What's the medical breakthrough that could save the most lives in the U.S. over the next 10 years? In the 2020s, medical research will likely inch forward when it comes to major killers like heart disease and cancer. But the biggest potential to save lives could lie in learning to prevent suicide.
The rates of reported suicides have been creeping up over the last two decades. Even more disturbingly, the Centers for Disease Control and Prevention reports that the suicide death rate for teens increased 56% between 2007 and 2017. Rising suicide rates might be a result of many things — rising levels of despair, the opioid epidemic, greater access to guns, even the proliferation of internet groups that offer people advice on how to kill themselves. It could also be that more people are reporting suicides instead of concealing such deaths as accidents.
It's a surprisingly common form of death — more prevalent than homicide or automobile accidents. Unlike cancer and heart disease, which are leading causes of death among the old, suicide robs people of decades of life. According to CDC statistics, it is the second most prevalent cause of death, after accidents, for people between 10 and 34 and fourth for people between 34 and 54.
Because it hasn't been all that thoroughly studied as a medical problem, there's room to cut down on that death toll even without any remarkable technological breakthrough. A streamlined three-digit suicide hotline number, approved last month by FCC, could become one of the great public health measures of the century. Further out on the frontier, researchers are having some success using artificial intelligence to identify suicidal people — those whose lives might be saved by talk therapy or drugs.
John Pestian, director of the computational medicine center at Cincinnati Children's Hospital, explains that there are different kinds of suicides. Some are driven primarily by chronic mental illness, while others are more impulsive. Those with chronic mental illness may make repeated attempts. People have a powerful instinct to live, he says, and for their psychological pain to override this, it must be incredibly intense. He's hoping to help such people through pharmacogenomics — finding drugs that will ease their chronic emotional pain.
The more impulsive cases are simpler to prevent — think of the teenager whose boyfriend or girlfriend just left, or a Wall Street trader who lost all his money, he says. If someone is going through an acute crisis and wants to jump out a window, the right words spoken at the right time might be the only treatment needed to save a life.
Renowned suicide researcher Edwin Schneidman writes in "The Suicidal Mind" that therapists can help people in this state by getting them to consider alternatives besides killing themselves — helping them see that they have choices. He describes how he helped a suicidal college student who felt hopeless after she found out she was pregnant. He got her to consider which of her options was least terrible, and she recovered.
In the memorable 2003 New Yorker story "Jumpers," Tad Friend describes conversations with several people who survived after jumping off the Golden Gate Bridge. They told him that they recognized their mistake before they hit the water: "I instantly realized that everything in my life that I'd thought was unfixable was totally fixable — except for having just jumped," one said. Another left a note saying 'I'm going to walk to the bridge. If one person smiles at me on the way, I will not jump.' "
