My friend David has been gone for 10 years now. He was my kayak and movie buddy. His companionship is deeply missed. Just 49 years old and single, David was sick. That’s what all the doctors said after his death. He must have been sick, they surmised, to do what he did.

David was fired from his job, and no one outside his employer knew about it, not even his closest friends. No one knew anything — until one day, he called from a pay phone in the middle of the night without revealing where he was located. We heard fear in his voice and a sense of dislocation and confusion. Such calls were not infrequent.

Eventually, he called and said he had no money left and that he was hungry. Would someone be willing to drive to Hartsville, South Carolina, some 500 miles away, and pay his motel bill? A New Jersey native, he had no friends or family in South Carolina. By the time we arrived in Hartsville, David had disappeared. His next panicked call came from Milledgeville, Georgia, roughly 230 miles away from his last location.

David told us he was under investigation by the FBI. The CIA, he claimed, was listening to his telephone calls and inspecting his emails. At that very moment, he believed, clandestine agents were searching for him.

David was in agony, and no one knew. He told no one. And so one autumn night in October 2010, his personal pit of hell opened wide — and there was no one to whom he could pour out his heart. No one who could patiently sit by and remind him that he was loved and that his presence made so many peoples’ lives better.

He crouched on the floor of his trailer in the woods south of Gainesville, Florida, and, placing a revolver’s muzzle against his heart, pulled the trigger. No one heard the shot. No one knew he had taken his life. It was a tragedy. But guns aren’t to blame for David’s death; rather, it’s the lack of mental health resources and awareness in this country. The rise of suicide in the U.S. is the real epidemic that people aren’t talking about enough.

America’s Oldest Epidemic

The Centers for Disease Control and Prevention (CDC) says suicide is a large and growing public health problem that is often connected to other forms of injury and violence. For example, suicide risk is higher among people who have experienced child abuse, bullying or sexual violence. And except for a decline in the late 1990s, the number of Americans committing suicide has increased each year for nearly half a century.

But long before the CDC was founded, suicide was part of the human experience. There are examples dating back thousands of years — to King Saul, Judas Iscariot, and Mark Antony and Cleopatra — and, more recently, to Marilyn Monroe, Ernest Hemingway, Kurt Cobain and Robin Williams. And there are far more victims that aren’t high-profile names for everyone to know, like my friend David. Millions of Americans have struggled and currently are struggling with private demons.

Suicide Indicators

The Suicide Awareness Voices of Education (SAVE) has identified these warning signs that a friend or family member might be considering suicide:

  • Talking about killing oneself or wanting to die
  • Looking for a way to kill oneself
  • Talking about feeling hopeless or having no purpose
  • Talking about feeling trapped or being in unbearable pain
  • Talking about being a burden to others
  • Increasing the use of alcohol or drugs
  • Acting anxious, agitated or reckless
  • Withdrawing or feeling isolated
  • Sleeping too little or too much
  • Exhibiting rage or talking about seeking revenge
  • Displaying extreme mood swings

The CDC notes that suicide is the 10th leading cause of death in the U.S. It was responsible for more than 48,000 deaths in 2019, which averaged roughly one death every 11 minutes. That same year, the CDC reported that 10.7 million American adults seriously thought about suicide, 3.3 million made a plan to carry it out, and 1.4 million attempted it.1

Breaking down these 48,000 deaths a little further, the American Foundation for Suicide Prevention found that most suicides are committed by men (3.63 times more likely than women), white males made up nearly 70 percent of suicide deaths, and half of all victims used a firearm to commit the act.2

Private & Impulsive

The decision to commit suicide is almost always a very private act. Most people make that decision shortly before acting on it, writes Nancy Schimelpfening, administrator for the nonprofit support group Depression Sanctuary. The decision to commit suicide is an impulsive act, not something extensively planned. Thus, there is a paucity of “suicide notes” so often mentioned in TV cop dramas.

“While there are many factors that can influence a person’s decision to commit suicide, the most common one is severe depression,” Schimelpfening declared. “Depression can make [a person] feel great emotional pain and loss of hope, making [him or her] unable to see another way to relieve the pain other than ending [his or her] own life.”

She adds that other mental illnesses also contribute heavily to such a decision: bipolar disorder, borderline personality disorder, eating disorders and schizophrenia.3 Schimelpfening says there are a host of other reasons that someone considers suicide other than mental illness. These are:

  • Traumatic stress — caused by rape, assault, physical abuse or war trauma
  • Substance abuse — drugs and alcohol contribute heavily to feelings of hopelessness
  • Loss or fear of loss — being arrested or imprisoned or experiencing financial problems, the end of a close friendship or romantic relationship, job loss, the loss of acceptance after revealing one’s sexual orientation, or the loss of social status
  • Hopelessness — pessimism and despair that go along with this illness (people with depression may not be able to appreciate that things will improve)
  • Chronic pain or terminal illness — an individual may view suicide as a means to regain dignity and control of his or her life
  • Other factors — belief that one’s life is a burden to others; experiencing bullying, shaming or humiliation (including cyberbullying); social isolation; or academic failure

How You Can Help

It can be upsetting to hear someone you care about express that he or she is thinking about suicide. Many of us don’t know what we can do to help. Others might think intervening will make the situation worse. However, action is always the best choice if you suspect someone you care about is suicidal. Asking about suicidal thoughts or feelings won’t cause a person to take his or her life. In fact, it will offer the individual an opportunity to express his or her feelings and may actually reduce the risk.

The Mayo Clinic urges friends and family to get involved to prevent suicide by being respectful, encouraging and reassuring. If a person says he or she is thinking of suicide or behaves in a way that makes you think he or she may be suicidal, don’t take it lightly. Many people who have committed suicide have expressed the intention at some point. Don’t fear that you’re overreacting to your concerns, and don’t worry about straining your relationship with the individual. Call 911. The National Suicide Prevention Lifeline (1-800-273-8255) is also available 24 hours a day, seven days a week. Your intervention may help to save the person and help him or her to get treatment.4

Mental Health of Our Vets

Suicide has been and remains a problem among our combat veterans dating back to before the American Civil War. While the various branches of the U.S. Armed Forces as well as the U.S. Department of Veterans Affairs (VA) recognize it as a serious issue, the help offered by either is not sufficient.

In 2016, the VA analyzed 55 million veterans’ records from between 1979 and 2014 and discovered that an average of 20 veterans and active-duty service personnel die from suicide every day. Veterans experience mental health disorders, substance abuse issues, post-traumatic stress disorder (PTSD) and traumatic brain injury at disproportionate rates compared to their civilian counterparts. Only law enforcement officers share a similar risk profile of the aforementioned health problems. The VA found that rates were the highest among veterans between the ages of 18 and 29 of Operation Enduring Freedom, Operation Iraqi Freedom and Operation New Dawn. A CDC report uncovered that the Marine Corps experienced the highest fatality rates per 100,000 for all causes, including 14 for suicide.5

Firearms Aren’t the Problem

Max Dolan, a Personalized Experiences, Engagement and Resources (PEER) support coordinator with Warrior Care (a division of the Department of Defense) responsible for North Carolina, South Carolina and West Virginia, wrote to the U.S. Concealed Carry Association last year recommending an article on suicide. Dolan’s job and special skills working with caregivers for positive health outcomes for veterans bring him into frequent contact with individuals who are depressed or who are experiencing PTSD, a disorder in which an individual has difficulty recovering after experiencing or witnessing a terrifying event.

Dolan, like many of us, is perplexed by the difficulty of breaking the suicide “firewall” that takes the lives of 7,300 veterans a year. He is also interested in the fact that firearms are the primary method individuals use to take their lives.

“Various factions in our government and society at large would love to take guns out of the hands of groups of people like veterans,” he stated, “citing the suicide risk from firearms.”6

The firearms industry is not deaf to the fact that, among men, a firearm represents the method of death in 50 percent of all suicides. Suffocation (28.6 percent) and poisoning (12.9 percent) are not even close. For women, firearms make up 31.5 percent compared to suffocation (29.9 percent) and poisoning (29.3 percent). Studies by Harvard University and Johns Hopkins University suggest that guns are thought of as lethal and instantaneous — though they often are not. Some organizations, such as the National Shooting Sports Foundation, have suicide-prevention resources available, aimed primarily at businesses and organizations in the sales chain.7

David’s Obituary

Guns are only the shadow of the larger problem, and tinkering with gun laws and regulations will have no impact on rates of suicide in the U.S. The real problem is the desperately low funding the government devotes to mental health issues, education and institutions. Mental Health America reports that mental health among the youth is worsening, and even before COVID-19, the prevalence of mental illness among adults was increasing. From 2017 to 2018, 19 percent of adults experienced a mental illness — an increase of 1.5 million people. Also, the suicidal ideation among adults is increasing. There is a mental health gap and an enormous need for mental health treatment among youth and adults. To make matters worse, insurance for mental health issues is dramatically lacking.8

A gun didn’t end David’s life. David did. David would have found a way to take his life with or without a firearm. He made that choice and, tragically, followed through with it. He desperately needed help, and, like thousands of other Americans who have committed suicide, he decided that taking his life was his only escape.

Endnotes

1 “Suicide Prevention: Fast Facts,” Centers for Disease Control and Prevention, March 23, 2021, CDC.gov/violenceprevention/suicide/fastfact.html.

2 “Suicide Statistics,” American Foundation for Suicide Prevention, AFSP.org/suicide-statistics/.

3 Nancy Schimelpfening, “Why Do People Commit Suicide?,” Verywell Mind, Feb. 19, 2021, VerywellMind.com/why-do-people-commit-suicide-1067515.

4 “Suicide: What to Do When Someone Is Suicidal,” Mayo Clinic, Jan. 31, 2018, MayoClinic.org/diseases-conditions/suicide/in-depth/suicide/art-20044707.

5 “Suicide Among Veterans and Other Americans 2001–2014,” Department of Veterans Affairs, Office of Suicide Prevention, Aug. 3, 2016, MentalHealth.VA.gov/docs/2016suicidedatareport.pdf; Leo Shane III and Patricia Kime, “New VA study finds 20 veterans commit suicide each day,” Military Times (July 7, 2016), MilitaryTimes.com/veterans/2016/07/07/new-va-study-finds-20-veterans-commit-suicide-each-day/; U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, and the National Institute for Occupational Safety and Health, “National Mortality Profile of Active Duty Personnel in the U.S. Armed Forces: 1980-1993” (Atlanta, GA: USDHHS, PHS, CDC, NIOSH, 1996), CDC.gov/niosh/docs/96-103/pdfs/96-103.pdf?id=10.26616/NIOSHPUB96103.

6 Max Dolan: “We have a great book, the Caregiver Resource Directory, in PDF format on our website (WarriorCare.dodlive.mil). You can find me and the rest of my co-workers on a map with our contact information at the bottom.”

7 “Means of Suicide,” Suicide Prevention Resource Center, June 2020, SPRC.org/scope/means-suicide; “Suicide Prevention Programs for Retailers and Ranges,” National Shooting Sports Foundation, NSSF.org/safety/suicide-prevention/; Karin Kiewra, “Guns and Suicide: A Fatal Link,” Harvard Public Health (Spring 2008), HSPH.Harvard.edu/news/magazine/guns-and-suicide/; Cassandra Crifasi, “How Do Gun Laws Affect Suicide Rates?,” Johns Hopkins Bloomberg School of Public Health, Bloomberg American Health Initiative, AmericanHealth.JHU.edu/article/how-do-gun-laws-affectsuicide-rates.

8 Mental Health America, “The State of Mental Health in America,” by Maddy Reinert, Theresa Nguyen and Danielle Fritze (Alexandria, VA: Mental Health America, Inc., 2019), MHANational.org/sites/default/files/State%20of%20Mental%20Health%20in%20America%20-%202020_0.pdf.