Monday, June 11, 2018

Part I

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As suicide rates rise, there are basic questions we must ask about why the problem is not getting any better

Just in one week, two very famous Americans committed suicide. They did so separated by an ocean but in them is united a story about suicide coming the very same week that the suicide statistics in the United States indicated that in 49 of 50 states over the last record period there has been an upsurge in suicide.

Kate Spade, the designer, committed suicide. Just a few days later Anthony Bourdain, the celebrity chef and television star did the very same. Those two celebrities committing suicide in the same week as both of them were by all appearances at the very prime of life. Both of them very wealthy, both of them very famous. It raises some of the most basic questions about the meaning of human life and where we are right now as a society. A society in which the rates of suicide seem to be skyrocketing.

That was made clear just last week not so much by the headlines about the celebrities but in statistics released by the Federal Government through the centers for disease control. The Dallas Morning News reported the front page story this way. Suicide steadily rising in the United States. The paper tells us, “Suicide rates rose steadily in nearly every state from 1999 to 2016, often by as much as 30%.” This, again, according to the Centers for Disease control and Prevention. In 2016, we are told there were more than twice as many suicides as homicides in the United States.

Now, this makes last week an outlier in news coverage because overwhelmingly primary attention is given to homicide rather than to suicides. Furthermore, the statistics that came from the CDC are very interesting because many of the occurrences of suicide in the United States are otherwise hidden from view. In the last full recorded year of CDC statistics in 2016, 45,000 Americans age 10 or older died by their own hands, and that’s an increase of between 24 and 25% since the year 1999.

The Washington Post reports the story this way. “Suicide rates rose in all but one state between 1999 and 2016, with increases seen across age, gender, race, and ethnicity.” The Washington Post went on to say, “Increasingly suicide is being seen not just as a mental health problem but a public health problem.” Now, that’s a very interesting vocabulary because a public health problem is one that demonstrates such a widespread pattern that it ought to have national attention. What’s also interesting in that sentence is that suicide is directly, immediately tied to the reality of a mental health problem. Even though, as the very report from the CDC indicated, a significant percentage of those who do die by their own hands have had no diagnosable mental illness prior to the suicide.

In The Washington Post’s words, “Among the stark numbers in the CDC report was the one signaling a high number of suicides among people without a known mental health condition.” In the 27 states that used the National Violent Death Reporting system, 54% of suicides were by individuals without a known mental illness. But almost immediately after that the Post then turns to Joshua Gordon, Director of the National Institute of Mental Health, who said that the statistic must be put into context. He said, “When you do a psychological autopsy and go and look carefully at the medical records and talk to family members of the victims, 90%,” he said, “will have evidence of a mental health condition.”

The complicated nature of the problem of suicide was made very clear in the front page article that appeared in The New York Times last Friday by Benedict Carey. The headline of that article, Suicide Rate Climbed 25% Even as Prevention Efforts Grew. Later in the article Carey says, “CDC officials said that the increase in suicide rates cannot be linked to a particular mental health diagnosis.” Carey went on to say the new analysis found that nearly 45,000 Americans age 10 or older died by suicide in 2016, “The increase varied widely by state from a low of 6% in Delaware to more than 57% in North Dakota.” “The rate declined,” says the Times, “in just one state, Nevada, where it has historically already been higher than average.”

The Times gets right to the scale of the problem as Carey reports, “Suicide is the 10th leading cause of death in the United States and one of three that is increasing.” The other two that are increasing are Alzheimer’s Disease and drug overdoses that largely tied to the epidemic of opioid abuse in recent years. Carey’s report in the Times is helpful, giving some historical perspective. He said, “Suicide rates have waxed and waned, and tend to reach highs in hard times.”

In 1932, during the Great Depression, the rate was 22 per 100,000, among the highest in modern history. Now, what should come immediately to our minds is the fact that the date back in 1932 related to the Great Depression and the United States did experience a recession often most importantly dated to 2008. The Recovery was somewhat slow from that period of economic recession, but the fact is that right now the American economy is very strong.

Furthermore, if you look at relative household wealth over the period of recent American decades, you compare 1932 to 2016 and there is virtually no comparison. The average American household and the average American citizen is wealthier by a multiplier effect since the Great Depression in the 1930s. Christians looking at this kind of data must recognize that there certainly must be a linked to economic factors, but the data demonstrate that the economic factors cannot be the predominant issue at stake here.

Carey reports, “The past three decades have presented a morbid puzzle. Rates have risen steadily in most age and ethnic groups even as rates of psychiatric treatment and diagnosis have also greatly increased. The reasons are many.” He says, “According to the experts, the biggest increases have been in states like Oklahoma, Montana, and Wyoming where gun ownership, drug use, and economic hardship are common. Among middle-aged people across the country, marriage rates have declined and social isolation has increased.”

Now we need to pause and recognize that in that series of seemingly disconnected issues that might be playing into the rise in suicide rates are some issues that Christians instinctively understand are incredibly important. Back on the front page of the print addition, Carey’s report had included these words, “Social isolation, lack of mental health treatment, drug and alcohol abuse, and gun ownership are among the factors that contribute to suicide.” Again, no debate there, but Christians will understand that the issues are wider and far deeper.

If you put all of these major media reports just from last Friday together, you come to understand that there is undeniable trendline that should have our attention, and that is a trendline towards a significant increase in suicide in the United States. Furthermore, we are told that those trendlines no longer discriminate the way they did in the past. For one thing, women are increasingly more likely to commit suicide, running now to the rates near those of men. We’re also looking at the fact that the increases ran across racial and ethnic lines as well.

There are a couple of other linkages we need to think about. We’ve been told that economic factors are a major issue. Well, we can understand that. We understand why in a time of economic stress suicides would increase. There could be a sense of immediate despair. There could be a sense of a foreclosed future. There could also be the sense of enormous loss, perhaps even public embarrassment. That was certainly true in the Wall Street crash in the Great Depression. We can see how the loss of a job or another kind of economic setback could lead to a depressive condition and, for that matter, to a lot of stress.

But we also need to note that in the factors listed here are mental health issues. But there we also face a very interesting and complicated picture because in recent decades the number of Americans who have both sought and received psychiatric and psychological treatment has increased again. Skyrocketed. We’re looking at the fact that even as Americans have increasingly turned to a therapeutic worldview that wants to define virtually all human realities and psychological or psychiatric terms, for which often the answer is apparently some kind psychotropic drug or psychotherapy, the reality is that suicide rates have gone up as also there has been an explosion in the number of Americans receiving mental health treatment.

Does that mean that Americans should not seek mental health treatment? No, it certainly does not mean that, but it does certainly indicate, perhaps even it indicts a society that seems to be creating a larger situation of common mental illness and economic and emotional and person distress of unprecedented levels. Here’s the Christian worldview quandary. People who are richer are seemingly not happier. People who have more economic security seem to have less personal security. Persons who have been defining their problems as overwhelmingly therapeutic seem not to be as helped by therapy as many had hoped.

In an analysis article inside the front section of The New York Times last Saturday, Carey raised some of these very issues. He wrote, “The escalating suicide rate is a profound indictment of the country’s mental health system. Most people who kill themselves have identifiable psychiatric symptoms even if they never get an official diagnosis.” He went on, “The rise in suicide rates has coincided over the past two decades with a vast increase in the number of Americans given a diagnosis of depression or anxiety and treated with medication.” Finally, he writes, “The number of people taking an open-ended prescription for an anti-depressant is at a historic high. More than 15 million Americans have been on the drugs for more than five years. A rate that has more than tripled since 2000.”

Carey then asks this question in his article in The New York Times on Saturday, and I quote, “But if treatment is so helpful why hasn’t its expansion halted or reversed suicide trends?” Well, here I think we need to note a few of the words that have appeared in a disconnected form in a lot of the media coverage. Words such as social isolation. Words such as increasing loneliness, and to the credit of The New York Times, it at least mentioned the fact that lower marriage rates might have something to do with both the isolation and the disconnection and the suicide rates.

Well, this is where Christians need to think for just a moment about how we might connect what the secular world seems unable or unwilling to connect. We can connect rising rates of suicide with a larger pathology in the nation’s psyche, and soul, and heart. We can understand that these kind of statistics point to a society that had better ask and had better ask urgently some very basic questions about what has gone wrong.

Part II

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Why the church’s response to the rising suicide rate must not be one of confusion, but of clarity

But those questions we also recognize have to be answered spiritually and theologically if there is to be any sanity or rescue. A secular society even faced with this kind of horrifying statistics seems to look only at disconnected issues that just might in some way have something to do with the problem. But here we need to remember that human identity and human worth is always grounded in the fact that human beings are made in God’s image. Furthermore, we understand the reality of sin, such that we as human beings are actually every single one of us incapable of holding ourselves together, of grounding our own worth, or even at looking internally or socially to understand why our lives are important and why they matter.

The biblical worldview reminds us that we have to go back to the reality that we are God’s creation, every single one of us, in order to find that dignity and worth. Furthermore, to understand that in a world that is filled with all kinds of pathologies, and problems, and sociological rates, and you could go on. And even as every single human life is a mixture of achievement and setbacks and of pleasure and pain, of happiness and sometimes of sadness, we have to understand that this is the lot of humanity in a sinful world from which the only rescue can never ultimately be any form of pill or any form of therapy or any form of self-help movement, but can only be the gospel of Jesus Christ.

Now, we as Christians also understand that God has given us by common grace certain means of understanding the human condition, which is why there are professions such as psychiatry and psychology, and why there are those who are ready to help individuals who may be especially in urgent or immediate distress. This is why Christians do not disparage modern medicine or many of the insights that come from psychology and psychiatry. We have to think about these things as Christians and our ultimate authority can never be the prevailing medical authority of the time when the most basic questions have to do with what it means to be human and what’s gone wrong with humanity. Truths and questions that can only be answered and secured in holy scripture.

As Christians who are grounded in scripture, we also remember that even before the fall it was the Creator who said of Adam, “It is not good that man should be alone.” We were not made for social isolation. We were made for community. We were made for true community and that true community is grounded in the most basic molecular units of community, which is the family. Behind the family, though even more basic unit of marriage. That very statement, “It is not good for man to be alone,” was in the context of Genesis 2, where the scripture tells us that God then created the woman and made the man and woman for each other and placed them together in the covenant of marriage in the garden. Therefore, a man shall leave his father and mother and shall cleave to his wife and they shall become one flesh.

Of course, right after that comes Genesis 3 and the fall, but here’s what’s important in the flow of biblical theology and history. We need to recognize that it wasn’t after the fall that God said of Adam, “It is not good for the man to be alone.” It was before the fall. We were made for community in such a way that it becomes an even more urgent need after the fall, but we were made for community and for communion from the very beginning. All that is to say that we should expect that a society that marginalizes marriage and beyond marriage and beyond romance and beyond questions of gender, and sexuality, and all those confusions, continues in virtually every way to be a society that increasingly focuses upon isolated autonomous individuals.

But if Christians understand anything about this reality it is that a recipe for disaster is found in defining humanity as a mass of autonomous and isolated individuals. But Christians must press beyond this and understand that a society that is not only made up of supposedly autonomous and isolated individuals but now also of secular individuals points to a huge secular vacuum that is also incredibly dangerous. It’s dangerous to mental health. It is dangerous to the society and it’s dangerous even in questions of life and death.

Christians and Christian churches often find a discussion of suicide to be embarrassing and awkward, and furthermore, we’re always worried about the danger of speaking about suicide in such a way that it raises the issue at a very moment of vulnerability for someone who may be in a moment of spiritual or mental crisis. But here’s where we have to understand that biblical Christianity doesn’t run from the problems, it identifies that problem. Out of love of God and love of neighbor, we are driven to talk about these issues and to seek to understand them not merely so that we can have an accurate, intellectual picture of the world around us, but so that we can be sensitive to human needs which are also all around us.

If any place should be safe for Christians to say, “I’m in trouble and I need help,” it should be the church of the Lord Jesus Christ. If anyone should be a safe agent to which a neighbor or a friend can come and say, “I need help,” it should be a Christian because it’s a Christian who understands that help is indeed needed, that every single human being is indeed broken, that there is no ultimate rescue other than the gospel of Jesus Christ, and that in a broken world we’re going to see full evidence of brokenness all around us and within us. It’s also Christians who have to press even further and understand that life, every single human life is God’s gift, that God is the sovereign creator and author. He is the Lord of life and that it is an active betrayal to the creator to depreciate, or to devalue, or to take our own life.

This is where Christians also understand that a part of God’s gift of life is the gift of time, as human beings are temporal creatures. We understand that in the equation of suicide and the impulse to suicide it often in a moment a very short amount of time of extreme anxiety, or pain, or depression that suicide appears to be an option. Sometimes what we need to do is to get a person through that relatively short amount of time. But that, Christians understand, is not the end of our responsibility. Our ultimate responsibility is the gospel responsibility, but that raises another issue and that is this, do Christians sometimes also struggle with these very same impulses? And the answer is yes.

The brokenness of the world is not fully overcome in this life. Our sanctification is progressive and we should expect that every problem that we see in a secular society, every problem we see in sinful humanity will show up in the church of the Lord Jesus Christ. But this is where Christians standing upon the total authority and trustworthiness of the word of God, standing in the total power of the gospel of Jesus Christ, understand that the answer to all of these questions cannot possibly be reached without reference to a cross and an empty tomb.

The secular world is looking at these statistics with a sense of urgency and confusion. The church of the Lord Jesus Christ must see if anything an equal urgency, but our response must not be one of confusion but rather of clarity. Otherwise, as we’re looking at this Monday in June in the year 2018, the most important even on the world scene at the moment is the meeting to take place tonight in Singapore between the dictator, the leader of North Korea and the President of the United States. Thus, we can expect there will be a lot for us to think about on The Briefing tomorrow, but in the meantime, the followers, the sons and daughters of the Prince of Peace should at the very least pray urgently this day in these hours for peace.

Part III

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Aleksandr Solzhenitsyn goes to Harvard: How one man who didn’t know how not to tell the truth, told the truth in a 1978 speech

But also, as we’re thinking about these days and the heavy issues we had to discuss today, we need to go back in time to June 6, 1978. It was on that date that one of the most important speeches in American history was given. It’s a speech that given everything we’re thinking about today should be very much on our minds. The speaker was Alexander Solzhenitsyn, the Russian author and the Russian dissident who had come to the United States fleeing his expulsion from the Soviet Union just years after he had won the Nobel Prize for literature because of his courageous literature, including The Gulag Archipelago. That massive work that demonstrated the great evil at the heart of the Soviet Union and the prison camps that became the great symbol of the repression and the evil of that communist regime.

One Day in the Life of Ivan Denisovich, Cancer Ward, other works that also pointed to not only the moral evil but the spiritual vacuum of the atheistic state and what the inevitably produced in repression and in horror, in evil. As Solzhenitsyn arose to speak on June 6, 1978, he was speaking to a very rarefied audience. He was the commencement speaker and the recipient of an honorary degree at Harvard University. But what Solzhenitsyn did in that address outraged, in general terms, the faculty of Harvard University and embarrassed the university. Why? Because Alexander Solzhenitsyn, who didn’t how not to tell the truth, told the truth.

His address was entitled The Exhausted West. It was sometimes reported as A World Split Apart. He was talking not only about the polarization of the world then between the world of freedom and the world of unfreedom, the world of western democracy and the world of the Soviet bloc, he was also talking about the Western world, which he indicted as a world in decadence and decline that had settled for mere freedom over against the expense of genuine liberty and human dignity. He said that the West was the final refuge. After all, he had fled the Soviet Union from which he was expelled to the West. First, to Germany and then to the United States, but he pointed in the United States and he spoke so bravely to the faculty and graduates of Harvard University in 1978 saying that the West was not so morally superior as it claimed when the West was itself embracing a decadence and a loss of spiritual truth that would spell the end of the West as much as it eventually did also for the Soviet Union.

Solzhenitsyn made a distinctively Christian theological argument to the largely secular context of Harvard University when he said, “Mere freedom does not in the least solve all the problems of human life. It even adds a number of new ones. However,” he said,” in early democracies, as an American democracy at the time of its birth, all human rights were granted because man is God’s creature. That is, freedom was given to the individual conditionally in the assumption of his constant religious responsibility. Such,” said Solzhenitsyn, “was the heritage of the preceding thousand years. 200 or even 50 years ago,” he said, “it would’ve seemed quite impossible in America that an individual should be granted boundless freedom simply for the satisfaction of his instincts or whims.”

It was also Solzhenitsyn just a few years later who addressed the United States and the West saying that, “In the Soviet Union it was often asked, ‘How could this have happened?’ The answer,” said Solzhenitsyn, “was simple.” “Men have forgotten God,” he said, “That’s why all this has happened.” It was a similar candor that was demonstrated by Alexander Solzhenitsyn at Harvard on June 6, 1978. Harvard was embarrassed, but the truth had been told. There hasn’t been a speaker at a Harvard commencement like Alexander Solzhenitsyn since, and I think we can understand why. People who have abandoned the truth don’t want to be told the truth.