Report highlights gaps, risks of suicide for Utah women, girls

SALT LAKE CITY — Women and girls experience unique challenges throughout their lives and one of them might be that they're more susceptible to mental illness amid hormonal fluctuations, which could also lead to suicide.

A new report released by the Utah Women and Leadership project on Wednesday reveals how women and girls in Utah may be at greater risk, due to differences from men in biology, as well as other outstanding factors that remain out of their control.

The "Suicide Among Utah Girls and Women" report released this month marks Suicide Awareness Month and an opportunity to explore gender-related risks, said Dr. Kristy Hodson, lead author and instructor at Western Governors University College of Health Professions.

"The reason why we felt like it was important is, or, one of the reasons, is because suicide is considered preventable. And if it's preventable, the more that we understand, the more we explore these topics, the more we are better able to help those who are most at risk," said Hodson. "What a great opportunity to share this information to be able to help more people, hopefully, and bring awareness to this important topic."

The United States has struggled with increasing suicide rates over the years. In 2020, suicide was the 12th leading cause of death in the nation, and the suicide rate was double the homicide rate. To help combat the nation's mental health crisis a national suicide and crisis hotline was launched — dialing 988 instantly connects a suicide prevention network.

The idea for the hotline began in Utah, with state Sen. Daniel Thatcher, R-West Valley City, who proposed the idea statewide. Discussions surrounding suicide awareness and prevention have occurred not just in legislative sessions but in classrooms, city council sessions, board meetings and homes across Utah for a number of years.

Yet, Utah has consistently struggled with suicide rates, as Centers for Disease Control and Prevention data in 2020 indicated that Utah had the ninth highest age-adjusted suicide rate in the nation.

It is the eighth leading cause of death for Utahns, according to the Utah Department of Health and Human Services. More deaths result from suicide than from motor vehicle crashes, breast cancer, or other chronic physical health problems, the data revealed.

Multiple risk factors

The Utah Women and Leadership Project analyzed both national and state data to identify key differences and gender-related risks for women and girls. While both genders experience a general risk for suicidal ideation or behaviors, the report notes the following seven risk factors:

Suicide attempts vs. deaths

Research reveals that although men are more likely to die by suicide than women, more women are likely to attempt suicide than men. Men tend to have a shorter duration of the suicidal process, which may lend to the difference, the report said. Methods for the attempt also vary greatly by gender, with men more often opting for a firearm, which can affect lethality.

Eating disorders

Eating disorders such as anorexia or bulimia more frequently occur in women than men and are linked to suicidal behavior. Suicide is the second leading cause of death for those with anorexia and occurs three times more in women than men, the report noted.

Hormonal fluctuations

The fluctuations of hormones — including puberty, pregnancy, menstrual cycles and menopause — make women more susceptible to mental illness during those times. The report pointed to a study that indicated 25% of women who had died by suicide were menstruating at the time of death, compared to 4.5% of the control group.

Pregnancy, fetal loss and fertility problems

Similar to the risk factor above, hormonal fluctuations at these times may increase risk as well as potential loss.

"One of the most interesting parts of this report to me is to recognize that women are more susceptible to be to suicide attempts, and maybe even mental health mental illness because of these hormonal fluctuations," said Hodson. "When women ... experienced these low estrogen times, we can actually see the brain activity change. And so, the more that we recognize this as a brain issue and a body issue, I hope to reduce the stigma associated with asking for help."

Mental health

Serious mental illness rates are higher among females (7.0%) than males (4.2%), and the rates are also associated with suicide, according to the report. New research is beginning to uncover the differences that make women more vulnerable to psychological illness.

Sexual abuse and childhood adversities

Physical, emotional and sexual abuse can lead to a substantially higher risk for suicide. Child sexual abuse is more common in girls and prevalent in Utah. The report revealed that 13% of Utahns report being molested before the age of 18, and 78.7% of all sexual assault victims in Utah report being sexually assaulted before their 18th birthday.

"If we can recognize that this is a risk factor, then we'll be able to hopefully put down those barriers that we put up. These ideas that we want to believe that the world is the way it should be, and in doing so ... people aren't willing to reach out because they are embarrassed about it," said Hodson. "But if we can recognize that this is very prevalent in Utah, it's more likely that, hopefully, those victims will reach out and get early help."

Marital status and intimate partner violence

While marital status is often considered a protective factor against suicide, the report indicated it may be less protective for women. One of the most significant factors of suicide for women is intimate partner violence.

Utah-specific factors noted in the report had overlap with some of the general gender-related risk factors mentioned. Specifically, the report further discussed the prevalence of domestic violence and dating violence in Utah. With 33.6% of Utah women experiencing intimate partner violence in their lifetime and one-third of teens experiencing unhealthy relationships, the risk for suicide rises.

Other factors indicated in the report that put women at greater risk for suicide include LGBTQ populations, religion, the opioid epidemic and substance use.

Ideas for decreasing occurrence

The report outlined 18 recommendations to decrease suicidal behavior among girls and women. Many of them include gender-specific and gender-related approaches, as well as a call for additional research into the differences.

"To treat everybody the same, even if there are differences, we lose opportunities — we lose so many opportunities to really understand what's going on," said Hodson. "There are specific factors that we could research on both females and males and those things could give us opportunities to understand difficult situations better."

"Women actually have higher rates of serious mental illness than men," she continued. "... and so, again, to treat them equally would be a disservice."

Some of the recommendations to solve the gender-related differences, include:

• Avoid normalizing suicide, or creating too much emphasis on the struggle and highlight that many individuals who have contemplated or attempted suicide have gone on to live healthy, normal lives.
• Focus resources on mental health programs that specialize in issues such as postpartum and eating disorders, while also educating the community about signs regarding postpartum and eating disorders.
• Proactively teach coping skills, problem-solving strategies, communication, and resilience training.
• Increase the connectedness of girls and women in Utah by encouraging healthy social connections, meaningful supportive relationships and inclusion in all its forms.

To read the report, visit the Utah Women and Leadership Project's website, at www.usu.edu/uwlp.

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