Middle-aged and older adults who had serious suicidal thoughts: who made suicide plans and nonfatal suicide attempts?

Background: High suicide rates in late middle-aged and older adults are significant public health problems. Although suicide risk and protective factors are well established, more research is needed about suicide planners and attempters. Using multi-year, national epidemiologic survey data, this study identified correlates of making suicide plans and nonfatal suicide attempts among U.S. adults aged 50+ years. Methods: Data are from the 2008 to 2012 U.S. National Survey on Drug Use and Health (NSDUH). Descriptive statistics were used to examine sample characteristics by past-year serious suicidal thoughts, suicide plans, and suicide attempts. Binary logistic regression analyses were used to examine potential correlates (sociodemographic factors, health status, religiosity, psychiatric and substance use disorders (SUDs), and mental health and substance abuse treatment use) of suicide plans and suicide attempts among those who reported serious suicidal thoughts. Results: Of the 2.5% of the study population that had serious suicidal thoughts (n = 804), 28% made suicide plans and 11.5% attempted suicide. Although 42% of those with serious suicidal thoughts had major depressive episode (MDE), MDE was not significantly associated with suicide plans or attempts in multivariate models. Being employed decreased the odds of making suicide plans, while mental health service use was associated with increased odds of suicide plans. SUDs increased the odds of suicide attempts. Conclusions: It is important to screen middle-aged and older adults for severe mental and SUDs and suicidal thoughts and to target interventions for likely planners and attempters.