Older Suicide Decedents: Intent Disclosure, Mental and Physical Health, and Suicide Means

Introduction: This study examined: (1) associations of suicide intent disclosure with depressed mood and health problems; (2) age-group differences in those associations; and (3) relationship between disclosure and suicide means among suicide decedents aged >= 50 years (N=46,857). Methods: Data came from the National Violent Death Reporting Systems, 2005-2014. Data analysis was conducted in 2017. Chi-square tests were used to compare disclosers and nondisclosers on sociodemographic and precipitating factors and suicide means. Logistic regression analyses were used to examine the research questions. Results: The overall disclosure rate was 23.4%. Logistic regression results showed that both depressed mood (AOR=1.57, 95% CI=1.50, 1.65, p < 0.001) and health problems (AOR=1.56, 95% CI=1.48, 1.64, p < 0.001) were associated with increased odds of disclosure. Compared with decedents aged 50-59 years, those aged 70-79 years and >= 80 years had greater disclosure odds. When interaction terms of age group X health problems were entered in the model, disclosure odds increased among those with health problems in the groups aged 60-69 years (ratio of AOR=1.19, 95% CI=1.06, 1.34, p=0.003), 70-79 years (ratio of AOR=1.29, 95% CI=1.13, 1.48, p < 0.001), and >= 80 years (ratio of AOR=1.41, 95% CI=1.20, 1.66, p < 0.001). Compared with other suicide means, both firearm use and hanging/suffocation were associated with lower disclosure odds. Conclusions: The older the decedents were, the more likely they were to have disclosed suicidal intent, and health problems largely explained their higher odds of disclosure. Healthcare providers need better preparation to screen and aid those in need to prevent suicide. Social support system members should also be assisted in identifying warning signs and linking older adults to services. (C) 2017 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.