The Limits of the Mental Illness Narrative
Suicide is too often framed as the result of individual pathology – a symptom of mental illness, personal crisis, or a failure to cope. While mental health challenges do increase suicide risk, this is a far cry from the full picture. Data from the National Alliance on Mental Illness show that only about 46 % of people who die by suicide have a known mental health condition, so what of the rest? Sure, some individuals may have had an undiagnosed mental illness or disorder. That still leaves a significant portion unaccounted for.
Critical suicidology is a field of study that explores suicide through multiple lenses (social, economic, historic etc) rather than viewing it solely as an individual or medical issue. When we reduce suicidality to illness, we place the burden on the individual and ignore the systems that may have failed them. Framing suicide as a failure of coping not only misassigns responsibility, it ignores the wider social and economic conditions that drive despair.
Asking better questions can broaden our understanding and lead to more responsive, trustworthy support for those in distress. Avoiding the assumption that someone is ill and instead thinking about the structural powers working against people, and what social, political, and economic factors are at play could lead to the development of much more nuanced responses to distress.
It’s vital to remember that people who live with a mental illness are not destined for suicide and people who do not live with mental illness are not safe from suicide. The issues at play here are far more complex and our thinking needs to reflect that.
Looking at the Bigger Picture
Suicide doesn’t happen in a vacuum. It’s often shaped by the world we live in – think poverty, homelessness, lack of job security, gender-based violence, homophobia, racism, social disconnection, trauma, among others.
The idea that society plays a role in suicide isn’t new. Émile Durkheim’s classic 1897 study showed that suicide rates are shaped by levels of social integration and regulation, factors like connection, stability, and shared moral frameworks. But as important as Durkheim’s work is, even his sociological lens may not fully capture the depth and complexity of the forces at play today.
When we work from a critical suicidology perspective, we’re encouraged to ask more complex questions. Critical suicidology challenges us to rethink our approaches to suicide and looks to address why we keep reducing suicide to what can be counted or “predicted”. Why do we rely so heavily on quantitative models and risk-factor checklists, even when these approaches exclude those whose lives don’t fit neat categories?
In focusing on individual mental health or generalised structures and systems, we risk erasing the lived experience of those who feel disconnected not only from society, but from the very definitions of community that research relies on.
Asking Different Questions
What about those who are queer, neurodivergent, undocumented, disabled, displaced, or otherwise excluded from mainstream narratives? Their suicidality is often overlooked or rendered invisible by conventional tools because it exists outside of mental illness.
To really engage with suicide ethically and holistically, we need to listen to the voices that fall outside the data. We need to move beyond predictive models and we need to start looking at:
- Who gets to define “risk”?
- Who gets included in “community”?
- Whose lives (and deaths) are being made visible and whose aren’t?
This is the work of critical suicidology. It doesn’t work to discard what we know, but to question how we’ve come to know it and most importantly to look at who we’ve left behind. If we want suicide prevention to be ethical, inclusive, and effective, we must start by asking better questions and listening to those we’ve long overlooked.