In 2008, an estimated 8.3 million adults aged 18 or older (3.7 percent of the adult population) had serious thoughts of suicide in the past year, 2.3 million (1.0 percent) made a suicide plan, and 1.1 million (0.5 percent) attempted suicide
Young adults aged 18 to 25 were more likely than adults aged 26 to 49 and those aged 50 or older to have had serious thoughts of suicide (6.7 vs. 3.9 and 2.3 percent, respectively), to have made any plans for suicide (1.9 vs. 1.1 and 0.7 percent), and to have attempted suicide (1.2 vs. 0.4 and 0.3 percent)
Of the adults who attempted suicide in the past year, 62.3 percent received medical attention for their suicide attempts, and 46.0 percent stayed overnight or longer in a hospital for their suicide attempts
Suicidality is a major public health problem that affects many Americans and their families every year. Suicidality ranges from suicide ideation (i.e., thoughts of suicide and making suicide plans) to suicide attempts to completed suicide. Over 32,000 adults committed suicide in 2006;1 however, these represent only a fraction of the individuals who consider or attempt suicide. Gaining a better understanding of suicidal thoughts and behaviors among adults may help to identify individuals at risk for suicide, to inform the development of screening tools, and to inform mental health and general practitioners on treatment planning.
Responding to a need for national data on the prevalence of suicidality, a brief series of questions on suicidal thoughts and behaviors was added to the National Survey on Drug Use and Health (NSDUH) questionnaire in 2008. In previous NSDUHs, suicidality questions were asked in the module on major depressive episode (MDE), and suicidality estimates could be generated only for persons who met the criteria for MDE. The new 2008 questions ask all adult respondents aged 18 or older if they had serious thoughts of suicide in the past year. If they had serious thoughts of suicide, respondents were asked if they made plans to commit suicide and if they attempted suicide in the past year. If they reported having made a suicide attempt, respondents were asked if they received medical attention for their suicide attempt; if they received medical attention, they were asked if they stayed in a hospital overnight or longer for their suicide attempt.
This issue of The NSDUH Report examines suicidal thoughts and behaviors among adults aged 18 or older; data are presented by age group, gender, and past year substance use disorder.2 All findings in the report are based on 2008 data.
Suicidal Thoughts and Behaviors
An estimated 8.3 million adults (3.7 percent of the adult population) had serious thoughts of suicide in the past year, 2.3 million (1.0 percent) made a suicide plan in the past year, and 1.1 million (0.5 percent) attempted suicide in the past year. Table 1 displays the numbers of adults who made suicide plans and attempted suicide among those who had serious thoughts of suicide; not all persons who attempted suicide had made a suicide plan. Among the adults who had serious thoughts of suicide, most (5.8 million) had not made a suicide plan or suicide attempt. Approximately 1.4 million adults had serious thoughts of suicide and made a suicide plan, but had not made a suicide attempt; 0.2 million had serious thoughts of suicide and made a suicide attempt, but made no suicide plan. An estimated 0.9 million had serious thoughts of suicide, made a suicide plan, and actually attempted suicide.
Table 1. Suicidal Thoughts and Behaviors in the Past Year among Adults: 2008
Suicidal Thoughts and Behavior
Number (in Millions)
Serious Thoughts of Suicide
8.3
Made Suicide Plan
2.3
Made Suicide Plan and Made Suicide Attempt
0.9
Made Suicide Plan but Did Not Make Suicide Attempt
1.4
Did Not Make Suicide Plan
6.0
Did Not Make Suicide Plan but Made Suicide Attempt
0.2
Did Not Make Suicide Plan and Did Not Make Suicide Attempt
5.8
Source: 2008 SAMHSA National Survey on Drug Use and Health (NSDUH).
Suicidal Thoughts and Behaviors, by Demographic and Other Characteristics
Rates of serious thinking about suicide, making plans for suicide, and attempting suicide were higher among young adults aged 18 to 25 than among adults aged 26 to 49 and those aged 50 or older (Figure 1). For example, 6.7 percent of adults aged 18 to 25 had serious thoughts of suicide in the past year compared with 3.9 percent of adults aged 26 to 49 and 2.3 percent of adults aged 50 or older. There was little difference in the rates of suicidal thoughts, plans, and attempts between females and males (Figure 2).
Figure 1. Suicidal Thoughts and Behaviors in the Past Year among Adults, by Age Group: 2008
Figure 1 Table. Suicidal Thoughts and Behaviors in the Past Year among Adults, by Age Group: 2008
Suicidal Thoughts and Behaviors
18 to 25
26 to 49
50 or Older
Had Serious Thoughts of Suicide
6.7%
3.9%
2.3%
Made Any Suicide Plans
1.9%
1.1%
0.7%
Attempted Suicide
1.2%
0.4%
0.3%
Source: 2008 SAMHSA National Survey on Drug Use and Health (NSDUH).
Figure 2. Suicidal Thoughts and Behaviors in the Past Year among Adults, by Gender: 2008
Figure 2 Table. Suicidal Thoughts and Behaviors in the Past Year among Adults, by Gender: 2008
Suicidal Thoughts and Behaviors
Male
Female
Had Serious Thoughts of Suicide
3.4%
3.9%
Made Any Suicide Plans
0.9%
1.1%
Attempted Suicide
0.4%
0.6%
Source: 2008 SAMHSA National Survey on Drug Use and Health (NSDUH).
Rates of serious thoughts of suicide, making plans for suicide, and attempting suicide were higher among adults with a past year substance use disorder than among those without a substance use disorder (Figure 3). For example, 11.0 percent of adults with a past year substance use disorder had serious thoughts of suicide compared with 3.0 percent of those with no past year substance use disorder.
Figure 3. Suicidal Thoughts and Behaviors in the Past Year among Adults, by Past Year Substance Use Disorder: 2008
Figure 3 Table. Suicidal Thoughts and Behaviors in the Past Year among Adults, by Past Year Substance Use Disorder: 2008
Suicidal Thoughts and Behaviors
Past Year Substance Use Disorder
No Past Year Substance Use Disorder
Had Serious Thoughts of Suicide
11.0%
3.0%
Made Any Suicide Plans
3.4%
0.8%
Attempted Suicide
2.0%
0.3%
Source: 2008 SAMHSA National Survey on Drug Use and Health (NSDUH).
Medical Attention for Suicide Attempts
Of the adults who attempted suicide in the past year, 62.3 percent (678,000 persons) received medical attention for their suicide attempts, and 46.0 percent (500,000 persons) stayed overnight or longer in a hospital for their suicide attempts.
Discussion
A large number of Americans think about, plan for, and attempt suicide every year. In 2008, an estimated 8.3 million adults had serious thoughts of suicide in the past year, 2.3 million made a suicide plan, and 1.1 million attempted suicide. Rates of suicidal behaviors varied by age, with young adults aged 18 to 25 displaying higher rates than older adults. Rates of suicidal behaviors were also significantly higher among those with a past year substance use disorder than among those without a substance use disorder. About 6 in 10 of the adults who attempted suicide received medical attention for their suicide attempt.
Preventing suicide and addressing the health care needs of persons at risk for suicidal behavior require public health information-sharing efforts that not only highlight the fact that effective preventive interventions exist, but also attempt to reduce the stigma associated with mental and emotional problems and mental health treatment. Further research on additional factors associated with suicidal behaviors (i.e., race/ethnicity, employment and occupation, and mental health and substance abuse problems), as well as on suicidal behaviors among specific subpopulations (i.e., young adults, veterans, and parenting adults), is needed to help guide the development of screening tools and prevention and treatment programs.
End Notes1 Centers for Disease Control and Prevention, National Center for Injury Prevention and Control [Producer]. (2009, May 1). Web-based Injury Statistics Query and Reporting System (WISQARS): Injury mortality reports, 1999 to 2006. Retrieved July 6, 2009, from
http://webappa.cdc.gov/sasweb/ncipc/mortrate10_sy.html 2 NSDUH asks respondents questions to assess their symptoms of alcohol or illicit drug dependence or abuse in the past year. Dependence on or abuse of alcohol or illicit drugs is defined using criteria specified in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). Dependence or abuse includes such symptoms as withdrawal, tolerance, use in dangerous situations, trouble with the law, and interference in major obligations at work, school, or home during the past year. Individuals who meet the criteria for either dependence or abuse are said to have a substance use disorder. For details on DSM-IV, see the following publication: American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.
Suggested CitationSubstance Abuse and Mental Health Services Administration, Office of Applied Studies. (September 17, 2009). The NSDUH Report: Suicidal Thoughts and Behaviors among Adults. Rockville, MD.
The National Survey on Drug Use and Health (NSDUH) is an annual survey sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA). The 2008 data used in this report are based on information obtained from 46,190 persons aged 18 or older. The survey collects data by administering questionnaires to a representative sample of the population through face-to-face interviews at their place of residence.
The NSDUH Report is prepared by the Office of Applied Studies (OAS), SAMHSA, and by RTI International in Research Triangle Park, North Carolina. (RTI International is a trade name of Research Triangle Institute.)
Information on the most recent NSDUH is available in the following publication:
Office of Applied Studies. (2009). Results from the 2008 National Survey on Drug Use and Health: National findings (DHHS Publication No. SMA 09-4434, NSDUH Series H-36). Rockville, MD: Substance Abuse and Mental Health Services Administration. Also available online: http://oas.samhsa.gov.
The NSDUH Report is published periodically by the Office of Applied Studies, Substance Abuse and Mental Health Services Administration (SAMHSA). All material appearing in this report is in the public domain and may be reproduced or copied without permission from SAMHSA. Additional copies of this report or other reports from the Office of Applied Studies are available online: http://oas.samhsa.gov. Citation of the source is appreciated. For questions about this report, please e-mail: shortreports@samhsa.hhs.gov.
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