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I’m as surprised as you are that the author doesn’t believe in impulsive suicide. For me this explains why restricting access to lethal means reduced suicide rates https://www.ncbi.nlm.nih.gov/pmc/articles/PMC478945/pdf/brjprevsmed00022-0018.pdf

I’m also skeptical that suicide risk in the elderly is related to repeated suicide attempts over a lifetime. Anecdotally, when I have seen serious suicidal acts in elderly people, these have occurred ‘de novo’ in people without much psychiatric history.

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I think the elephant in the room is completely ignored, and the author comforts himself with over-rationalisation. The elephant in the room is that suicide rates has risen ONLY in the USA. It has decreased in every other developed country, and even in undeveloped countries. The author should look what makes USA culture unique that it predisposes people to suicide.

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