The increase of suicide rates: the need for a paradigm shift

Suicide was highlighted as a major public health issue in a recent release of data by the US Centers for Disease Control and Prevention (CDC).1 The CDC reported a 30% increase (1999–2016) in suicide across all age groups up to age 75 years (in half of all US states), and in 2016, 54% of people in 27 US states who died by suicide had no mental health diagnosis.1 Yet most papers and reports on suicide stress that up to 90% of people who die by suicide had a psychiatric disorder. Despite innovative approaches in both psychiatric treatments and suicide prevention, some important shortcomings seem to have a role in impairing effective progress in reducing deaths by suicide. A paradigm shift is needed that should focus the assessment of suicide risk on the centrality of the mental pain in suicidal individuals