Suicide Risk Factors and Signs

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Older men die by suicide at disproportionately high rates.

Late-life risk often reflects several threatened psychological needs at once.

Prevention should restore agency, connection, usefulness, dignity, and meaning.

Robert, 78, did not describe himself as depressed. He said he was “just old.” After retirement, his wife’s death, and a hip fracture that left him unable to drive, his world became smaller. He stopped meeting former colleagues, declined invitations from his daughter, and insisted he did not want to “be a burden.” What looked like ordinary withdrawal from the outside was psychologically more complex: Several foundations of livability were weakening at once.

Robert is a fictional composite, but his situation reflects a broader epidemiological pattern. In the United States, men die by suicide far more often than women. Data from the Centers for Disease Control show that in 2023, the suicide rate among males was approximately four times higher than among females. And men aged 75 and older had the highest suicide rate of any age group. The pattern is not unique to the U,S.; male predominance in suicide deaths, especially in later life, has been observed across many high-income countries.

A purely diagnostic explanation is necessary but insufficient. Depression, chronic pain, alcohol use, sleep disturbance, neurocognitive changes, bereavement, and psychiatric comorbidity all matter. But late-life suicide among men cannot be understood only as untreated depression. It also needs to be understood as a crisis in psychological need regulation.

A Needs-Based Model for Late-Life Suicide Risk

The theory of universal psychological needs (TUPG) proposes that psychological stability depends on six basic needs: safety and predictability, connection and belonging, autonomy and influence, competence and effectiveness, dignity and recognition, and........

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