Suicides: Watching for a Recession Spike

TIME.COM - When Bernard Madoff's huge Ponzi scheme burst, the New York Post reported, in its typical cut-to-the-jugular style, that suicide hotlines were lighting up in Greenwich, Connecticut, home to many of the financial high-rollers snared by the alleged $50 billion scam. But the deadly fallout from it was no joking matter. Only a couple of weeks after Madoff's mischief was revealed, French financier Rene-Thierry Magon de la Villehuchet killed himself in his New York City office, apparently distraught by his having lost more than a billion of his clients' (and his own family's) money to the unprecedented fraud.

The Madoff case is just one example of the terrible news gripping the economy and financial markets of late, news that in extreme cases can drive people to take their own lives. Two prominent businessmen, one in Germany and another in England, recently threw themselves in front of speeding trains after grappling with the wreckage of their beaten-down companies. And late last month, a Los Angeles area man despondent over his faltering finances murdered his wife and five children before killing himself.

Suicide experts say there is a strong correlation between acute financial strains and depression, often a prelude to substance abuse and suicides. While people jumping out of buildings during the Great Depression was not nearly as common as Hollywood and cartoonists had everyone believe, suicide definitely spiked during that dark period in the nation's history. Suicides in the U.S. reached a peak in 1933 (increasing to 17 per 100,000, from 14 per 100,000 in 1929), around the same time unemployment had swollen to 25%. By contrast, more recent recessions have not had a marked effect on suicide rates, which in the U.S have been running at about 11 per 100,000 (and shown a slight overall decline during the last two decades of relative prosperity). (See pictures of the stock market crash of 1929.)

"If indeed this recession mirrors in some respects more the Great Depression than the other intervening much briefer recessions, then obviously we have reason for greater concern," says Dr. Alan L. Berman, executive director of the American Association of Suicidology.

There are some clear differences between today's conditions and those in the 1930s, which fomented key reforms, including the introduction of welfare and social security. Today people are more willing to acknowledge and are better prepared to address mental illness, though many states' current budget woes will undoubtedly mean some cuts in social services and counseling. And at the Depression's nadir, 34 million Americans had no income at all, which is not likely to happen today. Still, if poverty levels approached anywhere near those levels, the psychological toll could be greater because of the intervening erosion in family and community cohesion.

"What you find is that suicides happen because of the total burden the person is feeling, how much they feel things can't get better and they can't tolerate the psychological pain they are experiencing," says Dr. John L. McIntosh, a psychologist and suicide expert at Indiana University. "Sometimes it takes years for the effect of economic downturn or instability to trickle down to the level of the psyche or penetrate the psyche, to get under the skin to produce some of the negative outcomes such as suicides."

There are roughly 32,000 suicides every year in the U.S., almost twice the 18,000 homicides recorded each year. Even these figures are just a hint of the nation's psychic pain. There are an estimated 800,000 attempted suicides every year, with the elderly and teenagers or college-age kids the most vulnerable. And survivors — currently numbering somewhere between 10 and 20 million — are at a higher risk for subsequent attempts.

What's more, only about a third of people in need of treatment are getting any. "If we were in the professional world in advertising and marketing we'd all be fired because we are not reaching the majority of our audience," says Alan Ross, executive director of the New York chapter of the Samaritans, an international counseling organization. Last year his center fielded 58,000 calls, which in the last couple of years have been increasing at double previous annual growth rates. He attributes this to a tremendous increase in stress levels due to things like economic insecurities exacerbated by globalization.

The particular nature of the current crisis is also a cause for concern. "For most Americans, our homes are our primary investment and the locus of our identities and social support systems," notes the American Association of Suicidology. "When combined with the loss of job, home loss has been found to be one of the most common economic strains associated with suicides."

Warning signs are already erupting in parts of the U.S. hard hit by the housing crisis. In Los Angeles, calls into the suicide prevention call center run by the Didi Hirsch Community Mental Health Center spiked 65% in the second half of 2008 over the previous year. There has also been a surge of training requests from fire and police departments from throughout Los Angeles County — even from a mortgage counseling company — to help deal with an upsurge in suicide risk. "The reality is we are already overwhelmed," says Dr. Kita S. Curry, the center's executive director. With any publicity about her center, calls spike, suggesting unmet need.

For all the advances the mental health community has made in recent decades, including pharmacological treatment, the biggest factors influencing suicides rates seems far beyond its reach. "Suicide rates appear to be quite strongly associated with broad sweeping cultural trends rather than more minor things such as a treatment," notes retired Colonel David Litts, who played a key role in reducing suicide within the Air Force by 60% in five years. (The overstretched Army, by contrast, is still experiencing historically high rates.) "So in the face of this economic turmoil perhaps the most important thing we can do is relieve the financial strains on individuals because research has shown that financial strain is the link between unemployment and depression and suicide."