“If someone’s life is so awful that they want to die by suicide, why stop them?”
I am frequently asked some variation of this question, even by mental health professionals. Once, a therapist told me about a client of hers with schizophrenia. “He is miserable, and he will always have schizophrenia. I think letting him kill himself is humane.”
I am passionate about suicide prevention. My stance often draws the ire of people who think that people should have the right to end their own life without interference by well-meaning others.
To my mind, there are many reasons to stop someone from suicide. (I am not, by the way, including “death with dignity” or “hastened death.” That’s grist for another discussion.)
Before going into those reasons, I want to make clear that I don’t take intervention lightly. I don’t call the police if someone discloses suicidal thoughts. I don’t think people should be involuntarily committed to a hospital except in the most extreme circumstances, like if someone has a gun in their car and tells me they are going to shoot themselves when they leave my office, without any desire or will to come up with an alternative. I consider myself to be a therapist who doesn’t panic about suicide.
Why Prevent Suicide?
Except in very limited circumstances, such as states where physician-assisted death is legal for people with terminal illness, I believe that therapists should never give up helping a suicidal person to stay alive.
The most important reason to prevent suicide is that suicidal crises, though formidable and painful, almost always are temporary. Even if the person continues thinking about suicide, the intense suicidal intent usually subsides. Consider that 90% of people who survive a suicide attempt do not go on to die by suicide. That number is very revealing. Even among people who wanted to die so strongly that they tried to end their life, most ultimately chose to live.
As long as a person is alive, things can change for the better. Situations change. Even if their external situation is unchangeable, they may discover things that make their life worth living. There is always the possibility that they may find ways to cope. Or they may come to appreciate different things in life. They may even find a purpose in life that gives their loss or trauma meaning.
Kevin Hines is a suicide prevention advocate who, years ago, jumped off of the Golden Gate Bridge, the site in the U.S. with the most suicides every year. Death is almost certain when one jumps from the bridge. More than 1,500 people are known to have jumped to their death, and only 30 or so are known to have survived. So when Kevin jumped from the Golden Gate Bridge, he was absolutely intent on dying. And yet, even with that intention, the moment he jumped off the bridge, he instantly regretted his decision.
His experience is one of many (including my own story) that illustrates that the wish to die is fluid. It comes and goes to varying degrees. A great many people who are saved from suicide are thankful, sooner or later, to be alive.
Is Suicide Rational?
Another important reason to prevent suicide is because, proponents of rational suicide notwithstanding, suicide is often irrational.
Some research indicates that 90% of people who die by suicide had a diagnosable mental illness at the time of their death (though more recently, some evidence indicates that not as many people who die by suicide have a mental illness diagnosis).
Mental illness distorts thinking. What is bad can seem good, and vice versa. Often, very often, when a person’s mental health improves, the wish to die goes away.
Some people contest the high estimates of mental illness in suicide. Even if we presume the 90% figure is correct, not everyone who dies by suicide has a mental illness. Other things besides mental illness can also distort one’s thinking, such as substance use, sleep deprivation, and trauma.
When people address these issues, they often join the legions who seriously considered suicide or made an attempt, and who many years later live to tell about it.
Revised on May 30, 2017, this post was originally titled “‘If Someone’s Life is So Awful that They Want to Die, Why Stop Them?'”
© Copyright 2013 Stacey Freedenthal, PhD, LCSW. All rights Reserved. Written For: Speaking of Suicide. Photos purchased from Fotolia.com
A bullshit article … and not one compelling reason to not commit suicide. Not one. Spare everyone the things can change or you can learn to find new meaning in life…It does not speak to the realities of the very real hell people with disabilities, in poverty or living with trauma face.
[This comment was edited in accordance with the Comments Policy. – SF]
Ben,
I see that the article angered you. The hostility people have toward suicide prevention vexed me in the past. Over time, I’ve come to realize my conceptualization of suicide prevention is different from what many others mean. To me, preventing suicide is doing what we can to make life better for people, in general making it less likely that people would want to die by suicide, and helping people stay alive while (hopefully) their lives improve in ways they might not have thought possible. I’ve worked with so many people who are grateful to be alive, despite having been intensely suicidal, that I find tremendous value in this work. But to critics, suicide prevention seems to mean only showing up on someone’s doorstep with handcuffs and taking them to a hospital against their will to be forced to stay alive. That, to me, is a whole other issue, and it occurs to me as I write this that I ought to examine these differences in a future blog post. And I ought to examine the overlap, too – someone can be bound (professionally, morally, or both) by a duty to protect someone from suicide while also working to improve the person’s life and social conditions. It’s not either/or.
Thanks for sharing here. So you know, I removed all personal attacks from your comment, in keeping with the Comments Policy.
Stacey, with all due respect, if you would not cede back control of a persons life (THEIR life, THEIR body, THEIR suffering) after any amount of time spent in treatment, then I do not think that you can claim that your approach is exclusively about helping people and that you aren’t in effect playing the role of the jailer, forcing people to stay alive by any means necessary. Because I’m sure that you know that there are some people who remain suicidal no matter how long they’ve been in treatment, and if it were up to you, these people would stay and suffer indefinitely and nothing would change for them. Merely having the peace of mind of knowing that there is an exit may provide immeasurable peace of mind for many of your most troubled clients. I am wondering what you think about this case study: https://news.sky.com/story/ive-been-granted-the-right-to-die-in-my-30s-it-may-have-saved-my-life-12055578
I know that personally, just having the knowledge that I was not a prisoner here would be of immense peace of mind. It is much harder for me to improve my circumstances when I’m constantly worried about how I could plot an escape route from here whilst the backs of the guards are turned. A prison can become a home when you have the key.
“Existential Goof,”
I agree with you 100%: The possibility of dying helps many people stay alive. Nietzsche said as much: “Thoughts of suicide are a great consolation; they get many a person through a difficult night.” I also like the title of this article: “Suicide Fantasy as Life-Sustaining Recourse.” Same principle. And I have no doubt that it’s true. A lot of people who are given a lethal prescription for medication under Death with Dignity Laws don’t fill the prescription; a lot of people who fill it don’t ingest the pills. I’ve read qualitative research (sorry, can’t recall the citation right now) where people said they were able to stay alive until their disease killed them precisely BECAUSE they knew they had the option to die whenever they wanted to.
Where I disagree with you is the notion that I, somehow, am powerfully and magically forcing people to stay alive against their will. I’m just one person writing at a computer with, half the time, a cat in my lap. I’m not going door to door, invading people’s homes, reading their minds, and determining if they should be taken away. (Sorry for the sarcasm, but I really don’t understand why so many people think *I* singlehandedly am able to force people to stay alive, especially given that it would mean I’m a failure at it, with 45,000+ suicides in this country each year.)
On the rare occasions I have summoned emergency help for someone who had attempted suicide, or was on the verge of doing so, that person had first sought my help willingly. I had an obligation to their healthy self to do what I could, not only because I had legal obligations as a licensed social worker (though those obligations are quite salient), but also because the person voluntarily came to me for help to stay alive, not to die, and I had made a commitment to help.
I can’t stop anyone from dying by suicide unless they reach out to me in some way and give me the information needed to intervene. On rare occasion, someone’s submitted a comment to this site announcing their suicide and leaving their full name. They didn’t need to give me their full name; most people don’t. But they did, and now I know who they are, and they’re about to end their life, so what am I supposed to do? I notify the authorities in those cases. And isn’t that what they wanted, at some level? Why would they give their name (and city, in most cases where this has happened) to me, a person publicly committed to suicide prevention, if they didn’t want their suicide prevented?
Where I genuinely struggle – a LOT, I would add – is I do think people should be able to talk about the decision to suicide (or not) without fear of hospitalization against their will. And I do think if people could die by suicide with assistance from a physician, even in the absence of terminal illness, the suicide could be much less traumatic not only for them but for their loved ones. There’d be a chance to say goodbye. Nobody would discover the body unexpectedly (or NOT discover the body, which to me is its own kind of hell, to not know where your loved one disappeared to and if they’re alive or not). So, then, why shouldn’t we have suicide clinics where people can get their prescription, have their funeral in advance, and maybe even decide to live knowing they have the freedom to die peacefully at any time?
Here’s why, at least for me at this moment, since my mind constantly churns about this topic: Where do we draw the line? Very often, suicidal thoughts are temporary; two thirds of people who seriously consider suicide don’t consider suicide again in the subsequent decade. Not once. Roughly 90% of people who are stopped from killing themselves don’t end up dying by suicide, even many decades later.
So, why should we facilitate people’s deaths when those suicidal wishes will, in many cases, be temporary? No, they’re not temporary for all, and I struggle about the suffering of those for whom suicidal thoughts persist. But the wish to die is temporary for many, like Shannon Parkin, like Kevin Hines, and like myself.
Let’s not also forget the great harm suicide does to the living – the children who lose a parent, the parents who lose a child, the high school that experiences a cluster, etc. I don’t mean that people who suffer should continue to stay alive and suffer merely to spare others the pain of their death. I do mean that as a society, we should remain committed to trying to help people make it through a suicidal crisis alive the best we can – and to creating conditions that make a suicidal crisis less likely to begin with.
Another thing: How do we send a message to one group of people (say, children) that they should ask for help and not kill themselves, while sending a completely different message to others? It reminds me of that editorial cartoon of a suicide prevention clinic and a suicide clinic being next to each other, and a person in a wheelchair having to decide which one to visit. Talk about mixed messages.
So, ultimately, where I land is that any “solution” is imperfect. Some people will be hurt either way – the people who die prematurely, the people who can’t die prematurely, etc. Since there’s no way to make it work for everyone, I think we should just keep trying to help people stay alive, and if someone doesn’t want that help, they’re actually free to end their life. I know, it’s not ideal, to a suicidal person, to attempt suicide without certainty of death, or with the possibility of pain or permanent disability. But they’re also free to end their life – it’s not illegal – and others are free to try to stop them, if others know.
Really, I do know it’s imperfect. But maybe it’s the least bad option, at least to me, in this moment in time.
Anyway, I’ve clearly been thinking about this a lot and one day will write a post about it. For now, I think I’ve just written a post disguised as this comment. 😉
Thanks for sharing, and for challenging me so respectfully, and for “listening.” I appreciate the exchange of ideas.
Also, beautiful writing: “A prison can become a home when you have the key.” And it’s a very good point, too, among others.
That is exactly.. EXACTLY what it means though. I like your definition but we’re talking reality here reality is when i OD’d 2016… They arrested me they locked me in the psych ward I had to see a social worker who was then in control of my life for 2 years. And they made my life worse by making me mandatory do their rules all the way down to I must make three meals a day or I would be locked up again. So reality isn’t your dream wish on suicide prevention. Reality is the courts and the social workers and the police and the will basically make your life more miserable more harder and worse off…. And that is stupid! Do I want to die hell yes do I have a date in mind hell yes.
social worker told me wait 5 years and she said and then I know you won’t feel the same. Well I’m now off probation I don’t have to worry about anybody controlling my life. Hopefully the next time I be around to be arrested…
Src,
Thanks for writing here. I don’t know if your comment is directed at me or at “Existential Goof.” So I’m not sure how to respond but I do have a question. I’m wondering if you live outside the U.S.? What you’re describing is a process unlike any that I’ve heard of in the U.S. Most people here don’t even get help after a suicide attempt, let alone two years of services they don’t want from a social worker. Some states have “outpatient commitment” for people with mental illness, but that’s typically only for medication, not any kind of psychosocial services. And … probation? Doesn’t happen here. I have heard of a few very anachronistic anti-suicide laws that are still on the books in some cities, but they’re not really enforced anymore.
I’m quite familiar though (thank you, Twitter) with the UK’s liberal “sectioning” laws, so I wonder if you’re writing from there. I’ve read accounts by people on Twitter of being sectioned for six months at a time. Here, someone can be involuntarily committed, but it’s quite uncommon and seldom for that long. For example, this report published in 2019 states, “Today, in virtually every state, lengths of stay for committed patients are (usually) brief, typically a week to 10 days.”
In any case, I’m sorry you’ve gone through so much, and especially sorry you haven’t been helped. To be told to wait five years can be like telling someone with two broken legs to run five miles. I get that. I wish you could have relief without dying.
Also, I normally correct obvious errors in comments, but I’m not correcting your missing word in the last sentence. I’m not a Freudian, but I do think sometimes our unconscious asserts its wishes in spite of our conscious intent, and that very well could be what happened here. That – or you just absent-mindedly left off the word “won’t.” Either way, I don’t want to change the meaning of what you wrote, so I’ll leave it as it is.
I live in the state of Minnesota the Great supposedly friendly Midwest. And that’s exactly what happened they lock you up they take control of your life social work gets involved and the courts decide that they will be in charge of your life for the next x amount of years
Src,
Oh my, I thought for sure that hadn’t happened here. Well, we do have 50 states, all different. But wow, that’s some intense care you’re getting. I wonder, are you receiving services from an ACT? (Assertive Community Treatment). That’s more intensive. (Clearly I’m looking for logic here.)
So many people who want help can’t get it that it frustrates me you’re getting so much care you don’t want. If only you could give it to someone, you know?
Anyway, thanks for answering my question — and teaching me something new and important.
You know I don’t think until you really walk in certain people shoes but you can judge or tell them it’s wrong to leave this world by their own hands. You have no clue what everyone goes through. And if a person is really thought it out can they see that they have nothing or no possibility of a decent future I have no family and they’re all alone and their health isn’t good and they know as we get older health will deteriorate more and more and more then what the hell is the point why keep going. Just to say I’m going to keep fighting to the end? Or so no one says you gave up. Sometimes giving up is the right thing to do. It makes no sense when you’re constantly in pain or hurting and you’re all alone you don’t really have anyone except maybe a great friend who has their own life with their own family but your spouse has passed on your kids don’t talk to you and haven’t for years cuz they have their own lives for whatever reason and you just exist every day and night. It makes no sense to keep going on…. Especially if you believe that there’s a heaven and an afterlife that is way better than down here
You hit the nail right on the head
You’re so right. It’s too bad some people just don’t get it.
At 32 I got hurt at work, nothing was fixed after around 13 surgeries now I have constant pain and theres no help left for me. My pain is eating me alive. So tell me now what besides leaving this world!!! Im tired.
Kevin Hines regretted his unsuccessful attempt, but there is no evidence that anyone has ever regretted a successful one. Just because most attempt survivors don’t end up going by suicide doesn’t mean suicide prevention doesn’t cause more suffering.
Does anyone realize that other people have LESS say when someone gets pregnant but is not fit to be a parent? Or when someone with mental health issues decides to buy a gun? Or when irresponsible texting people get behind a wheel? A person should be able to just kill themselves if they want to die already! So much stigma, red tape, and bureaucracy surrounding SOMEONE ELSE’S life. It’s no one else’s business (life)!!!
Well, I certainly have to agree with your point, but it shouldn’t have to be the case.
I know that there are people who love me. Who Cherish me. But in a futile attempt to get rich and have money, it seems to be going bad. Just got a letter of demand, saying I must pay 16k in 21 days or it will be taken to attorneys, which may cost upwards of double that. It’s not actually my money though, it’s my mom’s. But if she goes down I go down with her. Her money and my money are one in the same. We are trying to get a business going but I am not the entrepreneur type. So now I feel lost. Probably need to get a job and hustle for some bullshit like money. This is why I’m here. Just dipping my toes in and test the waters. And it’s funny I was just in a club for the first time and it was fun. I know a very cool lady who would be very disheartened at me killing myself. Lots of friends would be hurt. And not to mention my mom. She’d end up killing herself shortly after, causing all my friends and her friends to be very hurt. I am that jokey type. That guy who loves showing care and affection, but my life seems to be steadily falling down with someone else’s. Why do humans show no empathy to each other, so little people would care for your death or passing. Might even mock you for being such a pussy for offing myself so early.
Why is life so miserable, why do we make it so hard for ourselves? I don’t like thinking negatively but recently it’s become horrid and unbearable. I think I should find a way out of it. I could try writing what I’m feeling. Maybe make it a book. Maybe offer some courses on getting through depression even though I have no clue what I’d be talking about. Maybe the book idea is good. But then again, there is still that Letter of demand and the rent to pay. And that’s not negotiable it has to get done. But I have like 1k in the bank, and I’m not making enough to possibly pay Vodocom in time. Maybe I should seek help from friends and see what they have to say, but I don’t want to loose any friends this way, they must have their own struggles that their dealing with.
Anyway, I do think Wendy’s statement is kind of false and true. If someone would be better off dead than alive, I think go for it, but those who love you will be heartbroken, and family members will be very much so, if not more. I suppose someone like me should not think this way. But when I see that 16k outstanding Letter of demand, I don’t know… It doesn’t seem right. It’s not like I was getting much done with my business.
I could keep writing but I’d be writing forever.