Suicide: why are so many dying of despair?

We don’t subscribe to print publications in our house (despite the best efforts of the New Zealand Herald to get us hooked with their free “hit” of six weeks’ free newspapers – we tried it once but it wasn’t worth the numerous letters and phone calls we received afterwards trying to convince us to purchase a subscription). Like many people of my generation, I read the newspapers and magazines I wish to read online. If it sits behind a paywall (The Times, for example) then I don’t read it.

Actually, I tell a lie. There is one publication that we do subscribe to – First Things – a magazine from the United States which deals with religion and the public sphere. It is also available online, but I only really read it in hard copy – there is still something about the tangible, crinkly, foldable, rollable magazine that cannot be replicated on a screen.

Anyway, after a two-month US summer hiatus, I was pleased to receive the September issue of the publication last week in my letter box. I have a set order in which I read its contents, and the large articles I leave until last. So it was only a couple of days ago that I read the lead essay, entitled “Dying of Despair”. It was written by Aaron Kheriaty, an Associate Professor of psychiatry and director of the Medical Ethics Program at the University of California Irvine School of Medicine. It details the disturbing trend in the USA of increased suicide and drug related deaths, such that, for the first time since the 1930s, overall life expectancy in the USA has begun to decline. (We have detailed this in a number of posts over the last few months: here, here and here.)

Kheriaty notes that Angus Deaton, a Princeton economist who won the Nobel Prize for work on the intricacies of measuring human wellbeing, has called the increasing numbers of Americans dying from alcohol, drugs and suicide, “deaths of despair”. Linked to this, depression is now the most common serious mental or medical health disorder in the USA (and the leading cause of disability worldwide).

Some 16 percent of Americans will have an episode of major depression at some time in their lives and six percent (14 million) have suffered from major depression in the last 12 months. The incidence of depression is increasing, especially among youth. A national study found that the share of 12-20 year olds who had suffered major depression in the last year had increased by 37 percent from 2005 to 2016.

Most people who commit suicide are suffering some form of depression, and the suicide rate has grown alarmingly at the same time as depression has increased. The rate of suicide for men and women and every age bracket in the USA increased between 1999 and 2014 and the rate among girls aged between ten and fourteen tripled. Suicide is now the second leading cause of death among adolescents and young adults and the tenth leading cause of death overall in the USA.

Kheriaty posits a few reasons for this increase: increased loneliness among Americans; the weakening ties of family and community; high divorce rates and low marriage rates; the loss of traditional blue collar jobs. Interestingly, economic explanations cannot account for the fact that adolescent suicide is equally common amongst the very wealthy and the very poor.

One group of persons, however, remain relatively unaffected by the rising suicide rates: the practicing religious. In one recent study of 89,000 people between 1996 and 2010, it was reported that those who attend any religious service once a week or more were five times less likely to commit suicide. Mere self-affiliation with a religion did not make a difference to the rate of suicide; the practice of religion was what was crucial. Of the 6,999 Catholic women in the study who said they attended Mass more than once a week, none committed suicide. Not only do most religions have strong moral prohibitions against suicide, but the mere act of church attendance creates a social activity that protects people against loneliness. Further, religious faith can instil a sense of meaning and purpose that transcends the slings and arrows of outrageous fortune.

Turning to my own country, New Zealand, one can see that, if anything, the trend is even worse. In the year to 30 June 2017, the number of deaths from suicide rose to 606 persons, up from 579 the previous year -- the third year in a row that the number has increased. (At 12.64 suicides per 100,000 of the population, this figure is surprisingly similar to the USA rate of 13.26, or 44,000 suicides in 2015.) Suicide is the second most common form of death for New Zealand non-Māori males, and the third most common form of death for Māori males. The country also has the highest youth suicide rate in the developed world.

Why is this happening in a country that is so rich, so beautiful, so peaceful? Is it because New Zealand is also so secular? Do people lack the prohibition against suicide that most religions bring, as well as the hope that belief can provide during times when the material world is not providing much of it?

A final anecdote: my brother-in-law stopped a girl from jumping off a bridge onto the motorway below last year. He stopped his car, grabbed her so she couldn’t physically jump and pulled her back over the railings. She had just broken up with her boyfriend and was not yet 20. When the police came, the policewoman who dealt with the girl was none-too-gentle, obviously angry at her selfishness. The officer had probably seen it happen far too many times before.

How do we prevent girls like that from becoming trapped in their depression – seeing only the boyfriend who has left, rather than the 60 years of life still ahead? How can we make girls like that see the family that she will condemn to a life of pain, let alone the damage, injury and death she will cause if she landed on a passing car below on the motorway?

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