Vol.:(0123456789) 1 3 Community Mental Health Journal https://doi.org/10.1007/s10597-020-00606-7 ORIGINAL PAPER Suicide in Older Adults in Ohio: Characteristics, Precipitants, and Mental Health Service Utilization Helen Anne Sweeney 1  · Cynthia A. Fontanella 2  · Danielle L. Steelesmith 2  · Camille Quinn 3 Received: 23 January 2019 / Accepted: 9 March 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020 Abstract The objective of the research is to examine characteristics of Ohio suicide decedents ages 65 + (N = 1273) and factors associ- ated with behavioral health (BH) services utilization. The Ohio Violent Death Reporting System, 2012–2015, was the data source. Logistic regression analyses were used to examine the association among characteristics, suicide means, and BH service utilization. Of the study subjects, 96.0% were non-Hispanic white; 84.6%, male; and 63.0% living in urban areas. About 75.1% used frearms; 27.6% reported recent BH treatment. Those who were never married, depressed, and had a prior suicide attempt were more likely to have BH treatment within two months of death. Findings suggest a need for training of primary and BH providers to improve screening and assessment, treatment, and follow up care for older adults, especially those with histories of suicide attempts, depression, and frearm access. Suggested interventions include annual BH screen- ings and lethal means restriction at the individual and community levels. Keywords Suicide · Older adults · Behavioral health treatment · Safety planning · National violence data reporting system Introduction Suicide later in life continues to be a signifcant public health issue given the human and economic tolls (Choi et al. 2017a, b; Choi et al. 2017a, b). In 2016, the annual U.S. suicide rate for persons over the age of 65 was over 16 per 100,000 indi- viduals; the rate increases for those aged 75–84, with over 18 suicide deaths per every 100,000 (Centers for Disease Control and Prevention 2016). The number rises even higher for those over age 85. Elderly white men were at the highest risk for suicide with a rate of approximately 30.99 suicides per 100,000 individuals each year. The rate of male suicides in later life is about six times greater than female suicides. Firearms are the most common means used for completing suicides among the elderly. Men use frearms more often than women. In Ohio, suicide mortality rates have been steadily increasing since 2011. In 2016, suicide rates for older adults rose to 16.22 per 100,000 persons from the 2011 rate of 12.22 per 100,000, a 33% increase (Centers for Disease Control and Prevention 2016). Elderly white men had a sui- cide rate of 33.77 per 100,000. With a rate of 16.22 per 100,000 persons and 33.77 per 100,000 for elderly white men, Ohio rates of suicide for older adults mirror average annual national rates. Late life suicide is a signifcant area of concern because suicide can increase among adults in the 65 and older cohort in ways that may not be evident in younger cohorts. Conwell et al. (2011) suggest that certain groups, including older age cohorts, tend to be susceptible to suicide, especially as they age. Specifcally, baby boomers had relatively higher sui- cide rates at any given age when compared to earlier and subsequent cohorts, suggesting that as baby boomers reach age 65, suicide rates are likely to increase for adults 65 and older (Conwell et al. 2011). Possible explanations for this include psychiatric illnesses, greater social isolation, deal- ing with stressful life events, and having personality traits associated with suicide risk, physical illness and functional impairment (Beautrais 2002; Conwell 2001; Conwell et al. * Helen Anne Sweeney hasweeney@twc.com 1 Ohio Department of Mental Health and Addiction Services, Ofce of Quality, Planning, and Research, 30 East Broad Street, Columbus, OH 43215, USA 2 Department of Psychiatry and Behavioral Health, Wexner Medical Center, Ohio State University, Columbus, OH, USA 3 College of Social Work, Ohio State University, Columbus, OH, USA