Broader Suicide Prevention Strategies Aid Farmer Facing Multiple Challenges

Chris Pawelski, a fourth-generation onion farmer in Orange County, New York, faced multiple difficulties that led to suicidal thoughts. His father died from renal cancer after a six-month diagnosis, leaving Pawelski as the primary caregiver for his mother with dementia.

The family farm was losing money, with Pawelski reporting that he grew about $200,000 worth of crops annually but took home only $20,000 due to low prices from wholesale buyers. Debt accumulated from suppliers and equipment, straining his marriage and limiting time for social activities.

Pawelski worked seven days a week from sunup to sundown. He described the pressures as collapsing upon him over weeks, months, and years.

Someone in America dies by suicide every 11 minutes. Suicide repeatedly ranks among the top 10 leading causes of death. Millions of Americans have serious suicidal thoughts annually, and tens of thousands die by suicide each year. The U.S. has higher suicide rates compared to other developed nations.

Traditional prevention has focused on connecting individuals in crisis with treatment, though therapy and medication can be expensive and the health care system faces demand challenges. Suicide is influenced by multiple factors, including but not limited to mental illness.

A growing movement emphasizes addressing external factors such as social and economic conditions. Sally Spencer-Thomas, a psychologist and suicide prevention researcher who lost her brother to suicide, stated that creating happier, healthier people leads to longer lives.

“It's not rocket science." If you have happier, healthier people, they live longer, happier lives. That means suicide prevention shouldn't be limited to answering hotlines or treating patients in psychiatric wards, she said. It should also involve running food banks to ensure families don't go hungry or hosting weekly book clubs for homebound seniors to make friends. It can take the form of school programs that build resilience in children or housing policies that prevent evictions. Decades of research shows these types of initiatives — even if they don't have the words "mental health" or "suicide" in the title — can reduce the number of people who kill themselves. They often lower rates of crime, addiction, and poverty, too. The U.S. has lagged other countries in adopting this approach, Spencer-Thomas said, perhaps because it's easier — and more politically palatable — to tell someone to go to therapy than it is to enact sweeping policy changes, such as an increased minimum wage.”

The Trump administration has championed cuts to Medicaid and the Supplemental Nutrition Assistance Program that are projected to leave millions of people without health insurance and food stamps in coming years. It has injected uncertainty into the economy through seesawing tariff policy and mass layoffs of federal employees.

It has canceled $1 billion in grants for school-based mental health initiatives, gutted federal programs that focus on at-risk blue collar workers, and cut gun violence research. Suicides account for the most common type of gun death in the U.S. Hannah Wesolowski, chief advocacy officer for the National Alliance on Mental Illness, stated that these changes create stress and anxiety, potentially leading to crises when people feel desperate.

Federal health officials maintain that suicide prevention is a priority. Allison Arwady, director of the Centers for Disease Control and Prevention's injury center, said the agency focuses on supportive systems regardless of external turmoil. Officials said several of the Trump administration's priorities align with an upstream approach.

For example, they said, its focus on youth physical and mental well-being could help address the increasing suicide risk among adolescents, since exercise is proven to improve mental health. Similarly, people who are homeless have higher rates of suicide, and the administration has been pushing them into treatment.

Federal officials have also encouraged partnerships with religious organizations, and research shows members of faith communities are less likely to attempt suicide. However, the Trump administration has made steep staff cuts at the CDC and SAMHSA and has repeatedly called for decreasing their budgets, leading to questions about whether or how this work will continue.

prevention gained national attention in the late 1990s. Deb Stone, who worked at the CDC for 15 years and now is with the Jed Foundation, recalled a 1998 gathering in Reno, Nevada, of officials, clinicians, and advocates to address rising rates among young people.

Subsequently, the surgeon general issued a call to action, and the federal government published its first national strategy. These emphasized identifying people in crisis and increasing access to medical treatment, while acknowledging societal and economic roles in suicide risk.

Many mental health researchers and clinicians view these steps as critical components of prevention.