Every year since 1999, more Americans have killed themselves than the year before, making suicide the nation’s greatest untamed cause of death. In much of the world, it’s among the only major threats to get significantly worse in this century than in the last.
There has been an almost 20 percent rise in the annual suicide rate, a 30 percent jump in the sheer number of people who died, at least 400,000 casualties in a decade—about the same toll as World War II and Korea combined.
In 2013, America is likely to reach a grim milestone: the 40,000th death by suicide, the highest annual total on record. In November 2012, a study lead by Ian Rockett, an epidemiologist at West Virginia University, showed that suicide had become the leading cause of “injury death” in America. As the CDC noted again this spring, suicide outpaces the rate of death on the road—and for that matter anywhere else people accidentally harm themselves.
|Public Health Burden of Suicidal Behavior in 2008|
Adults 18 and Older
All rates per 100,000 population
Source: CDC's National Vital Statistics System.
Interpersonal Theory of Suicidal Behavior
The interpersonal theory of suicidal behavior holds that an individual will die by suicide if he or she has both the desire for suicide and capability to act on that desire. According to the theory, suicidal desire results from the convergence of two interpersonal states: perceived burdensomeness and thwarted belongingness:
- Perceived burdensomeness is the view that one’s existence burdens family, friends, and/or society. This view produces the idea that “my death will be worth more than my life to family, friends, society, etc.” – a view, it is important to emphasize, that represents a potentially fatal misperception. Past research, though not designed to test the interpersonal-psychological theory, nonetheless has documented an association between higher levels of perceived burdensomeness and suicidal ideation.
- Thwarted belongingness is the experience that one is alienated from others, not an integral part of a family, circle of friends, or other valued group. A persuasive case can be made that, of all the risk factors for suicidal behavior, ranging from the molecular to the cultural levels, the strongest and most uniform support has emerged for indices related to social isolation
The diagram below sets out a visual representation of the interpersonal theory of suicide. The intersection of perceived burdensomeness and thwarted belongingness creates a desire for suicide. The intersection of that area and the capability for suicide creates the circumstances for suicide or near-lethal suicide attempt.
Expanding Use of Personality Tests and Potential Impact on Suicides
Studies have shown that being unemployed was associated with a twofold to threefold increased relative risk of death by suicide, compared with being employed. Given that more than 90% of persons who attempt suicide have mental illnesses, a process like the use of personality testing that results in persons with mental illnesses being excluded from employment consideration can lead to an increase both in (i) perceived burdensomeness and, (ii) as a consequence of not being employed, thwarted belongingness/social alienation. This happens both on an individual and aggregate level and may cause an increase in suicides.
To date, employment personality assessments have been used primarily in the context of recruitment and hiring for entry-level positions. Assessment use is expanding to a variety of employment actions, including promotion, leadership development, training, retention, succession planning, outplacement, and restructuring.
The possible knock-on impacts of the broadening use of assessments includes the potential that existing employees with mental illness (whether diagnosed or not), many of whom became employees prior to the widespread use of assessments in the hiring process, will find themselves unemployed and, as a consequence, having greater feelings of burdensomeness and thwarted belongingness. This, in turn, may lead to more suicides.