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Change Our Approach to Suicide

06/21/2018

New data strongly suggest that our current policy of counterproductive attempts to "prevent" suicide have failed to prevent or actually exacerbated the problem.

  1. We cannot measure the harm stemming from suicide with simple numbers of attempts or deaths.
  2. The harm to significant others affected by suicide stems in part from policies that discourage communication about suicide plans. We must stop labeling suicide as "crazy" behavior that can lead to commitment if we want people to talk about their plans and maybe change those plans. This means that we, as a society, must accept, and even support, suicide by competent adults as a legitimate, if undesirable, choice.
  3. We must accept that we can delay but not prevent suicide.
  4. We must abandon the phrase "commit suicide," which implies that suicide is a crime and increases stigma.
  5. People do not kill themselves for "reasons." We should stop asking "Why?" and look for the purpose served by suicide.
  6. Nothing "causes" suicide. Suicide is a choice.
  7. Even a "suicide note" may mislead. We may never know what motivated a person to end their life, but we will know much more if we create an atmosphere that encourages, rather than discourages, communication.
  8. We must reject the assumption that people who kill themselves "are depressed." Even if someone suffers from a depressive disorder, their choice to die may have no relation to that disorder.
  9. People who kill themselves may suffer from mental disorders other than depressive disorders or they may suffer from no mental disorder at all. If you believe that art imitates life, look at the list of movies with references to suicide here. Of the hundreds of movies indexed I challenge you to find more than a few that depict suicide in a person suffering from any mental disorder.
  10. Suicide accounts for more than half of firearm deaths. If we want to minimize violent means we must make available non-violent means, and even expert assistance.
  11. Suicide is not a "cause" of death. We must stop comparing deaths "caused" by suicide to deaths caused by overdose, for example. Some people kill themselves by overdosing. Suicide, like murder, is about who did the killing, regardless of the method.
  12. We should intervene when minors express intent to kill themselves, and we should develop interventions to temporarily postpone impulsive suicide with an emphasis on informing the individual of alternative ways to address their problems.
  13. Conscripting medical professionals to act as suicide cops and holding them responsible for the choices made by competent adults destroys trust and interferes with their ability to help them with mental and physical illness.
  14. We need a new legal definition of "competence to choose suicide." Criteria might include ability to understand methods of suicide as well as the consequences to others. 

Let's shut down the "suicide prevention" racket and get real about minimizing harm.