Suicide assessments

Acknowledgements: The authors wish to thank Dr. J. Raymond DePaulo for his helpful comments and suggestions. Background and introduction Worldwide each year approximately 1,000,000 people die by suicide. Using the most recent national data, in 2008 in the US, over 36,000 people died by suicide. [CDC, WISQARS, 2011] In the US in 2009, the number of emergency department (ED) presentations for self-harm was 374,486. Suicide, which has tripled among young males in the US since the 1950s, is the third leading cause of death among 10 to 24 year olds and accounts for 12% of all deaths amongst 15 to 24 year olds. Completed suicides “represent only the tip of the public health iceberg.” Rates of suicidal ideation and suicide attempts are significantly higher than suicide rates, with an estimated 10–200 suicide attempts for each completed suicide. However, these numbers may be even higher. Suicide rates are likely underestimated due to state or religious sanctions on reporting, insurance considerations, family and community sensitivity, the variation in professions and qualifications of individuals entrusted with the delineation of suicide, and issues involving how to define suicide.