Over half (56.8%, n
491) of the 2004 violent deaths (n
864) reported via SCVDRS are suicides. This represents 1.3 completed suicides per day, or a rate of 11.7 per 100
000 population. Demographically, the majority of victims (70.7%) were white males, followed by white females (16.7%), black and other males (10.2%) and black and other females (2.4%). Hispanic ethnicity was not included in this analysis. Males aged 75–84 years had the highest rate of suicide death (38.3 per 100
000), while males aged 45–54 demonstrated the highest number of deaths (n
88). Twenty victims were aged 17 years and younger. Among victims aged 25 years and older 74.2% completed a high school education.
The successful linkage of the SCVDRS data to additional human service databases provides supplementary insight to SCVDRS findings. The current analysis is designed to provide a broad overview; demographic differences in the findings are an area for later exploration.
UB‐92 hospital in‐patient and emergency room visits
Of the 491 suicides in 2004, 282 cases (57.4%) were linked to year 2003 and 2004 UB‐92 hospital discharge and emergency room records (fig 2). Two hundred and eight individuals (42.4%) did not link; 207 of these individuals did not have a hospitalization or emergency room visit during 2003–04, and a unique identifying number was unable to be assigned to one individual. The one individual for whom a unique identifier could not be assigned lacked sufficient identifying information (for example, date of birth, social security number, race, sex, or a combination of these).
Figure 2SCVDRS data linkage.
From January 2003 through December 2004, 282 individuals logged a total of 865 visits to a hospital or emergency room. Emergency room visits accounted for 573 visits (223 persons), and in‐patient care accounted for 292 visits (158 persons). Individuals averaged three visits to a hospital within the two years prior to suicide completion (table 1).
Table 1Number of South Carolina in‐patient hospitalizations and emergency room visits for persons who completed suicide in 2004, January 2003–December 2004 (282 linked individuals)
Primary and secondary E‐codes indicate intention. From the 282 linked files, 160 (56.7%) individuals had primary or secondary injury E‐codes from the final hospital or emergency room visit prior to suicide. Injuries were identified as suicide attempts in 80 hospital encounters by 70 persons (24.8% of linked records). Thirty eight (47.5%) encounters were firearm related, and 35 (43.8%) were poison related.
For 68 individuals (24.1% of linked files), less than one day elapsed between the last hospital encounter and suicide completion. It is possible this number reflects those who died upon arrival, eliminating the possibility that prevention programs would prevent a later suicide. Approximately 7% (7.1%, n
20) of completed suicides occurred within 1–7 days of the final hospital encounter, and 16.7% (n
47) occurred within 1–30 days of the final hospital encounter. The median number of days between the final hospital encounter and suicide (excluding those with less than one day) is 110. The 25th and 75th percentiles are represented by 35 and 271 days, respectively.
Table 3South Carolina Year 2004 suicide victims with criminal justice system contact within 18 months prior to death*
Department of Mental Health
History of contact with the DMH and year 2004 suicide victims between January 1996 and the date of suicide was reviewed. Electronic DMH records before 1996 were not available. Ninety one suicide victims were served by the DMH during this time period, representing 18.5% of SC suicides in 2004. The number of service contacts (that is, visits) with the DMH ranged from one (n
12) to more than 800 (n
1), with 75.8% (n
69) of victims having between one and 34 visits. The median number of visits per patient is 8. The 25th and 75th percentiles are represented by 3 and 34 visits, respectively.
The time interval between the last date of service contact with the DMH and suicide was analyzed (table 2). Two victims had contact with the DMH within one day of suicide; seven victims had DMH contact in the six days before suicide; and 46 victims had contact with the DMH within six months of suicide.
Table 2South Carolina Year 2004 suicide victims with Department of Mental Health (DMH) contact within 6 months prior to death*
Primary diagnosis of victims at time of last visit varies. Depression was most common (n
31), followed by “other mental illness” (n
15) and schizophrenia (n
12). “Other mental illness” are those not classified as attention deficit/hyperactive disorder, anxiety, bipolar, conduct, depression, post‐traumatic stress syndrome, substance abuse/dependence, borderline personality disorder, co‐occurring diagnoses, and other personality disorders.
Criminal justice: SLED and DJJ
Criminal histories were searched for all 491 suicide victims. The automated SLED database contains all arrests in and after 1977, and arrests before 1977 of those with an arrest in or after 1977. The DJJ database contains arrests in and after 1983. One hundred and ninety six individuals had a criminal history, representing 39.9% of year 2004 suicides (fig 2). Six individuals had a juvenile arrest record, and 189 had an adult arrest record. One individual had both a juvenile and an adult arrest record. Sixty nine individuals (35.2% of those with a criminal history) were arrested within 18 months prior to suicide completion, including all six individuals in the DJJ database and the individual in the SLED and DJJ databases (table 3).
Criminal domestic violence arrests
Forty individuals (20.4% with a criminal history) had an arrest record for criminal domestic violence. Sixteen of those individuals, or 40.0%, had criminal domestic violence arrest records 0–18 months prior to suicide. Two of these individuals, or 5%, had more than one arrest during the time period. Of those 16 cases, SCVDRS narratives indicated that only one law enforcement report mentioned a prior arrest or status as a suspect in a criminal domestic violence case. However, one law enforcement report and one coroner report mentioned criminal domestic violence as relevant to the suicide (that is, “Victim had physically attacked girlfriend”). In one case both the law enforcement report and coroner report indicated that the suicide victim had been a suspect in the death of his girlfriend.
Driving under the influence of alcohol or other drugs arrests
Eighty two individuals, or 41.8%, with a criminal history had arrest records for DUI. Nine of these individuals, or 11.0%, had arrests in the 18 month period prior to suicide. Three individuals, or 3.7%, had an arrest within the month of death, and five individuals, or 6.1%, between 6–12 months prior to death. Narrative information from law enforcement and coroner reports did not reflect DUI in any case. However, comments such as “Victim was known to have a drinking problem,” were present.
Sex crimes arrests (indecent exposure, sexual assault, etc)
Nine individuals with a criminal history, or 4.6%, had ever been arrested for a sex crime. Four of these individuals, or 44.4%, had been arrested for a sex crime within 18 months prior to death. Two individuals, or 22.2%, completed suicide within a week of arrest. One individual, or 11.1%, was arrested twice within the week prior. In only one case did the law enforcement and coroner narrative mention the arrests.