In the past two decades, New York City has seen a decline in overall suicide rates.1 The Department of Health and Mental Hygiene (DOHMH) recently announced that the suicide rate in NYC is approximately half that of the national suicide rate.1 Yet, the actual number of suicides is high: approximately 475 New Yorkers commit suicide annually—about nine a week.1
In order to better understand suicide risks and design prevention strategies, DOHMH conducts public health surveillance of suicide. Public health surveillance is the ongoing collection and analysis of data for the purposes of monitoring the health of a community and identifying high risk groups. Surveillance activities at DOHMH are diverse and include everything from tracking disease outbreaks to conducting annual community health surveys. Surveillance activities around suicide are a priority at DOHMH. Specific surveillance efforts include monitoring rates of suicide based on death records and reviewing records from the NYC Office of the Chief Medical Examiner. These activities provide the information DOHMH needs to understand the circumstances and risk factors related to suicide deaths, identify those populations at greatest risk, and plan prevention efforts.
As is the case nationally, in New York City suicide rates are lowest among young adults, black and Hispanic New Yorkers, and highest among white New Yorkers and men. Approximately three quarters of New York City’s suicides in 2007 and 2008 were committed by men.1 The most common method of suicide in NYC is by hanging, accounting for 28% of all suicides, followed by jumping from high buildings (18%).
Suicide can be prevented. Preventing the tragedy of suicide should involve a multi-pronged approach, including clinical, environmental, and community approaches. Clinical approaches aimed at identifying and treating depression and substance abuse are an important part of a comprehensive suicide prevention strategy. According to a recent review of the NYC medical examiner files, 64% of New Yorkers who had committed suicide had a documented history of depression.1 Alcohol use is also frequent at the time of suicide1.
As part of the clinical approach to preventing suicide, DOHMH is working to increase depression screening, diagnosis and treatment. Through publications and health bulletins, the Health Department provides information and resources to help physicians and mental health professionals recognize and effectively treat mental illness. Physicians should routinely screen patients for depression using a simple 2-item tool called the Patient Health Questionnaire-2 (PHQ-2).
Environmental approaches are also effective at reducing the likelihood that certain methods of harming oneself are within reach. New York City has one of the strictest gun control policies in the nation, making it difficult for people to obtain and carry a gun. Although nationally, firearms account for more than half (53%) of all suicides, in NYC firearms are responsible for only 16% of suicides. The low suicide by firearm rate may be partially attributed to the City’s enforcement of gun control laws.2
Although important suicide prevention strategies are already being implemented in NYC, there is still more work to do. Suicide prevention does not rest only with clinical and environmental strategies. We can all play a part in making sure our friends, family members, neighbors and co-workers are connected to the services and supports they need to live full, healthy lives. Jennifer Marcum, DrPH, is an Injury Research Scientist in the Injury Surveillance and Prevention Program, Bureau of Environmental Disease Prevention, Division of Environmental Health, at the NYC Department of Health and Mental Hygiene.
Dilruba Khanam, BA, is a Graduate Intern, in the Office of Research and Evaluation, Bureau of Mental Health, Division of Mental Hygiene, at the NYC Department of Health and Mental Hygiene.
Catherine Stayton, DrPH, MPH, is Co-Director of the Injury Surveillance and Prevention Program, Bureau of Environmental Disease Prevention, Division of Environmental Health, at the NYC Department of Health and Mental Hygiene.
Kate McDonald, DrPH, is a Senior Researcher in the Office of Research and Evaluation, Bureau of Mental Health, Division of Mental Hygiene, at the NYC Department of Health and Mental Hygiene.
References
- Coyle, E., Stayton, C., Ha, J., Norman, C., Sadler, P., Driver, C., Heller D., Singh, T., Olson, C., Suicide and Self-inflicted Injuries in New York City. NYC Vital Signs 2012, 11(1):1-4.
- NYC Media Release: Health Department Announces Suicide Rate in NYC Is Half of the National Rate and Is Lower Than Other Major U.S. Cities. February 2012.
