As Jobless Rates Climb, Study Finds Financial Stress Greatly Ups Suicide Risk
As millions of people struggle with economic hardships during the coronavirus pandemic, a new study shows that financial stressors may make people up to 20 times more likely to attempt suicide.
The research suggests that mental health providers should consider financial problems when deciding how best to help those who are hurting.
"We studied past homelessness, unemployment, debt and lower income, and all those financial conditions are being magnified by this COVID pandemic. Given those realities, it's going to be really important for clinicians, policymakers and the public to keep in mind the link between financial strain and suicide," said study author Eric Elbogen. He is a professor of psychiatry and behavioral sciences at Duke University in Durham, N.C., and a core investigator for the VA National Center on Homelessness Among Veterans.
Using data from a national survey, the researchers examined the combined impacts of several sources of financial strain, rather than just one, and subsequent suicide attempts or suicidal thoughts, Elbogen said. They analyzed survey data from 2001 to 2002 and again from 2004 to 2005. In the first wave, more than 43,000 adults participated. Of those, about 35,000 completed the second interviews.
The risk of suicide or suicidal thoughts grew with each added financial stressor, and those who experienced all four financial stressors were 20 times more likely to attempt suicide in the few years after the survey than those that had none of those strains.
"Focusing on one dimension may not be enough," Elbogen said. "Income support might help, but if people misuse their money, if they haven't gotten financial education, they could still go into debt, risk becoming homeless, and the current study shows that would increase risk of suicide attempts."
A practitioner who would already be attending to a patient's substance abuse and mental health concerns could also ask about financial stressors, jobs, risk of eviction and debt, Elbogen said.
"Health professionals can, in addition to psychotropic medications and psychotherapy, consider job retraining, vocational rehab, housing assistance, financial support systems, financial education, debt management," he said.
Policymakers addressing the pandemic could help prevent suicide rates from increasing by bolstering financial well-being through job creation, housing relief and financial education, Elbogen added. National hotlines could assist Americans with financial emergencies or existing hotlines could raise awareness about the links between financial strain and suicide, he noted.
The study was published online Sept. 3 in the American Journal of Epidemiology.
Suicide is a leading cause of death worldwide, and the U.S. Centers for Disease Control and Prevention reported increased rates of suicide in all age groups between 1999 and 2016. Past studies have shown a decline in suicide during times of economic prosperity and an increase during times of economic hardship.
Jill Harkavy-Friedman, vice president of research for the American Foundation for Suicide Prevention, said that many people who have financial strain will not die by suicide or be at risk for that, nor will many people who have mental health conditions.
"Suicide is complex. The way we think about it is there are some factors that can contribute to suicide for people who are already at risk for other reasons," said Harkavy-Friedman, who wasn't part of the new study.
"We have to be cautious and understand that when somebody is facing financial stress that could be a period of increased stress and risk, but not for everybody. You always want to have conversations with people who are facing that kind of financial stress and, unfortunately, that's a time when people often are hiding their experience, so it's all the more reason to reach out to people and have those conversations," she added.
This becomes particularly important if you're aware that someone in your life who may be experiencing stress for financial or other reasons also has a history that includes major depression, substance use or past suicidal behavior, Harkavy-Friedman said. About 90% of people who die by suicide have a potentially diagnosable mental health condition, she noted.
If you feel suicidal or like you don't count, don't want to go on or have a lot of emotional pain, you should reach out and get help, Harkavy-Friedman said. If you know someone who might be experiencing these issues, check in, have a conversation and trust your gut, she added.
If you are in crisis, call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255) or contact the Crisis Text Line by texting TALK to 741741.
Help is available at the National Suicide Prevention Lifeline.
SOURCES: Eric Elbogen, Ph.D., professor, psychiatry and behavioral sciences, Duke University, Durham, N.C., and core investigator, VA National Center on Homelessness Among Veterans; Jill Harkavy-Friedman, Ph.D., vice president, research, American Foundation for Suicide Prevention; American Journal of Epidemiology, Sept. 3, 2020, online