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Suicide Prevention Lifeline

World Suicide Prevention During COVID-19 Pandemic Requires Empathy and Outreach

September 10th 2020 is World Suicide Prevention Day.

CDC data indicates that suicide and suicidal ideation is higher in men aged 18-24, essential workers, blacks, and Hispanics who never graduated high school or serve as unpaid adult caregivers.

According to the Morbidity and Mortality weekly report published by the CDC, 40.9% of survey respondents reported at least one adverse mental or behavioral health condition, including symptoms of anxiety disorder or depressive disorder (30.9%), symptoms of trauma- and stressor-related disorder (TSRD) related to the pandemic.

This compares to less than 178 COVID-19 infections per 100,000 Americans that were severe enough to require hospitalization.  The overall cumulative COVID-19 hospitalization rate was 178.2 per 100,000, with the highest rates in people aged 65 years and older (481.5 per 100,000) and 50–64 years (266.3 per 100,000).  (See CDC published statistics.)

If you need help:

  1. Contact your physician, a therapist, or other behavioral health professional for a confidential discussion and assessment to discuss how you’re feeling
  2. There is a national U.S. suicide prevention hotline at 800-273-8255, go to or see the Lifeline chat

CDC data: suicidal ideation is higher in men 18-24 and essential workers

Suicidal ideation is higher in men aged 18-24, essential workers, black and Hispanic, who never graduated high school or who serve as unpaid adult caregivers

According to the U.S. Centers for Disease Prevention and Control (CDC):

  1. In 2003, suicide was the 11th overall leading cause of death in the United States and was responsible for 31,484 deaths,[i] which equated to one suicide every 17 minutes.
  2. In 2018, suicide is the 10th leading cause of death in the United States. It was responsible for more than 48,000
  3. During June 24–30, 2020, U.S. adults reported considerably elevated adverse mental health conditions associated with COVID-19. Younger adults, racial/ethnic minorities, essential workers, and unpaid adult caregivers reported having experienced disproportionately worse mental health outcomes, increased substance use and elevated suicidal ideation.

Suicide attempts and other acts of self-harm that result in nonfatal injuries affect the health of many persons and families. In 2004, approximately 535,000 visits to U.S. emergency departments were made after attempted suicides or because of other self-inflicted injuries.[ii]

These statistics aren’t just numbers; they are friends, members of a family, partners, parents, sons, and daughters.

Male Behavioral Health and Suicide

According to the UK based my GP, there are significant differences between genders. The number of suicides is much higher among males than females across all age groups in the world. In the UK, men are three times more likely to die by suicide than women.

When asked why they don’t get routine medical care such as an annual physical, men often report vague issues like a busy schedule.

Avoid trivializing men’s mental health.

Probably one of the most essential and significant points to consider. Avoid saying things that invalidate a man’s feelings—for example, “man up,” and “why are you so emotional?”. Instead, acknowledge the person’s feelings, show empathy, and provide support. If you find that you don’t know what to say, even listening without judgment is the best thing you can do.

CDC Data from June 2020 indicates males age 18 to 24 have had higher ideations of suicide, mental health symptoms, and substance abuse.

CDC data June 2020 on suicidal ideation by age and genderCDC data June 2020 on suicidal ideation by age and gender as well as the incidence of substance abuse

Prevent Suicide by Encouraging men to  express emotions

Expressing emotion and crying are normal reactions for all people, regardless of gender. Don’t associate crying or stereotypically feminine traits with being weak. Processing emotions make us human—encourage the men in your life to acknowledge this.

Prevent Suicide by Checking in with your friends and family

Dropping in, whether it is by their house or in their texts, shows that you’re there for them, and they can rely on you for support. Feeling alone is a massive symptom of depression, so let them know they’re not.

Essential workers are at significantly higher risk of suicide and have experienced greater adverse mental or behavioral health symptoms.

CDC data on suicide ideations and substance abuse by employment type
CDC data on suicidal ideations and substance abuse by employment type indicates that essential workers are more at risk

Unpaid adult caregivers are also at higher risk with higher ideations of suicide

CDC data regarding suicidal ideation among unpaid adult caregivers
CDC data regarding suicidal ideation among unpaid adult caregivers
CDC June 2020 data on suicideal ideation and substance abuse by race and ethnicity
CDC June 2020 data on suicidal ideation and substance abuse by race and ethnicity

[i] Hoyert DL, Heron MP, Murphy SL, Kung H. Deaths: final data for 2003. Natl Vital Stat Rep 2006;54

[ii] McCaig LF, Nawar EN. National hospital ambulatory medical care survey: 2004 emergency department summary. Advance data from vital and health statistics; no 372. Hyattsville, MD: National Center for Health Statistics; 2006


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Michael F. Arrigo

Michael Arrigo, an expert witness, and healthcare executive, brings four decades of experience in the software, financial services, and healthcare industries. In 2000, Mr. Arrigo founded No World Borders, a healthcare data, regulations, and economics firm with clients in the pharmaceutical, medical device, hospital, surgical center, physician group, diagnostic imaging, genetic testing, health I.T., and health insurance markets. His expertise spans the federal health programs Medicare and Medicaid and private insurance. He advises Medicare Advantage Organizations that provide health insurance under Part C of the Medicare Act. Mr. Arrigo serves as an expert witness regarding medical coding and billing, fraud damages, and electronic health record software for the U.S. Department of Justice. He has valued well over $1 billion in medical billings in personal injury liens, malpractice, and insurance fraud cases. The U.S. Court of Appeals considered Mr. Arrigo's opinion regarding loss amounts, vacating, and remanding sentencing in a fraud case. Mr. Arrigo provides expertise in the Medicare Secondary Payer Act, Medicare LCDs, anti-trust litigation, medical intellectual property and trade secrets, HIPAA privacy, health care electronic claim data Standards, physician compensation, Anti-Kickback Statute, Stark law, the Affordable Care Act, False Claims Act, and the ARRA HITECH Act. Arrigo advises investors on merger and acquisition (M&A) diligence in the healthcare industry on transactions cumulatively valued at over $1 billion. Mr. Arrigo spent over ten years in Silicon Valley software firms in roles from Product Manager to CEO. He was product manager for a leading-edge database technology joint venture that became commercialized as Microsoft SQL Server, Vice President of Marketing for a software company when it grew from under $2 million in revenue to a $50 million acquisition by a company now merged into Cincom Systems, hired by private equity investors to serve as Vice President of Marketing for a secure email software company until its acquisition and multi $million investor exit by a company now merged into Axway Software S.A. (Euronext: AXW.PA), and CEO of one of the first cloud-based billing software companies, licensing its technology to Citrix Systems (NASDAQ: CTXS). Later, before entering the healthcare industry, he joined Fortune 500 company Fidelity National Financial (NYSE: FNF) as a Vice President, overseeing eCommerce solutions for the mortgage banking industry. While serving as a Vice President at Fortune 500 company First American Financial (NYSE: FAF), he oversaw eCommerce and regulatory compliance technology initiatives for the top ten mortgage banks and led the Sarbanes Oxley Act Section 302 internal controls I.T. audit for the company, supporting Section 404 of the Sarbanes Oxley Act. Mr. Arrigo earned his Bachelor of Science in Business Administration from the University of Southern California. Before that, he studied computer science, statistics, and economics at the University of California, Irvine. His post-graduate studies include biomedical ethics at Harvard Medical School, biomedical informatics at Stanford Medical School, blockchain and crypto-economics at the Massachusetts Institute of Technology, and training as a Certified Professional Medical Auditor (CPMA). Mr. Arrigo is qualified to serve as a director due to his experience in healthcare data, regulations, and economics, his leadership roles in software and financial services public companies, and his healthcare M&A diligence and public company regulatory experience. Mr. Arrigo is quoted in The Wall Street Journal, Fortune Magazine, Kaiser Health News, Consumer Affairs, National Public Radio (NPR), NBC News Houston, USA Today / Milwaukee Journal Sentinel, Medical Economics, Capitol ForumThe Daily Beast, the Lund Report, Inside Higher Ed, New England Psychologist, and other press and media outlets. He authored a peer-reviewed article regarding clinical documentation quality to support accurate medical coding, billing, and good patient care, published by Healthcare Financial Management Association (HFMA) and published in Healthcare I.T. News. Mr. Arrigo serves as a member of the board of directors of a publicly traded company in the healthcare and data analytics industry, where his duties include: member, audit committee; chair, compensation committee; member, special committee.

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