Suicide rates in the United States increased again after two years of decline, and gun-related suicides and homicides continued to see a "worrisome" rise in 2021, two new CDC reports found—leading experts to say "[t]here is no doubt we are experiencing a mental health crisis in this country."

The US sees suicide rates rise after 2-year decline

According to a new CDC analysis, the overall suicide rate in the United States increased by 4% in 2021—the first increase in two years. The analysis is based on provisional data that includes over 99% of expected death records in 2021, and its findings are expected to align with the final data for the year once it's released.

Overall, there were 47,646 suicide deaths recorded in 2021, up from 45,979 in 2020. Although total monthly suicides were lower in January, February, and July of 2021 compared to the same months in 2020, all others had higher suicide rates.

Currently, suicide is the second leading cause of death for individuals ages 10 to 34. In 2021, the suicide rate rose for every age group between ages 15 and 74. Individuals ages 15 to 24 saw the highest increase in suicide rates at 8%, followed by individuals ages 25 to 34 at 4%.

Men had a suicide rate that was almost four times higher than that of women. In 2021, there were 38,025 suicides among men compared to 9,621 among women. Men ages 15 to 24 also saw the largest increase in suicide rates at 8%.

According to Sally Curtin, a statistician at CDC's National Center for Health Statistics who authored the report, it was "encouraging" to see suicide rates decline from 2018 to 2020, but the trend has since reversed and "we're almost back up to where we were in 2018, when suicides peaked at 48,344.

"There is no doubt we are experiencing a mental health crisis in this country," said Miriam E. Delphin-Rittmon, assistant secretary for mental health and substance abuse at the Substance Abuse and Mental Health Services Administration. "Largely due to the ongoing covid-19 pandemic, which continues to have ripple effects, we're seeing increased levels of anxiety and depression in children, as well as adults, and increased substance use."

Gun-related suicides and homicides are also on the rise

In a separate CDC analysis, researchers found that rates of gun-related suicides and homicides increased by 8% from 2020 to 2021, reaching the highest levels they've been in 30 years.

For the analysis, researchers used final mortality data from 2020 and provisional data from 2021 from the National Vital Statistics System, as well as data of all-cause homicide and suicide rates from the Census Bureau, to estimate increases in gun-related homicide and suicide deaths.

From 2020 to 2021, gun-related homicides among individuals ages 10 and up rose from 19,383 to 20,966, an increase of 8.3%. Gun-related suicides also increased by 8.3% during that time, going from 24,292 to 26,320.

"An 8 percent increase in gun suicides over one year is a really large increase," said Ari Davis, a policy advisor at the Johns Hopkins Center for Gun Violence Solutions, who was not involved in CDC's study. "It's very worrisome."

Gun-related homicide rates increased across every racial and ethnic group, with non-Hispanic Black individuals ages 10 to 24 seeing the highest rates. Across age groups, adults ages 25 to 44 had the highest gun-related homicide rates.

When it came to gun-related suicides, researchers noted that there was a "different pattern" in the demographics by age. The highest gun-related suicide rates in individuals under age 46 occurred among American Indian or Alaska Natives, while the highest rates for those older than 45 were among white adults.

According to Thomas Simon, a researcher from CDC's National Center for Injury Prevention and Control who led the study, it's currently unclear what is behind the increase in gun-related deaths, but the pandemic, as well as mental stressors, economic stressors, social isolation, and more, may be contributing to the rise.

In addition, Simon noted that racial and ethnic minority groups have been disproportionately impacted by these increases in gun-related deaths. "This is an example of an unacceptable disparity that has continued to go in the wrong direction," he said.

To help prevent gun-related violence in the future, Simon said it is important to address the needs of individuals with the greatest risk of experiencing violence. Some promising approaches include outreach programs that "chang[e] norms" around violence and hospital-based approaches, such as those from the Health Alliance for Violence Intervention. (Rabin, New York Times, 10/6; Firth, MedPage Today, 10/7 [1]; Chen, Axios, 9/30; Melillo, "Changing America," The Hill, 9/30; Firth, MedPage Today, 10/7 [2]; Edwards, NBC News, 9/30; Bernstein, Washington Post, 9/30)