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Seniors have highest suicide rate

They're often called The Golden Years . But for some seniors, life after 65 can be filled with declining health, isolation, and depression. Those are some of the factors that can lead to suicide. And as it turns out, seniors have a higher suicide rate than any other age group. KPBS Health Reporter Kenny Goldberg has the story.

Cecil King grew up on a farm in Kentucky during the Depression. He later joined the Marines, fought in World War Two, and started a number of successful businesses.

King had a real engaging personality, according to his son Jim.

Jim King: "He was extremely outgoing to the outside world. Humorous, funny, made jokes. Towards the end, or to the last few years of his life, it was pretty much a charade, that he was able to maintain."

Jim King's view of his father was shattered forever when the phone rang on an October afternoon in 1993.

King: "My wife actually got the call. And handed the phone off to me because she didn't understand what the person was saying. It turns out it was my mother, very hysterical, saying he had shot himself."

Cecil King left his son a suicide note.

King: "He referenced the fact that he did not want to end up in a nursing home, that was his great fear. And he said basically in the note that he had tried to live a good life, take care of his family, but he felt this was the best way to go.

People tend to think of suicide as something that primarily affects young people. But as it turns out, people who are 65 and older are almost twice as likely to kill themselves than younger adults. And men over 85 are nearly three times as likely to commit suicide.

Alan Smith: "One of the primary issues really is isolation. When you get into older adulthood, the biggest increases in suicide are among people who live alone.

Alan Smith is an epidemiologist with the San Diego County Department of Emergency Medical Services. He says the ratio of attempts to actual suicides is also much higher among seniors.

Smith: "Older adults are much more likely to use firearms than other people. They just seem to be more serious about it, to have more of a plan going in. They're less impulsive about their suicide gestures."

Doctors say across all age groups, the leading cause of suicide is depression.

Dr. Michael Plopper is a geriatric psychiatrist, and medical director of Sharp Mesa Vista Hospital. He says the mental health of seniors is often overlooked.

Dr. Michael Plopper: "Depression tends to be under identified in later life. We tend to focus more on their medical illnesses as physicians and less so on their mental state."

In fact, one study reveals nearly 70 percent of seniors who committed suicide saw their primary care doctor in the month prior to taking their own life. Plopper argues physicians who treat the elderly need to do a much better job of screening for depression.

Plopper says what makes things more challenging is seniors don't like to admit they may be having some mental health issues. Plopper believes stigma is a powerful force among older adults.

Plopper: "People do not want to be identified as having a mental illness, they don't want to identify as being in treatment, and therefore they tend not to seek it themselves. It's also true for families. Sometimes families just don't want to deal with that element of an older person's life, their parent's life, they are less likely to recognize it, ask appropriate questions about it. So older people tend not to get into treatment."

One of the problems is Medicare. The program provides mental health services for seniors who need to be hospitalized. But it only covers half of the cost of psychiatric care otherwise.

San Diego County is trying to step in to help. Thanks to the passage of Prop 63, the County will soon launch some new mental health programs directed at older adults. These will include a mobile outreach effort that will visit isolated seniors in their homes.

The County has a number of other activities designed to keep older adults engaged.

At the Neighborhood House Senior Center is Southeast San Diego, about 30 older adults are involved in an exercise class. This center and others throughout the region offer educational and volunteer opportunities, too.

Pam Smith directs the County's Department of Aging and Independent Services. She says older adult suicide is a major concern.

Pam Smith: "We know that happens when people get off alone and isolated. So we need to prevent that. And we need to have places where people can come and still be part of the community and enjoy."

There are some 75 senior centers in the County, not to mention hundreds of other community and school-based opportunities for seniors to get involved.
Jim King wishes his father Cecil had reached out. King says life for his family has been rough after his father's suicide.
King: "Probably the worst thing we've ever been through. As someone once said, it's a club that I didn't ask to belong to, but I'm a member.

And there will likely be a lot of other members over the next few decades, even if the older adult suicide rate declines. That's because the number of Americans 65 and older is expected to double within the next thirty years.
Kenny Goldberg, KPBS News.

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