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Key points
- Men are four times more likely to die by suicide than women.
- Men who work in law enforcement and first responder roles are at an increased risk of suicide.
- The psychological autopsy is an exceptional tool in trying to piece together why a loved one died by suicide.
A few weeks ago, a local police officer in my community died by suicide. Sadly, this occurs far more often than most imagine, particularly among police officers and other first responders.
According to the American Society for Suicide Prevention, suicide is the 10th leading cause of death in the United States. There were 47,511 suicides in 2019, which, on average, equates to 130 suicides per day.
Men are four times more likely than women to die by suicide, and middle-aged white men, like me, are considered “high risk.” White males accounted for 69.38 percent of all suicides in 2019. To break it down further, in 2019, the suicide rates were slightly higher among adults ages 45 to 54 years than those 55 to 64 years, yet the suicide rate was highest among adults ages 85 years or older, which may come as a surprise to some.
Sadly, this is not just a concern for Americans; it extends globally. A 2019 BBC report determined that globally, women are more likely to be diagnosed with depression and to attempt suicide, but the male suicide rate is still several times higher than females. In 2016, the World Health Organization (WHO) reported 793,000 deaths by suicide with most being men.
Women are more likely than men to attempt suicide, but men are more likely to die by suicide, and those suicides tend to be more violent, which is often attributed to men's access to firearms. For example, in the United States, six in ten gun owners are men. To compound matters, the suicide rate for men who work in law enforcement and corrections is twice that of civilian men. Let that sink in for a minute.
Can Suicide Be Prevented?
A 2020 Harris Poll concluded that 93 percent of American adults surveyed think suicide can be prevented, and I happen to be one of them. Nevertheless, if that’s the case, why haven’t we been more successful in preventing suicide among adults, particularly adult males, especially those who serve in law enforcement, corrections, and other public safety and first responder roles?
I’ve published, presented at conferences, and continuously advocated for change by emphasizing the importance of this topic for more than a decade, and yet, here we are. Very little has changed in the way of progress. The outcome is still the same, especially given that the suicide rates have neither declined nor stabilized, and that needs to change.
In short, men are less likely to share their emotional pain, even with those closest to them, and even if they acknowledge it they are often reluctant to seek help, particularly men who serve as public safety officers or first responders. The reasons are complex and varied. (Please see some of my other posts below for detailed explanations as to why men are less likely to seek help for their mental health needs, here, here, here, or here.)
When there’s a suicide, friends, family, and colleagues are left with one troubling question: Why?
To gain a better understanding of the question of “why,” investigators have relied on the psychological autopsy, which has become a best practice postmortem procedure or tool used in suicide, especially in suicide cases in which there were no prior indications or signs of suicidal thoughts or behaviors. While not necessarily a new procedure or tool, a psychological autopsy serves to reconstruct the proximate and distal causes of an individual’s death by suicide.
The term psychological autopsy, according to a study by Jacobs and Klein-Benheim, was first coined by Robert Shneidman, one of the leading authorities on suicide and its prevention during the late 1960s into the 1970s and founder of the American Association of Suicidology. The term refers to a procedure used to classify equivocal deaths, which are deaths not immediately clear as to whether the individual died by suicide or accident. The process entails reconstructing a biography of the deceased by gathering psychological information from personal documents; police, medical, and coroner records; and first-person accounts by interviewing friends, family, and coworkers along with the deceased individual’s health care workers (i.e., personal physicians, psychologists, and psychiatrists), especially in the days and weeks leading up to the suicide.
Early psychological autopsy studies determined that 90 percent of those who died by suicide suffered from mood disorders and/or substance abuse. Fast forward to the present day and most studies still support this conclusion that an underlying psychological disorder has gone undiagnosed and/or the individual never took the necessary steps toward seeking treatment; therefore, suicide prevention strategies, particularly those intended for men, are most effective if focused on the treatment of those mood disorders. That’s quite obvious, but how do you convince men, particularly men who work in law enforcement, corrections, and other public safety and first responder roles to seek treatment? With everything that we know, why haven’t we been successful?
“So long as we keep repeating the phrase, ‘encourage male help-seeking behavior’ in our grant applications, public health marketing, and outreach efforts, suicidal men will just keep dying. Hoping men will become more like women is costing us the lives of our fathers, brothers, sons, uncles, and nephews.” —Paul Quinnett, Founder and CEO of the QPR Institute
If you or someone you know is exhibiting warning signs of suicide, call the Lifeline by dialing 988, contact the Crisis Text Line by texting HOME to 741741, or seek help from a medical or mental health professional. To find a therapist near you, visit the Psychology Today Therapy Directory.
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