In Defense of Suicide Prevention

Many people take offense at my stance on suicide prevention. They send me angry emails. They post challenging comments on this site. A common argument is that people should be free to die by suicide without intervention by others, no matter what:

“For some people there is little to be done sadly and if they want to exit life then I completely understand and I believe they should be helped: either by medical personnel or at least by giving them access to pain-free means. This is the humane, moral and decent thing to do and it respects their autonomy and human dignity…”

That comment, by a reader named Zara, raises good points. It is just one comment among many that have caused me to question myself:

By advocating for stopping people from suicide except in the context of terminal illness, am I wrong?

Why don’t people, regardless of terminal illness, have the right to end their own life, without interference or interruption?

What if the suicidal person’s mental or physical suffering truly is intolerable and with no end coming soon, if ever?

Is it inhumane to stop a suffering person from ending his or her life?


Why not?

The Most Difficult, if Fleeting, Question

People who long for suicide typically want to escape unbearable torment. They experience deep emotional or physical pain, or malaise, or fear, or trauma, or something else so powerful that it snuffs out the biologically ingrained will to live.

They feel hopeless that things will ever change. Indeed, they do not simply feel hopeless. They are convinced they are hopeless.

They want to end their lives for very compelling reasons.

I think of all this, and a troubling question settles on me. I dedicate my work to suicide prevention, but even I wonder, if momentarily:

Why not let them die by suicide?

Suicide Prevention and the Greater Good

In preventing suicide, yes, we are trying to help the suicidal person. We know, based on years of research about suicide attempt survivors, that suicidal individuals are very likely to regain the desire to live. As I describe in the post “Where Are They Now?: The Fate of Suicide Attempt Survivors,” most people who survive a suicide attempt do not later die by suicide. 

But we are not only helping the suicidal person by working hard to prevent suicide. We also are helping people who care about the suicidal person.

Suicide hurts the living. We strive to prevent suicide not only to save the suicidal person from dying prematurely and unnecessarily. We also strive to prevent suicide to save children from losing parents, parents from losing children, partners from losing love, and communities from losing valued individuals.

As Jennifer Michael Hecht wrote in her book, Stay: A History of Suicide and the Arguments Against It: “The whole of humanity suffers when someone opts out.”

In seeking to prevent one person’s suicide, we also seek to prevent even more suicides. People who lose someone they love to suicide are at higher risk for suicide themselves. One suicide can lead to another, what is called “suicide contagion.”

Please let me be clear: In describing the harm that suicide does to others, I am not blaming the suicidal person. Rather, I blame the forces that lead to suicide, just as the blame for a person’s death to cancer belongs to the cancer, not to the person who died. In this regard, the person who died by suicide is suicide’s victim – but not the only one.

A World Without Suicide Prevention

Some people lament that suicide prevention measures deprive people of the ultimate liberty – that is, the freedom to die without interference or intervention, the right to end suffering on one’s own terms.

Consider the alternative: A society where people are not stopped from dying by suicide. Where parents and children and friends and lovers watch, without recourse, as tragedy unfolds. Where there is no pathway for keeping the suicidal person safe without the person’s consent, even though the chances are very high that the person will recover the will to live if given the chance. Where friends, family, and professionals are not allowed to prevent what might be preventable.

A society that tries to prevent suicide sends the message to people who suffer, and to those who love them, that their lives matter. That suicide is not the answer. That people care and can try to help.  That things have a good chance of getting better.

No doubt, we need to do more as a society. On a large scale, people need more resources and more reasons to want to stay alive. If society treated people better – if there were more jobs, better health care, and less violence, for example – fewer people would want to die.

Society needs to do more for suicidal people besides keep them alive and miserable. But letting people kill themselves without providing any means for prevention isn’t a solution, either.

Questions In Search of Answers

Graphic by Dese’Rae Lynn Stage

More emails from strangers will come to me, missives full of challenges, perhaps even anger. I know this. I anticipate some of the comments:

You are selfish. Why should one person suffer so that others don’t?

Why should people stay alive to help society when society doesn’t provide enough help to people who stay alive?

Who decides what is best for the suicidal person? For society?

Those are good questions, and I hope to tackle them in future posts.  

What are your answers?


Stacey Freedenthal, PhD, LCSW, is the author of “Helping the Suicidal Person: Tips and Techniques for Professionals.” 

Copyright 2018 by Stacey Freedenthal, PhD, LCSW. Written for All Rights Reserved. Photos purchased from

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  1. Rudy says:

    Oh yes, think of the people who “love” you. You know, the ones who won’t ever actually listen to you.

    • Cheryl Johnson says:

      Rudy, that hits home for me. I guess that I have always been irritated by the think of the ones who love you statement. These are the ones that you reach out to and they say you just need to get out of bed and do it. Or tell you to get over it. The ones that you tell about NAMI support group and they don’t go. The ones that you send book titles to for reading so they can try to understand what you are going through and they ignore it. But they continue to tell you that you have to straighten out your life. The ones who judge you because your house is a mess. I agree it should never be about the ones that”love” you. I understand that people do care in their own way. These are the same people that can make life more miserable with their uneducated advice.

  2. Cheryl Johnson says:

    I just came across your website. I have had suicidal thoughts for over 30 years. Some days they are less intense than others. I have felt on days that suicidal people should be allowed to die.The pain some days can be unbearable. I agree that more had to be done to help those who suffer with suicidal thoughts need more help finding hope and happiness. Attempting suicide and then being treated in the emergency room can be degrading. I was treated like I was wasting their time since I tried to commit suicide. Now when the urge is overwhelming I just go to the emergency room to be evaluated for psychiatric admission. In most cases the inpatient admission can bring me back to stability. Then again, this is no way to live. I have been committed twice in the past in order to keep me past 72 hours. When I am really sick I don’t cooperate very well with anyone. (I have 2 adult children who suffer also). Once out on my own there are little resources for me. I know where to find help and what I need to do. Mental Illness resources are so few that usually services are for low income or people who cannot manage on their own. I cannot apply for disability because I work. I cannot even keep my house clean because work exhausts me. Having a dirty house causes additional self hatred. I had three children to raise on my own and could not make meals or clean since I was working to pay bills. I couldn’t try different medications because if the side effects were bad, I wouldn’t be able to work. The biggest issue I have come across lately is the lack of psychiatrists. It takes an average of 3 months to see a psychiatrist or Nurse Practionier for medications. My son just went through a horrible experience with it. He had a psychiatrist who left the clinic my son was seeing him at. My son was finally on a medication that seemed to help. He was unable to refill his medication because he was unable too find another psychiatrist to fill it. His wife called every month for six months to try and get him in to another psychiatrist. They did not have any openings. My son had attempted suicide in the past. He had an episode and was hospitalized. While inpatient on a 72 hour hold he was seen by the only adult psychiatrist for the unit. I was committed by this doctor 7 years earlier so I knew his bedside manner. This doctor was so out of line that we called the hospital administration and at the end of the meetung the hospital pulled the adolocent psychiatrist to treat my son and the adult psychiatrist was supervised when seeing patients in a locked unit off the unit. Please understand that if you need help that you need to get help to keep yourself safe. There are many good doctor’s out there. My point is that there are too few doctors and resources. This incident has set my son back in the progress he was slowly making. If I did not know to call the administration, my son would have continued to be mistreated. I have always been able to survive but I want to live. I signed up for a DBT program last year. I waited 6 months to get to the top of the waiting list. I was unable to go because it was during work times. My story is very complicated and it would be a novel if I explained it. I am at a loss of how to let people know that people with a mental Illness need help from everyone around them and the professionals who help them. Education is lacking and I come across daily people who say suicide is selfish and a cowards way out. I can guarantee they would think differently if they had to deal with my mental health. I battle on my own and vowed to be there for my children if they battled too. I am reassured by the mental health professionals for my daughter and by my daughter that she is lucky I understand the illness. Family members need to understand the illness (mine do not) in order to help themselves and the person suffering. This is a family disease both emotionally and genetically.

    • Leann says:

      Wow! Reading your comment is like reading out my own life story.

    • Rudy says:

      “I cannot apply for disability because I work. I cannot even keep my house clean because work exhausts me. Having a dirty house causes additional self hatred.”

      I am able to work, too, but due to chronic (multiple) allergies/general sinus problems/barometric pressure sensitivity*, it is also a struggle for me to get through a work day. I have next to nothing left over at the end of what is generally a frankly not very challenging work day. My apartment is dirtier than it should be, but there are always lots of chores to get done on my days off, and cleaning often takes a back seat. Of course, the dust and dirt are not good for my allergy and sinus conditions; but then, I have to be careful when I clean, because if my sinuses are already inflamed, kicking up dirt can make them much worse. (I do use masks, but they aren’t usually adequate.)

      One of the most difficult things for me about my situation is having one foot in the larger social world, but having one foot out as well. I am half in and half out of life. I have the energy to work full-time, but I don’t have the energy to get to much of anything enjoyable on my days off, which are focused on chore triage. (What absolutely needs to get done before my energy gives out, as it probably will?) This means I have very little to talk about when my co-workers engage in the usually social rituals of asking about weekends and so forth. Those social rituals constantly remind me that I am half in and half out of life. I think it might be easier if I could live essentially as a hermit, rather than feeling pressure to meet the normal social expectations when I am not living a normal life.

      “I had three children to raise on my own and could not make meals or clean since I was working to pay bills.”

      I really can’t imagine this.

      *These problems may sound easily solvable, but I have been unsuccessfully try to get them under control with both conventional and unconventional approaches, for fifteen years. I still have some things to try, however.

  3. Cledwyn Baps says:

    “A society that tries to prevent suicide sends the message to people who suffer, and to those who love them, that their lives matter. That suicide is not the answer. That people care and can try to help.”

    It sends the message to me that my ass is government property, theirs by right of conquest, and therefore not mine to take out of circulation.

    Suicide prevention is a gamble at best, one all the more readily taken, in that it isn’t your ass that incurs the losses.

  4. vicki damico says:

    Hello Stacy. I read through the post from others and I think to my self both sides of suicide. I share my story where ever I can in the hope that I prevent another person from taking there life. Even though my son’s choice was weighed heavily on him being over medicated. I would be foolish to think that he did not struggle with his own metal illness. I don’t think there are enough trained doctors who truly want to dig down on issues and find solutions. Pills seem to be the easy fix. The deeper question is what happens when the pill no longer works and the issues come back? What people don’t realize is that suicide effects everyone associated, not just the suicidal one. I want to stress to anyone who is thinking about suicide, here is a perspective of my life as a mother, I am forever shattered by the suicide of my 22 year old son. My life will never return to what it was, my business has suffered greatly, sleepless nights the endless questions of why God Why? Day to day function of my life, The endless hair loss and uncontrolled crying. This is just a small snip-it of me trying to learn how to be human again. And as for my husband goes, “our son showed him how easy it is”. Wow I can’t express the lifetime effect suicide has had on our family. My pain began the day his stopped. I am over whelmed with grief and loss. But this is not about me the suicide survivor right? Its about the right to die. Not if its at a family’s expense!

    • mic says:

      Vicky, I appreciate how much suffering you’ve endured because of your son’s suicide. But your alternative is for your son (who never consented to his own birth) being burdened with suffering for the rest of his life in order to spare the people who chose to bring him into existence. Do you feel that it would have been fair for you to require your son to pay such a price for your benefit? Or would it be fairer for you to bear the consequences of a choice that you made on his behalf rather than using the long arm of the law to force your son to suffer for a long lifetime?

    • Stacey Freedenthal, PhD, LCSW says:

      Mic, how can you be so certain that someone would be “burdened with suffering for the rest of his life” or that it would be someone’s fate “to suffer for a long lifetime?” That, to me, is one of the many tragedies of suicide: the certainty that someone has that their pain will never end, when really it might. It also might not, but we can’t know what fate awaits us or another person. We have to stick around to find out. That Vicky’s son was unable to stay alive is devastating, and she deserves sympathy, not rebuke.

    • mic says:

      Stacey – the blog doesn’t allow me to respond to your post. Some people do go on from being suicidal to enjoy life, but the suicidal individual deserves some right to be able to make that decision for themselves. Parents, therapists and doctors can do all they can to help to swing the decision towards motivating people to want to live, but ultimately nobody should be legally required to live in order to spare anyone else from grief. I can’t be certain with any specific case, but there surely are some cases that are completely futile, and nobody is more qualified to determine whether the chances of improvement are worth the continued costs than the person in suffering.

      I do feel sympathy for Vicki, but approaching the topic from the other side, I find it unacceptable that parents gamble with the wellbeing of their offspring by bringing them into existence, and then not wanting to allow the offspring any rights at all in regards to whether to continue that existence, because the child now has a legal obligation to spare the parents the suffering that would be caused by losing their child. I know that Vicki is absolutely devastated, and that is a terrible thing, but we don’t have the testimony of her son to be able to know what he was going through that led him up to that point and the toll that it would have taken on him to continue to stay alive with only the possibility that things would improve substantially.

  5. Paul says:

    The way I look at suicide is that there are three reasons that it is attempted or tried, one is that the person has mental problems and they are depressed and seeking attention that they are not able to get otherwise (these people can be helped), then there are those that have mental problems where they hate themself and the fact that they even exist (sometimes they can be helped with medications and therapy), then there are those such as myself that know that one day it will be the only way that we can resolve our medical problems because we are not seen as cost effective to help enough that our life is worth saving. I am currently at somewhat of a knife edge, I need proper medications to take care of medical problems and there is more concern about abuse of those medications in the world than my very existence and millions of others like me. I have good feelings towards myself and others around me, but I am worried about the fact that we live in a world that paranoid about things is a normal condition, and I know that if I had a place to myself away from most and were allowed to for the most part do as I please I could see that it would be easy for me to life another 40 years and be able to enjoy my life to its fullest. However, I am not allowed to even have much of a say as to what I can and can not even put into my own body. How is it that we even live in a world as sick as this? The majority have basically tuned out of the real world and live in some fantasy of dreams that they get from watching TV, novels, etc, and sometimes drugs. The so called experts know a bit more about a small number of things, but when it comes to actual survival and being able to think on the fly about how to do the basic things many people today are lost, they can’t figure out how to even change a light bulb quite often, as they need to call someone such as myself. I know it is not too difficult to make the medicines that would help me to live a few decades more, but I would probably end up shot dead for trying that is if I could get my brain functioning enough to figure it out in the first place. We are told from a young age that we live in a democracy, even though it is not, it is a federalism system as the founders of this nation were afraid of democracy. This is one of the many things that many believe that is easily proven false, and we know how all of this will end, they will be glad to go off to war, and some of us will see they chose their own fate. After all when 3 people can read something and we can get 10 or more thoughts about what it was actually saying this just shows how deep problems in the world can run. when there are easy solutions someone always figures out how to earn a profit off of it, and keeping this in mind it helps to understand how things function around us.

    • mic says:

      It’s very unreasonable to categorise the non physically ill who want to be allowed to die as having “mental problems”. A lot of people just aren’t predisposed to overlook the mundanity of day to day living (if you’re relatively lucky) and the constant risk of being harmed, or actual adversity that you have to go through just to survive.

  6. mic says:

    Glad to see another entry on the blog. The only non-religious argument against suicide is the idea that suicide will harm others, which it does. If pain-free assisted suicide were available for all who needed it, then it would not be the person receiving assistance to die who would be harmed. Far from it, they will be helped to escape from any future possibility of harm, without any downside of having to be deprived of any future joys that they may have gone on to experience (including the feeling of being glad to be alive).

    Ultimately, life is a lottery and outcomes are distributed via unintelligent forces without any reference to fairness or equality. People who are persistently suicidal throughout their life have drawn a short straw in the lottery, and should have no obligation to carry a heavier share of the burden than those who were more fortunate in the lottery (and axiomatically, the people who get the least benefit out of being born are the ones who pay the highest cost). It’s also worth referencing the fact that this obligation doesn’t seem to cut both ways and the most privileged (you know, the people who are supposed to selflessly sacrifice their own wellbeing for the benefit of those far more privileged than themselves) are happy to sustain the status quo in which there exist homeless people, people being ruthlessly exploited by rapacious capitalism which benefits the wealthy, mentally ill people who are left in an asylum and forgotten about, people who have fallen on hard times and can’t get the benefits they need in order to put them back on their feet, and so on.

    • Paul says:

      I would like to make a comment on the thought of being glad to be alive, that is when you are allowed to enjoy life, if life is nothing but suffering and even more suffering each day, that is not what most would say is enjoying life. I get a little bit of enjoyment of life, but not nearly as much as I used to. This is mainly because how difficult it is to get the medications that keep me alive and a functional part of society. This is because now there is more concern about addicts than those that need medications for medical reasons such as to breathe, to think normally such as those of us with ADD, and pain. All medications can kill if used improperly, and the same can be said for many common items in the grocery store including foods. It is also possible to die from drinking too much water. Also if anyone thinks I am making it up please show me the research that shows that. I am going by actual deaths as reported. I am concerned about my health and ability to function, and told to relax, if I were more relaxed I would be dead at this point. It is hard to enjoy life when I am sleeping 14 hours and more a day. Does anyone know of anyplace in Southern California that can help me get back on my feet so to speak so I do not end up between two choices sleeping out on the street or ending my life?

  7. PattieH says:

    I do understand and respect your views, and how difficult it would be for society to see it even that broadly.
    Yet, I do feel there needs to be an understanding that “suicide” and “people” are not all the same.
    I’m frustrated with the lack of meaningful differences in public information about suicide. It really is stigmatizing and only adds to feeling of isolation when you know you’ve been reduced to a boilerplate 2D version of a person before you even speak.
    And my anger is about a mental health system, along with its increasingly less qualified, and often incompetent professionals, who DO NOT KNOW how to address suicide or WHEN intervention is appropriate, and ESPECIALLY the WAY! Its their business to have the training and expectation that RESPECTING A PERSON WHO MIGHT BE SUICIDAL OR MIGHT NEED TO BE HOSPITALIZED IS STILL THE HEALTH PROFESSIONALS DUTY TO THEIR PATIENT!!
    We are not animals to be removed by the game warden in a surprise attack, as if we were dangerous beasts who might kill the neighborhood if they told us first, so they have to sneak up on us, to get a good shot to knock us out, and throw us in a cage to be quarantined.
    Dont show your ignorance by assuming we are evil or demonic, or lack the capacity to communicate as a justification for your derogatory comments, your punitive demands and threats, and dont think we dont understand abuse when it’s forced onto us or into us or strapped around us and pinned down “because it was necessary”.

    That, Stacey, is a bigger issue than contemplating whether suicide is right or wrong. Regardless of laws, rights, policies, etc. Abuse, degradation and assumption of demonic possession and excorcist-like-danger is still common practice, and still considered necessary and acceptable by police, emergency rooms, and psych units.

    Thats what people need to be discussing in public policy, and how to demand the sufficient punishment for any abusive actions, and for those who do nothing to stop it or report it.

    • Paul says:

      You are right on with your statement, and I will put it this way… If I were to be locked up, I would lose everything in the world that holds me here. I would have absolutely no reason to go on living if I were locked up. I am a material person, and even my spiritual things would be lost as a result. I would much rather be dead than be a homeless person given my medical problems and the things that I enjoy in life. This is something that far too many people in the world fail to realize. It is why so many end their lives when they lose everything, as they have nothing left to live for in life. If life is nothing but suffering, and absolutely nothing to enjoy, death is the best option.

  8. anon says:

    At least one of the reasons for this hugely male phenomenon is that for the past 60 years, men have been blamed for every problem women have ever had; we’ve been constantly ridiculed, lied about, trashed, and thrown away. I’m pretty typical: married 34 years, 2 sons, totally dedicated to family. After a cancer diagnosis in 2011, with a 7- 9 year prognosis, I didn’t die. After a lifetime of being told I was the best husband and father ever, at age 72, not only am I divorced, but thrown away, with her taking every penny she could get away with. Instead of a 50-50 split, she’s gotten herself an in-court connection and I will get virtually nothing. A basic psychological need is for love and belonging. I regret that I was a loyal, faithful, completely family-minded husband. If a man did this to a woman, he’d be a pariah. A woman does it to a man, she’s liberated. Double standard indeed.

    This comment was edited to abide by the Comments Policy. – SF

    • PattieH says:

      Oh please dont think we dont recognize a female pariah!
      I understand your pain, and i would feel equally hurt and angered, but really, dont make it a generalization about women against men. In that vain, there’s the wife-beater, etc.
      No, what you describe is close to how I feel about ALL people, if that makes you feel any better, lol.😯

    • Paul says:

      I have read about things like this and know guys in that situation. One of the many reasons I chose to not have children (as long as I live in this country). There are some options, but the question comes down to what ones you are willing to choose. One of them is to skip the country, but to do that you will need skills that are wanted by companies in that new country. In the past people used to have an easier time of disappearing, that is about your only choice other than getting a better lawyer and moving to a place where you are better off, there are probably other options as well. This is the primary reason that I am married to the woman that I am, I spent a few years with her first to find out what I was getting into first. Also one of the most difficult things is finding someone that it is possible to get along with even if there is no sex, and also one that does not want to burden you with children. It is less expensive to go out and buy luxury cars and many other things than raise children in the world today. If more of us would keep this in mind before conception we would have fewer people getting into problems today. The other biggie is student loans, as they are more of a problem than housing for many people, speaking from personal experience. Also there are many other countries that you could move to and with the money that you are barely getting by on and be able to live there and enjoy life. I know there are a number of websites that promote other countries in Central and South America. All of them are easier on the pocket than the USA, but you need some source of income and many of those sites do show that as well, as you do not want to compete with the locals for work, but have an internet income. All of this beats the alternatives that you have in hardly getting by here. Trade what you have in on a plane ticket, you will be glad that you did.

  9. Gideon C du Toit says:

    In my opinion based on the road I have traveled through life and experience that i have gained, a suicidal person could be easy to spot if society pays as much attention as it does trying to “recover” someone after an unsuccessful attempt. If the person could be helped before it spirals down to the point of no return, less would even get to the stage of attempted suicide.

    If then after this pro-active intervention the individual still wants to exit, it should be respected and the means should exist to realize this in a humane and dignified way. Sure it is heartbreaking for the people staying behind, death is never easy to deal with, and we always tend to beat ourselves up with regrets like “I should have done more” and “if only I paid more attention.”

    My message is plain, simple and to the point. “Get out of your comfortzone and off your rear-end and do something NOW. Pay more attention NOW, otherwise you don’t have my sympathy, crying crocodile tears at someone’s funeral!” I am not saying that you are to blame for the loved one’s death, but you are to blame for not paying attention.

    I want nothing more than to die, but unfortunately I am not in a position to just leave. I have a responsibility towards individuals in my life and without me, they too would certainly perish. And I cannot do that. Yet I wake up in the morning cursing the day I was born. I was born with incredible intellectual capability, and a drive to succeed but no opportunities. No one wants to invest in me. I tried chasing my dreams by myself, wrote a book and landed up on the street. No-one cared that I was homeless. I had to do the unthinkable to get back off the street, and have for years tried to make a success out of my life, but I keep catching the rotten egg, time after time after time. I have never abused drugs or alcohol yet I am deemed unworthy by society to invest in.

    I am tired, I am going on 50, I feel I have had to endure what most people will not experience in nightmares and I prevailed. But still I am nowhere, I have no-one. My family, who are all doing well by the way, don’t care. I have no close friends, no children, recently got divorced and I realized. “Loneliness isn’t as much being alone as it is been forgotten.”

    My life is a failure, dispite my best attempts and somewhere I have to draw the line, and say “Enough is enough”. If I could find good homes for my pets, I would be out of this hell hole minutes after. Dignified and humane or not.

    • PattieH says:

      Gideon, you just spoke for me too.
      I look back and think “I should have trusted my instincts when I was young and first thought about, and attempted suicide”. It would have saved all the years of hard work and integrity to create meaning, only to suffer through the last 18 years of abuse and false accusations in a society that doesnt care about honesty or accountability, and has no integrity, where people are just mindless spectators at a game to win. The Hunger Games are not my idea of living!

  10. al says:

    As always Stacey, a well written, thought provoking article. I think the phrase “I don’t really want to die, I just want to stop living like this!” is the phrase so many of your respondents are looking for and one that appears all too commonly over at my place.

    I don’t think you have to offer any defense for wanting to help someone live. But, as you said, our society seems to be unable to *really* know how to work with the truly suicidal, there has to be a better option than keeping “them alive and miserable”

    Keep up the good work, ma’am. Even when I disagree with the absoluteness at times, I still respect you and the effort you extend.

  11. Maddi says:

    I don’t have any answers but wanted to say thank you for this thoughtful and considered post. Thank you also for the work you do, it’s difficult and important.

  12. Those questions are prickly, even for someone who is a suicide attempt survivor and who still fights suicidal ideation 20+ years later.

    I am one of the lucky ones who had the chance to see all the things that I would have missed out on, and who is blessed to have reasons to hang on…yet the onset of a painful chronic illness 6 years ago has brought those ideations to the fore once again as it has taken so much from me.

    I’ve advocated for suicide prevention for a little over a decade, but even before the Chronic Illness Fairy gave me her dubious gift, I always despised being seen as an example of “life gets better” or as someone who has “overcome” or “won.”
    The truth is that not all lives and situations will improve…some people who survive will not feel lucky and some will not get the happily ever after of good things they might have missed.
    I feel that advocates who lean heavily on that as a deterrent have missed a large part of the picture…and promising it will get better may be setting up some unrealistic expectations.

    I’m on treatment for depression and anxiety, but am by no means stable currently–I developed tardive dyskenesia from the SSRI that was my godsend for helping depression, so my dosage has been cut to a level that doesn’t work as well by far.

    I’m still fighting though. I know quite well my reasons to stay, and have a crisis plan for the times I can’t see the lighthouse past the rocky shore.

    Do I feel that suicide prevention is worthless?
    Not at all! For every person that just can’t be helped, how many others who can are we reaching? That’s how I measure success–if even one person is all I’ve helped, it’s immeasurably worth it.

  13. vicki says:

    Hi Stacey. After joining an SOS facebook page, I am reminded each time I log in my Facebook I am saddened by the overwhelming stories just like mine of family members who take their lives and the wake of devastation left behind. I see such gut wrenching heart ache of the survivors left behind to pick up the pieces of what is left of life after a suicide.
    In our case my son’s suicide could have been prevented, furthermore we have such a great opportunity to help others who struggle but I think the Gap is recognizing where people struggle. We are all products of our environment, we re- act the way we were taught as children just like our parents did. Except our age group(50’S) were expected to tough it out which many of us did. I dont feel that is the case today. I am a firm believer in behavioral therapy and breaking habits we learned as children. So many lack just the proper coping skills, which is why we are seeing so much depression. It’s OK to be sad and it’s OK to be happy and it’s OK to celebrate life. From the devastation my son left behind for us, it’s not OK to commit Suicide. My life has been ruined by his act. I urge anyone thinking about it to please reconsider.

  14. Alan Martin says:

    I believe that there are few people with a persistent desire to die. Mental health fluctuates. I have bipolar disorder and my moods shift. Fortunately, I now have it mostly under control, but I got paranoid a few times and went to the hospital twice because of it. I think we should intervene because suicide is permanent and the state of mind that produces it is transient. However, I do wonder about the few who have a very persistent desire to die. I do not think we are doing them a favor by saving them. However, figuring out who those people are and why their desire is persistent is hard. I do not know if our policies can be designed to accommodate them.

    • Stacey Freedenthal, PhD, LCSW says:


      You have captured well my own quandary: Even if we were to say that some people’s suicides are permissible, then how would we discern who those people are?

      I also worry about the message it sends for society to say some people’s situations are so hopeless that we will not intervene to prevent their suicide. Many people with severe depression, among other conditions, feel so much pain and hopelessness that they would believe 100% that they are in that category of people, even though, as you put it so well, “suicide is permanent and the state of mind that produces it is transient.”

      In some European countries assisted suicide (and even euthanasia) is permitted on the basis of mental illness. It must be very hard for suicide prevention advocates in those countries to argue that suicide should be prevented while formal mechanisms exist to assist people in dying by suicide.

      Ultimately, amid the doubts and confusion I experience when examining these questions, I come back to that image of a world without suicide prevention. Such a world would do far more harm, in my opinion, than the world we live in now, where people are protected from suicide and given the opportunity to cope, grow, heal, and want to live again.

    • Leslie K says:

      I’ve had a persistent desire to die since I was 17 years old. In my case, it has little to do with mental illness, but moreso due to my utter repulsion of modern day society.

      Humankind pretends to be so civilized yet has shown time and time again to be unable to work together for the greater good of its own species, moreless the planet. Within nearly every Western culture, a subset of the populous is disadvantaged only because they don’t conform to some arbitrary, socially constructed ideal. Tribalism is a fundamental quality of the human condition, and those stuck at the short end of the stick are doomed to suffer due to no fault of their own.

      If I saw any glimmer of hope for humanity, then I might change my mind. But the United States is so screwed up and backwards today (even more than it was 25 years ago), and the rest of the world seems to follow suit. Opting out now is almost the smartest thing I could do to save myself from this pointless torment.

  15. Thank you Stacey for this post and for your willingness to engage in and wrestle with these questions and dilemmas. I too struggle with these questions. I lost my mother to suicide when I was five years old. I believe in my heart that she was doing the best she could at the time. I also believe she was enduring profound, indescribable pain and suffering. I also know that I (and many others) continue to be impacted by her death some 45 years later. I often find myself wondering, “If she had known or somehow foreseen the possibility of healing and the legacy of her death, would things have been different?” As Hecht observes, the possibility of our future selves…

    • Stacey Freedenthal, PhD, LCSW says:


      I appreciate your kind words and your shared understanding. What a profound and painful tragedy your mother’s suicide was, especially at your tender age. It’s powerful that even with your experience, you struggle with these questions about suicide prevention. They are compelling questions.

      For folks who aren’t familiar with Jennifer Michael Hecht’s work (and what Scott referred to in his comment), in her book she talks about the obligation that the suicidal person has to the person they can become in the future: “The suicidal person owes something to his or her future self; a future self who might feel better and be grateful that the person who he or she once was fought through the terrible times to make it to something better.”

      Powerful words. Sadly, many who are suicidal feel no hope that their future selves would want to be alive. Though they often feel differently later, in their suicidal state they see only suffering ahead. Hence, the questions that you and I both struggle with, along with, I’m sure, many others.

      Thanks again for sharing.

  16. Sarah says:

    I believe mentally ill people should not be able to have the choice to commit suicide as they do not have the mental capacity to make choices. I know this from experience.

    They do not know what they want all they know is they want the pain to stop. And there is no other way to stop it.

    But there is. At the moment I am severely depressed and i have contemplated suicide but in the same day I can have thoughts that im glad I didn’t. Mentally ill people really do not know what they want.

    If someone helps them with suicide then the person does not have a chance to regret the decision.

    It’s just my opinion but im speaking from experience

    • Stacey Freedenthal, PhD, LCSW says:


      Thanks for sharing your experience. You illustrated very powerfully how the suicidal mind can work: wanting death one moment, not wanting it another. And really, often the person who wants death actually wants – as you note – to stop hurting. If they can have hope that their pain can end without dying, many people lose the desire to die.

      You were brave to leave this comment, because many people will disagree vehemently that people with mental illness do not have the mental capacity to make a decision about suicide. And if people criticize your comment, then you will join me in my club. 🙂 But seriously, thank you for speaking your truth even when it isn’t popular among everyone.

      As for your own suicidal wishes, please check out this page for a list of resources where you can receive help by phone, email, or text.

    • Leslie Krause says:

      I appreciate your viewpoints, but I beg to differ with the claim that mentally ill people are unable to make choices. That effectively reduces an entire demographic to the status of children in which a caregiver is responsible for making their decisions. What then are the parameters for consent? Should the state take legal guardianship of all mentally ill people. Should mentally ill people be required to report to a social worker and to request approval before engaging in any activity?

      I don’t think it is justified or warranted to usurp the liberties of an entire segment of society only because a subset of these same people are prone to bad judgment.

      I am mentally ill, for example, and I have wanted to die for 25 years. This desire has remained persistent despite countless hospitalizations and ongoing psychotherapy. I have very good reasons for not wanting to live, all of which have to do with wrongdoings of society. Given the social and political climate of today, it is unlikely these failures will be addressed and rectified within my lifetime. Moreover, my spiritual beliefs support the right of self determination.

      If an adult has no desire to live despite repeated attempts at mental health treatment, then forcing them to continue living against their will is tantamount to torture. Saving lives in this way is not compassion. It is incarceration.

    • mic says:

      People with mental illness are not one monolithic bloc. Mental health issues are very diverse, and there is also a broad range of degrees of affliction.

      Suicidal thoughts are not the only type of thought that can vacillate throughout the course of a single day. Should I change my job? Should I buy a flat instead of renting? Should I move to a different area? These are all thoughts that can vacillate in one day, for both people who have mental illnesses and those without. Are you suggesting that mentally ill people should be reduced to the status of children (as indicated by Leslie below) and barred from making any significant decisions in their life? The decisions that I have mentioned above are also those which can be regretted, but yet people with some degree of mental illnesses are permitted the autonomy to make those choices. The choice to die by suicide is not a choice that can be regretted, provided that safe and reliable means to do so are provided.

      The right to assisted dying is for those who have committed to that course of action, in order to spare them from having to endure any more pain than necessary, and in order to spare them from any risks, and also from having to traumatise others with their actions. Presumably if you can’t make up your mind, you would not personally go through with assisted dying. But I have made up my mind (I have never been diagnosed with a mental illness and do not feel that my thinking is impaired, but this holds true for those with diagnoses), and I should not be denied my right to bodily autonomy because other people are afraid to face up to big questions concerning death and the meaning and futility of life. That isn’t merely a restriction on freedom of bodily autonomy; it’s a restriction on freedom of thought. Your answers are true for you, but everyone else should be able to determine what is true for them, and be supported in taking action according to their own muses.

  17. Carl says:

    Most people, including myself, come to this web site because we are struggling to stay alive, because we really do want to survive and escape the pain that pushes us towards suicide. We come because of the helpful articles and ideas.

    It’s 2am. I’m struggling, and just need a small boost to get through the night. So here I am, online reading these articles. In 25 years of struggling with suicide, it’s nice to have this helpful site available and I’m grateful for it.

    To some degree we all feel anger towards what got us here. I’ve felt it too. But I can’t direct it easily towards my childhood abusers who merit it. Not unless I’m in an EMDR session with a skilled therapist. Without directing anger and shame in the proper direction it sometimes ends up in the wrong place, like towards a loved one or a suicide survivor advocate.

    I think that 99% of us that come to this site, really want to live, even the angry ones. Otherwise, they would no longer be here with us.

    May all those who suffer find recovery and peace. May we find the help we need so that we can process our lives.

    • Stacey Freedenthal, PhD, LCSW says:


      Thank you so much for sharing. I’m very sorry you were struggling in the middle of the night, but I’m grateful it brought you here and you were able to receive that small boost. Selfishly, I’m grateful for the reassurance you provided that even when my views on suicide prevention anger people, there is a greater good. They still might be helped.

      I share your wish for recovery, peace, and aid for all who suffer. Every little bit helps, right?