Hotel Room Suicide: Cuyahoga, Orange, Travis, and Wayne Counties

To compare the suicide rates of local residents registering in local hotels with the general suicide rate in that county and to compare the suicide rates of hotel guests from outside the county with the national suicide rate.

The numbers of cases of suicide in hotel rooms and the general community were tabulated for Cuyahoga County, Ohio, for calendar years 2010-2017; in Orange County, California, and Travis County, Texas, for 2010-2012; and in Wayne County, Michigan, for 1997 to March 2005. The percentage of local residents registering in local hotel rooms was estimated from various sources to stratify the suicide risk for travelers and local residents.

The suicide rate of local residents registering in local hotels was elevated compared to the general nonhotel population in each county (range of relative risk, 15.1-37.8; P < .0001, Poisson distribution). Hotel guests from outside each county had a reduced rate of suicide compared to the national rate (range of relative risk, 0.124-0.524; P < .05, Poisson distribution). With regard to suicide method, drug overdoses accounted for a significantly greater percentage in hotel rooms than in the nonhotel population in 3 of 4 counties (range of risk ratios, 2.03-4.51, P < .01; test of proportions), with the opposite pattern for gunshot wounds (range of risk ratios, 0.27-0.50; P < .01, test of proportions).

Although local residents register in hotels for various reasons, there appears to be a subpopulation with a purpose of avoiding rescue. Consistent with the risk-rescue rating, means of suicide with lower lethality, eg, drug overdoses, account for a greater percentage of cases in a setting with less chance of rescue. In contrast to the local use population, the sense of purpose or meaning inherent in travel could explain the decreased risk of suicide in guests from outside the county.