Where is the Outrage About Suicide?

Peter ForsterMajor Depression, Policy

A wonderful editorial in JAMA Psychiatry highlights the overwhelming evidence that stigma is continuing to drive underfunding for treatment and prevention of suicide deaths.

Suicide and “accidental” overdose deaths are an epidemic in this country.

Since 1999, the rate of suicide deaths increased by 28.2%, and this probably underestimates the increase because there is evidence that coroners are categorizing more and more deaths as “accidental” overdoses.

Mortality from self inflicted injury is greater than 70,000 lives per year, making it the 8th leading cause of death in the country. And death rates for self inflicted injury continue to rise as the rates of death from cardiovascular disease, cancer, and HIV fall.

The editorialist notes that stigma used to be a barrier to prevention of death from cancer, heart disease, and HIV, but “stigma fighters” worked to counteract these barriers…

Stigma Fighters often use symbolism and branding to garner support for public health concerns. The red ribbon project to promote AIDS awareness started after Tony Award presenters wore them. This symbol became a public health brand that started a conversation, is promoted by celebrities, and generates funding. Similarly, the pink ribbon for breast cancer awareness originated with Self magazine and Estée Lauder, and now the Ford Motor Company, the National Football League, and cities across the nation promote pink.

In addition to the need for stigma fighters to tackle the barriers to treatment for depression and other disorders associated with suicide, there is a clear need for advocacy to increase the shockingly low funding for prevention of suicide.

Although suicide is the fifth leading cause of years of life lost in this country, until 2014 there was practically no federal funding. And even now funding is ridiculously low.

In 2014, the National Institutes of Health supported $39 million of suicide-related research compared with $2.9 billion for HIV/AIDS research. Although the National Institute of Mental Health responded to the 2002 Institute of Medicine report by initiating 3 developing research centers for suicide prevention, these were defunded, and there has been no federally organized and funded efforts comparable to those for CVDs, cancers, or HIV/AIDS.


Lytle MC, Silenzio VMB, Caine ED. Are There Still Too Few Suicides to Generate Public Outrage?. JAMA Psychiatry. 2016;73(10):1003-1004. doi:10.1001/jamapsychiatry.2016.1736