It is time to rethink suicide as a medical issue

Dr. Konard Michel, a Swiss psychiatrist and professor at the University of Bern, has spent decades studying suicide and attempting to prevent it through his work. In his opinion, the current medical paradigm for suicide is not helpful as it views it as a form of pathology, which leads doctors to focus on identifying mental disorders or risk factors. This prevents them from understanding the subjective experience of a person facing suicide.

According to Michel, suicide can be understood as a personal action that arises from an individual's background and story. This means that rather than attempting to pathologize it or view it as a mental health issue, it should be seen as an understandable response to significant life events, such as a terminal illness diagnosis or the end of a relationship.

Fifty percent of people who have attempted suicide do not believe they need medical treatment and, in one study, ten percent of people pointed to health professionals as the person who could have stopped them from attempting suicide.

This may be due to the fact that people who are suicidal see their actions as making sense and being part of their normal life circumstances, which they do not require treatment for.

Shame is another common reason that young people, in particular, do not seek help for suicidal feelings. This may be due to feelings of shame for what they have done, what has happened to them, or feelings of shame about their appearance or identity.

The idea of suicide as a medical issue can also be harmful as it creates a barrier between those experiencing suicide and those who may be able to help them. Doctors are not able to relate to suicidal individuals as they are searching for signs of mental disorders, creating a disconnect between the two parties and resulting in ineffective help for those experiencing suicide.

Instead, Michel argues that we must adopt a person-centered model of suicide that prioritizes understanding the individual's subjective experience and framing help for suicide as a societal issue rather than a medical one. This model already exists and is used in Asist, ZeroReasonsWhy, and Orygen, and other public health programs.

According to Michel, the key to saving someone from suicide is listening to them empathetically without trying to talk them out of it. This allows the person to feel understood and valued, and recognized as a person, rather than marginalized as inadequate or mentally ill.

Overall, Michel's work emphasizes the importance of reframing suicide as a societal issue rather than a medical issue. By listening to those experiencing suicide and understanding their subjective experience, we can better support and advocate for those who may be struggling with suicidal thoughts.