Blog Harvey A. Friedman Center for Aging Behavioral/Mental Health

Older adults and suicide: How can mental health professionals increase prevention efforts?

Written by Jessica Rodriguez, MSW candidate, Brown School

As I approach the end of my master’s in social work program at the Brown School at Washington University in St. Louis, the pressure to ensure quality care and services to my future clients grows each day. During my field work prior to entering the Brown School, the topic of suicide was often avoided due to the stigma and fear people often experience when discussing the topic. While research continues to explore the topic across all sub-groups, the discussion of suicide among older adults is still uncommon.

According to the National Council on Aging, one in four older adults who attempt suicide will succeed. This is due to the higher likelihood that older adults will use or have access to a lethal method and more likely will have a well thought out plan. According to Koo and Kolves et al., the predominant methods of suicide in older adults are hanging, firearms, and drug poisoning.  The Substance Abuse and Mental Health Services Administration’s (SAMSHA) 988 Appropriation Report stated the highest suicide rate of 39.9%,  was among males ages 75+. In 2020, the Center for Disease Control and Prevention reported 20.9% of suicides were completed by adults 85 and older, followed by ages 75-84 at 18.4%. This is a mental health crisis we must address as a society. Naturally, a question we must ask ourselves is how can we provide mental health support to older adults?

Last year in July 2022, the 10-digit National Suicide Prevention Lifeline transitioned to 988. The new three-digit lifeline is easy to remember and will hopefully save many lives. Although the 988 number increases access, people are less likely to talk about their thoughts of ending their lives due to stigma and fear. According to Matt Blanchard, the clients’ primary motive for concealing suicidal ideation is fear of unwanted practical impacts, such as involuntary hospitalization. Secondary motives were around shame and embarrassment. He suggests providing comprehensive, transparent, and easy to understand psychoeducation about interventions, can help people feel safe disclosing and seek help.

Currently, I am on the clinical social work track and have taken many courses that provide a general understanding of suicide. While my programs offer many intervention courses and mental health courses, it lacks the integration of content on mental health in older adults. As mental health professionals, it is our responsibility to be well informed of the topic of suicide across all populations to be able to adequately support our clients and keep them safe.

To be able to intervene, people must be able to recognize warning signs to offer support. SAMSHA published a list of warning signs providers and caregivers should familiarize themselves with. SAMSHA also encourages mental health providers to receive early-career training in suicide prevention, suicide behavioral intervention, and suicide postvention. Increasing awareness and education of providers around suicide can help reduce suicide attempts among older adults. To support training in suicide prevention SAMSHA developed a toolkit for adult centers: Promoting Emotional Health and Preventing Suicide.

It is important to not only normalize conversations around mental health and support, but also ensure that providers have the necessary training to have these conversations and be prepared to help.

The author of this blog post is a student in the course, Contemporary Perspectives on Aging, led by Nancy Morrow-Howell, PhD, the Bettie Bofinger Brown Distinguished Professor of Social Policy, at the Brown School and Director of the Harvey A. Friedman Center for Aging at the Institute for Public Health. The course examines current issues of aging societies, from individual, family and community perspectives and uses a multidisciplinary lens to consider the biological, social, and psychological aspects of longer lives.