More adults in the Midwest and West have suicidal thoughts than people in the rest of the country, but Rhode Island leads in suicide attempts, according to the first government study of its kind.
The Centers for Disease Control and Prevention study, released Thursday, presents a different look at suicide in America -- one that focuses on suicide in the planning stages.
"This report highlights that we have opportunities to intervene before someone dies by suicide. We can identify risks and take action before a suicide attempt takes place," said CDC Director Dr. Thomas Frieden.
Overall, the Midwest and West had significantly higher rates of suicide contemplation than the South and Northeast. Researchers say they don't have any data to explain why some states or regions were different than others.
Utah had the highest rate of serious thoughts of suicide (1 in 15 adults) while Rhode Island was at the top of the range for planning a suicide (1 in 36) and suicide attempts (1 in 67).
Georgia was at the bottom of the range for suicide thoughts (1 in 50), planning a suicide (1 in 1,000) and suicide attempts (1 in 1,000), along with Delaware.
The study was based on confidential surveys of more than 90,000 U.S. adults in 2008 and 2009. The participants did not include homeless people, those in the military or those hospitalized with psychiatric problems.
The government's previous state-by-state suicide data was suicide deaths, with the highest rates in Alaska, New Mexico, Wyoming and Montana.
The new study's results suggest that places where a lot of people report contemplating suicide may not be the same places where suicide is most common.
For example, Rhode Island had one of the nation's lowest suicide rates in 2007. But in the new study, it ranked at the top in terms of both suicide planning and attempts.
Researchers aren't sure why, but there are theories.
Perhaps demographics are part of the answer. Adolescents and females had the highest rates of thinking about suicide, while older males have the highest rates of actual suicide deaths, said Dr. Alex Crosby, a CDC epidemiologist who is the study's lead author.
So a state with a lot of young people and women might look high in suicide thoughts and planning, but not as high in deaths.
Also, it's possible that suicide attempts in places like Alaska or Wyoming tend to use guns or other methods that are more lethal. It's also possible that suicide planners in sparsely populated Western states have fewer friends or health professionals around to save them, said Matthew Nock, a Harvard University psychology professor who has researched suicide patterns.