Why suicide rates are so high among older adults in Washington

Editor’s note: This article focuses on suicide, self-harm and other topics related to psychiatric distress. If you or a loved one is in crisis, call 988. Additional resources are available here.

Even as Washington’s overall suicide rates have fallen, they remain stubbornly high in an often overlooked group: Older adults.

In 2024, 216 people age 70 or older died by suicide in Washington, representing about 18% of the state’s total suicide deaths.

For the past 10 years, suicide rates in the 70+ population have consistently been above those in the general population. Between 2023 and 2024, the general population’s suicide rate fell from 15.4 to 14.4 per 100,000 people, but the rate for adults 70 and older rose from 20.5 to 22, state Department of Health data shows.

Experts attribute the high rate to mental health challenges that can be overlooked or written off as normal parts of aging.

Older people are also more likely to die when they attempt suicide, largely because they are more likely to use firearms. Nationwide, the rate of gun suicides among people over 70 has gradually risen, from 11.6 per 100,000 people in 2003, to 13.7 in 2023, according to data from the Gun Violence Data Hub.

“Our society defines people by jobs and productivity, and when people age we view it in a deficit lens. They’re not as valued,” said Lesley Steinman, the director of the University of Washington’s Program to Encourage Active, Rewarding Lives, which partners with community-based organizations to educate older adults about depression.

Aging brings challenges

The mental health challenges of aging come down to a combination of “isolation, loss and transition,” said Justin Pere, a Seattle-based therapist.

People they love are dying or moving farther away. Physical changes mean daily tasks can become harder and energy is lower. Some may be facing frightening health challenges, including terminal illnesses. Finances can be a challenge for adults who are no longer working and have medical costs. They’re also gradually losing autonomy and independence.

When these factors combine, they can lead to disconnection, isolation and, sometimes, depression. Losing a spouse is a particular risk factor for depression and suicide, said Alice Verstaen, a Seattle-based clinical psychologist who specializes in working with older adults.

Changes that are often thought of as a normal part of getting older — sleeping badly, forgetfulness, loneliness — can also be indicators of mental health challenges.

“These shouldn’t impact your mental health to the point you meet criteria for depressive disorder,” Verstaen said. “These may be common, but don’t have to be part of the aging experience.”

Suicide warning signs among older adults can be more subtle and are sometimes missed by traditional screening questionnaires, Verstaen said. Along with withdrawal and losing interest in things they used to enjoy, telling family or caregivers they feel like a burden is a major sign.

“Older adults say it in a way that sounds almost matter of fact, but it’s a big red flag,” Pere said. “Comments like ‘I don’t want to keep doing this’ or ‘it might be easier if I wasn’t here’ are easy to brush off, but those are direct expressions of distress.”

Among older adults, white men are at the highest risk of suicide. Men often “bear the cross of needing to be independent and be a provider,” Steinman said, and they’re less likely to ask for help.

In 2023, 83% of the adults 70 or older who died by suicide in Washington were men.

Older adults in rural areas are also more vulnerable, in part because they have less access to mental health treatment.

From 2015 to 2024, Stevens County had 37 suicide deaths among adults 70 or older, according to data provided by the Washington Department of Health. But because of its small population, the northeast Washington county had the state’s highest suicide rate for this age group: 50 deaths per 100,000 residents. Clallam, Mason, Whitman and Asotin counties all had rates above 35 deaths per 100,000 residents.

King County’s 70+ population had 346 suicide deaths in that same time period, but its large population meant that it had the second-lowest rate in the state for this age group: 17.3 deaths per 100,000 residents. (Some counties were excluded from state data because they had fewer than 10 deaths.)

What we can do about it

Older generations carry more stigma around mental health and may never have learned to discuss it. While working at the Seattle VA Medical Center, Verstaen recalls working with a veteran in his 70s or 80s who had struggled with anxiety his whole life without having a name for it.

“There were some pretty basic skills to manage anxiety he’d never learned,” she said. “He was able to open up and say, ‘This is an issue, I’d like some support.’ ”

Family members should ask their loved one directly if they’ve been feeling hopeless or don’t want to be here anymore, Pere said. If older adults bring up challenges or say they’re feeling down, don’t minimize what they’re saying or say things like “you’re fine, it’s just part of getting older.”

Fostering social connection is also a key way to keep loneliness at bay. Family gatherings, senior centers, community activities and volunteering can all help older adults stay connected to others.

PEARLS teaches two main strategies to help older adults be less depressed and more connected to the community. The first, behavioral activation, involves planning “mood boosters” and things that make you feel good — exercising, reconnecting with a friend, dressing up for a nice dinner — even if you don’t feel like it.

“There’s this tendency to say, ‘when I'm not depressed I'll then do these things,’ but it’s actually the act of doing them that might make us feel a little better,” Steinman said. “Connect with the person you’re worried about and say, ‘What’s something you used to do that makes you feel good?’ ”

The second, problem-solving treatment, can help in situations when “we feel like we’re drowning in problems,” Steinman said. Using this approach, PEARLS coaches help people take small steps to tackle problems one at a time and work toward goals.

Older adults are “incredibly resilient,” Pere said, in part because they’ve lived through so much.

“People talk as if change is impossible for older adults, but I see the change all the time when someone reconnects with community or finds a new sense of purpose or feels understood instead of invisible,” he said. “Their whole outlook can shift.”

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