What’s the link?
Having financial troubles is very challenging and for some, it can be overwhelming. When you don’t know how you’re going to take care of yourself or your family, you can feel like a failure and that you don’t have many options within your control. This leads people to make decisions out of desperation. How do they end up deciding that suicide is the answer? What can be done to prevent them from taking this step?
In the past few decades, there has been a surprising surge in suicides across the United States. The Centers for Disease Control and Prevention (CDC) reported that the age-adjusted suicide rate rose 33% from 10.5 deaths per 100,000 people in 1999 to 14.0 per 100,000 in 2017 (a 50-year peak), making it the 10th-leading cause of death for people of all ages in the country. In total, from 1999 to 2016, suicide claimed the lives of 453,577 adults between the ages of 25 and 64. Most of these suicides happened in cities and suburbs, where 80% of Americans live, but typically, a higher percentage of people commit suicide in rural areas. Suicide rates have been rising steadily since 2000, but the rate of increase essentially doubled after the 2008 economic downturn. There’s a powerful link between suicide and economic deprivation, which includes factors such as poverty, unemployment, low levels of education, and reliance on government assistance. Other elements are lack of health insurance, being a military veteran, and access to stores that sell firearms. Since our country’s health insurance model is privatized and tied to employment, when a person loses a job, they’re unable to get the mental health help they need. Data shows access to a means of suicide, like guns, tends to increase suicide rates. In recent weeks, there has been a rise in gun sales as Americans are gearing up for another possible economic shutdown. The coronavirus pandemic is creating the perfect situation for suicides to grow. As experts point out, many people at risk for suicide are more likely to experience negative effects from the steps necessary to prevent the spread of the virus, such as staying home and social distancing. This leaves them feeling isolated and financial struggles can make the situation seem unbearable.
Recent U.S. Census Bureau data shows that the pandemic has resulted in 50% of Americans experiencing a loss of income and over 25% are dealing with housing insecurity. Data from previous recessions revealed how economic downturns could cause a spike in mental health issues, like suicide attempts and suicide. A recent example of how economic troubles can influence the rate of suicide is the Great Recession of 2007-2009. The American Journal of Preventive Medicine found that “Suicide circumstances varied considerably by age, with those related to job, financial, and legal problems most common among individuals aged 40–64 years. Between 2005 and 2010, the proportion of suicides where these circumstances were present increased among this age group, from 32.9% to 37.5%.” According to the British Medical Journal (BMJ) in 2013, “After the 2008 economic crisis, rates of suicide increased in the European and American countries studied, particularly in men and in countries with higher levels of job loss.” They looked at 27 European countries and found that men’s suicide rate increased by 4.2% with no increase for women. In addition, the researchers examined 18 countries in the Americas, which showed an increase in suicide rates for men by 6.4.% and a 2.3% rise for women. A study conducted in 2014 and published in the British Journal of Psychiatry discovered that there were at least 10,000 more suicides than the average in the US and Europe between 2008 and 2010. The American Psychological Association notes, “Those who experienced personal hardships during the recession—whether financial, housing-related or job-related—showed an increase in panic attacks, excessive worry, depression, and problematic substance use. These mental health affects persisted into 2013, well into the economic recovery.” The economic downturn triggered by COVID-19 has caused the highest surge in unemployment since the Great Depression, leading to concerns about the impact it’ll have on all affected individuals’ emotional well-being, especially those with pre-existing mental health disorders. Recent estimations suggest that with a 12% unemployment rate, we could see an additional 6,600 deaths by suicide. Experts also point out that for each suicide, there are at least 5 suicide survivors, over 25 suicide attempts, and many more in psychiatric distress.
An older study published in the American Journal of Epidemiology conducted by Duke University backs the notion that financial strain is a significant risk factor for suicidal ideation and suicide attempts. The research was conducted before the Great Recession and analyzed information from 34,653 adults interviewed first in 2001–2002 and then in 2004–2005 as part of the National Epidemiologic Survey on Alcohol and Related Conditions. Based on the responses, the researchers found that being in debt or facing a financial crisis, unemployment, past homelessness, and having lower income were each associated with suicide attempts. It’s important to note that the study may have some limitations because suicidal ideation and suicide attempts were self-reported by the participants. Since society has stigmas surrounding mental health issues and suicide, some interviewees may have chosen not to disclose the full extent of their conditions. However, according to the data, people who’ve recently experienced severe financial strain may have a 20-fold higher risk of attempting suicide than those who have not encountered hardship. Due to the pandemic’s impact on economies, suicide attempts may become an even greater worry soon.
The rise in suicides is being seen more in rural white populations than any other demographic. Recent scrutiny of data helps explain why this is the case. In more metropolitan areas, the long-entrenched poor, typically communities of color, are better able to fend off despair by having access to social networks and shared resources, such as city parks, neighborhood barbershops, and community churches, that have sustained them through generations of hardship. Also, they are closer to a wider range of employment opportunities. Even in rural communities, minorities have similar shared institutions, which helps blacks and Latinos deal with long-standing poverty. In rural counties that are impacted by the more recent economic decline, the shared communities have dwindled. These are the places associated with the stereotypical picture of stable blue-collar, or nice, existence for whites. The areas used to be thriving rural places, near enough to cities and manufacturing hubs. However, with the collapse of industries like coal mining, the departure of manufacturing jobs, and a strapped agricultural economy, these communities got turned upside down. Many residents have fled, leaving behind others who’ve become increasingly isolated from one another and don’t have any optimism for the future.
The good news is that mental health issues, like suicide, are treatable. People facing job loss or financial uncertainty are afraid and struggling but might not show signs of mental distress. This is why it’s important to check in with your family, friends, and neighbors who are suffering financially and let them know they’re not alone. Find ways to support them and offer help in any way possible (it doesn’t always mean providing for them financially). We must realize that social distancing doesn’t mean social isolation, and that’s the message these individuals need to hear. Maintaining friendships and building connections with others are things that we can all do. The CDC supports this concept by saying that one of the most important things to prevent suicide is to be connected. While we can’t get together in person, technology can help us remain close by using phone calls, face time, and social media.
Experts note that social safety net programs and better access to physical and mental healthcare could lessen the impacts the pandemic’s economic downturn is having on individuals’ mental health. If businesses need to remain closed for several more weeks or even months, in the context of suicide prevention, considering assistance with income, employment, or both are necessary. If workers can keep their jobs through a shutdown, businesses could get back up and running quickly once social distancing measures are eased. As several European countries are, one way to handle this is by offering to pay portions of salaries, so companies are less likely to lay off employees during shutdowns. The US is subsidizing paid sick leave in hopes that workers can stay home from work if they contract COVID-19 without worrying about losing their jobs. In addition, we’ve also expanded unemployment benefit eligibility to workers who don’t normally qualify.
Some private sectors are working on solutions as well. Researchers at Columbia University’s Department of Psychiatry have created a financial wellness program. The program will be facilitated by peer staff—individuals who’ve experience psychiatric diagnoses firsthand and are trained to help others in their recovery process. It’s based on several years of research and field experience and was recently awarded a grant by the American Foundation for Suicide Prevention (AFSP). The project will last two years with the goal of fostering financial wellness, which will improve overall feelings of wellness, thus reducing suicide risk. Individuals will learn how to develop a financial wellness plan and have access to financial supports, such as free and certified financial counseling services. Each group will have 15 participants and meet weekly. The thought is when we feel hopeful about our financial future, it can have a positive impact on our emotional well-being. It makes you feel like you have options!
If you know someone at immediate risk of self-harm, suicide, or hurting another person, call 911. While you’re waiting for professional help, stay with the person and remove any weapons, medications, or other potentially harmful objects. If you or someone you care about is considering suicide, call the National Suicide Prevention Lifeline. They have trained crisis counselors available 24 hours per day at 800-273-8255 (TALK) or text TALK to 741741.