‘84 Youth Suicides a Blip in 7-Year Drop, Report Says

A 1984 youth suicide “epidemic” was a statistical quirk, not a crisis, that obscured a seven-year decline in suicide rates among young Americans, according to a government study released Tuesday.

The analysis also found that young people--especially white males 20 to 24--have come to dominate U.S. suicides, which historically had been overwhelmingly a problem of the old. And the most common means of suicide--in nearly two-thirds of the cases--is a gun, the report said.

Still, suicide rates among Americans 15 to 24 have been dropping continuously since peaking in 1977--with only a fleeting drift upward in 1984, researchers at the Centers for Disease Control concluded.

The rate for California also has fallen and is comparable to the national level. However, with its large population, California leads the nation in total youth suicides. The state also experienced the small rate increase that was felt nationally in 1984.

What happened in 1984 was a series of statistically improbable and unexplained suicide clusters, which gave the impression that youth suicide had reached a new level, attracting widespread national attention, the report said. News magazines put the story on their covers; television produced at least four movies on the subject.

Goal Set for 1990

Health and Human Services Secretary Otis Bowen told a conference here on youth suicide that he has set a 1990 goal of reducing youth suicide to a rate of 11 deaths per 100,000--from the current estimate of 12.

However, the head of a departmental youth suicide task force said government experts fear aging patterns among American young people may make another crisis-like peak in rates likely again in 1991. In 1977, the rate hit 13.6 and deaths totaled 5,565.

The new statistical analysis by the Centers for Disease Control found that in the 1970s, nearly 50,000 American young people took their lives. During the decade, guns--especially handguns--came to dominate youth suicide as no single means ever has, with 62.2% of such deaths due to firearms by 1980, up from 47.2% 10 years before. Drug overdose and poisoning plunged to just over 10% of such deaths from 20.9%.

The analysis underscored what a cross-section of experts at the conference said has been widely known in suicide study circles for the last two years--that 1977, not 1984, was the nation’s watershed year for youth suicide.

In concentrating erroneously on what was depicted at the time as a sudden, unforeseen epidemic of youth suicide, media and public agencies failed to discover that the events of 1984 masked another far more significant and unsettling development in youth suicide.

It was an enormous alteration of the demographics of suicide, with young people replacing the elderly as those stricken most by the problem. Suicide now ranks as the second most common cause of death for people 15 to 24, whose rate of killing themselves rose from 4.5 suicides per 100,000 population in 1950 to 12.3 in 1980, the last year included in the new CDC study. For the first time, the suicide death rates for the young have exceeded the oldest segments of the population.

Since 1980, the youth suicide rate has remained essentially unchanged except for minor year-by-year variations. The rate dropped to 11.9 in 1983 but then rose to 12.4 in 1984--with a preliminary estimate of incidence in 1985 of 12.

California has confounded the national trend that has its apparent roots 30 years ago. In the 1970s--the focus of the new CDC analysis--California defied a national trend in which youth suicide rates rose from 8.8 to 12.3 per 100,000. California’s rate dropped instead, from 17.7 in 1970 to 12 in 1980, though the state joined the rest of the country in experiencing an increase in 1977.

California is the only state to experience not just a drop in rates (Utah’s also went down) but a decline in the number of young people killed by suicide--from 632 in 1970 to 548 a decade later. In 1977, the state’s rate rebounded to 18.9 per 100,000 young people, with a total of 791 dead.

State Leads Nation

California, because of its large population of young people and other factors social scientists concede they do not understand, has long had the distinction of having more youthful deaths due to suicide than any other state--by far. California surpasses the second-greatest toll--New York’s--by more than 250 young people killed. There is no factual explanation for California’s deviation from the national norm on which researchers agree.

Moreover, concentrated national attention by news and entertainment media and public officials and agencies to the events of 1984 amounted--in the words of Dr. Shervert Frazier, director of the National Institute of Mental Health--to “misleading the public.”

Frazier was interviewed Tuesday where he was presiding at a national conference on strategies to prevent youth suicide. He heads the Department of Health and Human Services’ Task Force on Youth Suicide, which sponsored the conference. In depicting the events of 1984, Frazier said, news media and public officials failed to understand that in suicide, like in a variety of other diseases, small outbreaks occur continually. A suicide cluster occurred this past February in Northern California, for instance.

“Suicide is such a tragic event that it always attracts emotion,” Frazier said. “Statistically, 1984 was a quirk. If you say something is a major happening when it isn’t, you’re misleading the public.”

It was Frazier who revealed that another surge in suicide rates is possible in 1991. The periodic surges are due, Frazier said, to unexplained differences in suicide susceptibility among some age groups of young people born after World War II.

Little Hard Information

Frazier said government suicide experts are trying to devise strategies to intervene, but the conference heard speaker after speaker emphasize that suicide research has, of necessity, relied largely on guesswork with little available in the way of hard information on what makes a young person suicide-prone.

Other task force officials indicated some discomfort with Frazier’s identification of the fears for 1991. These officials said they were concerned about the possible effects of public anticipation of a hike in youth suicide rates.

In all likelihood, said Dr. Robert Litman, co-director of the Los Angeles Suicide Prevention Center and an internationally known expert in the field, youth suicide depends on a relatively large group of risk factors that thrust themselves into the young person’s life at once--oftentimes almost by chance.

“I compare it to the biggest slot machines in Las Vegas,” said Litman, “where they have seven things that have to line up to get a payoff. When you hit the jackpot, you can’t blame it on just one thing.”

The conference, which ended Tuesday, was convened to permit final debate on dozens of public policy recommendations by the task force due for official submission to Bowen early next year.

Dr. Mark Rosenberg, a CDC official who directed much of the task force activity, said that since 1950, the nation’s suicide patterns have been altered fundamentally. “People said suicide has always been with us and has stayed at about the same rate, so there really isn’t any need to do suicide surveillance,” Rosenberg said. “But something very basic has changed.”

Other Studies

Research prompted by the task force has already reached two potentially surprising conclusions. In one study at Columbia University in New York, a team has observed that, contrary to the assumptions of most psychiatrists, psychologists and laymen, fewer than half of all young suicide victims suffer from depression. The finding, which flies in the face of the basic tenets of suicide prevention and education programs, indicates that other mental health disorders--specifically schizophrenia--and drug abuse may play a more significant role in suicide in the young than depression.

And in another research study, reported at the conference Tuesday, a team at the National Institute on Alcohol Abuse and Alcoholism has found that concentrations of a chemical found in spinal fluid may influence suicidal behavior. The chemical is called 5-hydroxyindoeacetic acid. Swedish researchers working in the same field have agreed that the implication of the finding, may be that children from families where there is a history of suicidal behavior and abnormal concentrations of the spinal fluid component may have as high as a 30% suicide rate, reported the national institute’s Dr. Markku Linnoila.

Because basic research on youth suicide questions has so far been almost nonexistent, dozens of task force recommendations were weighted heavily in favor of far greater study of the organic and nonorganic causes of suicide. But Bowen said the Reagan Administration does not intend to release additional funds for study in the field.

At the moment, according to an analysis presented just after Bowen spoke, only $300,000 of the $4 million earmarked for National Institute of Mental Health suicide research support, will be spent on youth suicide projects. The amount is due to increase to $1.5 million, but that figure would still be less than 2% of the institute’s budget, analysts concluded.

Bowen said the Administration intends to focus instead on emphasizing the role of families in suicide prevention. “So often in the past, the nation has sought pocketbook remedies,” Bowen said. “I do not believe creating a costly new bureaucracy and calling that the answer should be our goal.

“The role of the family has been given too little attention in recent years.”