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Abstract
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North Carolina has set a bold goal to reduce our suicide rate to 11.1 per 100,000 by the year 2030 [1]. This article explores our pathway there using key prevention strategies, multi-stakeholder partnerships, and hope.
"When it is darkest, we can see the stars." With these words, Ralph Waldo Emerson offers us hope, the psychological antidote to suicide. Suicide is defined as the intentional act of taking one's life, but fundamentally it is the catastrophic loss of hope. Unsurprisingly, hopelessness is one of the strongest predictors of death by suicide [2]. While we must facilitate hope at an individual psychological level, we must also take comprehensive public health action at the population level. Suicide is not simply an individual threat, but an existential one, as it is increasingly claiming the lives of our nation's youth. Among Americans aged 10-24, suicide rates between 2007 and 2017 increased 56% [3], and by 2019 suicide was the second leading cause of death for ages 10-34 [4]. Additionally, every hour in the United States we lose an older adult to suicide [5].
Suicide and suicide attempts take an immense psychological toll on individuals, families, and communities. There are also enormous financial costs, and we simply cannot afford to delay action. Suicide deaths alone are estimated to cost the US economy over $463 billion in combined costs per year (using 2019 data) [6]. In 2019 in North Carolina, deaths by suicide led to 26,918 years of potential life lost before the age of 65 [7], and over $13 billion in combined costs [6]. We also know the COVID-19 pandemic has had substantial impacts on behavioral health. Nationally, mental-health-related pediatric emergency department visits are increasing, especially among adolescent girls [8, 9]. In North Carolina, emergency department presentations for opiate overdoses among adults are increasing, which is disappointing given the progress made before the pandemic [10].
There is also important health disparity work to be done, as populations that routinely experience discrimination are disproportionately affected by suicide. Alarmingly, data analysis of the Youth Behavior Risk Survey (YBRS) revealed Black adolescents had the highest increase in the prevalence of suicide attempts between 1991 and 2019 of any race/ethnicity [11], and lesbian, gay, and bisexual youth experienced more violence victimization and reported more suicide risk behaviors than heterosexual youth between 2015 and 2019 [12]. Transgender youth reported higher suicide risk than cisgender youth in a separate analysis of 2017 YBRS data [13]. Veterans are also at increased risk; the suicide rate between 2014 and 2018 was 2.4 times higher among veterans than nonveterans...
Language: en |