Lately, I’ve been reading Thomas Joiner and Anthony Pisani on suicide and its prevention. They approach the subject from slightly different views, but at base have community- and person-focused theories. The key distinctive between their theories and most of what I’ve seen is they don’t assume a suicidal person is “mentally ill.”
Illness or Lack of Community?
Here’s the difference between the mainstream and how these two researchers approach the subject.
Mainstream theories – 90-95% of people who suicide suffer from 1 of these 4 mental illnesses: depression, substance abuse, bipolar disorder, or schizophrenia.
Joiner / Pisani – People who suicide have reached a point where they cannot find meaning in life, lack a community where they feel valued, feel burdensome to those around them — and have also obtained the fearlessness, means, and skill to do the deed.
Historic Views, Newer Perspectives
It is important to recognize that the connections between bipolar, schizophrenia, and suicide is longstanding and well-documented. More than 15 percent of persons with either of these diagnoses are likely to die by suicide.
Linking “depression” as a clinical diagnosis and “substance abuse” as a clinical diagnosis with suicide is relatively new. Even newer is the idea that the best way to end a depression that has lasted as long as two weeks (the current DSM standard) is by prescribing a medication.
How It Can Look in Real Life
Let’s see how this can play out in real life.
A divorced woman’s last child has gone to college. She must move into a small apartment in a new neighborhood, since her husband will no longer pay for the house where she was raising the children. She has lost her sense of purpose as a mother, since there is no one to care for when she comes home from work. She bevcomes very depressed.
Because doctors prescribe medications, not life changes, she receives a prescription for an antidepressant. Does this help?
Not as the doctor expected. But Joiner and Pisani’s theories explain the results.
The “community” of her family has vanished; the community of her neighborhood has vanished. She has lost her sense of meaning and community. Instead of a remedy, the antidepressant becomes the means she desired. Over the coming months, she regularly overdoses on a mix of antidepressants and red wine.
Now Joiner is careful to say that antidepressants can be helpful in many cases and should not be avoided simply because some can be used as suicide agents. At the same time, I see a caution here for doctors — and a role for churches.
Caution for MDs, Job for Churches
Doctors can’t prescribe a sense of meaning and purpose. But this is precisely what churches are designed to provide.
It must be our job as Christ’s church to seek out and save those who are lost — especially those who feel so desperately lost they don’t have any reason to keep living.