The severity of the suicide epidemic in the United States is a public health issue. What causes it, how to understand it, and how to prevent it has become a more common conversation, and yet suicide still remains a complex, sensitive, and difficult issue. While increased research attention has been given to suicide during the past 10 to 15 years, many misconceptions and gaps in the knowledge base still exist, and stigma — the largest barrier to seeking help — continues to prevail.
The prevalence of suicide has risen steadily in the U.S. during the past decade. According to the Centers for Disease Control and Prevention, suicide is the 10th-leading cause of death in the U.S. For many age groups, it ranks as high as third. In 2017, the most recent year for which CDC statistics are available, more than 47,000 Americans died by suicide. That is an average of 129 people each day. These numbers reflect a 33 percent increase in rates of suicide during the past 18 years. While these statistics are alarming, they are also sadly inaccurate, as the actual number of deaths are likely higher due to underreporting.
As a Catholic, and as a licensed professional clinical counselor working in mental health and suicide prevention, I’ve often heard Catholics make comments such as “If only they had relied more on their faith they wouldn’t have completed suicide,” or “Going to church more consistently might have saved their life.”
If only it were that simple.
As Catholics, we must be more inclusive of how we understand and approach this issue. Suicide does not have a single cause, nor does it discriminate. It cuts across all demographics, geographic regions, ethnicities, cultures, ages, and populations. While it is often oversimplified, suicide truly is a very complex situation to understand and most often occurs when stressors and health issues converge to create an experience of hopelessness and despair.
Suicide does not have a single cause, nor does it discriminate.
Contributors to suicidal behavior
There are numerous considerations and reasons, separate from mental illness, that account for suicidal ideation and behavior.
Risk factors — characteristics or conditions that increase the chance that a person may attempt suicide — often come from multiple sources. These include feeling hopeless or helpless; experiencing a stressful life event such as divorce or financial trouble; experiencing prolonged stress from bullying, unemployment, or other issues; having a family history of suicide; and experiencing a death by suicide of a family member or close personal acquaintance. (A complete list of risk factors can be found on the American Foundation for Suicide Prevention’s website, AFSP.org.)
In addition, serious and persistent mental health disorders sometimes contribute to suicidal behavior, but they generally are not the cause of suicide on its own. People who have a suicide attempt in their past are at higher risk for another suicide attempt. Co-occurring issues such as depression, anxiety, psychosis, substance use/abuse, and other untreated mental health conditions can put people at higher risk of suicide. The CDC’s National Violent Death Reporting System found that just more than 40 percent of those who die by suicide have a mental health diagnosis.
Serious and persistent mental health disorders sometimes contribute to suicidal behavior, but they generally are not the cause of suicide on its own.
Equally important to “understanding the why” are protective factors. Everyone has positive personal and environmental characteristics that, when enacted, support managing difficult, low moments. Examples include behavioral health care, social support systems, cultural beliefs, and problem-solving skills, among others (a complete list can be found on the Suicide Prevention Resource Center’s website, SPRC.org). In general, the more protective factors someone possesses, the less at risk they are for suicide.
Faith can help
Interestingly, one of the most important protective factors for an individual experiencing a mental health crisis is related to faith in Christ, as spirituality and religion can be major deterrents to suicide. Research has shown that people with religious affiliation report higher levels of social support, religious well-being, and reasons for living. Engaging in spiritual beliefs and practices offers connection, meaning, and purpose, all of which contribute to feeling more hopeful and having a more satisfying life.
When we believe that we can cope, that people truly care about us, and that we have significant reasons to be alive, we can more easily choose life. It turns out that knowing Christ matters, which reminds us that we should share the love of Christ with everyone, especially those who may be at risk for ending their own lives.
Immediate warning signs
Some behaviors, however, may indicate that a person is at immediate or serious risk for suicide and require a quick response, especially if the behavior is new or has increased, and/or seems related to a painful event, loss, or change.
Important urgent warning signs that someone may be in a suicidal crisis include talking about wanting to die; researching how to kill oneself; talking about feeling hopeless or having no purpose; talking about feeling trapped or in unbearable pain; feeling like a burden to others; increased use of alcohol or drugs; acting anxious; agitation or reckless behaviors; sleeping too little or too much; withdrawal or isolating behaviors; showing rage or talking about seeking revenge; and displaying extreme mood swings.
The more of these signs a person demonstrates, the greater their risk to attempt suicide.
It is important to note that between 50 percent and 75 percent of people who attempt suicide actually demonstrate warning signs, including talking about their suicidal thoughts, feelings, and plans before they act.
The more of these signs a person demonstrates, the greater their risk to attempt suicide.
However, what makes recognizing these red flags so challenging is that most people in crisis don’t often directly reach out and ask for help. They will communicate their distress in other ways, and it’s a matter of whether or not we’re paying attention to them. It can be very easy to miss signs of distress when we can’t imagine that the people in our lives might be thinking about dying by suicide.
In addition, research consistently shows that for those who have attempted but not completed suicide, they never wanted to end their life in the first place; rather, the depth of pain simply became unbearable, which prompted finding a way to relieve it. In other words, people do not actually want to die but simply need their pain to end.
Also, we know that talking about suicide with someone who may be suicidal, or about the issue at large, won’t cause them to complete suicide. Being accurate and direct instead contributes to stigma reduction around mental health, encourages help-seeking behaviors, and can urge people to access the care and treatment they need.
How to help
So, how should Catholics start the conversation when worried about someone’s well-being?
First, extend an open invitation to talk with a nonjudgmental attitude, keeping in mind that people in crisis often feel shame and embarrassment, which promotes isolation and a reduced a willingness to seek help. Start by explaining that you are genuinely worried and share the concerning behaviors you are noticing.
Listen, engage with empathy, and communicate hope and healing. Remember that asking about suicide will not reinforce the idea; avoid the tendency to tiptoe around the issue or to avoid asking because of your own discomfort.
Use clear and direct language. Say things such as: “Have you ever thought about ending your life?” or “Are you thinking about suicide?” or “Are you worried about yourself?” Whether you get a “yes” or a “no,” let them know you care and help them access appropriate resources. If they are at immediate risk of harming themselves, stay with them and call 911.
If they are at immediate risk of harming themselves, stay with them and call 911.
In reality, many of those who have died by suicide believed in God and tried to follow his teachings daily. On days when they felt happy, connected, and peaceful, they wouldn’t dream of ending their life and hurting their relationship with God or with their friends and family. But they felt desperate, fatigued, tormented, and lost as to how to alleviate the pain they continually experienced. Irrational thoughts, negativity, and isolation suddenly became coping strategies.
I am quite convinced that our God of mercy, love, and compassion knows and understands both physical and emotional pain, sacrifice, isolation, rejection, and desperation better than anyone else. So yes, by all means let’s bring the love of Christ to people who are in despair, but let’s also see them as persons with dignity, not as just one solitary decision in a moment of significant distress.
There is much that needs to be done to end the phenomenon of suicide in our culture, but as Catholics who believe in the power of community, prayer, and the working of grace, we are greatly positioned to help destigmatize the issue and reach out to anyone who sits next to us in the pew.
While many variables apply to the unique situations of each person in distress, nonetheless, suicide is preventable. It’s important for us to come together with support.
FOR HELP:
If you or someone you know are in crisis, contact the National Suicide Prevention Lifeline (SuicidePreventionLifeline.org) at 1-800-273-TALK (8255) or the crisis text line by texting TALK to 741741.
Suicide: What does the Church teach? Resources to help those in need
