SOURCES: Katherine Hempstead, Ph.D., director, Robert Wood Johnson Foundation and the Center for State Health Policy at Rutgers University, Princeton, N.J.; Christine Moutier, M.D., chief medical officer, American Foundation for Suicide Prevention; Feb. 27, 2015, American Journal of Preventive Medicine
FRIDAY, Feb. 27, 2015 (HealthDay News) -- The financial stress of the last recession likely contributed to a recent increase in suicides among middle-aged Americans, researchers report.
Job, financial or legal problems played a role in 37.5 percent of all completed middle-age suicides in 2010, up from just under 33 percent of suicides in 2005, according to findings published in the Feb. 27 issue of the American Journal of Preventive Medicine.
Mental health problems remained the leading factor in middle-aged suicides, and were involved in four out of five suicide deaths, the study noted.
But financial pressures probably played a key role in triggering suicidal action in someone who might have only been contemplating suicide, the study authors added. However, the study could only find an association between tough economic times and suicide rates, it couldn't prove cause and effect.
"The middle-aged bear the brunt of economic stress associated with a downturn," said study author Katherine Hempstead, director of the Robert Wood Johnson Foundation and the Center for State Health Policy at Rutgers University in Princeton, N.J. "They're the bread-winner groups who are raising kids, paying for college, planning for their retirement and supporting their elderly parents."
Overall, suicide rates for U.S. adults between the ages of 40 and 64 have risen about 40 percent since 1999, the study found.
However, what had been a slow, steady increase in suicides among that age group jumped dramatically between 2007 and 2010.
Researchers decided to explore whether the last recession -- which began in December 2007, according to the U.S. National Bureau of Economic Research -- played a role in the increased suicide rate among middle-aged adults.
Economic evidence suggests that middle-aged people may have experienced more hardship during the recession, the study authors said. For example, more than one out of four workers aged 50 to 64 experienced salary reductions during the recession, compared with one out of five younger workers, according to background notes with the study.
To perform their study, the researchers turned to the National Violent Death Reporting System (NVDRS). The system links detailed information on violent deaths from multiple sources, including medical examiner and coroner reports, toxicology reports, law enforcement records, supplemental homicide reports and death certificates.
The researchers evaluated suicide data from 16 states that report to the NVDRS, excluding three states that either only recently began contributing data or only contribute information from parts of the state.
Based on the data, the researchers identified 17 distinct suicide circumstances in three major categories:
The researchers found an increase between 2005 and 2010 in middle-aged suicides involving external circumstances such as job loss or financial pressure. During the same period, suicides involving personal or interpersonal circumstances either remained stable or declined.
Younger people -- those under 40 -- did not show the same increased influence of financial factors on their decision to die by suicide, the researchers found. The percentage of suicides among younger adults linked to job loss or financial hardship remained level, even as these problems played an increasing role in middle-aged suicides.
"That middle-aged population, there is a lot more riding on their ability to have an income," said Dr. Christine Moutier, chief medical officer of the American Foundation for Suicide Prevention. "They're that sandwiched generation, having fiscal responsibilities for both sides, the younger and the older, their children and their parents."
Middle-aged people also have a dwindling number of years in the job market, meaning they have less time to make up for any lost earnings or declines in their investments, Moutier added.
The study suggests that workplaces can do more to prevent suicide, Moutier said. Human resources departments and managers should be aware that layoffs can trigger suicides, and be prepared to get people the help they need.
"When somebody is facing termination from their job, that would be a key time to understand those individuals may be at risk for suicide," she said.
Friends and family of a person undergoing financial problems should also be on the lookout for warning signs of suicide -- talking about suicide, giving away prized possessions, withdrawal and isolation -- and reach out if they believe the person needs help, Moutier said.
Healthy people facing a layoff "would be problem-solving probably fairly quickly, in terms of what steps to take next, whereas the suicidal individual begins to see suicide as a solution," she said. "It's not that these people are seeking death. They are seeing it as a way out of the intense despair, pain and hopelessness they are experiencing."
Visit the U.S. National Institute of Mental Health for more on suicide prevention.