March 31, 2016

Financial Cost of Suicide in U.S. Nearly Twice Previously Thought

WALTHAM, MA | A new study by researchers at Brandeis University’s Heller School for Social Policy and Management, the University of Massachusetts, and EDC finds that the economic cost of suicide in the United States has been significantly underestimated.

The researchers calculated that the annual public cost of suicide attempts and suicides in the United States is approximately $93.5 billion—nearly twice previously thought. Their study appears in Suicide and Life-Threatening Behavior, the official journal of the American Association of Suicidology.

The national cost of suicides and suicide attempts in the United States in 2013—the last year for which data are available—was $58.4 billion based on reported numbers alone. Lost productivity represents most of this cost. After adjusting for underreporting, the total cost increases to the aforementioned $93.5 billion, or $298 per capita.

“These numbers are staggering and we think the actual cost is much higher,” said principal investigator Donald Shepard from the Heller School. “With every problem, getting accurate data is a challenge, and that was the case with suicide. Most counts understate the total number of suicides due to the stigma involved.”

To adjust for this challenge, Shepard and his colleagues tapped research that quantified the misclassification of suicide in the United Kingdom. Applying this relationship to the most recent U.S. suicide data, they compensated for the large number of deaths that coroners fail to identify as suicides, particularly among teens and minorities. Then they put a price tag on this new higher suicide number by calculating direct medical expenses as well as indirect costs such as lost wages resulting from premature death and injury (in the case of attempted suicide).

“It is estimated that 10 to 15 percent of patients who engage in medically serious suicide attempts will die by suicide within 10 years,” said EDC researcher Morton Silverman. “Yet we know of a number of successful approaches for reducing the risk of future suicide attempts. For example, a more timely and efficient continuum of care across services within hospitals, as well as between hospitals and community services, could help lower both future suicide attempts and deaths.”

Based on their analysis, the authors recommend that every patient seen in an emergency room or trauma unit for attempted suicide receive a comprehensive suicide risk assessment, a brief treatment or an intervention before being discharged and a referral to a community-based behavioral health provider to ensure ongoing treatment for the underlying problems that precipitated the suicidal behaviors. These recommendations are in keeping with those of the National Action Alliance for Suicide Prevention.

The study projected that psychotherapeutic and other linkage interventions across the age spectrum would lower overall suicides by 10 percent. The resulting impact would represent an overall savings of $9.4 billion to the American economy—more than twice the estimated cost of implementing the interventions. It would also save an estimated 4,100 lives each year.

According to the National Institutes of Mental Health, suicide is the second leading cause of death for both 15-24 year olds and 25-34 year olds in the United States, and it is the tenth leading cause of death across all ages.

The full study is available at

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