I was recently included in a round table discussion with a few other therapists on our views of a couple big questions regarding suicide. I've included my response below.
When it comes to suicide, what are we missing? What are we doing wrong? As a society, as clinicians, as individuals. How can we improve?
I want to get into some important statistics first before anything else. In 2016, 45,000 people died by suicide - that rate comes to about 13.5 per 100,000 individuals, or 123 suicides per day. Of these people, 35,000 were men, and 10,000 were women. Suicide is the 10th leading cause of death in the US, with 51% of victims using firearms. Fifty-four percent of these people didn’t have a previously known mental health issue.
The answer to what we are missing is staggeringly obvious: our society doesn’t put nearly enough of an emphasis on mental healthcare. To give some perspective, think about all of the attention on school shootings. Since the start of 2016, there have been 64 deaths from school shootings; each day there are about 120 individuals who die by suicide. Furthermore, if you look at the top 12 causes of death, suicide is the only one that is intentional (heart disease, cancer, chronic lower respiratory diseases, accidents, stroke, alzheimer’s, diabetes, influenza and pneumonia, kidney disease, suicide, septicemia, and chronic liver disease & cirrhosis).
My point is that suicide has both the scale and the ability for the process to be interrupted to make it an issue that should be heavily focused on and improved. “Scale” meaning the large amount of deaths by suicide, and “ability for the process to be interrupted” meaning that since suicide is an intentional and often impulsive act, we can theoretically interrupt the process - unlike cancer, accidents, etc.
So, how can we do that - how can we interrupt that process so that someone doesn’t complete suicide, or even consider it? Many people will talk about gun control, and making it more difficult to acquire firearms quickly (seeing as 51% die by firearms). I think that could be a great start, could save many lives, and it would be easier than what I will be advocating for, but has the limitation of only making it more difficult for one method of suicide. What I advocate for is a new way of looking at our own mental health and mental health care.
The (albeit difficult) key to making suicide plummet down the list of top causes of death is by putting a priority on one’s mental health. When we’re growing up, and even into adulthood, there’s rarely a focus on mental health - coping skills, managing stress, social/relationship skills, ways to resolve conflict, and problem solving. Just like we put a priority on physical health, there should be at least an equal emphasis on mental health. Instead of having a societal belief that only the weak or mentally ill need help with their mental health, we should strive to promote the belief that everyone will need help at some time or another. Similarly to how we expect to get a cold here and there, we should expect and know how to deal with a depressed or anxious state.
I’m advocating for this more systemic change because we need to not only be able to help those in a suicidal state, but also make it so that less people will be susceptible to getting to this place. As mentioned above, one of the most difficult parts of suicide is that 54% of the victims didn’t have a previous known mental health issue. This means that it isn’t just mentally ill individuals who commit suicide, but people that have a lot of difficulty dealing with life’s stressors because they don’t have the skills, or access to get help.
In short, it all comes down to teaching these tools of coping with life when we’re growing up and throughout life, providing adequate and easily-accessible mental health services, and creating an environment in our society that promotes mental health care. Suicide isn’t a mystery - there are variables that protect from it, and those that make people more susceptible to it. It’s something that could drastically improve given the resources and effort, so why not make that change happen now?