Suicide and the Need for Low-Cost Therapy

The person sitting next to you on a bus or your best friend may be silently suffering without anyone knowing. I have sat with countless people who were in crisis, yet on the outside, they appeared "fine" or even what some would call "normal." However, they were hurting inside and felt the only option left was to end their life. This often leads people to question, Why do people end or attempt to end their own lives? Truthfully, there are several reasons. I believe that access to low-cost therapy and other mental and physical health treatment could be a way to help reduce the risk of suicide. I will go into more detail later in this blog about my belief. For now, according to the American Foundation for Suicide Prevention (2024), there are several different risk factors for why people attempt suicide. They break down these risk factors into three sections:

1. Health - Ex. Physical and mental health conditions

2. Environment - Ex. Life stressors, including financial concerns, and access to lethal means.

3. Historical - Ex. History of suicide and trauma. 

 Thomas Joiner (2005) proposes that there are three primary reasons why people die by suicide. 

1. Thwarted Belongingness - The person feels isolated, alone, and as if they do not belong.

2. Perceived Burdensomeness - The person feels as if they are a burden to others. They may also believe those around them would benefit more if they were no longer alive.

3. Capability for Suicide - The person does not fear death, may have acquired a tolerance to pain and risky situations that could lead to death. This person may also have access to lethal means (drugs, guns, etc.).

As you can see above, when thwarted belongingness and perceived burdensomeness occur, the desire to attempt suicide can present itself. When the capability for suicide is added, a suicide attempt can occur. A study conducted by Bantjes et al. (2016) supports the American Foundation of Suicide Prevention that financial stress can cause an increased risk of suicide. Bantjes et al. (2016) study shows that when someone lives in a low or middle-income country, they are 75% more likely to complete suicide compared to higher-income countries. In 2024, the CDC released information supporting this trend in the United States. Counties that had more access to the internet, healthcare, and had higher income were less likely to complete suicide (CDC, 2024). This leads me to believe that if we had more affordable access to mental and physical health care, we could decrease the risk of suicide.  When we look at Maslow's Hierarchy of Needs (McLeod, 2025), we see that we need our foundational needs met to meet "Self-Actualization". This is what most people desire: to become the best version of ourselves. Maslow proposed that if we do not have our basic human needs (food, water, air, shelter, etc.) met, and we do not feel safe and secure (health, finances, etc.), it is difficult for us to establish belongingness and self-esteem. 

This is where I believe that Joiner (2006) comes into play. When a person does not have their basic needs met due to financial concerns, they could develop a sense of thwarted belongingness. When a person has to depend on family members to care for them due to financial barriers or inability to access health care, they could develop a feeling of perceived burdensomeness on their family. According to the Office of Disease Prevention and Health Promotion (n.d.), people who live in lower-income areas are more prone to being exposed to violence and crime than people who live in higher-income areas. This touches both on Maslow's (McLeod, 2025) belief that safety needs to be met and Joiner's (2006) idea that someone who is exposed to life-threatening situations may have a higher likelihood of attempting or completing suicide. 

What does this all mean? To me, this means that people who come from lower-income areas and do not have adequate access to health care are more likely to attempt to complete suicide. What can be done? Getting better healthcare would be a great option, but it is not that easy. I believe that if there are more resources, such as low-cost therapy, to support people with a lower income, we can help make a positive step to reduce the rate of suicide. Every life matters, no matter their income. 

References: 

American Foundation for Suicide Prevention (2024, August 9). Risk factors, protective factors, and warning signs. American Foundation for Suicide Prevention. https://afsp.org/risk-factors-protective-factors-and-warning-signs/

Bantjes, J., Iemmi, V., Coast, E., Channer, K., Leone, T., McDaid, D., Palfreyman, A., Stephens, B., & Lund, C. (2016). Poverty and suicide research in low- and middle-income countries: systematic mapping of literature published in English and a proposed research agenda. Global mental health (Cambridge, England), 3, e32. https://doi.org/10.1017/gmh.2016.27

Centers for Disease Control and Prevention (2024, September 10). New CDC report shows suicide risk tied to local economic and social conditions. Centers for Disease Control and Prevention. https://www.cdc.gov/media/releases/2024/s0910-vs-suicide-risk.html 

Joiner, T. (2005). Why people die by suicide. Harvard University Press.

McLeod, S., (2025, October 23). Maslow’s Hierarchy of Needs. https://www.simplypsychology.org/maslow.html

Office of Disease Prevention and Health Promotion. (n.d.). Crime and Violence. https://odphp.health.gov/healthypeople/priority-areas/social-determinants-health/literature-summaries/crime-and-violence#:~:text=Low%2Dincome%20neighborhoods%20are%20more,crime%20than%20high%2Dincome%20neighborhoods.&text=Types%20of%20violence%20include%2C%20but,sexual%20violence%2C%20and%20elder%20abuse.