Welcome to our (almost) Autumn newsletter. It has been a busy summer for us, and presumably for most in the threat assessment field. The events that have occurred throughout this past year, whether terrorist-related or not, have raised sensitivity to the importance of paying attention and of not ignoring those signs that could suggest an impending risk of violence.
This past week, several of us within CRA attended the annual Threat Management Conference sponsored by the Association of Threat Assessment Professionals, as is our August custom. It is a very valuable opportunity for us to learn and meet with others who work within our specialty across many disciplines. I have presented below some of what I picked up from a presentation by Drs. Lynn Van Male and Mario Scalora on the relationship between suicide and violence toward others, especially in relation to their work with military veterans. While this is a subject that I have touched in prior newsletters, I felt that some of these new findings were worth passing along.
Suicide and Homicide
As a reminder, suicide is not a rare event in our society. It is the 10th leading cause of death in the U.S., with approximately 117 suicides occurring daily. As I have previously reported, approximately 5% of Americans have attempted suicide in their lifetime, with that figure being probably an underestimate, due to misclassification and a reluctance to report.
One of the reasons that we are increasingly interested in this subject is that the suicide rate is increasing. From 1999 to 2010, there has been a substantial increase in suicide rates (approximately 27%), especially among those who are middle aged (35 - 64). Among veterans in particular, the rate has risen astronomically. The good news, according to this recent research, is that the rate has significantly decreased among those veterans who have utilized the services of the Veteran Administration Healthcare (VHA) system. In fact, while the frequency of suicide among veterans who have not taken advantage of the VHA services rose 61% between 1999 and 2010, suicide decreased by almost 31% by those who have used VHA services based on this recent research. This is a testament to the value of early intervention and appropriate treatment.
However, their more significant finding is the relationship between suicide and violence toward others. These studies reported a 30% overlap, meaning that of those who have attempted suicide, over 30% have also been violent toward others. I should note that other studies that I have previously reviewed have actually reported even higher rates.
The fact that these two behaviors can often co-exist is important enough, but the most important finding, in my opinion, is that suicide and violence have numerous risk factors and warning signs in common. In other words, the emotional, social, behavioral and environmental factors that can alert us to impending suicidal behavior are also the very same factors that we look to when assessing a general risk of violence. According to Van Male and Scalora, researchers have concluded that suicide and violence toward others can be thought of as "different expressions of the same phenomenon," separated by only a "thin dividing line."
At the very least, this implies that we should always be conscious that when we are confronted with behaviors and circumstances that suggest either the risk of suicide or the risk of violence toward others, we should be assessing for both.