ArticleEClinicalMedicine2021
Fatal self-injury in the United States, 1999-2018: Unmasking a national mental health crisis.
Article in EClinicalMedicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed.
- Use of Vital Records to Improve Identification of Suicide as Manner of Death for Opioid-Related Fatalities.Crisis · 2026Article
- Risk factors for unnatural mortality in persons with serious mental illness.Scientific reports · 2025Article
- It is Time to Realize the Promise of the Digital Mental Health Transformation: Application for Population Mental Health.Journal of medical Internet research · 2025Article
- Psychiatric and racial/ethnic differences in incident and long-term benzodiazepine use: A commercial healthcare claims study.Journal of psychiatric research · 2025Article
- Escalating costs of self-injury mortality in the 21st century United States: an interstate observational study.BMC public health · 2023Observational
- Unanticipated Changes in Drug Overdose Death Rates in Canada During the Opioid Crisis.International journal of mental health and addiction · 2022Article
- Suicidal motivations among opioid overdose survivors: Replication and extension.Drug and alcohol dependence · 2022Article
- Responding to the opioid crisis in North America and beyond: recommendations of the Stanford-Lancet Commission.Lancet (London, England) · 2022Review
- Association of State Social and Environmental Factors With Rates of Self-injury Mortality and Suicide in the United States.JAMA network open · 2022Article
- Preliminary Evidence That the Short Allele of 5-HTTLPR Moderates the Association of Psychiatric Symptom Severity on Suicide Attempt: The Example in Obsessive-Compulsive Disorder.Frontiers in psychiatry · 2022Article
- Geographic Disparities in Readmissions for Peripheral Artery Disease in South Carolina.International journal of environmental research and public health · 2021Article
- Suicide-related care among patients who have experienced an opioid-involved overdose.General hospital psychiatryArticle
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Authors and funding
21 authors.
Funding
Abstract
backgroundSuicides by any method, plus 'nonsuicide' fatalities from drug self-intoxication (estimated from selected forensically undetermined and 'accidental' deaths), together represent self-injury mortality (SIM)-fatalities due to mental disorders or distress. SIM is especially important to examine given frequent undercounting of suicides amongst drug overdose deaths. We report suicide and SIM trends in the United States of America (US) during 1999-2018, portray interstate rate trends, and examine spatiotemporal (spacetime) diffusion or spread of the drug self-intoxication component of SIM, with attention to potential for differential suicide misclassification.
methodsFor this state-based, cross-sectional, panel time series, we used de-identified manner and underlying cause-of-death data for the 50 states and District of Columbia (DC) from CDC's
findingsThe national annual average percentage change over the observation period in the SIM rate was 4.3% (95% CI: 3.3%, 5.4%;
interpretationDepiction of rising SIM trends across states and major regions unmasks a burgeoning national mental health crisis. Geographic variation is plausibly a partial product of local heterogeneity in toxic drug availability and the quality of medicolegal death investigations. Like COVID-19, the nation will only be able to prevent SIM by responding with collective, comprehensive, systemic approaches. Injury surveillance and prevention, mental health, and societal well-being are poorly served by the continuing segregation of substance use disorders from other mental disorders in clinical medicine and public health practice.
fundingThis study was partially funded by the National Centre for Injury Prevention and Control, US Centers for Disease Control and Prevention (R49CE002093) and the US National Institute on Drug Abuse (1UM1DA049412-01; 1R21DA046521-01A1).
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