Updated 5 January 2025
Suicide is a critical public health issue that often goes underreported or misclassified. For various reasons, such as social stigma, financial consequences and the complexities involved in determining the true cause of death, the actual number of suicides is likely higher than reported statistics indicate.
Underreporting of suicides is a multifaceted issue. Many individuals who die by suicide may have been living seemingly normal lives, showing no outward signs of distress. This can make it difficult for families and authorities to recognize their deaths as suicides. In various cultures, including the military, people are often taught to function through immense pain, including mental pain. Consequently, even those who are battling severe depression may still perform well at work and maintain social relationships, masking their true struggles.
A considerable number of suicides are hidden under other types of fatalities, such as drug overdoses, car accidents and falls. These types of deaths are easier to attribute to accidental causes rather than intentional self-harm. Without thorough investigations, which often require skilled coroners and detectives, the true intent behind these deaths might never be revealed. When it comes to veteran suicides in southern Arizona, we have worked closely with the Pima County Office of the Medical Examiner (PCOME) to help track and publicize the numbers. The numbers shown in for veteran deaths that were handled by PCOME from January 2022-December 2024 in Pima, Cochise, La Paz, Graham and Santa Cruz Counties reveal that 480 (or 48%) of the 1,004 deaths are categorized as accidental. Of those, the cause of death of 202 are listed as "Fall", 97 as "Drug Death", and 92 as "Motor Vehicle Related". We can't help but find it concerning that 202 veterans have accidentally fallen to their death in the past three years in Southern Arizona. [see footnote 1]
Life insurance policies often have clauses that can nullify benefits if the insured's death is ruled a suicide within a certain period after the policy is enacted. This financial implication significantly influences how deaths are reported. Families and even some medical professionals might hesitate to declare a death as a suicide to ensure that insurance payouts are not jeopardized.
Identifying and reporting suicide as a cause of death is fraught with difficulties. These challenges can stem from insufficient evidence, ambiguities in the circumstances surrounding the death and a lack of skilled coroners to investigate thoroughly. Additionally, social stigma surrounding suicide can lead to families wanting to avoid the label, further complicating accurate reporting.
Emotional pain is notably less visible than physical pain, making it difficult to recognize, document and report. People who suffer from extreme emotional anguish often do so in silence, and their outward appearance can be deceiving. This invisibility hinders proper acknowledgment and reporting of suicides and results in underrepresentation in public health data.
The scarcity of coroners in some regions, such as Cochise County, significantly impacts the accurate reporting of suicides. Without a trained professional to investigate suspicious deaths, many cases that may have been suicides can be misclassified as accidental or due to natural causes. This lack of resources leads to gaps in data and misinforms public health initiatives aimed at combating suicide.
Addressing the underreporting of suicides requires a multifaceted approach, including reducing stigma, ensuring financial protections for families and investing in skilled coroners. By acknowledging and tackling these challenges, society can better understand the true scope of the problem and implement more effective prevention and intervention strategies.
Pima County Office of the Medical Examiner Special Populations: www.veteranstats.org/pcome > veterans; captured 5 January 2025
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