Suicide is one of the most difficult tragedies a family and a community can face. Although its suicide rate tracks very closely with the national average, the number of suicides and suicide attempts in Virginia each year has been increasing.
Why is This Important?
Suicides and suicide attempts exact a heavy toll in terms of loss of life, medical costs, grief and suffering, and disruption of families and communities. In Virginia, medical costs for hospitalizations due to self-inflicted injuries total more than $20 million per year. Given that research suggests inaccurate reporting on suicides due to the social stigma attached, these figures may not reflect the true total costs, both emotionally and financially, of suicides and attempted suicides.
How is Virginia Doing?
Suicide rates have generally been increasing in both Virginia and the nation overall. In 2014, Virginia had the 15th lowest (age-adjusted) suicide rate in the country: 12.9 deaths per 100,000 people and about the same as the national average (also 12.9). Peer states Tennessee (14.1) and North Carolina (13.0) had higher suicide rates than Virginia, while Maryland (9.8) had a markedly lower rate. New York was the leading state, with 8.1 age-adjusted deaths per 100,000 people due to suicide in 2014.
Within Virginia, suicide ranked 11th for cause of death among residents and was the third leading cause among 10- to 24-year-olds.
1,146 Virginians died by suicide in 2014. The largest number of victims were male (77.4%), white (84.8%), and aged 45-54 years of age (20.3%). Regionally speaking, the Southwest region had the highest suicide rate at 19.4 per 100,000 in 2014, followed closely by the Valley with 18.7 deaths; the Northern region had the lowest rate at 10.0 deaths.
What Influences the Suicide Rate?
Many factors influence suicide rates, making suicide very difficult to prevent and treat. These factors include:
- History of mental disorder, particularly depression
- History of alcohol and substance abuse
- Family history of suicide
- Family history of child maltreatment
- Feelings of hopelessness
- Impulsive or aggressive tendencies
- Barriers to accessing mental health treatment
- Loss (relational, social, work, or financial)
- Physical illness
- Easy access to lethal methods
- Unwillingness to seek help because of the stigma attached to suicidal thoughts or to mental health and substance abuse disorders
- Cultural and religious beliefs -- for instance, the belief that suicide is a noble resolution of a personal dilemma
- Local epidemics of suicide
- Isolation, a feeling of being cut off from other people
- Previous suicide attempt(s)
Two groups particularly at risk are youth and the elderly. Data from the Virginia Department of Health indicates that rates of suicide in Virginia were higher for older people than youth -- but suicide is still a concern for younger people because it is a leading cause of death in their age group.
According to the Centers for Disease Control and Prevention, adolescents and young adults often experience stress, confusion, and depression from situations occurring in their families, schools, and communities. Such feelings can become overwhelming and make suicide appear as a "solution."
Older adults who are suicidal are more likely to be suffering from physical illnesses and be divorced or widowed (DHHS 1999; Carney et al. 1994; Dorpat et al. 1968). Interestingly, most elderly suicide victims are diagnosed with mild to moderate depression by their primary care provider a few weeks prior to their deaths (DHHS 1999).
Military veterans -- especially those who have served in Vietnam, Iraq or Afghanistan -- have emerged recently as another group who are at higher risk of suicide, largely due to an increased risk of developing post-traumatic stress disorder (PTSD); left untreated, PTSD can lead some to take their own lives.
In addition, suicide rates tend to rise during recessions and to decrease during periods of economic prosperity. Economic hardship may be an aggravating factor for individuals who have other risk factors.
What is the State's Role?
Mental health services have tended to be chronically underfunded in the U.S. and are often among the first services to be cut when government budgets must be trimmed. As a result, reliable access to care -- especially in a timely fashion -- can be elusive; often there simply aren't enough facilities or mental health professionals available.
The Patient Protection and Affordable Care Act (ACA) has made mental health services a mandatory part of all health insurance plans; it remains to be seen if this more generous coverage can also affect longstanding attitudes and resistance toward acknowledging mental health issues by patients, the justice system, and society at large. The 2015 General Assembly of Virginia did boost funding for mental health, including services for severely mentally ill patient, as well as funding for free clinics, children's psychiatry, and crisis services.
The Virginia Departments of Health (VDH) and Behavioral Health and Development Services (VBHDS) work to improve measures that combat suicide. The Virginia Department of Veterans Services is also active in efforts to help troubled veterans of the Vietnam, Iraq, and Afghanistan wars.
State rankings are ordered so that #1 is understood to be the best.
Data and Definitions
Centers for Disease Control and Prevention (CDC). WISQARS fatal injury data, 1999-2014, www.cdc.gov/injury/wisqars/fatal_injury_reports.html
Virginia Department of Health, Office of the Chief Medical Examiner, Annual Reports
Virginia Department of Health, Center for Health Statistics, City/ County profiles, www.vdh.virginia.gov/HealthStats/stats.htm
Locality graphs display crude rates (not age-adjusted) and are computed using U.S. Census population estimates.
Seven facts about America's mental health-care system, Wonkblog, Washington Post, December 2012.
Luo L, Florence CS, Quispe-Agnoli M, Ouyang L, and Crosby AE. Impact of business cycles on US suicide rates, 1928-2007. American Journal of Public Health 2011: 6, 1010: 1139-1146.
Suicide Prevention Resource Center. Virginia State Information, www.sprc.org/states/virginia
The Relationship Between PTSD and Suicide, U.S. Department of Veteran Affairs (last updated July 2016).
See the Data Sources and Updates Calendar for a detailed list of the data resources used for indicator measures on Virginia Performs.