Most people who kill themselves do so from a place of great pain, hopelessness, self-worthlessness and despair. But suicide is best explained not with reference to the concepts of philosopher Jean-Paul Sartre (as was done in the Sept. 24 commentary, "Explaining the inexplicable: suicide". That's like trying to explain why people die from malaria by quoting Aristotle. Severe depression is an illness. Everybody should know that.
States with the highest rates of people taking their own lives have many characteristics in common, including a shortage of facilities for the treatment of mental disorders; proportionately larger populations of groups most prone to suicide, including Caucasians, Native Americans and men; higher rates of alcohol abuse, unemployment, poverty, geographic and social isolation; widespread gun ownership; and the "cowboy mentality" in which self-reliant individualism is lauded and help-seeking is eschewed, and as a result, psychology, psychiatry and mental health practitioners often are looked upon with suspicion or distain.
By contrast, the states with significantly lower rates of suicide have more hospitals and medical professionals, allocate more resources for education and mental health services, have higher median household incomes, more restrictive gun laws, a greater proportion of college educated citizens (shown in studies to be less apt to stigmatize mental illness and more tolerant of diversity regarding race, religion, and sexual orientation), and easier access to places of worship and other supportive institutions.
Most importantly, severely depressed people living in the low suicide states have far greater access to mental health services and (at much higher rates) are treated with antidepressant medications and supportive psychotherapy. The vast majority of suicides occur when agonizingly distraught people are suffering from an untreated mental disorder, most commonly a severe and biologically based major depression or bipolar disorder.
While suicide often comes in the context of a significant loss or other extremely stressful event, an abusive environment, a serious illness, or occupational stress, we know that mood disorders run in families. Countless studies confirm an "epigenetic" explanation: Genetics and other biological factors load the gun, then a complexity of life experiences and environmental conditions determine whether those genetic vulnerabilities are expressed or suppressed.
Medical science gives us the most accurate, de-stigmatizing understanding of mental illness and suicide, while epidemiological studies show us where we are failing to provide urgently needed mental health education and accessible social supports and affordable treatments.
Ann Kaiser Stearns, Baltimore
The writer is a professor of psychology at the Community College of Baltimore County and the author of "Living Through Personal Crisis."
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