Hope Always: How to Be a Force for Life in a Culture of Suicide

by Matthew Sleeth

Every single day, someone you know is thinking about committing suicide. It isn't just one or two--ten million Americans will consider killing themselves in the upcoming year. Dr. Matthew Sleeth believes Christians--and our churches--should be the first to offer hope. Are we prepared to do so?

As a physician and minister, Dr. Sleeth shares his personal and professional experiences with depression and suicide, challenging Christians to become part of the solution. With sound medical principles finding their rightful place beside timeless biblical wisdom, Hope Always offers the practical and spiritual tools that individuals, families, and churches need to help loved ones who are stressed and struggling.

In Hope Always, you will find
research-based and scientifically grounded information about the suicide epidemic,
biblically based information to start a conversation about the spiritual and emotional battles that so many of us face, and
a practical toolkit to consult when a loved one is dealing with suicidal ideation.

Genres: Nonfiction, Counselling, Christian, Theology, Faith, Psychology, Religion

224 pages, Paperback

Published May 4, 2021

About the author

A former emergency room physician, Dr. Matthew Sleeth felt like he was straightening deck chairs on the Titanic, saving one patient at a time while the whole ship (Earth) was going down. Together with his wife and two teenaged children, he began to bring his lifestyle in line with his values, cutting back on their fossil fuel by two thirds and electricity use by nine tenths.


Following a new calling, Dr. Sleeth resigned from his position as chief of the medical staff and director of the ER to teach, preach, and write about faith and the environment throughout the country. Dr. Sleeth is a graduate of George Washington University School of Medicine and has two post doctoral fellowships. He is the author of Serve God, Save the Planet: A Christian Call to Action (Zondervan), the introduction to the Green Bible (HarperOne), and will release a second book, The Gospel According to the Earth: Why the Good Book Is a Green Book (HarperOne), in fall of 2009. He is currently the executive director of Blessed Earth.

Reviews

[Heather · Rating 4 out of 5]

4.5 ⭐️’s — I teared up multiple times reading this mostly because of how the author talks about how the church must be a place of refuge for people who are depressed/have a mental illness/are suicidal. I resonated with it so much. The gospel is woven so well throughout.

[Dani · Rating 4 out of 5]

A good starting point for talking about suicide and mental illness from a compassionate, Bible- and medical-supported perspective. Definitely not an exhaustive resource, but far better than silence or shame.

[Nick · Rating 5 out of 5]

Practical wisdom and highly readable. Dr. Sleeth has written an important book that more Christians should read. With nearly 1.4 million suicide attempts each year, we cannot ignore this crisis or overlook the warning signs. I only wish I had read it sooner.

[Susan C · Rating 1 out of 5]

This book came into my possession through my sister. Someone gave it to her, claiming that the author was a good friend of his and that he helped write this book. I checked for an acknowledgments section to verify this person's claim. However, there isn't an acknowledgments section. Sleethe only briefly thanks the depressed and suicidal people he interviewed in the introduction. No thanks to any of the usual suspects: editor, agent, publisher, research assistant, family, pastor. Nothing. That should have tipped me off.

First, let me lay out what is good about this book. There is a chapter on speaking to a loved one who may be suffering from depression and suicide ideation that someone who has never been through such training would find helpful as a starting point. He also lays out a clear presentation of the gospel.

To list all my issues with this book would result in a review longer than the book itself. And in the interest of full disclosure, I must state that after reading the first 8 chapters, I got to the point where I could only skim the final two.

The handling of scripture is sloppy. The author does not exegete the meaning out of a passage, and thus often misses the point. Eisegesis of passages is common, forcing suicide in where it doesn't exist. For instance, just after clearly articulating that intent to die is determinate if a behavior is suicidal (this is true), the author makes the claim that Adam and Eve attempted suicide by eating the forbidden fruit. "They did the one thing they knew would kill them." Genesis 3 makes it clear that their intent was NOT to die, but to be like God, a crucial detail that Sleethe conveniently ignores in order to support his opinion that suicide is a sin as old as humanity. He doesn't go so far as to say suicide is Original Sin (at least not in the first 8 chapters), but one would be forgiven for drawing that conclusion. In my estimation, this is the most egregious of his scripture bungles, especially since the rest of his book is built on this premise. But it is by no means the only one.

Many of the depression remedies/preventions presented are quite shallow. Read the bible, pray, exercise, and get adequate sleep? So exactly the good habits I had established long before depression descended on me AND that I continued once it did? There seems to be little to no acknowledgement that to even a moderately depressed person, the tasks of self care are often insurmountable. This is especially true when a depressed person is responsible for the care of other humans. I have to get dressed AND see to it that the two depressed teens in my care do too?

Which brings me to the "Life Continuum Scale." It's a subjective scale, meant to show the overall direction of one's life. The thing is, you can develop an ambivalence about your own life while still willingly and even joyfully serving others. I spent several years living at both a -6 and a +6, and in speaking with a couple dozen people, I found that isn't uncommon. The scale is so subjective that it is of very little value. Also, the assertion that therapy only strives to bring a person up to zero is false. That wasn't the case in my own therapy, nor in that of any of my family members and friends. In fact, my step-sister who is a therapist called such an approach malpractice.

This book isn't even enjoyable to read. The writing style is erratic. Topic sentences of paragraphs are routinely left unsupported. Paragraphs within a section often don't relate. And don't get me started on tangential details that an editor should have cut. These side bars consistently interrupted the flow. And woven throughout the entire book is the author's pride. Suicide prevention is not Sleethe's specialty. As far as I can tell, he has never worked in psychology, psychiatry, or even soul care ministry. His only experience with suicide prevention is in lifesaving after an attempt has been made. While there may be some value in that, there are far more knowledgeable experts on the subject of prevention long before it gets to that point. Why not collaborate with one of them?

[Abby · Rating 5 out of 5]

This is a very good starter book for helping others struggling with depression and suicidal ideation, from a Biblical perspective. This book was quite refreshing in that it was both medically sound and Biblically so, and included in appendices further resources as well as music and book recommendations (fiction and nonfiction) for hope in dark times.

[Heather · Rating 5 out of 5]

True to form, Dr. Matthew Sleeth has written another powerful book that both clergy and laypersons can easily understand on a difficult topic. As a former medical doctor and student of the Bible, Sleeth combines his expertise to create a sturdy foundation on which to build practical applications to tackle a “culture of suicide.”

With another look at familiar characters in the Bible, you will see the nuances when dealing with suicide. Sleeth has given us a toolbox to help others (or ourselves) identify the immediacy in which to act to prevent the loss of life. This is not a book that suggests if you pray hard enough your mind will be healed or if you’re a good enough Christian that feelings of depression and suicidal thoughts will go away. This book tackles the brokenness within the world and humans. It goes through many mental diagnoses in order to educate about what some people are dealing with. He believes that a mental diagnosis should be treated like a physical diagnosis. Just as a person may share a physical diagnosis to be lifted up in prayer, persons should feel as comfortable with sharing a mental diagnosis.

Hope Always gives you the questions and actions to practice and be prepared for when you encounter a depressed or suicidal person. They can’t wait for you to research “how-to” or look up phone numbers for hotlines. Get those things in order before you need them. It’s matter of life and death.

[Ann Gemmel · Rating 5 out of 5]

Grateful to Matthew Sleeth for this timely book. The first part he presents a compelling and likewise alarming assessment of just how severe of a mental health crisis our nation (and world is in) and how Christ followers and the Church needs to be on the front lines of countering and caring better as to the current suicide pandemic we are in.
From his years of work as an emergency room physician - Sleeth brings a unique vantage point and is not afraid to address the issue from a strong biblical perspective. This is a book Christians need to read and seek to implement in their own spheres of influence. Too many are suffering and we cannot look away and relabel it “life choice”. Each life is too precious. I plan to give this book to many - such an important message!
I am grateful to NetGalley for an ARC. My opinion is my own.

[SarahEmily · Rating 1 out of 5]

I think he means well but no. Just no.

[Kyle Inman · Rating 4 out of 5]

This one is so close to 5 stars, but alas, I found it just isn’t as applicable as some of Sleeth’s other books. That being said, this is a great resource for so many reasons.

For starters, I love that Sleeth doesn’t dodge the centrality of religious belief as the building block for everything else. While this will certainly cause many to turn up their noses before giving the rest of the book a chance, I think the honest reader will be able to hear the case he’s making; namely, if you believe you’re just a cosmic accident, you are much more likely to undermine the value of life, including your own. I’ve been a Christian well over a decade now, and I can’t honestly say I’ve ever heard anyone make a good case for suicide being a sin issue which faces ridicule. In typical Matthew Sleeth fashion, he won me over. To be clear, I’ve always been an advocate for life, but I’ve felt myself (with the culture) begin to view it as much more of a moral grey area, something to sympathize with rather than criticize. I feel like crying even giving voice to that now! Sleeth gives historical examples of cultures keeping people alive by being in loud opposition to suicide, as well as the numbers (on that note, if you’re an analytical mind, Sleeth will absolutely scratch that itch for you!) to back it up. This book will leave you itching to get out there and (proactively rather than reactively) save a life! If there’s one thing I’d have liked him to touch on more, it would be on how to navigate conflict with the victim when they begin to distance themselves from you after you try to get the hospital involved. Getting the hospital involved is the primary suggestion given, and I found the alternatives lacking, which is especially problematic seeing as how that’s the main issue I’ve had to navigate with my suicidal friends.

Okay, I’ve rambled enough. This is a good book and you should read it. :)

[John · Rating 3 out of 5]

Matthew Sleeth’s “Hope Always” addresses an important topic: the serious epidemic of suicide. He writes primarily to those struggling with suicide and does so through an unapologetically Christian perspective. I don’t know another book quite like Sleeth’s and am so grateful he wrote it. It’s important we have resources for those struggling with suicide and for those walking alongside them.

Sleeth is at his best when he is helping frame the significance of the issue, explaining how the statistics are bad, but even worse than they look (because of the fact that modern medicine saves many lives). I also appreciated his perspective as an ER doctor. In fact, I wish he would have shared a bit more from this perspective.

While Sleeth spends a fair amount of time in scripture, I don’t think this is the strength of the book. He lacks nuance at times and a few times I think he mishandles the passage a bit (his interpretation of Samson is a miss, for instance).

I’m addition, while Sleeth says the book is for those wrestling with suicide, he seems to spend a fair amount of time (maybe even more?) speaking to pastors. On this count, he’s fairly weak. Like “Reforesting the Faith,” Sleeth harps on how rarely pastors preach on suicide and how litte seminary training they receive. Coming from a non-pastor, it’s frustrating to have Sleeth level these accusations. I’m not diminishing Sleeth’s interests and projects, but he seems to get tunnel vision and not understand the breadth of the role of the pastor nor a grounded philosophy of preaching (for many of us, we have expositional convictions which mean we primarily preach through biblical texts, not topically).

I’m short, I’m grateful for Sleeth’s book, but am hoping for an even better resource to come around on the same subject.

For more reviews see thebeehive.live.

[Manette · Rating 5 out of 5]

Suicide is becoming so prevalent in this age most people are touched by it either directly or indirectly. I buried a son to suicide and six years later my husband. That gives me an insight I hope that no one else has to see.

I read a review of this book in a blog and quickly ordered it. When the book arrived I read it from cover to cover in two sittings. The author, Matthew Sleeth, is a former emergency room physician and chief of the hospital medical staff. He shares stories from his experiences and his knowledge from the medical field. He does so in easy to understand language. There is no need for intimidation he speaks with ease to every reader.

Personally, I think this should be a primer for every pastor, doctor, counselor, teacher, coach, and lay person who considers themself a Christian. There are good tools and resources presented in this book. We live in a world where many are feeling hopeless. Please, be a conduit of hope to those around you. Read this book to be aware and ready should someone struggling with depression touch your life.

A quote from the book:
“Every Christian needs to be prepared to help save a friend who is over their head in the sea of depression.”

[Amy · Rating 4 out of 5]

In this book, Dr. Matthew Sleeth presents his argument for why suicide is a sin, and how we can help prevent suicide in those around us. As a physician, Sleeth presents the most helpful ways to engage those around us who may feel depressed or the desire to end their life in conversation, to get them help, and the most helpful things to say to encourage them to get help.

I appreciated how well thought out Sleeth presented his Biblical arguments for why suicide is a sin. While I can wholeheartedly agree with the assertion that suicide is a problem, I'm not sure I fully buy into the assertion that it is a sin. Some of his arguments were hard for me to accept right out. This was the first time I'd ever heard someone speak to specific stories in the bible in terms of suicide. It's definitely given me much to think about and consider.

I received a copy of this book from the publisher and NetGalley. This review is my own, honest opinion.

[Cathy · Rating 4 out of 5]

This book is a good resource for a lay person who might encounter people who are depressed or suicidal. Although it's not a comprehensive text, Dr. Sleeth offers both biblical AND scientific ways to offer hope and encouragement to those who seem to have lost all hope. I am happy to add this book to my knowledge base, and I expect that I will return to it from time to time. I wish that this book had been available when I went through my Stephen Ministry training many years ago. This text would supplement the Stephen Ministry curriculum well.

[Jeff Bobin · Rating 4 out of 5]

Written by a doctor with emergency department experience and that has done research into suicide there is a lot of excellent information here.

I found the stories he shares most helpful in thinking through the many issues around suicide in our culture. While many illnesses are publicly addressed the mental health issues aroud suicide are often kept secrete and that has impacted the data around suicide.

The two chapters at the end for pastors and churches I found very weak and not particulary helpful as a pastor.

This will help prepare you for dealing with a suicidal person.

[John David · Rating 4 out of 5]

I HAD THE PRIVILEGE OF HEARING DR. SLEETH GIVE A TALK ON THE TOPIC OF SUICIDE RECENTLY. I WALKED OUT OF THAT TALK WISHING EVERYONE I KNEW COULD HAVE BEEN THERE...

NOW I CAN RECOMMEND THIS BOOK INSTEAD. SUICIDE IS A VERY HEAVY TOPIC, BUT I AN INCREASINGLY PREVAILING SITUATION THAT WE OUGHT TO TALK MORE ABOUT. IF DR. SLEETH IS RIGHT, OUR CULTURE WILL SOON NOT ONLY ACCEPT SUICIDE, BUT WELCOME IT.

THIS BOOK OFFERS SO MUCH WISDOM ON HOW TO ENCOURAGE THOSE WRESTLING WITH DEPRESSION AND SUICIDAL IDEATIONS, AND I CANNOT RECOMMEND YOU READ IT ENOUGH.

[Stacie Ange · Rating 4 out of 5]

“No man is an island, entire of itself; every man is a piece of the continent, a part of the main. If a clod be washed away by the sea, Europe is the less, as well as if a promontory were, as well as if a manor of they friends’s or of thine own were. Any man’s death diminishes me, because I am involved in mankind.” - Donne

This book was more an overview of mental illness that leads to depression and suicide which by default leaves nuggets of truth for those fighting the battle themselves. It was, however, written from a biblical perspective and pimarily for people of the church.

[Laura Fincher · Rating 5 out of 5]

This book by Dr. Sleeth is a great resource for all Christians. It discusses some of the biblical theology behind why suicide is wrong and then also goes into many mental health reasons as to why people feel isolated or suicidal. It finishes with some practical solutions for lay people, pastors, and churches. I feel more comfortable talking about this topic with somebody that might be struggling with this issue after reading the book.

[Melissa Ried · Rating 5 out of 5]

This is an incredible book that I encourage everyone to read. It is a sad reality that at some point in our lives, we may encounter someone who is suicidal. Reading this book is a great way to prepare for that situation, because it will be a matter of life or death. Dr. Sleeth provides a well-written guide to being a force for life in a culture of suicide.

[Ashton E. · Rating 5 out of 5]

Wow I think Sleeth made so much clear to me about how God is for life. I love the life continuum scale going all the way to sacrificial love rather than stopping at desire to live.
“Surgeons can’t begin to heal us unless they first cut us open” he talked about the importance of taking suicide seriously rather than sensationalizing it in media.

[Barbara · Rating 5 out of 5]

This is the second book I've read by Matthew Sleeth. While I don't always agree with him 100% theologically, his writing is fascinating and informative. If you are concerned about the rate of suicide in this country, want to be encouraged to be a force for life, or just want to learn about the issue, this is a great place to start.

[Dennis Bryan · Rating 5 out of 5]

An Informative Christian Resource

The author has an extensive medical background as a physician with real-world experience on the front line in the emergency department. Good for both Christian and secular counseling.

[shannon dunn · Rating 5 out of 5]

I will read anything by Matthew Sleeth and love it, but if suicide has touched your life in any way, you will want this book. Written with such wisdom and grace, I appreciate someone writing a book that offers real help to hurting people and those that love and care for them.

[Gina Cummings · Rating 3 out of 5]

Listened on audio. Interesting writing about suicide. There are a lot of takeaways from this book.

[Alexandra Medina · Rating 5 out of 5]

This was a great starting point for those in the church who want to confront the issues of depression and suicide. It was both gentle and straightforward with a number of practical resources.

[Dan Nale · Rating 4 out of 5]

A thoughtful and compassionate look at suicide.

[Ursula · Rating 3 out of 5]

My church had him come and speak. Didn't get to listen to the sermon that he gave but I at least enjoyed the book.

[Maddi · Rating 3 out of 5]

3.5

[Angie Mccarty · Rating 4 out of 5]

This book talks honestly about suicide and is written from a conservative theological standpoint.

[Kayla Guthrie · Rating 1 out of 5]

Dnf

[Caryn · Rating 5 out of 5]

A great resource for pastors and churches in suicide prevention