Suicide and SelfInflicted Injury in Maine Erika Lichter

Suicide and Self-Inflicted Injury in Maine Erika Lichter, Sc. D University of Southern Maine/ Maine CDC

One year in Maine (2007)…. • 158 people died by suicide (Maine Vital Records, 2007) • 1, 094 were hospitalized for a self-inflicted injury (Maine Hospital Discharge Data, 2007) • 1, 911 were treated in the emergency department for a self-inflicted injury (Maine Hospital Outpatient Discharge Data, 2007) • 6, 700 high school students and 27, 000 adults considered suicide in the previous 12 months (Maine Youth Risk Behavior Survey, 2007 and Maine BRFSS 2009) • 2, 800 high school youth and 4, 000 adults attempted suicide in the past 12 months. (Maine Youth Risk Behavior Surveyand Maine BRFSS 2009)

Five Leading Causes of Death in Maine, 2003 -2007 15 -19 years 20 -24 years 25 -34 35 -44 45 -54 Unintentional Injury Malignant neoplasm Suicide Malignant neoplasm Heart Disease Malignant neoplasm Heart Disease Unintentional Injury Heart Disease Suicide Homicide Diabetes Mellitis Liver Disease Source: CDC NCIPC, WISQARS

Suicide Mortality

Suicide Mortality by County, Maine

Suicide Mortality 1994 -2007, 5 -year averages Source: CDC NCIPC, WISQARS

Preliminary Suicide Deaths from Medical Examiner Year Number of Suicide Deaths 2003 -2007 2008 2009 January- June 2010 166 187 72 Source: Maine Office of the Medical Examiner

Suicide by sex Maine, 2003 -2007 Source: CDC NCIPC, WISQARS

Suicide by sex, Maine, 1997 -2007 Source: CDC NCIPC, WISQARS

Suicide rates by age Maine, 2003 -2007 Source: CDC NCIPC, WISQARS

Suicide by age Maine, 2003 -2007 120 80 15 60 10 40 20 0 0 15 -1 10 -1 9 20 -2 4 25 -2 9 30 -3 4 35 -3 9 40 -4 4 45 -4 9 50 -5 4 55 -5 9 60 -6 4 65 -6 9 70 -7 4 75 -7 9 80 -8 4 85 + 5 Age Rate per 100, 000 Source: CDC NCIPC, WISQARS Number of suicide deaths Rate per 100, 000 100 20 4 Number of Suicide Deaths 25

Suicide and Race/Ethnicity, 2000 -2007 Race/ ethnicity Number of Suicide Deaths White Non. Hispanic Population Total 2000 -2007 Rate per Age-adjusted 100, 000 rate per 100, 000 1, 279 10, 051, 742 12. 7 12. 1 5* 92, 471 5. 4 4. 5 11* 65, 332 16. 8 17. 2 Asian/Pacific Islander 6* 91, 139 6. 6 9. 5 Hispanic 4* 102, 999 3. 9 4. 1 Black/African American Non -Hispanic Native American *estimates may not be reliable Source: CDC NCIPC, WISQARS

Methods of Suicide Death, Maine, 2003 -2007 100% 90% 80% 70% 60% Other 50% Poisoning 40% Suffocation 30% Firearm 20% 10% 0% 14 10 - 4 2 20 - 44 35 - Source: CDC NCIPC, WISQARS 64 55 - 84 75 -

Methods of Suicide by Sex, 2003 -2007 Source: CDC NCIPC, WISQARS

Hospitalization and ED visits for selfinflicted injury • For every suicide death in Maine in 2007 (n=191), there were: – 6 people (n=1, 095) hospitalized for a self-inflicted injury – 10 people (n=1, 911) who visit an emergency department for a self-inflicted injury Source: Maine Inpatient and Outpatient Hospital Discharge Data

Hospitalization and Outpatient ED visits for Selfinflicted injury, Maine, 2000 -2008 Source: Maine Inpatient and Outpatient Hospital Discharge Data

Hospitalizations and Outpatient ED by Sex, Maine, 2008 Source: Maine Inpatient and Outpatient Hospital Discharge Data

Hospitalization and ED visits by Sex, Maine, 2000 -2008 Age-adjusted Rate per 10, 000 25 20 15 Female ED Male ED 10 Female Hospitalization Male Hospitalization 5 0 2001 2002 2003 2004 2005 2006 2007 2008 Source: Maine Inpatient and Outpatient Hospital Discharge Data

Hospitalizations and Outpatient ED visit rates by Age, Maine 2008 57 60 Rate per 10, 000 50 46, 6 40 28 30 18, 0 20 10, 5 17, 1 13, 5 Inpatient Outpatient ED 9, 5 9, 1 4, 8 10 -14 2, 20, 6 15 -19 20 -24 25 -34 Age Group 34 -64 Source: Maine Inpatient and Outpatient Hospital Discharge Data 65+

Methods of Self-inflicted injury Maine, 2008 100% 90% 23 14 80% 11, 5 70% 72, 1 37, 6 60% Suffocation 50% Other 40% 37, 3 30% 20% 10% 0% Firearm Inpatient Outpatient ED Source: Maine Inpatient and Outpatient Hospital Discharge Data Cutting Poisoning

Self-reported Suicidal Behavior/Risks • • Ideation Attempts that don’t require medical treatment Depression Non-suicidal self-inflicted injury • Maine Integrated Youth Health Survey/YRBS • Maine Behavioral Risk Factor Surveillance System

Past year self-reported suicide ideation and attempts, Maine Adults (BRFSS 2006 -2007) High School Students (MIYHS 2009) 30 24, 1 25 21, 8 Percent 20 13, 8 15 11, 8 9 10 5 0 2, 4 Considered 1, 8 Planned 0, 4 Attempted Depressive Symptoms Diagnosed depression

Suicidal behavior in Maine HS students, 2009 Source: MIYHS 2009

Depression and non-suicidal selfinjury, Maine HS students, 2009 Source: MIYHS

Suicidal ideation, attempts, and depression among Maine HS students 30 25 Percent 20 Considered 15 Attempted Depression 10 5 0 2001 2003 2005 Source: 2001 -2007 YRBS and 2009 MIYHS YRBS Module 2007 2009

Lifetime suicide and non-suicidal selfinjury, Maine 7 th & 8 th graders, 2009 Source: MIYHS

Summary • Maine’s suicide rates have not changed significantly over time. • The highest number of suicide deaths occur among adult males age 40 -59. • Self- hospitalizations and outpatient visits for self-inflicted injury are increasing. • Female youth and young adults are most likely to be treated for a self-inflicted injury. • Self-reported ideation and attempts among youth increased in 2009.

Conclusion Suicide, self-inflicted injury, and depression are public health problems that affect Maine residents of all ages.

Questions? Erika Lichter erika. lichter@maine. gov 287 -4598

Maine HS students who considered or attempted suicide by sex, 2001 -2009