The Suicide Conundrum

by Brendan I. Koerner

Sorry to start this gorgeous summer day on an exceedingly somber note, but it's time to talk suicide.

I've written a lot about this topic over at Microkhan, primarily from a public-health angle. Despite all we've learned about human psychology over the past several decades, we seem unable to make much of a dent in America's overall suicide rate, which has remained remarkably stable over the past half-century. In fact, the rate of suicide attempts seems to have gone up over that time period; the rate of successful attempts has most likely held steady due to advances in emergency-room medicine. (Sparsely populated states such as Montana often have high suicide rates because people live so far from ERs.)

So, aside from offering psychological intervention at the right time, what's the best strategy for helping people who are sorely tempted to take their own lives? Historically, the greatest declines in suicide rates have come about due to changes in the availability of methods. Take, for example, what happened in Great Britain (paywalled):

The availability of specific methods of suicide affects secular trends. This is of particular importance with respect to gassing. Prior to 1905, gassing accounted for a negligible percentage of all suicides. However, there was a rapid increase in suicides by gassing in
the early 20th century and it became the most commonly used method of suicide in the 1930s in women and 1950s in men, before declining after the 1960s with the changes in domestic gas supply from coal gas (high carbon monoxide content) to natural gas (low carbon monoxide content).

Britain's suicide rate plummeted by roughly 40 percent after the switch to natural gas. And it slid several more percentage points starting in the early 1990s, after the introduction of catalytic converters reduced the toxicity of vehicle emissions, and therefore made suicide-by-tailpipe a lot tougher.

The big difference between the U.S. and Britain, of course, is the availability of firearms, which are lethally efficient when compared to such methods as hanging, pill ingestion, or wrist slitting. (56 percent of male suicides and 31 percent of female suicides in the U.S. involve firearms.) And while trigger locks may be able to prevent some cases of teen suicide, there really isn't much that can be done to suicide-proof a .38 owned by an adult intent on ending it all.

And so the mystery remains: How do we reduce America's suicide rate, which has barely budged for 50 years? The natural answer is to address the underlying causes, such as desperate economic circumstances and poor mental health. But if we were intent on launching a 10-year crusade to reduce the national suicide rate by, say, 30 percent, what sorts of (relatively) quick, affordable fixes could we marshal? Will bridge barrier and signs work, for example, despite some recent evidence to the contrary?

Readers with serious public-health chops, this is your time to shine. Please chime in.

See also: Microkhan on the link between literacy and suicide.