Highlights of a state Department of Health report on “;Suicide in Hawaii”; by Dan Galanis, Iwalani Else and Dr. Dan Alicata:

» Suicide is Hawaii's leading cause of fatal injuries, with 722 cases from 2001 to 2006, accounting for one-fifth of the total number of deaths.

» Hawaii's suicide rate from 2001 to 2005 was 47.8 per 100,000 residents, slightly behind the national rate of 54.2 per 100,000 residents.

» Two-thirds or 475 suicides from 2001 to 2006 were on Oahu.

» A decreasing trend occurred in the annual number of cases, but the number of undetermined fatal injuries increased, which could be possible suicides or, less likely, homicides.

» The youngest suicide victim was 10. About 95 percent were 20 or older, with the highest rates for residents 85 and older and from 40 to 54.

» Nonfatal suicide attempts increased, based on the number of injuries treated in emergency departments. About 60 percent of patients were under 35 years old, and 15- to 19-year-olds had the highest rates of hospitalizations and emergency visits.

» Kauai and Hawaii counties had substantially higher rates of nonfatal self-inflicted injuries than Honolulu and Maui counties. Most emergency visits and hospitalizations were caused by drug or medicinal substance poisoning.

» Males outnumbered females 3-to-1 in suicide deaths, while 60 percent of nonfatal suicide attempts were by females.

» The fatality rate for Oahu (67.1 per 100,000 residents age 20 and older) was much lower than the rate for the combined neighbor islands (85.8 per 100,000).

» Caucasians had the highest suicide rates from 2003 to 2007 with 271 cases. Japanese had 98 cases; Hawaiians, 79; Filipinos, 75; Chinese, 23; and Koreans, 9.

» Hanging or suffocation comprised 46 percent of suicides, followed by firearms, 21 percent.

» About 75 percent of victims had a history of mental illness, according to autopsy records from 2001 to 2004.

» The most common problems for victims involved intimate relationships, 24 percent; a breakup or divorce, 16 percent; and serious illness or medical issues, 21 percent. About one-fifth, or 22 percent, had used illegal substances; 12 percent tested positive for alcohol, and 23 percent for illicit drugs.

» Nearly one-fifth, 17 percent, of victims had attempted suicide previously.