This chapter aims to examine the link between suicide and disadvantage more closely, and put to rest false assumptions about suicide and mental illness. It will also review the disproportionate amount of socio-economic distress and discrimination experienced by the psychiatrically disabled, to drive home my argument that it’s injustice that’s at play in the deaths of most decedents who do have histories of mental illness – not their “mental illness.” While I don’t deny there’s a small link between mental illness and taking one’s life, the evidence is overwhelming that having a mental disorder is only one of several risk factors.28
I want to demonstrate the above points to help raise the conversation about prevention to a level where truly effective policies are developed:
“A genuinely open discussion of suicide must be a wide discussion – not just a medical or public health discussion, but a social, cultural, moral, political and even religious discussion,” wrote medical ethicists Fitzpatrick and Kerridge, on the type of dialogue which must now occur.
Let me provide some information from China, as an end to this long introduction, to help drive home my point. China is the only country where women take their lives at higher rates than men.29 Suicide there is often an expression of protest or revenge against a party which has publicly shamed, abused or oppressed a person, because suicide causes Chinese perpetrators to “lose face”.30
While unfortunately in the U.S., suicide doesn’t cause anybody but its victims to “lose face,” I think it does collectively symbolize a sort of silent protest, as well as hopelessness, from a growing population of oppressed and disenfranchised, middle-aged adults. We live in a period of widely-recognized, heightened economic inequality where people at the bottom of the social ladder aren’t reaping the benefits of soaring national wealth. There is a strong correlation between low socio-economic status and suicide, as will be discussed later. We’re not going to reverse escalating suicide rates by pumping more money into treating depression; we have to attack what’s causing our national depression: social injustice.
As psychiatry professor John Werry said, “The thing that’s most likely to have an effect [on suicide] in the long run is social policies which aim to give children, adolescents, and their families a fair break in life.”31
I tried to kill myself because I knew I was never going to get that “fair break.” And I firmly believe that’s the same reason more than 43,000 Americans are dying yearly in what is an entirely avoidable tragedy – if the powerful of our country simply cared.
The author can be contacted at jeaneneharlick[at]gmail[dot]com.
Additional sections in this chapter include:
Suicide = Mental illness: An insidiously harmful myth
Suicide taboo and the imperative to reverse it
Suicide and socio-economic status
Suicide, socio-economic status & the mentally ill: More disadvantaged, more oppressed
Conclusions and recommendations
1Brontë, C. (1853/2001). Villette. New York: The Modern Library, p. 179.
2Brontë, C. (1853/2001), p. 183.
3Didi Hirsch Mental Health Services (2013). Survivors of suicide attempt support group. Retrieved March 18, 2016, from http://www.didihirsch.org/survivors-of-suicide-attempt-support-group.
4Dokoupil, T. (2013, May 23). Why suicide has become an epidemic – and what we can do to help. Newsweek. Retrieved December 15, 2014, from http://www.newsweek.com/2013/05/22/why-suicide-has-become-epidemic-and-what-we-can-do-help-237434.html.
5National Center for Health Statistics. (2016). Increase in suicide in the United States, 1999-2014. (NCHS Data Brief No. 241). Hyattsville, MD: Author. Retrieved April 23 from
Tavernise, S. (2016, April 22). U.S. suicide rate surges to a 30-year high. New York Times. Retrieved April 23, 2016 from http://www.nytimes.com/2016/04/22/health/us-suicide-rate-surges-to-a-30-year-high.html?_r=0.
6The Joint Commission (2016, February 24). Detecting and treating suicide ideation in all settings. (Sentinel Event Alert, Issue 56). Oakbrook Terrace, IL: Author.Retrieved May 1, 2016 from
9National Center for Health Statistics, 2016.
10Bui, Q. (2016, May 12). Where the middle class is shrinking. New York Times. Retrieved May 13, 2016 from http://www.nytimes.com/interactive/2016/05/13/upshot/falling-middle-class.html?hp&action=click&pgtype=Homepage&clickSource=story-heading&module=second-column-region®ion=top-news&WT.nav=top-news&_r=0.
11Hempstead, K. & Phillips, J. (2015). Rising suicide among adults aged 40-64: The role of job and financial circumstances. American Journal of Preventive Medicine, 48(5), 491-500.
12Kolata, G. & Cohen, S. (2016, January 16). Drug overdoses propel rise in mortality rates of young whites. New York Times. Retrieved January 18, 2016 from
Myerson, H. (2015, Nov. 4). America’s white working class is a dying breed. Washington Post. Retrieved May 19, 2016 from
13National Center for Injury Prevention and Control (2015). Suicide: Facts at a glance. Retrieved from
14Baudelot, C. & Establet, R. (2008). Suicide: The Hidden Side of Modernity (David Macey, Trans.). Cambridge, MA: Polity Press. (Original work published 2006).
15Baudelot & Establet, 2008, p. 2-4.
16National Center for Injury Prevention and Control, 2015.
17Centers for Disease Control and Prevention (2016). FY 2016 Operating Plan. Retrieved March 8, 2016 from
18Witte, T., Smith, A., & Joiner, T. (2010). Reason for cautious optimism? Two studies suggesting reduced stigma against suicide. Journal of Clinical Psychology, 66(6), 611-626.
19Guo, J. (2016, March 4). Death predicts where people vote for Trump. Washington Post. Retrieved May 19, 2016 from
21Packer, G. (2016, May 16). Head of the class. The New Yorker.
23Priebe, S. & Ceccherini-Nelli, A. Economic factors and suicide rates: Associations over time in four countries. Social Psychiatry & Psychiatric Epidemiology, 46, 975-982.
24Pridmore, S. (2015). Mental disorder and suicide: A faulty connection. Australian & New Zealand Journal of Psychiatry, 49(1), 18-20.
25Weaver, J. (2014). Sorrows of a Century: Interpreting suicide in New Zealand, 1900- 2000. Canada: McGill-Queen’s University Press.
Fitzpatrick, S. & Kerridge, I. (2013). Challenges to a more open discussion of suicide. Medical Journal of Australia, 198(9), 470-471.
26Luo, F., Florence, C., Quispe-Agnoli, M., Ouyang, L., & Crosby, A. (2011). Impact of business cycles on US suicide rates, 1928-2007. American Journal of Public Health, 101(6), 1139-1146.
Stuckler, D., Basu, S., Suhrcke, M., Coutts, A., and McKee, M. (2009). The public health effect of economic crises and alternative policy responses in Europe: an empirical analysis. The Lancet, 374, 315-23.
Case, A. & Deaton, A. (2015). Rising morbidity and mortality among white non-Hispanic Americans in the 21st century. Proceedings of the National Academy of Sciences of the United States, 112(49), 15078-15083.
Hempstead & Phillips, 2015.
Baudelot & Establet, 2008.
27National Center for Injury Prevention and Control, 2015.
29World Health Organization (n.d.). Suicide rates: Data by country. Retrieved February 25 from
30Baudelot & Establet, 2008.
31Weaver, 2014,p. 230,as cited in Pridmore, 2015.