DOWAGIAC — Each year, 44,965 Americans will die by suicide, as it is the 10th leading cause of death in the U.S.

In elders, suicide rates are 50 percent higher than the national average, said Bart Carrel, during a presentation at Borgess Lee Memorial Hospital about suicide prevention in older adults. Carrel is an employee of Senior Life Solutions, a program dedicated to addressing the emotional and behavioral health of adults over the age of 65.

In his presentation, Carrel discussed the scope of suicide in the U.S. to help attendees learn of suicidal behavior in older adults and about effective strategies to prevent suicide.

Older adults over the age of 65 have a higher suicide rate than the national average, according to the Center for Disease Control and Prevention.

In older people, there are four suicide attempts to one completion, Carrel said, which is usually in an older man over the age of 65, who uses a firearm.

“Women over the age of 60 usually do not have a high suicide rate,” Carrel said.

In the presentation, Carrel said 66 to 90 percent of elders have a diagnosable mental illness, which Carrel noted was in most cases depression.

During Carrel’s PowerPoint presentation, he said two to four percent of elders who completed suicide were terminally ill.

“If you have terminal cancer or a terminal heart condition where your heart is failing or severe breathing problem like chronic obstructive pulmonary disease where you are terminally ill, you’d think those would be the people who would be likely to commit suicide,” Carrel said. “Not true.”

Carrel also discussed elder risk factors associated with suicide, which included being a male, white and over 65, having depression, access to firearms, substance abuse, social isolation, physical illness or fear of prolonged illness.

Another risk was a major change in social roles, which is one explanation for why elderly males are more likely to commit suicide. Older men have particularly high rates of suicide, according to the CDC.

“They may have had that role of provider and protector,” Carrel said. “They may have had that father role and children have moved away, maybe their wife has passed away. They are no longer in that role where their life has a lot of meaning and purpose.”

Another risk factor is missed opportunities in clinical settings, which Carrel said physicians are improving at. Often, when someone is contemplating suicide, they will go and see a doctor shortly before. They will not tell their doctor they are contemplating suicide but they want something for possible joint pain, fatigue or insomnia.

Carrel said depression is of similar prevalence in the elderly as any other age group, but the elderly also have chronic physical illnesses to deal with, too.

“In the elderly, there is also a chance of relapse,” Carrel said. “People can be treated for depression and get back to the normal function, but they are more likely to have a relapse or recurrence back into depression.”

Carrel said doctors are getting better at diagnosing and treating elders with depression as Medicare includes an annual wellness exam and a depression screening.

A new type of therapy, known as cognitive behavioral therapy, can result in positive results within three months, Carrel said.

Years ago, Carrel said people were told never to ask someone if they were thinking about suicide. Now, he said, suicide preventionists say asking can be an effective way to determine if someone is planning a suicide.

Lastly, Carrel said if someone knows of a person thinking of suicide, they can make referrals to senior life solution’s program or to get on the phone with the National Suicide Prevention Lifeline 1-800-273- TALK.

“If you’re with somebody, and they are telling you they are going to harm themselves, what you should do as uncomfortable as it is, is stay with them and call 911,” Carrel said. “How would you feel if you left that person and later on they happened to commit suicide or were injured because they attempted?”