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. 2018 Jun 8;67(22):617–624. doi: 10.15585/mmwr.mm6722a1

TABLE 2. Circumstances preceding suicide among decedents aged ≥10 years with and without known mental health conditions — National Violent Death Reporting System, 27 states,* 2015.

Characteristic Total
No. (%) Known mental health condition†
No. (%) No known mental health condition
No. (%) Chi-square p-value OR§ (95% CI) Adjusted OR (95% CI)
Suicide with known circumstances
18,764 (91.8)
9,407 (100)
 9,357 (84.8)
 <0.01
 N/A
 N/A
Mental health
Any current diagnosed mental health condition**
Depression/Dysthymia
 —††
7,076 (75.2)
 N/A
 N/A
 N/A
 N/A
Anxiety disorder
 —††
1,579 (16.8)
 N/A
 N/A
 N/A
 N/A
Bipolar disorder
 —††
1,431 (15.2)
 N/A
 N/A
 N/A
 N/A
Schizophrenia
 —††
509 (5.4)
 N/A
 N/A
 N/A
 N/A
PTSD
 —††
424 (4.5)
 N/A
 N/A
 N/A
 N/A
ADD/ADHD
 —††
226 (2.4)
 N/A
 N/A
 N/A
 N/A
Not specified
 —††
760 (8.1)
 N/A
 N/A
 N/A
 N/A
Current depressed mood§§
 7,038 (37.5)
3,962 (42.1)
 3,076 (32.9)
 <0.01
 0.7 (0.6–0.7)
 0.7 (0.6–0.7)
Problematic substance use
Any
 5,319 (28.3)
2,976 (31.6)
 2,343 (25.0)
 <0.01
 0.7 (0.7–0.8)
 0.7 (0.7–0.8)
Alcohol
 3,268 (17.4)
1,862 (19.8)
 1,406 (15.0)
 <0.01
 0.7 (0.7–0.8)
 0.7 (0.7–0.8)
Other
 3,084 (16.4)
1,768 (18.8)
 1,316 (14.1)
 <0.01
 0.7 (0.7–0.8)
 0.7 (0.7–0.8)
Treatment
Current mental health/substance use treatment
 5,141 (27.4)
5,077 (54.0)
 64 (0.7)
 <0.01
 0.01 (0.01–0.01)
 0.01 (0.01–0.01)
Ever treated for mental health/substance disorder
 6,717 (35.8)
6,323 (67.2)
 394 (4.2)
 <0.01
 0.02 (0.02–0.02)
 0.02 (0.02–0.03)
Relationship problems/loss
Any relationship problem/loss
 7,948 (42.4)
3,726 (39.6)
 4,222 (45.1)
 <0.01
 1.3 (1.2–1.3)
 1.3 (1.2–1.4)
Intimate partner problem
 5,098 (27.2)
2,270 (24.1)
 2,828 (30.2)
 <0.01
 1.4 (1.3–1.5)
 1.4 (1.3–1.5)
Perpetrator of interpersonal violence in past month
 414 (2.2)
131 (1.4)
 283 (3.0)
 <0.01
 2.2 (1.8–2.7)
 2.0 (1.6–2.4)
Victim of interpersonal violence in past month
 84 (0.4)
53 (0.6)
 31 (0.3)
 <0.05
 0.6 (0.4–0.9)
 0.8 (0.5–1.2)
Family relationship problem
 1,671 (8.9)
873 (9.3)
 798 (8.5)
 NS
 0.9 (0.8–1.0)
 1.0 (0.9–1.1)
Other relationship problem (nonintimate)
 403 (2.1)
202 (2.1)
 201 (2.1)
 NS
 1.0 (0.8–1.2)
 1.1 (0.9–1.3)
Argument or conflict (not specified)
 2,914 (15.5)
1,278 (13.6)
 1,636 (17.5)
 <0.01
 1.3 (1.2–1.5)
 1.4 (1.3–1.5)
Death of a loved one (any)
 1,497 (8.0)
826 (8.8)
 671 (7.2)
 <0.01
 0.8 (0.7–0.9)
 0.9 (0.8–0.9)
Nonsuicide death
 1,181 (6.3)
647 (6.9)
 534 (5.7)
 <0.01
 0.8 (0.7–0.9)
 0.9 (0.8–1.0)
Suicide of family or friend
 379 (2.0)
217 (2.3)
 162 (1.7)
 <0.01
 0.7 (0.6–0.9)
 0.8 (0.7–1.0)
Other life stressors
Any life stressor
 9,171 (48.9)
4,442 (47.2)
 4,729 (50.5)
 <0.01
 1.1 (1.1–1.2)
 1.1 (1.0–1.2)
Recent criminal legal problem
 1,588 (8.5)
586 (6.2)
 1,002 (10.7)
 <0.01
 1.8 (1.6–2.0)
 1.7 (1.5–1.9)
Other legal problem
 748 (4.0)
378 (4.0)
 370 (4.0)
 NS
 1.0 (0.8–1.1)
 1.0 (0.9–1.2)
Physical health problem
 4,179 (22.3)
2,012 (21.4)
 2,167 (23.2)
 <0.01
 1.1 (1.0–1.2)
 1.0 (1.0–1.1)
Job/Financial problem¶¶
 2,941 (16.2)
1,530 (16.8)
 1,411 (15.6)
 <0.05
 0.9 (0.8–1.0)
 0.9 (0.8–1.0)
Eviction or loss of home
 722 (3.8)
317 (3.4)
 405 (4.3)
 <0.01
 1.3 (1.1–1.5)
 1.4 (1.2–1.6)
School problem***
 162 (19.9)
70 (17.8)
 92 (21.9)
 NS
 1.3 (0.9–1.8)
 1.3 (0.9–1.9)
Recent release from an institution†††
 1,412 (7.6)
941 (10.2)
 471 (5.1)
 <0.01
 0.5 (0.4–0.5)
 0.5 (0.4–0.5)
Jail/Prison/Detention facility
 203 (14.4)
82 (8.7)
 121 (25.7)
 <0.01
 3.6 (2.7–4.9)
 4.5 (3.2–6.4)
Hospital
 517 (36.6)
311 (33.0)
 206 (43.7)
 <0.01
 1.6 (1.3–2.0)
 1.3 (1.0–1.7)
Psychiatric hospital/institution
 469 (33.2)
439 (46.7)
 30 (6.4)
 <0.01
 0.1 (0.1–0.1)
 0.1 (0.1–0.1)
Other (includes alcohol/SU treatment facilities)
 223 (15.8)
109 (11.6)
 114 (24.2)
 <0.01
 2.4 (1.8–3.3)
 2.5 (1.8–3.3)
Crisis within past or upcoming 2 weeks§§§
5,525 (29.4)
2,444 (26.0)
 3,081 (32.9)
 <0.01
 1.4 (1.3–1.5)
 1.4 (1.3–1.5)
Intimate partner problem
 1,968 (35.6)
854 (34.9)
 1,114 (36.2)
 NS
 1.1 (0.9–1.2)
 1.1 (0.9–1.2)
Physical health problem
 739 (13.4)
315 (12.9)
 424 (13.8)
 NS
 1.1 (0.9–1.3)
 1.0 (0.8–1.2)
Criminal legal problem
 621 (11.2)
203 (8.3)
 418 (13.6)
 <0.01
 1.7 (1.5–2.1)
 1.6 (1.3–1.9)
Family relationship problem
 430 (7.8)
212 (8.7)
 218 (7.1)
 <0.05
 0.8 (0.7–1.0)
 0.9 (0.7–1.1)
Job problem
 354 (6.4)
191 (7.8)
 163 (5.3)
 <0.01
 0.7 (0.5–0.8)
 0.7 (0.5–0.8)
Suicide event/history
Left a note
 6,468 (34.5)
3,182 (33.8)
 3,286 (35.1)
 NS
 1.1 (1.0–1.1)
 1.2 (1.1–1.2)
Disclosed suicide intent
 4,405 (23.5)
2,306 (24.5)
 2,099 (22.4)
 <0.01
 0.9 (0.8–1.0)
 0.9 (0.8–0.9)
History of ideation
 5,990 (31.9)
3,838 (40.8)
 2,152 (23.0)
 <0.01
 0.4 (0.4–0.5)
 0.4 (0.4–0.5)
History of attempts 3,732 (19.9) 2,770 (29.4) 962 (10.3) <0.01 0.3 (0.3–0.3) 0.3 (0.3–0.3)

Abbreviations: ADD/ADHD = attention deficit disorder/attention deficit hyperactivity disorder; CI = confidence interval; N/A = not applicable; NS = not significant; OR = odds ratio; PTSD = posttraumatic stress disorder; SU = substance use.

* Alaska, Arizona, Colorado, Connecticut, Georgia, Hawaii, Kansas, Kentucky, Maine, Maryland, Massachusetts, Michigan, Minnesota, New Hampshire, New Jersey, New Mexico, New York, North Carolina, Ohio, Oklahoma, Oregon, Rhode Island, South Carolina, Utah, Vermont, Virginia, and Wisconsin.

† Decedent had been identified as having a current diagnosis of mental health condition in coroner/medical examiner or law enforcement reports.

§ OR reflects the risk among those without known mental health condition relative to those with known mental health condition.

Logistic regression was used to estimate adjusted OR with 95% CIs after controlling for sex, age group, and race/ethnicity. Known mental health condition was the reference group.

** Includes decedents with one or more diagnosed current mental health conditions, which are not mutually exclusive. Therefore, sums of percentages for the diagnosed conditions exceed 100%. Denominator includes the number of decedents with one or more current diagnosed mental health conditions.

†† The specific type of mental health condition was calculated only among those with one or more known diagnosed mental health conditions.

§§ Not a diagnosis.

¶¶ Denominator is decedents aged ≥18 years.

*** Denominator is decedents aged 10–18 years.

††† Denominator of institution subgroup is decedents with recent release from an institution. Recent release from an institution is defined as having occurred within the past month.

§§§ Denominator of crisis subgroup is decedents with any crisis within past or upcoming 2 weeks. Crises depicted here represent the most commonly occurring categories.