CONTENTS

About This Course

Table of Contents

1. The Nature and Scope of Suicide
2. Recognizing the Progressive Development of Suicide
3. Substance Abuse as a Major Contributor to Suicide
4. Suicide Across the Life Span
5. Special Populations and Suicide Risk
6. Prevention and Early Intervention for Suicide and Substance Abuse Problems

Supplements
References
Resources

Holding the Lifeline
A Guide to Suicide Prevention

Substance Abuse and Older Adults

Although estimates of substance abuse problems among older adults who died by suicide have been lower than other age groups, Dr. Frederick Blow, a leading expert in older adults and substance abuse, notes that the role of alcohol may be underestimated in late-life suicide. He observes that it may be difficult to show the link between suicide and alcohol abuse because of:

• The difficulty in assessing and detecting alcohol abuse in this population
• Increased effect of even light to moderate alcohol use among older adults
• Problems with using standard criteria for diagnosing alcohol abuse and dependence among the elderly. ref

The National Strategy for Suicide Prevention (NSSP) establishes suicide prevention for the elderly as a top priority and has identified goals pertinent to this population:

• Increase the proportion of evidence-based suicide prevention programs among state or local area agencies on aging to help coordinate services for older people and training for workers and volunteers working with older adults. ref
• Reduce access to lethal means, such as improving automobile design to deter carbon-monoxide-mediated suicides. ref
• Train nursing care workers in the assessment and management of suicide risk. ref
• Implement screening for depression, substance abuse, and suicide risk in primary care settings, hospices, and skilled nursing facilities. ref

Unlike other age groups, particularly youth and adolescents, there appear to be fewer programs targeting older adults for suicide prevention. Suicide prevention efforts are already occurring at the grass roots level in physician's offices, among family members, and in elder-care facilities. The suicide prevention movement is a relatively new public health priority. As the NSSP's goals are implemented, and public awareness of suicidal behaviors as a public health problem grows, suicide prevention programs aimed at senior citizens should grow.