Rising Suicide Rates Highlight the Need for Residential Mental Health Treatment

The death of Thomas Joiner was a tragedy, and one that is becoming increasingly common. Since 1999, “more Americans have killed themselves each year than in the one before,” and suicide is now the leading cause of death in the developed world for people ages 15-49, outpacing more visible killers like heart disease, car accidents, cancer, strokes, wars, and natural disasters. Contrary to the historical trend of adolescent and young adult suicides, this rising suicide rate is primarily affecting people in mid-life; in the United States, suicide amongst adults 35-64 increased by nearly 30% between 1999 and 2010. For white middle-aged men, the increase was over 50%, and white middle-aged women experienced a staggering 60% rise, causing the Centers for Disease Control and Prevention to identify suicide as an increasing public health concern and call for increased preventative measures “directed towards middle-aged populations.”

However, while middle-aged populations may currently have the highest suicide rate, Julie Phillips, a sociologist at Rutgers University, suggests that this reflects a “new epidemiology of suicide,” and is only the beginning of a fundamental cultural shift. According to Phillips’ research:

Everyone born after 1945 shows a higher suicide risk than expected—and everyone is on pace for a higher rate than the boomers. That means that the last decade isn’t just a statistical blip, a function of a bad recession, unlocked gun cases, or an aging counterculture. It’s much darker, and deeper than all that.

So what is causing these dramatically rising suicide rates? The answers are complex and elusive. Researchers examining this contemporaneous phenomenon have found the traditional list of risk factors for depression and suicide too broad to be meaningful, and have had to create a new model of risk assessment to more adequately capture the conditions that lead to suicide.

Thomas Joiner’s son, who now has a PhD in clinical psychology, has developed a set of three conditions that, when combined, set the stage for suicidal ideation and, ultimately, action. In an interview with Newsweek magazine, he outlined this model of suicide to illuminate the dark path taken by those who end their own lives:

Low belonging

Loneliness is one of the most important ingredients in suicidality. However, loneliness is also a common feeling that virtually everyone experiences from time to time. The type of loneliness implicated in suicide is a fundamental lack of inclusion, connection with other human beings, and sense of belonging in the world; this is a form of loneliness that can cause severe damage to mental health and allow depression to flourish unchecked. In today’s culture, low belonging may be additionally exacerbated by decreased face-to-face connection with others and lack of stable, cohesive, and enduring communities, which can offer protection against emotional distress.

Burdensomeness

Human beings are generally built for purpose. That is, we want to do, experience, provide, give, produce. We need the ability to contribute and be a resource to our family and friends, our jobs, and the world around us. “When [we] lose that view of [ourselves], when it curdles into a feeling of liability, the desire to die takes root.” While this explains the clear and obvious connection between suicide and unemployment, it also illuminates the relationship between mental illness and suicide further; psychiatric illnesses can severely limit everyday function, drain us of purpose, and frame us (in our own minds) as a burden rather than an asset.

Fearlessness

As humans, we typically have a profound and innate fear of death. We are designed to want to live at virtually all costs, and our bodies are remarkably resilient to allow for endurance through even the harshest trials. Overcoming that extraordinary desire to live results in a kind of fearlessness that removes psychological barriers to suicide. “Suicide takes a slow habituation to pain, a numbness to violence,” which may explain the “heightened suicide risk shared by athletes, doctors, prostitutes, and bulimics.” However, in today’s media-saturated world, this numbness may not need to come from direct, first-hand exposure to violence, but could potentially develop through mediated exposure to both real and fictional acts of violence.

Additionally, mental illness itself may habituate one to pain, as pain becomes a constant condition, overriding the instinct for self-preservation, much to the bafflement of those who do not understand how illnesses like depression can ravage the mind. As William Styron wrote:

To those of us who have suffered severe depression—myself included—this general unawareness of how relentlessly the disease can generate an urge to self-destruction seems widespread; the problem badly needs illumination. Suicide remains a tragic and dreadful act, but its prevention will continue to be hindered, and the age-old stigma against it will remain, unless we can begin to understand that the vast majority of those who do away with themselves—and of those who attempt to do so—do not do it because of any frailty, and rarely out of impulse, but because they are in the grip of an illness that causes almost unimaginable pain.

Styron also believed that depression treatment is where the true promise of healing lies. He wrote, “What is of ultimate importance to the victim of depression is not the cause but the treatment and the cure.” With this in mind, suicide prevention must focus not only on the causes of depression itself, but on ensuring that people have access to the best treatments possible to truly recover from the burden of mental illness.