THE SOCIOLOGY OF SUICIDE PREVENTION: POLICY IMPLICATIONS OF DIFFERENCES BETWEEN SUICIDAL PATIENTS AND COMPLETED SUICIDES*

In spite of hundreds of thousands of dollars in federal support, American suicide prevention centers have not succeeded in lowering the suicide rate. It is hypothesized that this failure to prevent suicide stems in large measure from the statistically sig-nificant differences between completed suicides and suicidal patients. American sui-cide prevention centers are simply not contacting those persons with high suicide potential. As a result of the present investigation it is concluded specifically that completed suicides are more likely to be male, old, married, to have come from fewer broken homes, to be more independent, less active socially, in poorer physical health, more successful vocationally,'and to have made fewer, more lethal suicide attempts than the patients. Thus, if one wants to lower the ^ suicide rate, the inter-vention services of the suicide prevention center must be redesigned to accommodate the life-style of the completed suicide. It is remarkable how stable the sui-cide rate has been in twentieth century America.1 Except for slight peaks dur-ing depression years and troughs dur-ing the two world wars, the rate of suicide has been constant for the last 68 years. This constancy is all the more striking when contrasted with the vari-ability of other causes of death. Table 1 reveals that deaths by diseases of childhood (scarlet fever, diphtheria, measles, etc.) have been virtually elim-inated. Deaths by pneumonia are one-fifth what they were at the turn of the century. Tuberculosis deaths are two percent of their 1900-1904 rate; chronic nephritis deaths, six percent. Generally the crude death rate has de-creased from 17.2 per 1,000 population * This research was supported by Na-tional Institute of Mental Health grants ##14679-01 and 14701-01. I wish to ac-knowledge the assistance of Sharon Bradley, Robert Dreyfoos, and Edmund D. Meyers in the preparation of this report, read in abbreviated form at the 63rd Annua