Beyond Therapy: How Systemic Change Can Prevent Suicide in America

If you or someone you know is experiencing a mental health crisis, contact the 988 Suicide & Crisis Lifeline by dialing or texting “988.”

In the U.S., someone dies by suicide every 11 minutes—a rate that has persisted despite decades of mental health advocacy. While suicide is often linked to mental illness, a growing movement suggests that systemic failures in society may play an equally critical role in driving despair.

From Crisis Care to Systemic Solutions

Traditional suicide prevention has focused on connecting individuals in crisis with therapy and medication. However, these approaches face significant barriers: high costs, limited healthcare access, and overwhelming demand. Research increasingly shows that suicide is influenced by a complex interplay of factors beyond mental health alone.

Chris Pawelski’s story highlights how economic and social pressures can push individuals to the brink. After his father was diagnosed with renal cancer and passed away six months later, Pawelski became the primary caregiver for his mother, who had dementia. At the same time, his family’s multigenerational onion farm in New York’s Orange County was collapsing financially.

Pawelski described the farm’s struggles: “I was growing roughly $200,000 worth of crops some years but took home only about $20,000.” Unable to negotiate fair prices with wholesale buyers, he faced mounting debt to suppliers and equipment vendors. The financial strain strained his marriage, leaving little time for social connections as he worked sunup to sundown, seven days a week.

“It’s all stuff collapsing down upon you,” Pawelski said. “It’s weeks, months, years of dealing with all sorts of pressures that you can’t alleviate.”

During this period, Pawelski found himself contemplating suicide. “You think you’re already on your way out, so why wait?” he recalled.

Suicide in America: A Persistent Crisis

Suicide remains a leading cause of death in the U.S., ranking among the top 10 causes annually. Unlike many developed nations, the U.S. has not seen a significant decline in suicide rates in recent decades. This stagnation has prompted experts to question whether prevention efforts need to expand beyond individual treatment.

The COVID-19 pandemic further exposed this gap. Rates of anxiety and depression surged not because of widespread changes in brain chemistry, but due to systemic disruptions—job losses, social isolation, and financial instability. This shift led many advocates to argue that suicide prevention must address the root causes of despair, not just its symptoms.

Rethinking Prevention: Beyond the Individual

While crisis care and mental health treatment remain essential, experts are calling for a broader approach that tackles the societal and economic pressures fueling suicide. This includes:

• Strengthening financial safety nets for struggling families
• Improving access to affordable healthcare, including mental health services
• Addressing systemic issues like wage stagnation and healthcare inequities
• Supporting caregivers and individuals facing chronic stress

For Pawelski, the turning point came when he sought help—not just for his mental health, but for the financial and caregiving burdens overwhelming him. His story underscores the need for prevention strategies that look beyond the individual to the systems shaping their lives.