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For decades, suicide and other fatal and non-fatal forms of self-harm has been a crucial public health concern, worsened by the health and social isolation (Steelessmith et al., 2019) effects of the COVID-19 pandemic. According to the World Health Organization (“WHO”), approximately 800,000 persons commit suicide globally each year, one every 4 seconds (World Health Organization, 2021). If estimates are accurate that 10-20 non-fatal suicide events also occur for every death, then 16 million people across the globe may be attempting suicide every year (World Health Organization, 2021). Per 100,000 people, the average global suicide rates in 2016 for both sexes was 10.6, for females is 7.7, and for males was 13.5 (World Health Organization, 2021). By gender the highest number of suicides occurred with males in Europe (26.7) and the Americas (15.1), while the highest numbers for females were in South-East Asia (11.6) and the Western Pacific (9.4) (World Health Organization, 2021). By country the highest rate of suicide in 2016 was found in Lithuania where per 100,000 persons both sexes averaged 31.9, females numbered 9.5, and males were 58.1 (World Health Organization, 2021). Globally the United States’ ranked 27th (World Health Organization, 2021) in suicides, while within the United States suicide was the 10th leading cause of death in general and the second leading cause among people aged 10 to 34 (Hedegard et al., 2018). Although suicide rates globally have declined since 2000, in the United States the age adjusted suicide rate increased by 30% (Hedegard et al., 2018). Currently available data does not include the effect of the pandemic on suicide rates, which are believed to be both globally and domestically higher in 2020 and 2021.
The relationship between substance abuse and suicide reaffirms the public health nature of this issue. A 2002 systematic review of studies linking mental disorders with persons who died by suicide showed that 98% of them had a diagnosable mental disorder (Bertolote & Fleischmann, 2002). Later evidence from the Substance Abuse and Mental Health Services Administration (“SAMHSA”) states that substance abuse is also a “significant factor” that is linked to suicide and self-harm. Approximately 1 in 12 (21.5 million) persons in the US had a substance use disorder in 2015 (Centers for Disease Control and Prevention, 2020). According to the CDC, approximately 22% of deaths by suicide involved alcohol intoxication, while opiates were present in 20%, marijuana in 10.2%, cocaine in 4.6%, and amphetamines in 3.4% of suicide deaths (Centers for Disease Control and Prevention, 2020). According to the CDC, beyond mental health issues, other circumstances that are connected to suicides and suicide attempts are intimate partner problems (31.2%) and a crisis preceding or impending 2 weeks (26.4%) (Centers for Disease Control and Prevention, 2020). Physical health problems (22.3%), job concerns (15.4%) and financial issues (13.6%) respectively impacted suicidal choices (World Health Organization, 2014).
The societal harms of suicide include significant economic costs. According to an article published in the journal, Suicide and Life-Threatening Behavior, the national economic costs of reported suicides and suicide attempts in the United States in 2013 was $58.4 billion (Suicide Prevention Resource Center, 2015). The lost productivity of individuals connected to suicides or suicide attempts represent over 97% of these costs (Shepard et al., 2016). Indeed, if suicide and suicide attempt data are adjusted to include under-reported data, the total cost to in the United States alone approaches $93.5 billion (Shepard et al., 2016). In Australia, researchers determined that the present value of the economic costs of suicide and Non-Fatal Suicide Behavior (“NFSB”) was approximately $6.73 billion (Kinchin & Doran, 2017).