James Donaldson on Mental Health - Experts Warn Suicides are Undercounted in the U.S.

An accurate account of suicide burden is needed to develop, implement, measure prevention efforts Key Findings Many suicide deaths may be incorrectly recorded as accidents or undetermined deaths, meaning the true number of suicides is likely higher than official records show.

Drug overdose deaths are especially difficult to classify because it is often impossible to determine a person's intent after death.

Researchers propose using a broader reporting measure called self-injury mortality (SIM) to better capture deaths that may involve self-harm, even when intent cannot be confirmed.

Improvements in how deaths are investigated and classified are necessary to understand how big the suicide problem is in the U.S.

America is undercounting the number of suicide deaths, despite the rise in suicide rates in the 21st century, experts caution in a commentary published in the journal Injury Prevention .

In 2024, the national suicide rate was 37.5% higher than in 2000.

During that same period, the death rate from opioid and other drug poisoning increased more than threefold.

Yet the recorded suicide rate from drug poisoning only increased from 1.3 to 1.8 per 100,000 people.

Injury epidemiologist Ian Rockett, PhD, adjunct professor of Psychiatry at University of Rochester Medicine who authored a lead essay in the commentary, believes that as many as 30% of overdose deaths recorded as “accidental” or of “undetermined” intent may in truth be suicides.

Why are most overdose deaths classified as accidents?