27 states with complete data participating in CDC’s National Violent Death Reporting System (NVDRS) in 2015, and includes those with and without known mental health conditions, ages 10 and up. (I’m pasting almost verbatim from this article, btw.)

NVDRS defines mental health conditions as disorders and syndromes listed in the DSM 5, with the exception of problematic alcohol use and other substance use that are captured separately in NVDRS.

Here’s the interesting part: our standard messaging is: suicide = mental illness. The CDC says, “Nah, 54% don’t have MH history, and also here are important life events that affect suicide.”

But then the article says that, in fact, that list of factors—relationship issues, recent crisis, job issues, houselessness—actually affected those who died by suicide WITHOUT a MH history more than they affected those who died and DID have an established MH history!

“Decedents without known mental health conditions had a significantly higher likelihood of any relationship problem/loss (45.1%) than did those with known mental health conditions (39.6%), specifically intimate partner problems (30.2% versus 24.1%)...

“arguments/conflicts (17.5% versus 13.6%), and perpetrating interpersonal violence in the past month (3.0% versus 1.4%).”

Decedents without MH hx were also more likely to have experienced any life stressors (50.5% versus 47.2%) such as recent criminal legal problems (10.7% versus 6.2%) or eviction/loss of home (4.3% versus 3.4%)...

and were more likely to have had a recent or impending (within the preceding or upcoming 2 weeks, respectively) crisis (a current or acute event thought to contribute to the suicide) (32.9% versus 26.0%).

So, wait. Not only have we learned that over half of those who died from suicide didn’t have established MH histories, but we’ve also learned that folks without MH histories are more likely to end their lives in response to crises initiated/affected by...

scenarios in their lives that are extremely difficult for most folks to relate to—like relationship issues and breakups; immediate crises; legal issues; and houselessness or eviction?

This is weird. It’s almost like these folks responded to situations in their lives that made them feel helpless, hopeless, despairing, or pained.

And they didn’t even have the excuse of being CrAZy (or, y’know, having an established MH history).

Interestingly, physical health and job/financial issues were stressors among those with and without MH histories.

And by “interesting,” I mean, “no one here should be surprised by this information.”

Here’s a piece of info buried in there that IS actually interesting: “suicide decedents without known mental health conditions also had significantly higher odds of perpetrating homicide followed by suicide.”

Wait, wait! “Decedents without known MH conditions were significantly less likely to have a history of suicidal ideation (23.0%) or prior suicide attempts (10.3%)” than those who had established MH histories.

So...it’s almost like we’re saying that, even though we LOVE to talk about how the MeNtAlLy IlL are prone to suicide, folks w/o MH hx are more likely to respond to difficult life situations by killing themselves than are folks with established MH histories.

The numbers look to be negligible, but that sure is interesting, given that all our messaging around suicide prevention points us toward people with MH histories as most at risk.

Okay, but for real: WTF IS THAT ABOUT?

From the conclusion:

“Suicidologists regularly state that suicide is not caused by a single factor; however, suicide prevention is often oriented toward mental health conditions alone with regard to downstream identification of suicidal persons,

“treatment of mental health conditions, and prevention of reattempts. This study found that approximately half of suicide decedents in NVDRS did not have a known mental health condition, indicating that additional focus on nonmental health factors further upstream could provide

“important information for a public health approach. Those without a known mental health condition suffered more from relationship problems and other life stressors such as criminal/legal matters, eviction/loss of home, and recent or impending crises.”

Also: “Two thirds of suicide decedents with mental health conditions had a history of treatment for mental health or substance use disorders, with approximately half in treatment when they died.”

Well, if that ain’t a hella damning appraisal of our mental health system!

I don’t wanna sound like a conspiracy theorist or anything, but it’s almost like there’s some sort of agenda behind the fact that SP/suicidology have ignored this information for two years.

Either that or laziness. Not sure which is worse.

Third option: a paralyzing inability to cope with the thought that suicide could be a much, much bigger problem than we ever could have imagined because we were too busy oppressing and abusing the crazies. ¯\\_(ツ)_/¯

So much to think about on this fine Tuesday evening. I’m going to eat dinner now.