Editor’s note: This article focuses on suicide, self-harm and other topics related to psychiatric distress. If you or a loved one is in crisis, call 988. Additional resources are available here.
Washington saw fewer suicide deaths last year than it has in the previous seven years, according to early data.
The change is a positive one. But experts say it’s difficult to explain what’s behind the apparent decrease — or to attribute it to one specific thing.
Data from the Washington State Department of Health showed that suicide deaths in Washington decreased by 6.6% last year, going from 1,278 deaths in 2023 to 1,193 in 2024.
Preliminary data from the Centers for Disease Control and Prevention’s database showed an even bigger decrease — 21% fewer suicide deaths in 2024 than the previous year. The data, as of Thursday, showed that 996 people died by suicide last year in Washington, a decrease from 1,259 the previous year.
Raechel Sims, a spokesperson for the Department of Health, said early numbers may vary between the two organizations due to differences in time of reporting. And, she noted, the data is subject to change.
Still, the potential for a decrease is promising, as suicide rates have risen over the past two decades. As of 2023, the rate of suicides in Washington remained higher than the national rate. According to the CDC, suicide rates climbed 37% between 2000 and 2018. They dropped 5% between 2018 and 2020, but had peaked again by 2022 and stayed high, hovering around 14 deaths per 100,000 people nationally as of 2023.
Washington’s suicide rates have remained above the national rate since at least 2014, as far back as the CDC provides state data on its website. Rates remained fairly steady between 2014 and 2016, peaking in 2017 at 16.9 per 100,000 people. Rates have trended down since then, but ticked up again in 2023 to about 15.7 per 100,000.
Those who work in suicide prevention say it’s hard to point to one clear cause for any decline, especially for preliminary data.
Summer Starr, the interim director of the Washington chapter of the National Alliance on Mental Illness, said she was surprised by the CDC’s statistic, although pleasantly so.
She said without knowing statistics about suicidal thoughts and attempted suicide, it’s hard to know whether specific interventions are working.
Still, she said, it’s heartening to see lower numbers.
“Some things that come to mind in terms of interventions are things like our support groups, anti-stigma campaigns that are opening up conversations about mental health, Mental Health First Aid, which is giving people tools for how to have conversations with people they are worried about, and QPR training,” Starr said in an email, referring to the “question, persuade and refer” method of suicide prevention training. The method, which mental health professionals liken to CPR for its ability to intervene during an emergency, trains people to identify warning signs and ask people directly if they are considering suicide, then refer them to crisis services like 988 for immediate assistance.
Dr. Jeff Sung, a psychiatrist who works with the University of Washington’s Forefront Suicide Prevention program, declined to comment on the 2024 numbers because they’re still preliminary. But he said the framing of suicide, prevention and intervention bears a closer look.
Sung said suicide is often viewed as being tied to one specific cause or incident. But in reality, he said, determining who’s at risk for suicide is more complex, and factors span economic, interpersonal and public health circumstances.
The field of suicide prevention, he said, often includes two approaches: a high-risk or clinical angle, and a broader public health approach.
Crisis intervention programs, such as the 988 crisis line that launched in 2022, are vitally important, he said.
But many people who die by suicide, he said, don’t exhibit high-risk factors beforehand.
“So crisis, treatment services, even though those are incredibly important and such a part of what people need, it’s not clear that something that’s focused on a high-risk population would have broad effects on suicide rates,” he said.
What could have a broader effect on those rates, he said, are economic supports, interconnectedness with community and society, and sometimes, less access to lethal means like firearms.
He recalled the beginning of the pandemic. In 2020, he said, many Americans faced mental health crises as the rapid spread of COVID-19 forced people to isolate from their communities and their regular routines.
“There was so much discussion about how COVID introduced a mental health crisis in America, exacerbated existing disparities, social determinants of health, contributing to anxiety, alcohol and drug use,” he said.
But in 2020, he said, overall suicide rates decreased slightly.
Sung said those who study suicide are still trying to understand what happened during the pandemic.
Some psychologists, he said, have considered the societal “pulling together” that can happen when there’s a large event, either positive or negative. That connectedness, he said, can have a suicide prevention effect.
But looking at specific demographic groups, Sung said, suicide rates in 2020 did not always go down.
For Black men and American Indian and Alaska Native men and women, suicide rates continued to rise.
“So that means somehow, economic factors, interpersonal factors, alcohol use, drug use, mental health conditions, interpersonal connectedness, coping, firearm accessibility, toxic substances — everything came together in a way that suicide rates drifted up or down for certain age groups or demographics,” he said.
Sung said the public health approach to suicide prevention, which focuses on broader health and social conditions, can also help prevent other types of premature death.
He recalled his time working at Harborview Medical Center’s Pioneer Square Clinic, treating homeless patients. People who would come in with a history of trauma, abuse, neglect and substance use, could be more susceptible to a variety of things, he said — suicide, accidental death, death from drug use, homicide.
Increasing social connectedness, access to support services and treatment could decrease the risk of all those causes of premature death, Sung said.
But framing that as suicide prevention can be challenging, especially when seeking out funding for programs that are looking for obvious, direct impacts.
Funding also tends to skew toward suicide prevention for people aged 24 and under, Sung said.
But adults over 25 account for the majority of suicides, he said.
“We want the investment in suicide prevention across the life span to match the investment in younger populations,” he said.
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