The suicide rates in the US have been on a steady climb for decades, inching up nearly every year since 1999. In 2020, however, rates and numbers dropped by 3% overall, according to a report released in November from the National Center for Health Statistics.
There was a noticeable drop, 14%, in April 2020, when many cities began declaring pandemic-related lockdowns.
The year was rife with economic uncertainty, job loss, and grief due to the pandemic, protests over systemic racism, and a contentious presidential election. Income and job stress can be suicide risk factors, and the report noted there was an increase in anxiety, depression, and substance abuse.
The US National Suicide Prevention Lifeline is 1-800-273-8255. The Trevor Project, which provides help and suicide-prevention resources for LGBTQ youth, is 1-866-488-7386. Find other international suicide helplines at Befrienders Worldwide (befrienders.org).
“There was concern that suicide would also increase,” said Sally Curtin, an NCHS statistician and the report’s lead author. “I think some people will be surprised by these findings.”
Rates did dip by 2% in 2019 — the first time in a decade — before the 2020 drop. Other than that, suicide rates have for decades mostly increased each year, going up 35% between 2000 and 2018, Curtin said.
“I have been working on this for years now, and it seems like it was just going up, up, up,” she told BuzzFeed News. “So the 2% drop between 2018 to 2019, and then this further 3% drop, is encouraging.”
Suicide is complicated and can also be driven by a person’s relationships, community, and societal factors, said Deb Stone, a lead behavioral scientist at the CDC’s National Center for Injury Prevention and Control.
“While it may seem counter-intuitive to see reductions in suicide during the pandemic, given increases in risk factors, this pattern is not unprecedented,” she said in an email. “Based on prior disasters, suicide rates sometimes dip only to go back up again after the immediate crisis has passed.”
A second study published in the Lancet earlier this year looked at 21 different countries, all middle to high income, and found similar overall declines, Curtin said.
The numbers are preliminary and need to be confirmed, particularly because it can take time to determine if overdose deaths are accidental or intentional. The overall trend in suicide rates is not expected to change. However, the final count may impact the numbers in some groups of people, such as women, among whom this is a more common suicide method than among other groups of people.
Suicide rates did not go down among young adults or Black, Latinx, and Native American men
In the US, the declines were mostly driven by a drop in suicides among certain groups, including white people, women, and middle-aged and older adults.
There was a decline in suicides among women 35 and older, with the biggest drop in women between the ages of 45 and 64 (who are at the highest risk for suicide among women of any age group).
In people ages 10 to 34, the rates stayed the same or increased. For example, rates increased by 5% for people ages 25 to 34, according to the report.
There was a 10% drop in white women and a 3% decline in white men. However, suicide rates stayed the same or increased among Black, Latinx, and Native American men.
Native Americans have the highest suicide rates of any ethnic group in the US, and that didn’t change in 2020.
In Native Americans and Alaska Natives, there were 35.8 suicide deaths per 100,000 men and 11.6 per 100,000 women. Compared to white people, the group with the second-highest rate, there were 27.1 suicides per 100,000 men and 6.9 per 100,000 women.
“We must remain vigilant, and work to address suicide in populations disproportionately impacted,” Stone said.
A separate study looked at suicide risk in the LGBTQ community
The NCHS report didn’t specifically look at suicide rates in people based on their sexual identity, in part because the agency didn’t have that information. But experts say this can be a major risk factor, especially for young people.
“One of the biggest problems is that death investigations don’t collect data on sexual identity,” said Rajeev Ramchand, a senior adviser on epidemiology and suicide prevention at the National Institute of Mental Health.
Ramchand and colleagues published a study in November in the American Journal of Preventive Medicine that found that, compared to heterosexual people, lesbian, gay, and bisexual people have three to six times more risk of having suicidal thoughts, plans, and attempts. That was true regardless of their age group, race, and ethnicity.
The researchers looked at survey data from more than 190,000 people collected between 2015 and 2019, so they did not have information for the pandemic years.
They found that suicidal thoughts or attempts tended to decline in heterosexual men and bisexual and lesbian women with age, but this wasn’t consistently true in gay or bisexual men.
“The thinking is that you struggle as a young person and then you come out and it’s all Pride parades and rainbows,” Ramchand said. However, the findings suggest that outreach and interventions should not be limited to young people.
It was more common for bisexual women than gay women to have suicidal thoughts, according to the report. Black women had lower rates of suicidal thoughts and plans than white women, regardless of sexual identity.
“I think there are groups that we need to be looking at a little more carefully,” Ramchand said. “Sometimes we need to look at subgroups of subgroups to better identify where we tailor our interventions.”
There are some pandemic factors that may have contributed to the drop
Risk factors for suicide are complex and can vary by subgroup, so It’s hard to tell what factors may have affected the 2020 rates, Ramchand said.
Teens might be at greater risk due to bullying or social media use, while veterans and members of the military might have other health conditions, such as PTSD, that may play a role.
“I think we need to be looking at multiple subpopulations,” he said. “I don't think there is one overarching story.”
During the pandemic, some relationships might have been strengthened by spending more time together, despite the mental health impact and uncertainty of lockdown.
“For some people, everyday stresses might have been reduced during stay-at-home periods, and for others, the collective feeling of ‘we’re all in this together’ might have been beneficial,” wrote the authors of the Lancet study.
Ramchand suggested that it's possible "it wasn't as bad to feel socially isolated" because virtually everyone shared this common experience.
It’s possible that the effects of job loss on suicide risk may be mitigated by social programs and economic support, as happened during the pandemic, Ramchand said. In some ways, a nationwide phenomenon that leads to job loss may not be as isolating as an individual losing their job alone.
“If everyone is losing their job, it’s possible your job loss might not feel as immediate or impactful,” Ramchand said. “What worries me is who gets left behind in the rehiring?”
During disasters in general, people may "come together through a shared sense of community and the desire to cooperate and help," Stone said. "This type of connectedness can buffer against suicide through improved mental and physical health."
When people engage and connect during troubled times, they may learn about resources and find support that they may not otherwise have known existed, she said.
Here’s how to get help for yourself or someone else
If you have thoughts of suicide, the first thing to do is tell someone. “Talk to someone you trust so that they can help,” Stone said.
You can reach out to the US National Suicide Prevention Lifeline at 1-800-273-8255 (TALK) or text the word “start” to 741741.
“These services are available 24/7 and are free. Trained counselors can direct you to helping services,” she said. “If you are in immediate danger go to the nearest emergency department or call 911.”
Anyone can call the suicide prevention lifeline, including people who are concerned about a friend or family member, Ramchand said. If you have repetitive thoughts of self-harm, known as suicidal ideation, mental health professionals have science-backed approaches that can help, he said.
Keep looking to find the right person and consider telehealth, which research suggests is just as good as meeting in person, he said. If you live in a rural community or don’t have internet, a phone call can help.
“You may have to shop around to find the right person,” Ramchand said.
He recommends finding a therapist or counselor who has experience helping people with the issues you are facing. “If you are gay or bisexual, say, ‘I’m gay. Do you have experience and competencies working with gay men?’” he said.
“Decreases in suicide are of course always welcomed, however, we cannot rest, because rates are still much too high,” Stone said. “We cannot rest when we see rates in some groups going in the wrong direction.”