Background: In the West, beginning in the early 19th century, the belief was published that suicide was always, or almost always, the result of a mental disorder (a medical problem). This belief became established wisdom when psychological autopsies commenced in mid-20th century. However, should this belief be inaccurate, our suicide prevention strategies, which are currently medically orientated, need to change.

Aim: To argue the case that metal disorder is not always, or almost always, the cause of suicide, and that suicide may be triggered by a host of other factors.

Method: The scientific basis of psychological autopsies and the practice of medicalization were explored. The opinions of non-medical experts were explored, including philosophers, historians, sociologists, economists and ethicists, among others. Epidemiology of rates in different countries and gender differences were examined for evidence.

Conclusion: Suicide is not exclusively a medical problem. While suicide is more common in people who have a mental disorder than people without a mental disorder, mental disorder is not a necessary condition. Thus, open discussions about the nature and causes of suicide are required, with a view to involving experts from a range of fields, and the general community, in developing and funding suitable prevention strategies.