This Week is Suicide Prevention Week

Recently, a married man with HIV stabbed himself in a public bathroom, and another man who was fearful of the prospect of growing older and had been ordering Viagra and sleeping pills on the internet shot himself.

Many of the suicides in the gay community occur while men and women are coming to terms with sexual orientation and gender identity and prior to publicly disclosing these issues. But even within the gay community, the subject of gay suicide is taboo.

Although there is no evidence to suggest that homosexuality is a disorder, there is a fear that talking about suicide reinforces the stereotype: Gay people are all on a long, downhill slide; they are nothing but alcoholics, drug and sex addicts, and in general, society’s losers.

Although studies of psychiatric disorders in the LGBT community are rare, there is evidence of increased rates of diagnosable psychiatric disorders, substance abuse and an alarming rate of suicide in the LGBT community,

Sexual orientation is a complex issue and includes sexual attraction, sexual behavior, sexual fantasy, social preferences and self-identification. Although many in the gay community have reached a point of acceptance of their sexual orientation and made a public disclosure of it, only 45% of men who report having had same sex partners identify themselves as gay, homosexual or bisexual. More men who self-define as heterosexual are having sex with men than are gay-identified men.

Of the 2-7% of all men who report having had a male sexual partner, about ½ of them have at least one symptom related to suicide. Since 4 out of 5 who commit suicide are men, it is likely that a significant portion of the are men who have had difficulty dealing with sexual orientation conflicts, although it is never mentioned in research about causes and prevention of suicide.

Many of the risk factors that are associated with suicide are the same symptoms associated with coming to terms with sexual orientation or gender identity.

Risk factors associated with suicide:

+ Feeling alone
+ Feeling hopelessness
+ Alcohol and drug abuse
+ Guilt
+ History of depression

As men age, additional issues may increase the risk of suicide. The most vulnerable age for men for being depressed is from 45-50 years old. . This finding is consistent around the globe for all types of people, men and women, single and married, rich and poor and with children and without.

According to the Centers for Disease Control, the suicide rate among 45-54 year olds increased dramatically from 1999-2004, far out-pacing other age groups. Several possible explanations are given: a staggering increase in drug overdoses, economic and employment pressures and frayed social support systems.

Additional risk of suicide for mature men:

+ Physical changes related to aging
+ Death of loved ones
+ Serious physical illness
+ Unemployment or financial problems

We must recognize our brothers and sisters of all ages who are continuing to struggle with their sexual orientation or gender identity and whether or not to publically disclose it.

By the age of 50, men and women begin to emerge from these low periods, and assuming good health, a person of 70 is likely to be as happy and mentally healthy as a 20 year old.

A dedicated strategy under a national suicide prevention framework to address the unique risk of suicide in all ages of the LGBT community is needed. Increased awareness within the gay community of who is at risk and the warning signs is also important. Efforts to reduce homophobia, discrimination, and violence directed toward the LGBT community are important to help reduce risks of self-harm.

Critical signs of suicide risk in all age groups:

+ Expressions of hopelessness
+ Anxiety, agitation and irritability
+ Direct or indirect threats
+ Getting affairs in order and giving away belongings
+ Decreased performance in school or work
+ Changes in eating and sleeping
+ Social withdrawal and isolation

Resources available:

o National Institute for Mental Health http://www.nimh.nih.gov
o Substance Abuse and Mental Health Services Administration http://www.samhsa.gov
o Suicide Prevention Resource Center http://www.sprc.org
o Surgeon General’s Call to Action to Prevent Suicide http://www.surgeongeneral.gov/library/calltoaction/default.htm

IF YOU ARE IN CRISIS AND NEED IMMEDIATE HELP: Please call 1-800-273-TALK (8255)

The preceding was contributed by Loren A. Olson, MD, DLFAPA, a Board Certified by the American Board of Psychiatry and Neurology and has been engaged in the clinical practice of psychiatry for over thirty years. He has conducted independent research on mature gay men, and he currently is writing a book on the subject of coming out for mature gay men. Dr. Olson and his life partner of over 20 years will be married in Iowa September, 2009.