I am suicidal and have been off and on for years due to disability/pain from medical mistakes that cut my life short at 30. I am 45 now. That led to immediate loss of quality of life, career, financial security...and a slow painful loss of relationships and self worth. I was told to "get help", and did when I could afford it, but the problem is the root issues were never addressed. All mental health care has for most people is superficial bandaids. You cannot live an entire and healthy life drugged while things fester. You cannot cope every minute of every day. Life also isn't static or always improving and we have to deal with new issues like added health problems, aging, financial pressure weighing us down further. Bail one bucket of water out, two more pour in.

I had to ask family for help and one by one after a time they began to resent me and abandon me. I was denied SSDI. I was denied nearly everything I applied for and buried in bureacracy. I lived abroad for a time and had a much better quality of life and access to healthcare, but I couldn't legitimize permanently (still a fantasy at times) and had to come back to the USA. I now live, and who knows for how long they will allow it, with resentful family, isolated in rural Murica with no transport or access without much more expense and effort. No insurance. Limited income based medical care. Living on 600 dollars a month from a partial pension I was fortunate to have. Hearing every day how it simply has to be my fault and treated as if I am a loser who chose and continues to choose this. I am the same person I was when I was a public servant and seen as doing good in the world, but now that I have lost my autonomy I am lower class and shamed.

There was a time when my root issues would have been addressable and I could have had a decent life, but there was no help and things got worse. There was a time I though if I could just find someone to give me the "right" job that would work around my issues I could have a survivable life, and finally a kind and caring soul did that after years of nothing, but those two buckets I mentioned above poured in and things got worse and I wasn't able to do it. Now I have no idea what if anything can save me. How is one supposed to survive since "suicide is never the answer" when you have a miserable, painful life and no realistic way to dig yourself out? I cannot magically become a citizen of a nation with social support and healthcare. I don't have the bootstraps to pull on and rebuild. I cannot endure decades more of this yet anytime I discuss it I hear "seek help" or other shallow pearls of wisdom. Hotlines and calling the police seems the default response if someone brings up the topic. Everyone feels good like they did something and pats themselves on the back. The patient might get sent to hospital and that results in tens of thousands in medical debt and a worse problem. So it goes. No real solutions happening.

In cases like mine, which are a majority of suicidal people in my experience professionally and personally, it's rooted, situational stuff (often from multiple angles) and not some primary mental illness that Prozac and CBT mitigates. It's not simply about insurance (or the lackthereof) and what it will and will not pay for. I have been to a lot of doctors in my day and not a single one has improved my quality of life, most in fact the opposite. It's about there being no willingness to solve root causes and the eventual response being victim blaming and turning a blind eye when the bandaids don't work. Until society addresses the fact that many people end up in bad situations through no fault of their own (and honestly even those to blame somehow are still human beings who deserve help and not some abstract calculations on a moral or financial ledger) and provides a safety net and path to rebuild as much life as possible (something friends have accomplished in nations with such support), you will find more and more people choosing to quit living. We don't want to...we have no options...most especially not in America where all the things we need to stabilize and rebuild are even more costly and unattainable...where the only places we can afford are isolated with no services...where we are further and further cut off. Everything that would give me a chance is the opposite to where and what I am living now. Can't win.