The Economics of Suicide
Why trying to kill yourself may be a smart business decision.
When Kirk Jones jumped over the guardrail at Niagara Falls last week and fell 180 feet alongside 150,000 gallons per second of rushing water, traditional explanations for his leap were plentiful. Jones' parents said he had lost his job and was depressed. A suicide expert pointed out the appeal of dramatic farewells. And everyone called the jump suicidal: Jones is the first person to survive a Niagara fall without safety gear.
But when it later came out that Jones had boasted to a friend, "If I go over and I live, I am going to make some money," it was time to call in the economists.
Jones is now negotiating with tabloids to sell his story for thousands of dollars. His case, however, will complicate a debate that is roiling suicidology, one that pits economists against psychiatrists over a basic question: Is suicide a rational decision?
This controversy began in 1974 when two Princeton economists created a model to forecast suicidal decisions. Admittedly, the economists wrote, some suicidal behavior is purely irrational. But evidence suggests that economic theory explains some suicides. The economists proposed that the value of a life might be calculated the same way we value companies: Measure all the happiness a life might contain, discount it by the cost of achieving that happiness, and if the net present joie de vivre is less than zero, suicide is a viable option.
The economics of suicide were largely ignored in the ensuing decades. But last year Dave Marcotte, a professor of public policy at the University of Maryland, Baltimore County, pushed the field forward when he wondered what happens to people like Jones who attempt, but do not achieve, suicide. * There are about 20 attempts for every successful suicide. (Approximately 2.9 percent of the U.S. population has attempted suicide—1,760 attempts per day.)
Previous studies had demonstrated that as personal incomes rise, the propensity for suicide falls (presumably, money doesbuy some happiness). Marcotte's insight was that individuals contemplating suicide do not just choose between life and death. Rather, they choose between three alternatives: life, death, and the gray area of unsuccessful suicide, which may be negative (expensive injury and permanent disability) or positive (a "cry for help" that elicits attention).
The resulting formula contains a somewhat paradoxical conclusion: Attempting suicide can be a rational choice, but only if there is a high likelihood it will cause the attempter's life to significantly improve.
Marcotte couldn't test the relative "life improvement" of successful suicides—since they were, of course, dead—but he could study those who had failed at suicide to determine if their lives improved after the attempt. The results are surprising. Marcotte's study found that after people attempt suicide and fail, their incomes increase by an average of 20.6 percent compared to peers who seriously contemplate suicide but never make an attempt. In fact, the more serious the attempt, the larger the boost—"hard-suicide" attempts, in which luck is the only reason the attempts fail, are associated with a 36.3 percent increase in income. (The presence of nonattempters as a control group suggests the suicide effort is the root cause of the boost.)
Why should suicide be an economic boon? Once you attempt suicide you suddenly have access to lots of resources—medical care, psychiatric attention, familial love and concern—that were previously expensive or unavailable. Doubters may ask why the depressed don't seek out resources earlier. But studies have demonstrated that psychological and familial resources become "cheaper" after a suicide attempt: It is difficult to find free medical care when you are sad, but once you try to kill yourself, it's forced on you.
Suddenly the calculus of suicide has become even more complicated. Now attempting suicide seems a rational choice, as long as the attempt isn't too successful. But this conclusion alarms suicidologists: Treating suicide as a logical act runs counter to everything they have been advocating for the past 40 years.
The suicide-prevention movement of the 1960s was founded upon the idea of "suicide crisis moments"—relatively brief periods when "psychological pain and mental illness causes irrational thoughts, which are treatable and temporary," explained Dr. David Rudd, president of the American Association of Suicidology. This idea is the basis of suicide hotlines, which studies prove are effective in saving lives. Suicidology suggests that most failed suicide attempts are not caused by permanent mental illness. Rather, they are the products of momentary lapses in reason. Once the crisis moment is resolved through intervention and care, suicidal instincts pass and would-be attempters go on to fruitful and healthy lives. (Many economists and suicidologists agree that multiple suicide attempts and successful suicides are often products of longstanding mental illnesses.)
Constructing suicide as a momentary loss of reason is vitally important to the suicide-prevention movement because it suggests that men and women who have attempted self-murder should be allowed to shrug off social stigmas. If suicidal instincts are just momentary delusions, they are easily explained and dismissed. The suicide-prevention movement fears that if suicide is deemed the rational product of someone's mind, we may feel justified in suspecting that mind forever.
But by objecting to rational explanations of suicide, the suicidology community may be undermining its own cause. Although suicide attempts cost the nation more than $3 billion per year, and suicides claim more American lives than homicides, suicide prevention is hampered by scarce resources. Ultimately, say mental health advocates, legislators don't like to fund suicide prevention because they believe that suicidal people must be crazy, and crazy people don't really want help. Perhaps if suicide were considered a rational and combatable disease, like skin cancer or high cholesterol, we might see well funded educational campaigns similar to those for more socially acceptable ailments.
Correction, Nov. 6, 2003: The piece originally identified Dave Marcotte as a professor at the University of Maryland, which may have misled some readers. The term "University of Maryland" is generally understood to refer to the university's flagship campus, University of Maryland, College Park. Marcotte is a professor at a different campus, University of Maryland, Baltimore County. Return to the corrected sentence.
Charles Duhigg is a reporter for the New York Times, based in New York, and the author of the book The Power of Habit: Why We Do What We Do in Life and Business.
Illustration by Robert Neubecker.