. 469; Wodarski & Harris, 1987, p. 477). Because suicide attempts, successful or not, are often identified in hospital records simply as serious injuries, the numbers are difficult to confirm. Consequently, experts differ in whether they consider suicide the second or third leading cause of death among young people.
There are gender- and race-related differences in suicide rates and in the characteristics of suicide attempts. During the last quarter century, the suicide rate for females 15-24 has doubled and the rate for males has tripled (Neiger & Hopkins, 1988, p. 469).
Although the reported suicide rate among black adolescents is much lower than the reported rate for whites, over the last twenty years black males are the group with the greatest increase in suicide incidence; the incidence of suicide among black males went from 4.1 to 12.3 per 100,000. Clinical evidence supports the widespread belief that males and females differ in their use of suicide methods. Boys prefer violent means. Almost two-thirds of the males 15-24 who commit suicide use firearms, for example, but only about half the females do; more boys than girls hang themselves. It is generally believed that women choose less violent means, such as poisoning, because they fear disfigurement should they live through the attempt. Shooting oneself is the most common method employed in completed (successful) suicides, but drug overdose is the most common method used when the attempt fails. It makes sense, therefore, that although females engage in suicidal ideation (thinking about suicide) more often and attempt suicide more often, males are successful more often in the attempts they do make. Among young people the ratio of male to female suicides is about 4 to 1, while among adults it is approximately 3 to 1 (Berman, 1986, pp. 155-157; Holden, 1988, p. 840; Martin & Dixon, 1986, pp. 267-268; Simons & Murphy, 1985, pp. 423-434).
Aside from race and gend...