By: Panicha McGuire, PsyD, RPT-S™, LMFT
September is National Suicide Prevention Month in the United States. When we ask people to reach out, check on one another, and recognize signs of distress, we also need to talk about what people are being asked to survive. For someone who cannot find work, cannot get enough hours, or is working constantly without earning enough to meet basic needs, emotional distress exists alongside very real material problems.
As a therapist who works with young adults, I am hearing more conversations about how difficult it feels to build a life right now. There is fear about losing a job, being replaced by AI, or never getting the opportunity to begin a career. Some young adults who graduated this spring have spent the months since applying for work and are entering fall without employment. Similar concerns keep coming up in my consultation groups and conversations with colleagues. These observations cannot tell us how widespread the experience is, but they raise questions about the circumstances surrounding the distress we are seeing.
For someone beginning their adult life, this uncertainty can be especially disorienting. They may have spent years being told that education, effort, and persistence would lead to opportunity. Now they are trying to reconcile that promise with applications that go unanswered, financial dependence they had hoped to move beyond, and a future that feels difficult to plan. We need to make room for the grief, frustration, and fear that can come with that gap between what someone was told to expect and what is actually available to them.
It is difficult to feel secure when you do not know whether you can pay rent next month. It is difficult to imagine a future when each week requires another decision about which bill can wait. And when that uncertainty unfolds alongside international conflict, political instability, and fear for the people we love, reassurance can feel disconnected from what is happening. Suicide prevention needs room for this reality. Support needs to extend to the conditions a person returns to after the conversation ends.
You may have heard that one in five suicides is linked to unemployment. This estimate comes from a study examining 63 countries between 2000 and 2011, which found that approximately one in five suicide deaths in those countries was associated with unemployment (Nordt et al., 2015). Although this is not a current worldwide estimate, more recent research reinforces the importance of economic security in suicide prevention. A 2024 review found that unemployment, financial hardship, and economic downturns are associated with increased suicide risk across countries at different income levels, including among people who are employed but struggling financially. The authors emphasized that prevention efforts must address these material conditions through adequate wages, income assistance, employment support, and strong public services, while avoiding policies that can deepen hardship (Sinyor et al., 2024). These studies give us something to learn from the past. Economic hardship has consequences for mental health, and the choices societies make in response can help protect people or deepen their vulnerability. We have reason to take financial distress seriously before someone reaches a crisis. If our prevention efforts leave the conditions contributing to that crisis unaddressed, how much of the work of prevention are we actually doing?
Suicide has multiple interacting influences. Financial hardship can contribute to risk alongside mental health concerns, isolation, discrimination, loss, and other experiences. These connections do not mean that unemployment inevitably leads to suicide or that economic conditions explain every person’s distress. They do mean that understanding someone’s mental health requires curiosity about the world they are living in. Losing a job can mean losing several sources of stability at once. Income is the most immediate, but there may also be changes in routine, relationships, confidence, and access to care. The World Health Organization (2024) identifies unemployment, recent job loss, and financial and job insecurity as risk factors for suicide attempts. It also recognizes that decent work can support connection and well-being.
Then there is the meaning we attach to employment. When we meet someone, one of the first questions we often ask is, “What do you do?” We usually mean what they do for a living. It can be an ordinary attempt to connect, but it also reveals how readily we use employment to understand who someone is. Sometimes I wonder what it communicates when our first curiosity about another human being is how they earn money, as though being alive is not enough to deserve our interest. Work can be meaningful. People can feel proud of their skills, find community through their jobs, and care deeply about what they contribute. But when paid productivity becomes a measure of human worth, losing work can become an identity judgment: “I cannot find a job” turns into “There must be something wrong with me.” Someone may be navigating repeated applications, unanswered messages, and interviews while also feeling pressure to defend their effort and explain why they have not found something yet.
There is a particular cruelty in asking people to keep proving their motivation while treating the absence of an offer as evidence that they have not tried hard enough. It also leaves little room to recognize caregiving, friendship, creativity, community involvement, or the work of getting through a difficult day. None of these needs to produce an income to matter. And a person should not have to list other contributions to justify being cared for when paid work is unavailable or inaccessible.
Changing this begins, in part, with the conversations we have. We can ask what someone cares about, what they enjoy, what they are learning, or how they have been spending their time. We can remain interested in their life without making every interaction a request for an employment update. When someone tells us they are out of work, we can ask how they are doing and what kind of support they want before offering advice. These shifts will not resolve economic insecurity, but they can help create relationships in which belonging does not depend on a job title.
Underemployment deserves attention here, too. Someone may have a job but want and need more hours than their employer offers. Someone else may be unable to find work that uses their training or experience. Low pay and insecure employment are related concerns: a person can work full time, or hold several jobs, and still lack financial security. Imagine a worker whose shifts change every week. They cannot predict their income, yet they are expected to remain available. Or a person whose professional qualifications are not recognized after moving, leaving them unable to access the work they trained to do. Or a disabled worker who could sustain employment with appropriate accommodations but cannot find a workplace willing to provide them.
Disability is central to this conversation. I have worked at the intersection of disability and mental health for years, and I keep returning to the contradiction between encouraging people to build stable lives and maintaining systems that make stability difficult to achieve. Disabled people deserve choices, relationships, rest, financial security, and the ability to plan for a future. Yet accessing support can require navigating rules that restrict the very security that support should make possible. For example, in the United States, Supplemental Security Income (SSI) generally limits countable resources to $2,000 for an individual and $3,000 for an eligible couple. Those resources can include money in checking and savings accounts. Some assets are excluded, and certain savings arrangements have special protections. For people who depend on SSI, ordinary emergency savings can put eligibility at risk. Consider what we are asking of people. We encourage saving for emergencies and becoming financially secure, then limit how much someone can set aside while receiving essential support. How is a person supposed to feel less anxious about the future when building a financial cushion can threaten the assistance they rely on? To me, this is a structural contradiction that deserves far more attention in our conversations about mental health.
Employment is not a straightforward way out of these constraints, either. In clinical conversations, we might encourage someone to request workplace accommodations, and accommodations can make a meaningful difference. Under the Americans with Disabilities Act, covered employers generally must provide reasonable accommodations to qualified disabled applicants and employees unless doing so would create an undue hardship. But having a legal right does not guarantee that a workplace will honor it when it is needed. Workplace discrimination still happens, and accountability can come after someone has already lost income and stability. “Ask for accommodations” can therefore be the beginning of support, but it cannot be the end of our responsibility. We also need to ask whether someone feels safe disclosing their needs, whether the accommodation actually provides access, and what support is available if the employer refuses or responds with discrimination. Expecting someone to advocate for themselves indefinitely can become another demand placed on a person whose resources are already stretched.
Some disabled people want paid work and encounter barriers that should never have been there. Others cannot work, or cannot work consistently, and deserve the same security and dignity. Our response cannot depend on whether someone can eventually become productive enough to satisfy an employer. If suicide prevention includes helping people see possibilities for their lives, then disability benefits that allow financial stability and workplace protections that translate into actual access belong in that work.
Global tension adds another layer. For a person living through war, the loss of a livelihood may be inseparable from threats to physical safety. For someone with family abroad, economic insecurity can coexist with fear about loved ones and the pressure to keep sending support. These experiences are not interchangeable. Living through violence is different from fearing its effects at a distance. Countries also differ in their social protections, health systems, employment opportunities, and community resources. A global conversation needs to acknowledge those differences while recognizing that financial and emotional lives cross borders.
I do not have all the answers to these problems. But as a clinician and an educator, it becomes increasingly clear to me that depression and suicidal ideation can be deeply intertwined with the structural conditions of our society. I cannot understand someone’s hopelessness without asking what opportunities, protections, and choices are available to them. I also cannot assume that helping someone cope means the circumstances they are coping with are acceptable.
For clinicians and other helpers, this means asking about the circumstances surrounding distress. Can this person meet their basic needs? Are their hours or income changing? Is fear of losing employment contributing to their suicidal ideation? Have repeated experiences of exclusion affected how they see themselves or their future? Are practical barriers making care inaccessible? There is room for coping strategies and for an honest recognition that some of the problems causing distress require material assistance or institutional change.
For friends and family, support can become more useful when it is specific and offered with consent. That might mean bringing groceries, helping with an application, offering childcare during an interview, or spending time together without making employment the central topic. It can also mean resisting the urge to turn someone’s uncertainty into a lesson about attitude, gratitude, or trying harder.
At the policy level, income security deserves a place in suicide prevention. A prevention agenda should include accessible care, housing stability, meaningful income support, fair pay, predictable schedules, and workplaces that accommodate disability. These are priorities to build and evaluate alongside crisis services. If we are asking people to believe that a future is possible, we also have a responsibility to help make that future more accessible.
If you are unemployed, underemployed, or exhausted from working without getting ahead, your employment situation does not determine your worth. You do not need to minimize what is happening, and you do not have to earn care by first demonstrating that you have exhausted every possible solution. Support can begin while the circumstances are still unresolved.
This September, I want our conversations about suicide prevention to include the graduate still waiting for an opportunity, the worker afraid of losing their income, and the family trying to stretch what they have across rising needs. I want us to consider what we communicate about human worth through our everyday conversations and through the systems we maintain. Prevention means responding to distress with care and taking seriously the conditions contributing to it. People deserve enough security, connection, and support to imagine what comes next.
If you are thinking about suicide or need support through emotional distress, consider contacting someone you trust or a qualified mental health professional. If you are in the United States, visit our crisis resources page.
References
Nordt, C., Warnke, I., Seifritz, E., & Kawohl, W. (2015). Modelling suicide and unemployment: A longitudinal analysis covering 63 countries, 2000–11. The Lancet Psychiatry, 2(3), 239–245. https://doi.org/10.1016/s2215-0366(14)00118-7
Sinyor, M., Silverman, M., Pirkis, J., & Hawton, K. (2024). The effect of economic downturn, financial hardship, unemployment, and relevant government responses on suicide. The Lancet Public Health, 9(10). https://doi.org/10.1016/s2468-2667(24)00152-x
WHO. (2024, September 2). Mental health at work. World Health Organization. https://www.who.int/news-room/fact-sheets/detail/mental-health-at-work
