Over the past decade, while life expectancy has increased and homicides have decreased5, America’s suicide rate has increased by almost 20 percent every year – that amounts to at least 400,000 deaths, nearly the number of people killed in WWII and the Korean War combined6. Death by self-harm hit its highest rate since 1987 in 2012 – 12.6 deaths per 100,000 Americans, according to a Centers for Disease Control and Prevention (CDC) report released last year. The report also revealed suicide to be the only top-ten cause-of-death to rise during 2011-2012, in contrast to illnesses such as cancer or stroke, whose death burden decreased7.
And, for every suicide completion, there are many more attempts. A prior suicide attempt is the “single most important risk factor for suicide in the general population, according to WHO8.
Suicide is a global concern as well. Last year WHO released a landmark report on rising suicide rates, highlighting the need to recognize it as a worldwide public health issue, and emphasizing the imperative to increase prevention efforts in all countries9. Globally, more than 804,000 deaths by suicide occurred in 2012 – an estimated 60 percent increase since WWII – or 11.4 per 100,000 people; suicide accounts for 50 percent of all violent deaths in men and 71 percent in women. In developed countries, self-harm is the leading cause of death for people ages 15-49 – higher than cancer and heart disease10.
Said the WHO report, “There is no single explanation of why people die by suicide. However, many suicides happen impulsively… Social, psychological, cultural and other factors can interact to lead a person to [it], but the stigma attached to… suicide means that many people feel unable to seek help. Despite the evidence that many deaths are preventable, suicide is too often a low priority for governments and policy-makers.”
In the United States, a suicide occurs every 13 minutes11. Almost 40,000 lives are lost to it yearly – more than road accidents; it is the 10th leading cause of death overall, and the top cause of “injury death” in America12. Despite all this, far greater sums of research money from organizations like the CDC and the National Institutes of Health continue to be devoted to finding cures for diseases and social problems which kill far fewer Americans13.
If you don’t care about suicide after hearing statistics like the above – and most researchers believe suicide is widely under-reported – or because you mistakenly believe it’s the act of cowardly or selfish people (more on that later), maybe you’ll care about this: Every suicide costs society about $1 million in medical costs and lost work, on top of emotionally traumatizing at least 10 other loved ones and friends14.
Perhaps most importantly, the present suicide scourge is not simply a passing trend explained away by events like the Great Recession; according to a Rutgers University paper analyzing 80 years of suicide data, Americans born after 1945 show a higher suicide risk than expected, and everyone is heading toward a higher suicide rate than the age group most responsible for driving current statistics15.
And which U.S. age group is that? The middle aged, according to the CDC and a 2012 Global Burden of Disease Report16. A more careful analysis of the numbers this past fall – by two Princeton economists – showed that mortality rates for U.S., non-Hispanic whites ages 45 – 54 suddenly stopped declining in 1998, while that age group in other rich nations has continued its post-1970, downward trend of a 2 percent, yearly decrease in deaths. Suicide and drug poisonings were identified as the driving forces of increasing, American mid-life mortality and morbidity. Wrote report authors Anne Case and Angus Deaton:
“No other rich country saw a similar turnaround… If the white mortality rate for ages 45 – 54 had held at their 1998 value, 96,000 deaths would have been avoided from 1999 – 2013… If it had continued to decline at its previous rate, half a million deaths would have been avoided…. [This all] points to increasing distress in this population.”
This isn’t surprising, when you consider the research emerging from sociology and psychology – some of it summarized below – and the day and age we Americans live in: The impossible, media- and social-media-driven criteria for success; increasing economic and class disparities; high rates of divorce; the stigma crippling the “mentally ill” (or, as I prefer to call us, people who make others uncomfortable because we threaten established norms); prejudice of all sorts; and the complete collapse of the American promise that you can make it in this world if you simply work hard. Problems, in other words, which tend to fall on the shoulders of adults and family breadwinners.
Suicide is a multi-faceted problem which can’t be boiled down to one factor – unemployment, mental illness, gun access, or whatever societal ill is the scapegoat of the moment. As Tony Dokoupil, in Newsweek, eloquently put it, “It’s a problem with a broad base and terrible momentum, a result of seismic changes in the way we live… We know, thanks to a growing body of research on suicide and the conditions that accompany it, that more and more of us are living through a time of seamless black… We’ve reached the end of one order of human history and are at the beginning of a new order entirely… The takeaway is darkly profound: we’ve become our own greatest danger.”
While psychiatry, mental health practitioners and politicians seem bent on treating and researching suicide as a mental health issue, sociologists and public health experts are recognizing the need to address suicide for what it is: the symptom of a very sick society – rather than of sick, deviant, or morally bereft individuals.
In a 2011 article surveying suicide research in the Annual Review of Sociology17, authors noted suicide often reflects disintegrating levels of social integration and cohesion; they emphasized the need to treat suicide as a “significant social problem in and of itself,” to embrace the complexity of suicide, and that sociological understandings of suicide “are not only relevant but essential to prevention efforts.” Nonetheless, sociological contributions continue to be mostly ignored in suicide prevention and research, with the act and risk factors reduced to individual problems surrounding mental illness – even when social and contextual factors are obliquely acknowledged. In psychiatric research, allegedly hard-wired, biomedical predispositions presumed to be fundamental risk factors in suicide tend to ignore how brain processes are flexible, the result of dynamic interactions between neurons, genes, society and the environment, the authors said:
“Given this individualistic frame, biomedical and psychiatric perspectives have become paradigmatic, with… prevention strategies focused aimed at high-risk individuals… [The solutions] which flow from this framework tend to neglect social and ecological determinants… We argue the present situation is problematic for sociology, for the scientific research agenda on suicide, and for the creation of solutions to this pressing social problem. In an age when biomedicine and genomics tend to dominate scientific and public policy debates” a multidisciplinary approach to suicide research and prevention is paramount, the authors wrote.