The Strongest Suicide Prevention Tool May Be a Steady Paycheck

Rei Scott is a transgender and nonbinary adult. But their gender identity isn’t what led them to consider suicide more than once. That can be credited to poverty. “There’s so many times in my life where I’ve thought if I had $5,000, I wouldn’t even be suicidal right now,” Scott told KFF Health News.

Some of those times include weeks in adolescence when Scott lived out of a car with four family members and their dog. During one such stretch, they dialed the national suicide hotline for help only to conclude that talking about their distress felt nice for a moment but ultimately resolved nothing.

“[W]hen you’re struggling to eat and you don’t have a roof to be under, I honestly don’t think words can go as far as you need them to,” Scott said. Decades of research affirms their logic. Studies on suicide’s relationship to unemployment, low income, high debt, unstable housing and food insecurity have shown that when people’s basic needs aren’t met they are more likely to kill themselves.

Likewise, when our systems change to reduce the difficulty of survival — increasing minimum wage, providing food assistance, offering tax credits and expanding healthcare — suicide rates fall.

One study found that expanding Supplemental Nutrition Assistance Program participation by just 5% could have prevented nearly 32,000 suicides over 15 years. Other high-income countries have made changes that acknowledge suicide isn’t always an individual or strictly psychological issue, but the U.S. is still catching up.

“We all need to be challenged to broaden our aperture, to broaden the lens of what is mental health,” said Benjamin Miller, a Stanford researcher and expert in mental health policy who argues that alleviating poverty, rather than expanding crisis services, would be the single most impactful strategy to reduce suicides in the U.S. today.

That “allows us to reconcile and solve for these conditions that put people in places of despair,” he said. “I don’t know what stronger intervention one could possibly have.”

Kacy Maitland sees that gap in real time. As chief clinical officer at Samaritans, a half-century-old Boston-based crisis line that fields upwards of 10,000 calls a month, she says financial stress, housing worries and unemployment are among the most common reasons people call the line — not some other imminent crisis. When SNAP benefits were delayed during a government shutdown, her phone rang.

“If people don’t have access to eat, to feed their children, to be alive, quite frankly, how are they able to move further through anything else?” Maitland said. Suicide prevention, she added, doesn’t always look like a crisis hotline. “Having your basic needs is also a form of suicide prevention.”