September is Suicide Prevention Awareness Month. Although conversations around the topic shouldn’t be limited to once a year, it’s an opportunity to raise awareness and break the stigma around talking about suicide. Discussions on suicide prevention often center mental health, but socioeconomic factors also play a role. Amid a pandemic that has caused unemployment, job insecurity, social isolation, and “Covid-induced chronic illness and disability” (The Guardian), widening the scope of support for people seeking or needing help beyond mental health care is essential.
Suicide is a public health issue and a leading cause of death in the U.S. (CDC). In 2020, 45,979 people died by suicide in the United States (CDC). That is one death every 11 minutes. While anyone can be impacted, veterans, people living in rural areas, LGBTQ+ people, Native and Indigenous people, and chronically ill and disabled people disproportionately experience factors linked to suicide or suicidal ideation. It’s important to note that these marginalized groups are not predisposed to suicide. They are, however, disproportionately affected by systemic inequalities that limit their access to healthcare, food and financial security, and housing, which are also suicide risk factors.
• Know the warning signs of suicide and how to effectively help those in need or looking for support.
• Support and use peer support and crisis hotlines that are divested from the police, including Trans Lifeline, BlackLine, and LGBT National Help Center.
• Support and volunteer with your local mutual aid network to provide and receive community-based support.
Mental health issues like depression are widely associated with and discussed in conversations on suicide. Other factors like economic issues and chronic pain and illness are also associated but are less discussed. This is partly because 46% of people who die by suicide have a known mental health condition (CDC). Still, most people with mental health problems don’t attempt or die by suicide, and strategies for suicide prevention highlight the need for “easy access to healthcare” and “strengthen economic support” in the form of financial security and stabilized housing policies (CDC, CDC).
“Mounting debt, losing a job, a home, or retirement income can be linked to a wide variety of negative health outcomes,” the Pennsylvania Suicide Prevention Coalition told Health (Health). “Such stressors may lead to thoughts of suicide or even to attempts and completions.”
National economic downturns and recessions coincide with higher suicide rates (Crisis). Mental health experts warned that pandemic social distancing policies could increase the risk of suicide via isolation and economic stress (JAMA Psychiatry). In 2020, overall suicide rates declined by 3% but rose among Black, Native and Indigenous, Hispanic people, and multiracial women (National Center of Health Statistics). Disabled people were three times more likely to report suicidal ideation in 2021 than people without disabilities (CDC). Additionally, suicide-related calls to national crisis hotlines increased during this time (Journal of Psychiatric Research).
Greater access to healthcare services via telehealth is a probable cause for the decline (Stat News), but unaddressed socioeconomic failures continue to be a stressor. In a study examining the effects of financial strain and suicide attempts, researchers found that debt, housing instability, unemployment, or low income increased the risk of suicide (The American Journal of Epidemiology). Those who experienced all four were 20 times more likely to attempt it.
For disabled and chronically ill people, who tend to have limited healthcare access and are more likely to live in poverty, navigating the healthcare system that continually disregards and fails to meet their needs has caused increased mental distress (CDC). And since healthcare is unaffordable, human rights advocates warn that assisted suicide and euthanasia laws instead of adequate financial support would have a “discriminatory impact” on disabled people (AP News).
Financial therapist Amanda Clayman said economic strains like, “Debt can make us feel really trapped. Anything that makes us feel trapped is something that will kick off our fight, flight, or freeze response” (Allure). She says in these moments shift from thinking of the future and “Reground in basic survival needs, in the here and now. Do I have a roof over my head? Do I have food? Is there someone I can call? Get back to the moment.”
Suicide is not inevitable. And having a mental illness or encountering socioeconomic hardships doesn’t mean one is prone to suicide. It is, however, preventable with more education and investment in mental health and suicide prevention and intervention. Annually, about 275,000 become suicide survivors (SAVE). Knowing the signs, reaching out, and directing people to help can make a difference and has the “power to save a life” (Know The Signs). But prevention and intervention shouldn’t stop there. Our approach and discussions on suicide should be more comprehensive than just mental health awareness and care. Initiatives like an increase in the minimum wage, most significantly during periods of high unemployment, can help reduce suicide rates. An estimated $1 minimum wage increase was linked to a 3.5%-5.9% decrease in the suicide rate for people with a high school education or less (Journal of Epidemiology and Community Health). And when states increased their spending on medical benefits, unemployment insurance compensation, and family assistance programs, there was a decrease in suicide rates statewide.
From providing a livable wage and access to healthcare to housing and food security, when we address these broader issues and systemic inequities, we can make a difference in not only preventing suicides but also improving people’s overall health and quality of life.
• Suicide is complex and has no singular cause, but is preventable.
• Suicide prevention must expand beyond mental health awareness and care.
• Resolving the economic and social issues that lessen distress or hardship can help prevent suicides.