October 30, 2012

Suicidal Thoughts and Behavior in 33 Metropolitan Statistical Areas: 2008 to 2010

Suicide is a major public health problem in the United States and a tragedy for all involved—family, friends, neighbors, colleagues, and communities. In 2008, suicide was identified as the 10th leading cause of death in the United States.¹ Individuals who die from suicide, however, represent a fraction of those who consider or attempt suicide, and research suggests that there may be between 8 and 25 attempted suicides for every suicide death.² Suicide is a public health concern that transcends State and regional borders. Research has shown that reported prevalence of serious suicidal thought, suicidal planning, and suicide attempts vary across States and across areas within States.^3,4 Data on metropolitan areas provide additional insight into the distribution of adults with suicidal thoughts and behaviors and help State and local public health authorities to better understand and effectively serve their communities.

The National Survey on Drug Use and Health (NSDUH) can help address the need for more localized information on suicidal thoughts and behaviors. This issue of The NSDUH Report presents estimates of serious suicidal thought, suicidal planning, and suicide attempts among those aged 18 or older in 33 metropolitan statistical areas (MSAs) (Table 1); comparisons are made between each MSA and the Nation as a whole.⁵ In the 2008 to 2010 NSDUHs, all adult respondents were asked whether they had thought seriously about trying to kill themselves at any time during the past 12 months; those who reported having had serious thoughts of suicide were then asked whether, in the past 12 months, they had made any plans to kill themselves and whether they had tried to kill themselves. The MSAs were selected based on a combination of the available data and the intent to get population representation and regional coverage in the Department of Health and Human Services regions.⁶ All estimates in this report are annual averages based on the combined 2008 to 2010 data. Only differences in estimates that are statistically significant are discussed in the text.⁷

The 2008 to 2010 combined data indicate that about 1 in 26 (3.8 percent; 8.5 million) adults aged 18 or older had serious thoughts of suicide in the past 12 months (Table 2). Rates ranged from 2.0 percent in the Raleigh MSA to 6.5 percent in the Salt Lake City MSA (Figure 1). Among the 33 MSAs, Houston (2.7 percent), Kansas City (2.4 percent), and Miami (2.4 percent) had rates of adults with serious thoughts of suicide that were lower than the Nation as a whole. No MSAs had rates of adults with serious thoughts of suicide that were significantly higher than those in the Nation as a whole.

Figure 1. Serious Thoughts of Suicide in the Past Year among Persons Aged 18 or Older, by Metropolitan Statistical Area (MSA): 2008 to 2010

Nationwide, about 1 percent of adults aged 18 or older (2.4 million) made any plans to commit suicide in the past 12 months (Table 2). Rates ranged from 0.2 percent in the Atlanta and Raleigh MSAs to 1.9 percent in the Las Vegas MSA (Figure 2). Among the 33 MSAs, the rates of suicide planning were lower than the national average in Atlanta (0.2 percent), Cleveland (0.6 percent), Miami (0.5 percent), Pittsburgh (0.5 percent), Raleigh (0.2 percent), San Francisco (0.5 percent), Tulsa (0.4 percent), and Washington (0.5 percent). Again, no MSA rates were significantly higher than those in the Nation as a whole.

Figure 2. Suicide Plans in the Past Year among Persons Aged 18 or Older, by Metropolitan Statistical Area (MSA): 2008 to 2010

Based on combined 2008 to 2010 data, about 1 in 20 (0.5 percent; 1.1 million) adults aged 18 or older made a suicide attempt in the past 12 months (Table 2). Rates ranged from less than 0.1 percent in the Raleigh MSA to 0.8 percent in the Dallas MSA (Figure 3). Among the 33 MSAs, Atlanta (0.1 percent), Boston (0.2 percent), Kansas City (0.2 percent), Philadelphia (0.2 percent), Portland (0.2 percent), Raleigh (<0.1 percent), San Diego (0.2 percent), St. Louis (0.2 percent), and Washington (0.2 percent) had rates that were lower than the Nation as a whole. No MSAs had rates of adults attempting suicide in the past year that were significantly higher than those in the Nation as a whole.

Figure 3. Suicide Attempts in the Past Year among Persons Aged 18 or Older, by Metropolitan Statistical Area (MSA): 2008 to 2010

Suicide is a public health problem that transcends geographical boundaries. Behind the statistics on completed suicides are the troubling large numbers of Americans who think about, plan for, and attempt suicide every year. Preventing suicide and addressing the health care needs of persons at risk for suicidal behavior require public health information-sharing efforts that raise awareness and explain that effective preventive interventions exist. Highlighting the prevalence of suicidal thoughts, plans, and attempts in metropolitan areas may help Federal, State, and local policymakers continue to plan for and allocate resources to reduce the stigma associated with mental and emotional problems and mental health treatment seeking. Further research on additional factors associated with geographic variations in the prevalence of suicidal behaviors is needed to help guide the development of screening tools and prevention and treatment programs.

This page was last updated on October 11, 2010.