The Problem With Saying Suicide Is Preventable

When I left my father’s condo for the airport on a sunny March day in 2018, I did not once think that he might kill himself. Yes, his depression had returned, dense and unsteadying. But he had just come home from a week of voluntary inpatient care at the psychiatric hospital. He had a psychiatrist, an acupuncturist, and a sunlamp. During my visit, I drove him to his outpatient group therapy. We played Scrabble and listened to 80s dance hits.

What I saw when I spent that week with my father was a man doing everything he could to shrug the mantle of depression from his shoulders. But within 48 hours of me leaving, my father ended his life.

He was one of more than 48,000 Americans who died by suicide in 2018, a then-record that has since been surpassed by steadily rising suicide rates in the midst of a mental Health crisis the surgeon general called “the defining public Health crisis of our time.”

As this crisis rages on, we have made strides in fighting suicide, like the 988 lifeline and increased barriers on bridges and high structures throughout the United States. This spring, the Biden administration released a new 10-year strategy for suicide prevention. These improvements bolster the declaration that now feels ubiquitous in mental health messaging: suicide is preventable. But that phrase masks a nuanced, persistent reality of suicide that we must acknowledge.

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Though well-intentioned, the truth is that not all suicides can be stopped, even with the best efforts. But right after my father’s death, everywhere I looked I read that suicide is preventable. This instilled an immediate, unconscious conviction in me of a double failure: my father, who had not done enough to save himself, and those of us who loved him most, who had not done enough, either. Collectively we could have deterred his death. But we did not.

In the months following my father’s death, I channeled my guilt into an obsessive energy toward understanding and advocating for suicide prevention. I fundraised for the American Foundation for Suicide Prevention, lobbied for policy change in Tennessee, and charted my father’s risk factors against his protective factors, certain I would find the tipping point where he should have gone left instead of right—where I should have stayed, instead of left him.

Alongside the insistence that suicide can be stopped lie reminders for survivors not to feel guilty or blame themselves, a request that feels impossible, as you’re handed checklists of preventative measures. But it is not only for the sake of those left behind that we should add nuance to what we mean when we say suicide is preventable.

The crux of the issue with blanketing suicide as something that can be stopped is that it flattens one of the most confounding psychological, medical, and philosophical questions of being human into something simpler than its reality. Perhaps one day we will be able to say that, with the right blueprint, suicide is preventable. But we do not have the knowledge, let alone the resources, to make that true now.

Today I imagine my father on a precipice, teetering between life and death. I will never know exactly why he fell one way and not the other, in the same way we do not know what causes one person to take their life and another to not. We do not know whether the seeds of suicidality are planted moments before a person decides to die, or decades. For each individual, it is different. But it is not something we can cut open on the autopsy table, tracing its progression and tearing it out at the root.

This does not mean suicide prevention efforts are futile. One of the few, but most encouraging, empirically backed strategies to reduce suicide deaths is limiting access to lethal means—hence the importance of bridge barriers, firearms safety, and safe medication storage. But as my therapist reminded me after my father’s death, people have still found ways to end their lives while in the middle of inpatient mental health treatment. There were no guarantees that anything I might have done would have stopped my father’s death. 

At first, I interpreted his reminder as bleak. But over time, I started to see the way that my obsession with what could have gone differently dehumanized my father. It was both more painful and more honest when I began to accept that my father’s reality was different from my own. I would have given anything for him to still be alive, but I also did not want to deny what life was like for him. In a world still riddled with stigma against mental illness, those who die by and attempt suicide deserve the dignity of us acknowledging their pain as real.

This is a scary thing to admit, to both validate the severity of psychological crisis without dismissing suicide deaths as inevitable. And though I want us to add nuance to our language around suicide prevention, I do not believe the suicide epidemic is unstoppable. But we need more than better quality and access to mental health care (which, we do need)—we also must frame mental health as something inclusive of trauma, poverty, substance abuse, and economic, food, and housing insecurity. We need to intercept suicide far before the crisis moment.

Take, for instance, Italy’s community-centered Trieste model, where people in mental health crisis are directed to short-term stays in peer-managed housing that is more similar to a home than a hospital. The Trieste model also focuses on meeting patients’ basic needs, like food, clothing, housing, and jobs. In the U.S., California awarded $116 million to launch a pilot program replicating the Trieste model in Los Angeles. But the program has been stalled since it received funding in 2019, and remains under revision. More concentrated efforts, like free school lunch programs that have been shown to improve student mental health, can help address some destabilizing factors with more immediacy as larger systemic changes take hold.

We can also expand therapeutic interventions in a system that does not have enough clinicians to meet the needs of a worsening mental illness epidemic. Earlier in 2024, Alaska passed a law requiring mental Health curricula in public schools, following in the wake of states like New York and Virginia. Alabama high-schoolers have been testing a self-guided pilot program to improve mental Health literacy before crisis, which research has shown works.  These kinds of approaches contribute to a broader ecosystem of knowledge and resources that help reduce how many people reach a crisis point to begin with.

Acknowledging that, currently, suicide is not always preventable alleviates the burden for survivors wondering what we did wrong. It also honors that what the world is like for those who die by suicide is real to them, rather than implying that they failed in not doing more to help themselves. And it allows us to admit how much we still don’t know, giving us space to create more holistic, expansive solutions for all that mental health care can be.

When I stopped focusing over what might have prevented my father’s suicide, my perception of his life burst open into so much more than how he died. His death had made me question whether any of the joy and laughter and car sing-a-longs I’d shared with him in the days before were real. But once I accepted that his suicide was both his choice to make, and just one part of his story, I recognized that his depression did not invalidate all the other things that drove him. Like showing up for the people he loved, solving problems, and creating beauty around him. The way he died does not diminish how dedicated he was to growth and evolution, and it does not invalidate the countless ways he chose to live.

I have hope that, with continued research, interventions, and destigmatization, suicide deaths will decline. But I also have peace knowing that my father’s death is not defined by what he or I did wrong, but instead is one of the many continuing unknowns we must make space for in how we speak about mental health.