Archive for: Mark S. Kaplan

Most Male Suicides in U.S. Show No Known Prior Mental Health Link, Study Reveals Use of firearms and alcohol consumption are common factors in these deaths, UCLA and CDC researchers find

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By Stan Paul

A majority of American men who die by suicide don’t have any known history of mental health problems, according to new research by UCLA professor Mark Kaplan and colleagues.

“What’s striking about our study is the conspicuous absence of standard psychiatric markers of suicidality among a large number of males of all ages who die by suicide,” said Kaplan, a professor of social welfare at the UCLA Luskin School of Public Affairs.

For the study, published online in the American Journal of Preventive Medicine, Kaplan and his co-authors from the Centers for Disease Control and Prevention tracked recent suicide deaths among U.S. males age 10 and older. They found that 60% of victims had no documented mental health conditions.

Further, males without a history of mental health issues died more frequently by firearms than those with known mental health issues, and many were found to have alcohol in their systems, the researchers noted.

The report highlights the major public health challenge of addressing suicide among males, who are far more likely to die by suicide and less likely to have known mental health conditions than females. In 2019, for instance, males accounted for 80% of all suicide deaths in the U.S., the authors said, and suicide is the eighth-leading cause of death among males 10 and older.

Kaplan and his colleagues examined data from the Centers for Disease Control and Prevention’s National Violent Death Reporting System for the most recent three-year period available, 2016 to 2018, during which more than 70,000 American males died by suicide. More than 42,000 of them had no known mental health conditions, they found.

The researchers then compared characteristics of those with and without known mental health conditions across their life span in four age groups: adolescents (10–17 years old), young adults (18–34), middle aged adults (35–64) and older adults (65 and older). Identifying the various factors that contribute to suicides among these groups is crucial to developing targeted suicide prevention efforts, especially outside of mental health systems, the team emphasized.

Among their findings, they discovered that across all groups, those without known mental health conditions were less likely to have had a history of contemplating or attempting suicide, or both, than those with such issues. In particular, young and middle-aged adults without known mental health conditions disclosed suicidal intent significantly less often, they said.

In addition, males with no mental health history who died by suicide in three of the four age groups — adolescents, young adults and middle-aged men — more commonly experienced relationship problems, arguments or another type of personal crisis as precipitating circumstances than for those with prior histories.

The researchers emphasized the importance of focusing on these kinds of acute situational stressors as part of suicide prevention efforts and working to discourage the use of alcohol, drugs and guns during times of crisis — particularly for teens and young adults, who may be more prone to act impulsively.

Kaplan and his colleagues said the findings highlight the potential benefits of strategies to create protective environments, provide support during stressful transitions, and enhance coping and problem-solving skills across the life span.

“Suicide prevention initiatives for males might benefit from comprehensive approaches focusing on age-specific stressors reported in this study, in addition to standard psychiatric markers,” the researchers wrote.

“These findings,” Kaplan said, “could begin to change views on the non–mental health factors driving up the rate of suicide among men.”

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Alcohol Use Prior to Suicide Trends Higher in Women Than Men in New Study

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Alcohol use preceding death by suicide increased among women compared with men in the United States between 2003 and 2018, according to a newly published study co-authored by UCLA Luskin Social Welfare Professor Mark S. Kaplan. The report, published in the May 2022 online edition of Addiction, a publication of the Society for the Study of Addiction, included data from the National Violent Death Reporting System. The data included more than 115,000 men and women 18 years and older who died from alcohol-involved suicide from 2003 to 2018. Kaplan and co-authors Shannon Lange, Alexander Tran and Jürgen Rehm, researchers at the Center for Addiction and Mental Health, Institute for Mental Health Policy Research, in Toronto, found that while the prevalence of heavy alcohol use and the suicide mortality rate increased among men and women, women had experienced a notably higher increase in both. Because heavy alcohol use — a well-established risk factor for suicide — may have contributed to the observed sex disparity in the suicide mortality rate increase, the researchers sought to estimate the temporal trend of the sex- and age-group-specific proportion of suicides that were alcohol-involved in the United States. In the study period, the proportion of suicides that were alcohol-involved significantly increased on average annually for women of all age groups, while only middle-aged men experienced a significant average annual percentage increase, they reported. Kaplan and colleagues note that the results of the present study are important for both clinical and preventative efforts. “Evidence that alcohol use may have been a core driver in the accelerated increase in the rate of suicide among women will, hopefully, promote additional research in this area,” they wrote.

 

UCLA Luskin Scholars Receive Fulbright Awards

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Two UCLA Luskin Social Welfare faculty members have been named Fulbright awardees by the U.S. Department of State and the Fulbright Foreign Scholarship Board. Professor of Social Welfare Mark S. Kaplan received a Fulbright Specialist Award, which will allow him to complete a project at Universidad Carlos III de Madrid in Spain in the Department of Social Sciences. Professor of Social Welfare Ian Holloway received a Fulbright U.S. Scholar Award, which enables American scholars, artists, faculty and professionals to lecture and conduct research abroad for up to a year. Kaplan, now a four-time Fulbright awardee, said the main focus of his project with the Spanish university is to help “design and plan internationalization strategies for their research that maximize the impact of their work.” The Fulbright Specialist Program sends U.S. faculty and professionals to serve as expert consultants on curriculum, faculty development, institutional planning and related subjects at academic institutions abroad for two to six weeks. Holloway will spend four months as a visiting scholar at Universidad de Los Andes and work in partnership with a community-based organization in Bogotá, Colombia, that serves transgender people engaged in human rights organizing. The Fulbright Program is the flagship international educational exchange program sponsored by the U.S. government and is designed to build connections between the United States and other countries. The program, which operates in over 160 countries, was established in 1946 and has provided more than 400,000 students, scholars, teachers, artists and scientists the opportunity to study, teach and conduct research, exchange ideas, and contribute to finding solutions to shared international concerns.

 

Kaplan Explains Rising Suicide Rates Among Middle-Aged Men

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Professor of Social Welfare Mark Kaplan was featured in a Real Issue Productions film about the rise of mass shootings and the controversies surrounding the national gun debate. “The role of social status and suicide, particularly among males, is gaining attention,” Kaplan said. He explained that the mortality rate among white middle-aged men is rising, largely in part to an increase in suicide rates. As the middle class shrinks, many have lost their jobs and feel humiliated and unhappy — particularly less educated men who feel disenfranchised and abandoned by society. Suicide and mental illness are highly stigmatized in the United States, Kaplan said, noting that “people don’t like to talk about their mental health problems.” Even if guns are taken away, some people still may attempt suicide but “if they do, they are less likely to do so with highly lethal means,” Kaplan said. The film is available for viewing via the UCLA Library.

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Kaplan on Mitigating Youth Suicide Risk During Pandemic

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Professor of Social Welfare Mark Kaplan was featured in a Press-Enterprise article about the increase in suicide risk among young people during the COVID-19 pandemic. While there has been a decline in adult suicides since the beginning of the pandemic, data show that suicides among minors have stayed consistent or increased compared to before the pandemic. Many experts have expressed concern that social isolation, distance learning and other pandemic stresses are hitting young people especially hard. Crisis hotlines have experienced an increase in calls from young people suffering mental health problems. Kaplan, who has been studying suicide for decades, explained that young people who were already more likely to consider killing themselves are more vulnerable now, including LGBTQ youth, those suffering abuse, homeless youth, those with substance abuse problems, those living in foster homes or those growing up in poverty. “There’s a physical isolation that’s taking its toll,” he said. “It’s leading to despair.”

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Kaplan on Pandemic Stress, Increased Firearm and Alcohol Sales, and Suicide Risk

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“The convergence of stress from the pandemic with increased firearm and alcohol sales creates a hazardous situation for those at risk of suicide,” cautioned Professor of Social Welfare Mark S. Kaplan, co-author of a correspondence in the latest volume of The Journal of Studies on Alcohol and Drugs. Kaplan and a team of researchers from around the United States responded to recent research suggesting an increase in alcohol-related suicides due to the economic decline related to the COVID-19 pandemic. Noting previous co-authored research, Kaplan and his colleagues wrote that “alcohol ingestion itself (and especially acute alcohol intoxication) might be a key risk factor for suicide during and shortly after economic contractions.” The unemployment rate during the current pandemic could exceed that of the Great Depression of the 1930s, especially among socially disadvantaged groups, they point out in the journal published by the Rutgers Center of Alcohol Studies. “Particularly relevant to the economic contraction related to COVID-19, we found that suicide rates were most closely associated with rising poverty. These findings suggest that more than individual-level economic factors are at play in influencing suicide risk; place-level economic shocks also matter,” they noted. Kaplan and his team cite the increase of alcohol sales during a time of physical distancing when people may be becoming intoxicated in isolation. They also noted that the current situation could provide opportunities for suicide prevention. Experts in the field suggest increasing alcohol taxes, limiting times for alcohol sales, reducing the density of alcohol outlets and increasing access to treatment for people with substance use disorders.

Kaplan on Inequalities Underlying Gun Violence

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Social Welfare Professor Mark Kaplan was cited in an 808 Opinions blog post about the exacerbation of gun violence during times of crisis. The post argued that economic hardship and social unrest as a result of the COVID-19 pandemic have incited fear and panic. It also pointed to a rise in shootings, online ammunition sales and processed background checks for firearm purchases. The author cited a presentation by Kaplan that tied gun violence to racial and socioeconomic inequality in America. “You hear all about poverty, but inequality is another measure of economic well-being,” Kaplan said. “There is a strong correlation between homicide per million and income inequality.”

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Social Work Journal Tackles Firearm Violence in Special Issue Professor Mark Kaplan of UCLA Luskin sees latest issue of Health & Social Work as a call to action for social workers and the profession to address a national epidemic

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By Stan Paul

A new special edition of a social work journal focuses on gun violence in part because of guidance provided by Mark Kaplan, professor of social welfare at UCLA Luskin.

Kaplan was part of an editorial team of social work scholars from throughout the United States who bring together research on various aspects of firearm violence in the November edition of Health & Social Work, which is published by the National Association of Social Workers (NASW) Press and Oxford University Press.

He said that the special edition was meant to spark serious discussion and serve as “a call to action to people to begin thinking of this as a major challenge in professional circles.”

Kaplan, who uses population data to understand suicide risk factors among veterans, seniors and other vulnerable populations, joined colleagues in contributing articles to the publication. Kaplan’s contributions were co-authored with UCLA Luskin Social Welfare Ph.D. students Amelia Cromwell Mueller-Williams and Carol Leung, along with Ziming Xuan, an associate professor at Boston University’s School of Health.

According to an editor’s note about the special issue, “The field of social work has an obligation to address significant issues affecting clients and communities, including the outstanding issues of gun violence in the United States.”

Firearm violence in the United States is considered a public health crisis, and statistics cited in connection to the special issue paint a sobering picture.

Almost 40,000 people — about 60 percent from suicide — die annually. A large proportion of those dying are young people, the editors noted in their call for papers. Not all populations are affected equally — African American men make up the majority of firearm homicides.

The special issue also looks at the stress faced by people who survive shootings, pointing out that many live with chronic effects from their injuries. Gun violence affects immediate victims plus their families and communities.

Kaplan serves on the Board of Scientific Counselors for the National Center for Injury Prevention and Control, a branch of the Centers for Disease Control and Prevention. And he is a scientific advisor to the American Foundation for Suicide Prevention.

“Given the alarming rates of gun deaths in this country, the time seems right for social workers to address this issue in a more comprehensive way,” said co-editor Mickey Sperlich, an assistant professor at the University at Buffalo’s School of Social Work. The volume’s other co-editors are Patricia Logan-Greene, also an associate professor at the University of Buffalo, and Karen Slovak, who serves on the faculty of the School of Social Work at Capella University in Minneapolis.

Although recent mass shootings across the country have heightened public awareness and concern, policy action and research remain obstructed at the federal and state levels by strong opposition from national anti-gun-regulation groups, according to the editors. They note that some professional organizations have responded to this crisis by issuing comprehensive policy statements and practice guidelines for frontline workers, but little guidance exists for social work practice.

Contributors to the special edition delve into the relationship of firearm violence to race, gender and geography, as well as a less-publicized aspect — suicide.

Articles focus on the impact of firearm safety legislation on homicide rates and data that show differences in effectiveness for black and white populations. Another article looks at how fear of crime and racial bias influence gun ownership, especially for white people. A literature review of gun violence published in social work journals since the 1990s identifies the strengths and weaknesses of existing scholarship. Another literature review of community-based gun violence interventions suggests the value of systems-based approaches.

An article by Kaplan and his co-authors looks at the effects of firearm control policies on suicide rates for men, a “hidden epidemic” that accounts for the majority of deaths — not only of suicides but all gun-related deaths nationwide.

“One of the things we tried to do with the hidden epidemic paper was to even dig deeper and show that suicides involving firearms are even more hidden than other forms of gun violence, which often get most of the attention,” Kaplan said. “Most gun deaths in the country are suicides.”

At one level, the more guns in a community and the more guns in a state, the greater the age-adjusted firearm suicide rate, according to the article. “There are policy levers that we identified,” Kaplan explained. “So this is an epidemic that may be amenable to policies that would restrict people’s access, population-level access, to guns.”

In a “Viewpoint” article, Kaplan writes that “evidence suggests firearm-means restriction and firearm-suicide prevention represent gaps in social work education and practice, offering opportunities for universities and continuing education programs.” By increasing knowledge in this area, social workers can effectively engage their communities and advocate for stricter firearms laws. When enacted statewide, such laws lead to decreased numbers of firearm suicides.

A “Practice Forum” in the volume describes how social workers who were already engaged in a community-violence-prevention initiative responded to local outrage over the shooting of Alton Sterling, a 37-year-old black man and father of five who was shot and killed by Baton Rouge police in 2016.

“Social workers have an important role to play in supporting communities to heal and promoting community health in the aftermath of gun violence and trauma,” the authors conclude.

“Hopefully, it’s the start of a conversation that people will have about resorting to means that are more policy-oriented approaches,” Kaplan said. But he cautioned, “This is not a problem that will be resolved or addressed adequately on a one-by-one individual level. This is a much larger problem that needs to be addressed in a more upstream, universal way.”

For more information on the special edition of Health and Social Work and to access the articles, visit Oxford University Press (Oxford Academic) or NASW Press.

Kaplan to Advise CDC on Prevention of Violence and Injuries

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The U.S. Department of Health and Human Services has named UCLA Luskin Professor of Social Welfare Mark S. Kaplan to a board of experts on the prevention of violence and injuries. Kaplan will serve a four-year term on the Board of Scientific Counselors for the National Center for Injury Prevention and Control, a branch of the Centers for Disease Control and Prevention. The CDC reports that 214,000 people die from injury every year in the United States, and millions who survive an injury face lifelong mental, physical and financial problems. The board will advise the federal agencies on a variety of research areas to help set priorities and improve public health. “This is an incredible career achievement,” Social Welfare chair Laura Abrams said of the appointment. Kaplan’s research has focused on understanding suicide risk factors among veterans, seniors and other vulnerable populations. The CDC reports that suicide is one of just three leading causes of death that are on the rise. Members of the Board of Scientific Counselors represent several disciplines and include epidemiologists, statisticians, trauma surgeons, behavioral scientists, health economists, political scientists and criminologists.

In Wake of Recent Celebrity Suicides, Kaplan Appears on Radio Panel

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Professor of Social Welfare Mark S. Kaplan joined other experts in a recent KPCC broadcast following recent high-profile suicides that included celebrity chef Anthony Bourdain and designer Kate Spade. “Suicide is a remarkable public health issue because it is to some extent a hidden problem and in some cases almost a hidden epidemic. … And it is a remarkable problem because it is also associated with firearms,” said Kaplan, who studies suicide risk among vulnerable populations. Kaplan noted that of the approximately 45,000 yearly suicide deaths, half involve the use of firearms.

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