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Why elderly men have the highest rates of suicides

AYESHA RASCOE, HOST:

Preliminary data just came out showing that in 2022, the number of suicides in the U.S. rose by 3%. We're now going to look at one piece of that report, suicide rates among men 75 and older. They continue to be two or three times higher than many other demographic groups. And before we get any further, if you or someone you know may be considering suicide or is in crisis, call or text 988 to reach the Suicide and Crisis Lifeline. We're joined by Kim Van Orden, co-director of the Center for the Study and Prevention of Suicide at the University of Rochester. Thank you for coming on.

KIM VAN ORDEN: Delighted to be here, Ayesha.

RASCOE: I understand that we're not saying anything new here, but this is something I didn't know. Elderly men, especially white men, have had higher rates of suicide than other groups for some time now. Why is that?

VAN ORDEN: Well, first, Ayesha, thanks for asking this question because suicide in later life is a significant public health problem around the world, not just the U.S. And so you combine that with population aging. The magnitude of that problem is increasing. So as to why older adults have higher rates, that's actually a more complicated question because suicide isn't caused by any one factor.

My colleagues and I like to describe these as the five Ds of late-life suicide. So that's depression, disconnection, disability, disease and access to deadly means. So depression most people know about. It's present in most older people who die by suicide. Disability refers to any form of functional impairment like trouble walking or sensory loss. Disease means physical illness. And then disconnection - that's social disconnection. And then access to deadly means is a key one. In the U.S., that means firearms.

RASCOE: So are older men more likely to be depressed than younger men?

VAN ORDEN: Actually, no. In fact, later life is characterized by less depression, greater well-being, more positive emotions and better capacity to manage emotions. So on average, Ayesha, an older person is probably quite a bit happier than you or me right now. So that can be kind of seeming like a paradox. And so the way I like to think about it is that the healthy trajectory in later life is one of greater well-being, but some older people get off that path. And so some people end up having all of those risk factors pile up. And as well, older men are less likely to share their suicidal thoughts, and they're more likely to die when they have them. They use more immediately lethal means, and they're more planful.

RASCOE: And is that why it's - older, elderly men have higher rates of suicide? Is it because they're not seeking help; they're not opening up?

VAN ORDEN: Yes - as well, using the more lethal means. So things like if someone were to take pills - there's time for them to be rescued. If you use a firearm, unfortunately, that's much less likely to happen.

RASCOE: What about mental health care, like therapy? - the way people think about that. Are older people going to therapists and asking for help? Or are there therapists specializing in treating the elderly?

VAN ORDEN: Absolutely. And so I'm a geropsychologist, which means that I specialize in working with older people, and I see older people for therapy. And so one thing that's interesting is they speak about their depressive symptoms a little differently. So you might hear things like trouble concentrating or trouble sleeping. And they're more likely to share those symptoms with their primary care physician.

RASCOE: Do enough primary care physicians understand that? And are they doing those referrals or working with therapists like yourself to get help for an older person who's saying, I'm having trouble sleeping; I'm having trouble concentrating?

VAN ORDEN: It does happen, and we need it to happen more. So one thing we need to do as a society, as more people have the privilege of living longer, is have more professionals who work with older people.

RASCOE: A lot of what we hear about is suicide among younger generations or specific demographic groups. And often, we don't hear much about older people dying by suicide or the idea that that is a concern.

VAN ORDEN: You know, absolutely. And my sense is the reason we don't talk about it as much is our society is deeply embedded in ageism. There's, you know, kind of a belief that aging is kind of an awful thing, that when you're older, it makes sense that you don't feel good. And that's a reason that patients don't seek help. So I hear this all the time in my practice. So we as a society need to value our older people more.

RASCOE: Kim Van Orden, co-director of the Center for the Study and Prevention of Suicide at the University of Rochester and a clinical therapist herself, thank you so much for joining us.

VAN ORDEN: Thank you so much for having this conversation, Ayesha.

RASCOE: And that number for the National Suicide and Crisis Lifeline, once again, is 988. Transcript provided by NPR, Copyright NPR.

NPR transcripts are created on a rush deadline by an NPR contractor. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.

Ayesha Rascoe is a White House correspondent for NPR. She is currently covering her third presidential administration. Rascoe's White House coverage has included a number of high profile foreign trips, including President Trump's 2019 summit with North Korean leader Kim Jong Un in Hanoi, Vietnam, and President Obama's final NATO summit in Warsaw, Poland in 2016. As a part of the White House team, she's also a regular on the NPR Politics Podcast.