U.S. deaths from self-injury surpass those from diabetes

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[August 30, 2018]  By Linda Carroll

(Reuters Health) - More people in the U.S. are dying from self-inflicted harm, including suicide and drug overdose, than from diabetes, a new study suggests.

In 2016, for every 100,000 people, 29 deaths were due to self-injury and 25 were due to diabetes, researchers found when they looked at data from the Centers for Disease Control and Prevention.

Until 2015, diabetes was the seventh most common killer of people in the U.S., the authors note in Injury Prevention.

"We have a major mental health crisis that has been placed on the back burner," said study leader Ian Rockett, professor emeritus at West Virginia University in Morgantown. "We need to bring these mental health problems to the forefront. Mental health is crucial to the wellbeing of society."

There is a price to be paid for ignoring mental health issues, he added. "There is a huge ripple effect to not treating the problems of individuals who died by suicide or what may be classified as accidental drug intoxication," Rockett said. "They are members of families; they have friends and work colleagues. The ripple effects of their deaths can lead to all sorts of mental and physical problems among those who know them and care about them."

The researchers believe the decline in life expectancy in the U.S. is largely due to increases in suicides and drug overdoses. Between 2000 and 2016, self-injury jumped by 80 percent and drug overdose deaths tripled. In the same period, suicides increased by 34 percent.

The surge in self-injury deaths was largely driven by increases among men, whose rates of self-inflicted death had already outstripped diabetes deaths by 2002, the researchers note.

Among women, diabetes deaths continued to exceed self-inflicted ones during the study period, but the gap narrowed dramatically over time. In 2000, there were four diabetes deaths among women for every self-injury death; in 2016, that ratio shrank to 1.6 diabetes deaths for every self-injury death.

Combining all self-injury deaths, whether intentional, unintentional or undetermined, into one number may help spotlight a growing problem and lead to more effective prevention, Rockett said. That's because the factors leading to these deaths are often similar.

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Living in West Virginia, Rockett has seen those factors up close. "In West Virginia, we've got a huge problem with addiction and a high opioid death rate," he said. "This is a coal mining area. We have people who had been making a very good living doing very hard, dangerous work. But then the bottom fell out of the coal industry and left people in very bad shape."

Some of those people had painful injuries for which they were prescribed opioids, and some tried to self-medicate their psychic pain away.

The new article underlines a problem that's recently come on the radar for mental health professionals, said Dr. Jack Rozel, associate professor of psychiatry and adjunct professor of law at the University of Pittsburgh, and president-elect of the American Association for Emergency Psychiatry. "We've been talking about 'diseases of despair' for the last two to three years," said Rozel, who wasn't involved in the study.

"There are scores and scores of wonderful, effective, evidence-based treatments" for these conditions, Rozel said. "The problem is translating them to the real world from the medical journals."

A big stumbling block has been access to treatment, Rozel noted. "Most people with significant depression or anxiety, or PTSD or bipolar disorder, if they take the right medications and are managed right, will do really well," he said. "And their risk of suicide is reduced."

SOURCE: https://bit.ly/2wtzi9p Injury Prevention, online August 27, 2018.

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