Suicide in Old Age: A Tragedy of Neglect

Objective: To investigate the incidence and treatment of depression in geriatric suicide. Method: All coroners' records, autopsy and police reports for suicide victims aged 65+ in Ontario (n = 543) over 3 years were examined. Results: Over 80% of the elderly who committed suicide received no psychiatric referral. Of the sample, 87% were untreated while only 13% received antidepressants. Tricyclics, which are lethal in overdose, were the drugs of choice. None of the sample was treated with the safer specific serotonin reuptake inhibitors (SSRIs). Females were 3 times as likely to be treated as were males, and those seeing psychiatrists were 4 times more likely to be treated with antidepressants than those seeing general practitioners (GPs). The physically ill were rarely treated. Conclusions: These findings suggest that early geropsychiatric assessment and vigorous treatment could prevent many suicides in old age.