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13.

Let us now shift our focus from national to local data, and examine suicidal deaths in Cuyahoga County, Ohio, the area served by MHS. Cuyahoga County had a population of 1,380,421 in 2000. It is the most populous county of Ohio, and the 25th most populous county in the United States. A diverse county, it comprises 59 municipalities and 31 school districts, with a land area of 459 square miles (1,189 square kilometers). Cleveland is the county seat, a city of 478,403, with a land area of 77 square miles (199 km²). (For a map of the County and its municipalities, click here).

Data in this section are from the superb reports published each year by the Cuyahoga County's Coroner's Office, Elizabeth K. Balraj, M.D., Coroner. We thank Dr. Balraj and her staff for these invaluable reports.

The two-line graph presented below shows the annual number of suicidal and homicidal deaths in Cuyahoga County, Ohio, from 1943 to 2001. During these 59 years, there were 10,860 suicidal deaths (an average of 184 per year), and 10,390 homicidal deaths (an average of 176 per year). Not included on the graph are the most-recent data for the year 2002: 167 suicides, and 117 homicides.

As shown in the graph, there was substantial variability in the number of suicidal deaths from year to year. The gradual increase in suicidal deaths from 1943 to 1979 must be understood in the context of a growing population through 1970. The number of suicidal deaths increased 63% from 1940 to 1970 (137 suicidal deaths in 1940; 223 in 1970), but the population grew 41% during this 30-year period. The peak of 276 suicidal deaths occurred in 1979. This represents a rate of 18.4 per 100,000.

14.

The annual number of deaths by homicide is also presented on the graph, because homicide is another form of intentional, violent death. The average year-to-year variability in homicidal deaths is nearly twice that of suicidal deaths. The number of homicides exceeded the number of suicides in the 15-year period of 1969-1983, and in the 7-year period of 1988-1994. This is shown more clearly in the following figure.

The decline in homicidal deaths during the 1990's was consistent with the national trend at the time. From 1992 to 1999, violent crime fell 26% nationally, and the number of homicides declined 35%. There was no corresponding decline in suicidal deaths, which are now far more numerous than homicidal deaths both locally and nationally. In Cuyahoga County in 2002, the number of suicidal deaths (167) was 43% higher than the number of homicidal deaths (117).

15.

The rate of suicidal deaths in Cuyahoga County is higher than the rate for Ohio, or the nation. The rate of suicidal deaths in Cuyahoga County in 2001 was 12.8 per 100,000 people. In that same year, the suicide rate in all Ohio was 9.7. Similarly, the rate of suicidal deaths in Cuyahoga County during the years 1996-1998 was 10.7, compared with a rate of 9.7 for all Ohio.

The rate of suicidal deaths in Cleveland is even higher than that of Cuyahoga County. In 2002, there were 64 suicidal deaths in Cleveland. This number, divided by the estimated (U.S. Census Bureau) population of Cleveland on 1 July 2002 of 467,851, and multiplied by 100,000, yields a suicide rate for the City of Cleveland of 13.7 per 100,000 people. This rate is more than 41% higher than the rate for all of Ohio.

16.

Monthly variation in the number of suicidal deaths in Cuyahoga County, Ohio, is shown in the figure below. This figure shows the highest, lowest, and average number of suicidal deaths during the seven-year period of 1995-2001. From this graph, suicidal deaths appear to be slightly more frequent in January, April or May, and again in August or September. Some researchers have found that disturbances of mood are associated with changes in production of the hormone melatonin. These changes are more pronounced during Spring and Autumn, when the length of day increases and decreases most quickly. Disturbances of mood, and resulting difficulties in the management of emotional states, are potent risk factors for suicidal conduct.

17.

Methods used in the suicidal deaths of men and women in Cuyahoga County, Ohio, in 2001 are shown in the final figure, below. Men are much more likely than women to use a gun, both locally and nationally. Taking steps to safeguard firearms, and to limit access to potentially harmful medicines are valuable suicide prevention strategies.

18.

The Executive Director of MHS, Steven M. Friedman, Ph.D., and leaders of our Mobile Crisis Team submitted a proposed suicide prevention plan to the Cuyahoga County Community Mental Health Board (CCCMHB). A planning group comprising community mental health providers and the CCCMHB met for the first time on February 20, 2002. Efforts were made to invite other community representatives who have experience in suicide prevention planning. On July 15, 2002, the planning group held an all-day retreat, and worked to apply a state plan to suicide prevention activities in Cuyahoga County.

The proposed plan emphasized steps to increase awareness that suicide is a public health problem, in order to reduce stigma and increase people's willingness to seek help. One specific recommendation was to conduct a public education campaign with the support of The Plain Dealer (a major daily newspaper), and local radio and television stations.

The plan also recommended that the community enlist the help of clergy, since religious leaders often counsel those who would not consider treatment with a mental health provider. Strong feelings of shame and guilt often accompany thoughts of suicide. Many people naturally seek the counsel of clergy to address these feelings. Moreover, members of the clergy often serve as emotional supports for suicide survivors, and this role adds to the importance of religious leaders in the community's suicide prevention activities.

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It was most recently updated on 4 October 2007.
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