September is Suicide Prevention Awareness Month. Organizations such as the National Alliance on Mental Illness (NAMI), whose motto for the month is “One conversation can change a life,” are reminding us how important it is that we talk more openly about suicide and its connection to depression and other mental illnesses. Far too often, those who struggle with mental illness are barred from getting the help that they need because of the stigma around mental illness and its treatment. We need to talk more openly and honestly about these issues and just how widespread they are. In fact, suicide rates in the US are now at a 30-year high.
Suicide is, of course, a moral issue. That is true not only because suicide, if freely undertaken, is a major moral failing, but also because the ways that we speak about suicide and about mental illness and about one another can impact the likelihood of those who need help getting it (or not). In other words, how we talk about suicide is also a moral act. I would like to offer some guidance from the Catholic moral tradition.
It is commonly and mistakenly reported that the Church teaches that suicide is always a mortal sin and unforgivable, and that those who die by suicide are in hell. It is crucial to nuance and correct this. In keeping with its vision of the dignity of the human person and the sacredness of human life, the Church teaches that, when chosen in freedom, suicide is a gravely sinful act. This is because God remains the author and master of our lives; we are merely their stewards. It is because we have a natural inclination to preserve our lives and are called to have a just love of ourselves. It is because suicide is an offense against the ties of solidarity we are called to have with family, friends, and the whole human family. As anyone knows who has survived the suicide of a loved one, suicide is, objectively and horribly, evil. The pain of losing someone this way is a unique and terrible wound.
But that objective, serious evil is not the whole story. In the Catholic moral tradition, our culpability for what we do is measured in large part by our freedom in choosing it. And so it is crucially important to talk about freedom and mental illness when we talk about suicide. The traditional language related to mortal sin is helpful here. For a sin to be “mortal” it needs not only to involve serious matter, but both the will and the intellect must be seriously and freely engaged in the act. This is what freedom is, and moral responsibility goes hand in hand with freedom. In other words, the agent must have a clear understanding of what s/he is doing and must freely choose to do it anyway. A traditional example: if I go hunting and am completely convinced I am aiming (through some trees, perhaps) at a deer but shoot and kill my brother, that is a horrible tragedy, and that death is objectively evil. But I never intellectually engaged the possibility of killing my brother. I never set my will upon killing my brother. I never considered it and chose it. Morally, I’m just not culpable for murder. (Judge me for shooting a deer, judge me and my brother for not investing in those bright orange vests, judge me for not taking more time to be certain of what I was shooting at—certainly I would be haunted by those and a thousand other little choices. But I should not be considered a murderer.)
Something very similar goes on when we talk about someone whose intellect is clouded by mental illness. In ways too complicated to engage deeply here, when someone has severe depression or is living with the hallucinations and delusions of schizophrenia or the challenges of an anxiety disorder, the brain simply does not process information in a normal way. And so, it makes all the sense in the world to consider the possibility—the probability in the case of someone with a long history of living with mental health issues—that many people who die by suicide have an intellect so obscured by the symptoms of mental illness that they are not capable of seeing the act for what it is, objectively speaking. Like the trees obscured my ability to see clearly what my act was objectively, so mental illness obscures the reality of what one chooses when one chooses suicide. Ask anyone who has had a long-term relationship of any kind (family, friend, romance) with someone with a mental illness; despite the fact that they can and do often process information rationally and act on information in normal, rational ways, sometimes they just can’t, and they just don’t. You can’t argue someone out of depression or hallucinations or anything else. When they are symptomatic, their minds and moods just work a bit differently.
And so, we can say with real legitimacy that, when someone who is living with severe mental illness chooses suicide, the act is likely not undertaken in full freedom, with full engagement of the intellect and will. And so, we have great reason to trust in God’s love and mercy for those who take their own lives, especially when this happens at the end of a battle with mental illness. The Catechism of the Catholic Church expresses the idea this way: “Grave psychological disturbances, anguish, or grave fear of hardship, suffering, or torture can diminish the responsibility of the one committing suicide” (CCC #2282).
I want to offer some specific ways that we should be changing the conversation.
- Stop using the verb “commit” in reference to suicide. We generally reserve that verb for sins and crimes (they committed adultery; he committed a felony). If someone died by suicide, say that they died by suicide. In all likelihood, the best way to think of it is that they died because of the predictable progression of an untreated illness.
- Stop using mental health diagnoses as insults. When you use a word like manic, bipolar, schizophrenic, or OCD to disparage behavior that you don’t like (even when it is your own), you extend the stigma around mental illness.
- Spread the most fundamental message about mental health: recovery is possible. With a good diagnosis and treatment plan, most people with a mental health episode live happy and productive lives. Some math for you: 20-25% of the population has a mental health issue each year, and less than 6% of the population falls into the category of those with a severe, persistent, mental illness. That means that 15-19% of the general population is living well with a mental illness. And that means that more than 2/3 of people who have a mental health episode recover sufficiently to return to work or school.
- In this Jubilee Year of Mercy, we should let mercy pervade our language, our thinking, and our relationships. Although it is crucial to continue to teach that suicide is a grave, objective, moral evil, we should hope that those who die by suicide did not choose it freely. Let’s be careful to share the hope of God’s mercy with those they have left behind.
If you or someone you know needs immediate help with suicidal thoughts, call the suicide prevention lifeline at 800-273-8255 (800-273-TALK) or visit their website to chat online or seek information. If you are looking for ongoing support for someone with a mental illness or for family and friends of those with a mental illness, check out NAMI. They probably have an education program or a support group (or both!) near you that could help.
Remember that if there are 5 or more adults in a room, one of them is likely living with a mental health issue. And it is almost certain that at least one has a close friend or family member who has a mental health issue. Let’s all strive to speak with kindness and compassion, in ways that understand these as health issues that need treatment and support, not as moral failings. This will go a long way both toward embodying the Year of Mercy and toward creating a culture where it is easier to seek help in times of mental health challenges.