Although most older adults report higher levels of well-being and greater meaning in life than their younger counterparts, late-life suicide remains a pressing public health concern. There are sobering data to support this paradox. In 2017, when the average suicide rate in the U.S. was 14.0 deaths per 100,000 individuals, the second highest rate (20.1) occurred in those 85 years or older (CDC 2019). Research estimates suggest that there are as many as 200 attempts for each completed suicide in adolescent and young adult samples, but this is drastically cut to 2-to-4 attempts for each suicide death among older adults (Conwell 2013). Suicide attempts are more likely to result in death among older adults than younger individuals, in part because older adults tend to plan more carefully, use more lethal means, and are less likely to be discovered and rescued. Their physical frailty also means they are less` likely to recover from an attempt.

Suicide in later life is a complex phenomenon that is likely driven by multiple determinants. As such, it will take a commitment across health care and social service systems to systematically improve detection and intervention to prevent suicide deaths. The following are considerations to improve suicide care and reduce the number of individuals falling through the cracks of our systems.

Consider the role of ageism. There exists a dangerous and outdated norm that decline, deficits, or disorders are common, normal, and expected among older adults.

Grantmakers should work with their grantees and provider partners to promote a version of the aging experience that challenges simplistic notions that later life is a period of inevitable loss, decline, and pathology.

Consider the stakeholders. Longer life expectancy means that people are living with chronic conditions for a longer period, sometimes with a lifetime diagnosis of one or more psychiatric disorders. This means that many older adults receive care from primary care providers for their chronic physical conditions (e.g., diabetes, cardiovascular disease) if not also their mental health conditions (e.g. depression, anxiety).

Thus, primary care providers and staff have a key role in reducing suicide deaths through early detection.

Consider the evidence base for effective treatment. The primary driver of reduced suicide deaths is early detection of risk. However, matching a suicide prevention intervention to an individual in need can be difficult because individuals at risk may be missed, and not all individuals who appear to be at risk (e.g., have depression) need a suicide prevention treatment.

Because only a small proportion of older adults in need of mental health care receive adequate treatment, it is particularly important to target nontraditional linkages to care, such as integrated mental health care in other medical or aging (social) services.

The National Suicide Prevention Lifeline is a hotline for individuals in crisis or for those looking to help someone else. To speak with a certified listener, call 1-800-273-8255.

Read the full article about suicide in older adults by Brenna N. Renn at Grantmakers In Health.