Every September 10, I have mixed feelings about World Suicide Prevention Day. Observed each year on September 10, the day is intended to bring greater attention to suicide, reduce stigma, and strengthen our collective commitment to prevention.
I understand why we need the day. Suicide is one of those realities human beings have historically surrounded with silence, moral judgment, fear, euphemism, and shame. A day devoted to bringing it into the open matters. Public awareness matters. Better mental health care matters. Research, screening, crisis intervention, and prevention matter. Anything that makes it easier for a suffering person to tell the truth about what is happening inside them is worth doing.
But September 10 never feels like an awareness day to me. It feels personal.
Long before I knew anything about prevention, mental health, trauma, chaplaincy, or existential health, suicide was already part of my emotional world. I encountered its reality first as a child trying to understand my mother, then as a teenager grieving my closest friend, and later as a chaplain standing with families after someone they loved had died.
There are subjects we study because they interest us, and there are subjects life hands us before we are old enough to refuse them. This was one life handed me early.
And every September 10, I think about Mike.
I was born to a mother with untreated mental health problems. Throughout much of my childhood and youth, she spoke openly to me about wanting to kill herself. I was too young to understand what was happening psychologically, but children do not need clinical language to know when something is terribly wrong.
Coming home from elementary school involved a ritual no child should have to learn. I would enter the house and quickly assess the situation. My mother was often passed out on the couch from alcohol, and I had to determine whether she was sleeping, unconscious, or dead.
There is a particular kind of intelligence children develop in unstable environments. You learn to read a room before entering it fully. You notice tone, silence, posture, breathing, the placement of objects, whether something feels different from yesterday. Your nervous system becomes a kind of early-warning system. Other children come home thinking about what is for dinner or whether they can go outside and play. Some children come home and check whether everyone is still alive.
At the time, I did not think of this as unusual because childhood has no comparison group. Whatever world we are given initially appears to us simply as the world. Only later do we discover that some of what we learned to call normal was actually survival.
Looking back, I understand something else about those years. My first education in suicide did not come through a theory about death, but through proximity to another person’s unbearable pain. Long before it became an intellectual or professional concern, it was a possibility hovering over someone I loved.
My best friend in high school died by suicide. His name was Mike.
Though I played sports throughout my youth and high school, I was a withdrawn kid and something of a loner. I knew plenty of people, but knowing people and being known by someone are different experiences. Mike was my close friend, and when he died, something disappeared from my world that could not simply be replaced by meeting somebody else.
I was devastated and lost. I also discovered what countless people bereaved by suicide eventually discover: a death like this leaves behind a particular architecture of questions. You revisit conversations. You search your memory for signs. You wonder what you missed, what you might have said, whether there was a moment when some different sequence of events could have changed everything.
The mind wants to return to the scene and rearrange the furniture.
With enough years, you learn that grief does not surrender its mysteries simply because you have thought about them for a long time. There are questions about Mike I will never answer. There are things I wish I could ask him. There is a version of adulthood in which he remained alive that exists nowhere except in imagination.
I still miss him. When September 10 comes around, I think about the boy I was and the friend who was suddenly gone. I think about everything Mike never got to become, but I also resist reducing his life to the manner of his death. Suicide has a way of swallowing the biography of the person who died. The final act becomes so enormous that it casts a shadow backward over everything that came before it.
Mike was more than what happened to him. He was my friend. He was a human being whose existence altered mine. All these years later, Mike still matters.
These encounters did not end with childhood or with Mike. Over the years, I have led too many memorial services for people who took their lives. As a Humanist Chaplain, I have been called to suicide scenes and sat with people in the strange and terrible hours when ordinary life has been interrupted by something the mind cannot yet comprehend.
I have also stayed in contact with mothers and fathers whose children died this way. There are forms of grief for which language seems almost offensively inadequate. A parent describing the death of a child often speaks from a place beyond our usual vocabulary of loss. The future itself has been injured. Birthdays continue arriving. Holidays return. Other children grow older. The world keeps moving with an almost indecent normality.
Public discussions of suicide necessarily rely on numbers. In the United States alone, tens of thousands of people die this way each year, and it remains one of the leading causes of death among young people. We need epidemiology. We need to know who is at risk, where rates are increasing, which interventions work, and where systems are failing. Good policy requires measurement.
But statistics have an inherent limitation: they count what they cannot contain.
A number cannot contain the sound of a mother talking about her dead child. It cannot contain the bedroom left largely unchanged, the last text message, the photographs, the anger, the unanswered questions, or the strange reflex of wanting to call someone who is no longer there. It cannot measure the years of life that continue radiating outward from a single death.
This is why suicide prevention must remain rigorously evidence-based without ever becoming merely technical. The moment we forget the human being inside the data, we misunderstand the phenomenon we are trying to address.
My experiences have also made me deeply concerned about the ways religious communities sometimes respond to mental health struggles and suicide.
Religion is not inherently destructive to mental health. Religious communities provide millions of people with belonging, meaning, ritual, friendship, moral orientation, practical support, and ways of carrying suffering. Intellectual honesty requires saying that plainly.
But intellectual honesty also requires acknowledging the other side. Authoritarian and toxic forms of religion often create conditions in which psychological distress becomes entangled with spiritual shame. Depression is interpreted as a failure of faith. Anxiety becomes an inability to trust God. Doubt signals rebellion. Despair suggests ingratitude. Professional treatment is sometimes regarded as secondary to prayer, scripture, obedience, or correcting one’s relationship with God.
A person who is already struggling then acquires another problem: they begin judging themselves for struggling.
This is one of the most dangerous things any meaning system can do to a human being. Suffering is difficult enough to carry without being required to interpret your suffering as evidence against your own worthiness.
I have spent much of my adult life thinking about authority, shame, belief, identity, and what happens when people lose trust in their own experience. Toxic religion does not merely give people questionable theological ideas. At its worst, it alters the relationship people have with themselves. The inner world becomes a courtroom. Thoughts are monitored, desires become suspicious, doubt requires explanation, and ordinary human vulnerability is placed under spiritual surveillance.
For a person already experiencing serious psychological distress, this environment becomes especially dangerous. Someone who needs permission to say, “Something is happening to me and I need help,” instead learns to ask, “What is wrong with me that I feel this way?” Those are not the same question.
One of the ideas at the center of my work in existential health is what I call reality contact: our capacity to encounter the conditions of our actual lives without requiring them to conform first to an inherited explanation.
This matters profoundly when we are talking about suffering.
Human beings understandably reach for explanations when confronted by another person’s despair. We want to know why. We want a diagnosis, a cause, an event, a belief, a chemical process, a trauma, something that allows the incomprehensible to become comprehensible again. Explanation has an important place in medicine, psychology, public health, and suicide research.
But explanation is not the same as contact. To encounter another human being in profound despair requires the capacity to remain present to something we cannot immediately fix. It means taking seriously what their world feels like from inside their experience rather than rushing to persuade them that they should experience it differently.
This is one reason I distinguish existential health from simple positive thinking or the pursuit of happiness. Existential health is not a state in which life feels meaningful all the time. It concerns our capacity to remain in relationship with life through experiences of uncertainty, mortality, loss, identity disruption, meaning collapse, isolation, freedom, limitation, and change.
Psychological health and existential health overlap, but they are not identical. A person’s decision to end their life is shaped by a complex interplay of psychological, biological, social, economic, relational, cultural, and other factors. It would be irresponsible to reduce that complexity to an existential explanation.
At the same time, the suicidal person is not merely a collection of symptoms. There is still a human being there experiencing a world. And sometimes that world has become impossible to inhabit.
This is where existential health adds an important dimension to the conversation.
The question is not always simply, “Why does this person want to die?” There is another question worth asking alongside it: “What has happened to the person’s relationship with being alive?”
For some people, meaning has collapsed. For others, belonging has disappeared. A former identity no longer works, but another has not formed. Shame has made the self feel intolerable. The future has ceased to appear as a place worth arriving at. A person feels trapped inside circumstances they cannot change or inside a version of themselves they no longer know how to carry.
None of these observations replaces clinical assessment or mental health treatment. They deepen our understanding of the human being receiving that care.
We are meaning-making creatures. We inhabit stories about who we are, where we belong, what our suffering means, whether our lives matter, and whether tomorrow contains anything capable of calling us toward it. When those structures collapse, the resulting crisis is not imaginary because it is existential. Meaning, identity, belonging, agency, and hope are not decorative additions to human life. They are part of the ground from which a life becomes livable.
This is especially important in our present cultural moment. Many people are experiencing the erosion of institutions, communities, inherited identities, religious frameworks, and shared narratives that once supplied a ready-made sense of place. Some of those structures needed to be questioned or abandoned. Yet dismantling a harmful worldview does not automatically produce a habitable life on the other side.
This vulnerability becomes especially visible in my work with people leaving religion. When someone has spent years being taught that truth comes from outside themselves, that their inner life is fundamentally unreliable, and that belonging depends upon conformity to an approved framework, leaving that framework involves far more than changing beliefs. The person may lose community, identity, ritual, moral orientation, and the structure through which life once made sense.
I describe this as outsourced authority: learning how to receive a life rather than author one. When the old map disappears, the capacities required to navigate without it do not suddenly appear. This is why deconstruction, even when necessary and liberating, sometimes produces a period of profound existential exposure. Freedom from an old structure and the capacity to live without it are different achievements.
The task is not to replace one system of certainty with another, but to develop the capacities that make a less certain life inhabitable: self-trust, belonging, agency, relationship, and the ability to remain present to questions that no longer come with predetermined answers. For some people, the distance between the collapse of an inherited world and the formation of a livable one is an intensely vulnerable place. Part of the work of existential health is learning how to meet people there.
Suicide prevention rightly involves trained clinicians, crisis services, screening, medication when appropriate, research, public policy, and accessible mental health care. There are moments when someone’s immediate safety requires urgent professional intervention, and no philosophical account of suffering should obscure that fact.
But prevention also raises a cultural question. What kind of people are we becoming for one another?
A society can have crisis lines while remaining profoundly lonely. It can improve screening while constructing forms of life organized around performance, comparison, exhaustion, precarity, and isolation. A community can publicly affirm mental health while privately rewarding people for concealing how badly they are doing.
We have become skilled at asking people how they are while giving them powerful reasons not to answer truthfully.
A deeper culture of suicide prevention would make truth-telling less costly. It would create families, schools, religious communities, workplaces, friendships, and public spaces in which admitting despair does not immediately diminish someone’s standing. It would recognize that listening is not passive when another human being is struggling to remain connected to life.
There is also a humility that belongs in any serious conversation about suicide. We should build better systems of care, become more attentive to one another, reduce shame, strengthen belonging, and make help easier to reach. None of this gives us control over another person's decision to remain alive. Those who have lost someone to suicide already know the merciless questions that follow: What did I miss? What should I have said? Why didn't I know? Prevention matters precisely because lives matter, but prevention must never become another burden placed upon the grieving. Sometimes people love deeply, show up faithfully, seek every available form of help, and still lose someone they love.
This is where prevention becomes more than intervention. It becomes a way of constructing human environments in which people have a better chance of remaining connected to themselves, to others, and to a future.
I previously wrote an article titled ** The Question Beneath Suicide: Suicide, Existential Health, and the Search for a Life Worth Staying For**. I wrote it because I wanted to explore dimensions of suicide that are easily…
