By Dr. Elizabeth Weinberg, M.D. 
In my last post, I addressed the report from the May 3 report of the CDC showing an increased rate of suicide over the past decade in adults. In the work of The Suicide and Self-Destructive Behavior Laboratory of the Austen Riggs Center (SSDBL), we have been conducting a systematic review of the literature to integrate a model drawn from a range of theoretical perspectives, including psychodynamic, genetic, cognitive-behavioral and interpersonal models. In reviewing the literature on suicide we have learned that although there are many different types of suicide crises, a picture emerges of suicide as the result of an emotional crisis resulting from intolerable inner states. Typical types of feelings that contribute to the crisis include shame, rage, and psychological pain. When these feelings reach a certain level of intensity, the suicidal person becomes unable to cope with this experience and becomes less able to think clearly. Although many different stresses can contribute to a suicidal crisis, in general the most important stresses are those that threaten a person’s identity and sense of self, or that result in a feeling of aloneness and lack of belonging among others.
The economic and social changes of the past few decades have done much to derail key financial and emotional supports. In general, economic hardship and social adversity are likely to contribute to increased risk of suicide. People commonly rely on work both for feelings of connection to others and for the self-esteem and sense of identity that can come from achievement within a professional role. Members of the “boomer” generation may face a very different adulthood than the one their parents experienced, with less economic security, more fluid social roles, and less secure family and social connections. So in these turbulent times, what is the role of mental health treatment? I will complete my discussion of the subject with comments about this issue in my next post.