Indiana University       Research & Creative Activity      September 2001 • Volume XXIV, Number 2

Calling it Quits

by Walton R. Collins

When it comes to suicide, psychologist John L. McIntosh is a walking encyclopedia.
He can tell you, for example, that 30,575 Americans killed themselves in 1998, that this translates into one suicide every 17.2 minutes, that suicide ranks as the eighth leading cause of death in this country, well ahead of homicide, which ranks 13th.

He’ll tell you that the preferred method of ending one’s life is with firearms or explosives; that hanging, strangulation, and suffocation rank second; that jumping from a high place barely makes a footnote in the statistics. He’ll tell you that 80 percent of all suicides are committed by men and that 90 percent of those men are white. He’ll tell you that the highest-risk states are Nevada, Alaska, and Wyoming.

But all of this is secondary to his 20-year effort to dispel a stubborn myth about suicide: “Most people believe young people in the 15-to-24 age range are most at risk,” says McIntosh. “They’re rather shocked to learn that older adults kill themselves at a higher rate than the young.”

He was shocked himself when he looked closely at the numbers while working on the dissertation that earned him his doctorate from Notre Dame in 1980. Those numbers left no doubt about which population cohort committed suicide most frequently. And the numbers still say the same thing today, even though rates for older adults have gone down substantially while those for young people have risen.

“There’s still a gap,” McIntosh says. “The rate for older adults today is 17 suicides per 100,000 people, for young people only 11 per 100,000. The gap is not as large as it once was, but it’s still nearly 50 percent.”

McIntosh, who is professor of psychology and chair of the IU South Bend psychology department, can also cite more upbeat numbers: There’s been a downward trend in all suicides in this country since 1933, with a few blips here and there that generally seem to be tied to bad economic times. Only one of every 25 suicide attempts is successful. And despite its high rate among the elderly, suicide accounts for less than half of 1 percent of all older adults’ deaths, and barely ranks in the top 15 causes of death for that cohort.

John McIntosh is professor of psychology and chair of the psychology department at Indiana University South Bend. Photo Gary Mills.

McIntosh has been teaching at IU South Bend since 1979. The 1990 recipient of the American Association of Suicidology’s prestigious Edwin Shneidman Award, he has published six books and numerous articles in professional journals. Correlations are hard to pin down in his field of research, but it’s abundantly clear to McIntosh that two factors are decisively linked to suicide: money and health.

“If you’ve got those, you’re pretty much in good shape no matter what,” he says, adding: “Economics plays a role at global and macro levels as well as micro levels. Suicide rates go down in good times and up in bad. This is true of suicide rates in general, but older adults show the pattern to a greater extreme.”

From the Depression years of the 1930s, there has been a clear trend downwards. The economic travails of the 1980s bumped rates up, but the nifty ’90s brought them down again—although there was a small, short-lived increase early in the last decade that puzzles McIntosh: “It seems to have been one of those fluctuations that happen,” he says with a shrug.

If economics is one key variable, health is another. Most people today reach their senior years in better health than their counterparts in former times, notes McIntosh, “and it’s likely that older adults in the next wave will be a little bit healthier still.

“The feeling of well-being among the older adult population is important background information,” Macintosh continues, “and I think it’s a major reason why older adult rates since the 1930s and 1940s have shown a decline. Older people do feel a sense of greater security now. There’s Social Security, for one thing. And people are thinking a little more about preparing for retirement. In addition, we have the promise of longer life and being better off financially.”

McIntosh believes his research has clear implications for public policy. “It shows that we truly need to be mindful of issues like Social Security, Medicare, Medicaid, prescription drug coverage, and long-term care. These issues are at a really crucial point right now. If we don’t do the necessary planning to resolve them, we’ll still be facing them in 20 years, but it’ll be too late for the baby boomer generation.”

Indeed, some observers predict that when boomers reach later life, suicide rates could mushroom. McIntosh understands the reasoning but he is skeptical. Although he acknowledges that “the boomer cohort has higher rates of depression, which could increase suicides, this may be balanced out because boomers are more likely than their predecessors to ask for help. Mental health services are seen as less of a stigma than they were by previous cohorts.”

McIntosh believes his research has equally pertinent implications for aging well. “When we talk about mental health issues, we generally talk about the mentally unhealthy, so suicide becomes a focus. Clearly, many older adults are finding enough satisfaction that they don’t reach the threshold of psychological pain that leads to suicide. They may be unhappy, but they don’t hit that threshold.”

Statistics aside, McIntosh is ever mindful that suicide is an individual decision, one that may be triggered by the death of a loved one, uncontrollable pain, social isolation, or physical illness. Other risk factors are depression and abuse of alcohol or drugs. Most people who commit suicide send out signals, often verbal, and McIntosh urges caregivers to the elderly to watch for changes in eating or sleeping habits, trouble concentrating, sudden indecisiveness, crying, withdrawal from family and friends, loss of interest in personal appearance, and preoccupation with death. Caregivers should take these clues seriously, he says, and not be afraid to ask directly if a loved one is thinking about suicide. Such a question usually will elicit an honest answer.

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