Complex emotional needs, overcontrol and death by suicide in older adults

Abstract

Globally, older people are frequently at consistently greater risk of dying by suicide than those belonging to any other age group. In countries that report low or moderate rates of suicide in older people, under recognition, under reporting, and under responsiveness may be factors that impact the statistics collected. In countries like the UK, where suicide rates in older people have fallen in line with the national average, suicide in older people occurs ambiguously, may be hidden, or not considered a deliberate act. The introduction of specialist older adult teams and legal restrictions around access to firearms, has likely had some positive impact on the reduction in suicide rate in some older people since the 1980s in the UK. However, these factors may also mean that suicide in older people occurs in individuals who do not access mental health services, or who now use methods that do not appear to be deliberate attempts to die. Psycho-social differences in suicidal older adults are outlined. Older people with complex emotional needs are at greater risk of death by suicide, if they have been given a diagnosis of ‘avoidant’ or ‘obsessive compulsive personality disorder’. It is suggested that ‘overcontrol’ is an underlying psychological need that greatly increases the risk of death by suicide in older people. Identification and treatment of overcontrol is briefly discussed.