Elderly at highest risk for suicide

Not long after Anne Beale Golsan, 72, had retired on disability from her job as a librarian, she put a stack of paid bills out for the mail, hung up a freshly pressed outfit and taped a note to the front of the house.

"Don't come in by yourself. Get somebody to come with you. Sorry, Love Beale."

Her niece arrived at the house they shared in Baton Rouge, La., and found police there. Golsan had killed herself with a gunshot to the head.

"Every single day it makes me feel like I wish I could have done something," Jane Golsan Ray said, recalling her aunt's death eight years ago.

The elderly are the highest-risk population in the country for suicide. But few suicide-prevention programs target them — a result, experts say, of scarce funding and lack of concern for older Americans.

Mental-health experts say the number of such suicides is likely to climb as baby boomers age.

The overall U.S. suicide rate is 11 per 100,000 people. But for those 65 and older, that rises to 14 per 100,000, according to the Centers for Disease Control and Prevention, which based its findings on data from 2004, the most recent available.

Older adults are less likely to seek help and are more successful in their suicide attempts. So experts say special care is needed to reach out.

Dale Smith, 67, said he might not be alive if not for a suicide-prevention program in Spokane, Wash.

Two years ago, he attended a meeting at his retirement complex where everyone filled out a screening form for depression, a key risk factor for suicide.

Based on his answers, a caseworker and psychiatrist developed a plan of medication and therapy that Smith said probably saved his life.

"I'm not unique. I think there's a lot of individuals out there who do suffer from depression and they have no clue," he said.

In addition, many older Americans have fewer options for treatment than younger people.

"It's a not-so-subtle social-political assignment of resources," said Donna Cohen, a professor in the Department of Aging and Mental Health at the University of South Florida.

Ten states passed laws last year intended to curb suicide among children and young adults. Only two — New Jersey and New Mexico — passed laws addressing suicide among the elderly, according to Suicide Prevention Action Network USA.

In addition to depression, other key factors linked to risk of suicide in older Americans include previous suicide attempts or a family history of suicide; a history of alcohol or substance abuse; loss of personal, social or professional ties; and illness or isolation.

Depression is underdetected at all ages, mental-health groups say. But much more funding is available for treating younger people, including $82 million in federal money approved in 2004.

The situation prompted Sen. Harry Reid of Nevada, who lost his father to suicide, to propose funding more suicide-prevention programs for the elderly and changing a Medicare coverage rule that forces seniors to pay more for outpatient mental-health services than other medical care.

Some advocates and mental-health workers say they also have to battle a prevailing notion that depression is a normal part of aging. "It is not natural and should be treated at all times," said Dr. Paula Clayton, a psychiatrist and medical director for the American Foundation for Suicide Prevention.

Experts say there need to be services tailored to the elderly because they handle depression differently than younger patients.

In Spokane, the program that helped Smith, Elder Services, trains people who come in contact with the elderly — from bank tellers to postal carriers — to notice signs of trouble, such as mail piling up or bills going unpaid. Those people can then notify social workers.