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Research Letter
February 17, 2020

Trends in US Suicide Deaths, 1999 to 2017, in the Context of Suicide Prevention Legislation

Author Affiliations
  • 1Centre for Research and Intervention on Suicide, Ethical Issues and End of Life Practices, Department of Psychology, Université du Québec à Montréal, Montreal, Quebec, Canada
  • 2Department of Psychology, Université du Québec à Montréal, Montreal, Quebec, Canada
JAMA Pediatr. 2020;174(5):499-500. doi:10.1001/jamapediatrics.2019.6066

Burstein et al1 have reported that visits to US hospital emergency departments (EDs) for suicide attempts (SA) or suicide ideation (SI) doubled among youth aged 5 to 18 years between 2007 and 2015. The question remains whether this trend is paralleled by an increase in suicides. The United States has greatly invested in youth suicide prevention during this period. If only ED visits increased but not suicide mortality, this would suggest that prevention activities resulted in more youths seeking help in EDs. However, if suicide had an increase similar to SA/SI, this might suggest that more needs to be done or new approaches need to be undertaken. We examine if suicide rates had increasing trends similar to the increase in SA/SI ED visits.

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    1 Comment for this article
    Population HEALTH
    Paul Nelson, M.S., M.D. | Family Health Care, P.C. retired
    Most succinctly, our nation's Population HEALTH is characterized by the worsening events of maternal mortality (for more than 25 years), childhood maltreatment, childhood obesity, adolescent suicide/homicide, teenage pregnancy, substance abuse/mortality, homelessness, mass shootings, mid-life depression/disability, and stagnant longevity at birth (2010-18). As represented above, our nation's healthcare is faced with issues that are likely beyond its direct prevention, mitigation, or amelioration.

    We have all been either directly or indirectly connected with community efforts to mount collaborative efforts to resolve locally identifiable human adversities. The concepts of social cohesion, social capital, and social dilemmas surface repeatedly but without
    a clear and well-defined interconnection with any long-term and broadly supported concept for meaningful change. Admittedly, the entrenched traditions that drive pockets of poverty and "the mindless menace of violence" ( Senator Robert Kennedy 1968) are very complex, generational problems.

    At the same time, our nation's worsening health spending has steadily interfered with our nation's investment in higher education, housing infrastructure, and a resilient safety net for each community. Remember that early childhood education has an ROI (return on investment) of 7:1, disaster mitigation of 4-6:1, and higher education of 3:1. I would add that our nation's health spending problem will not resolve without reducing the daily experience of STRESS by our resident persons afflicted by restricted social mobility and chronic social isolation, community by community. A nationally sanctioned and promoted, locally controlled and implemented strategy will be required. HINT: Look up the Smith-Lever Act passed by Congress in 1914.