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Archive for the ‘excess suicides’ Category

It Might Get Better

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It is dishonest and cruel to prime children to expect better things from the future than the future in fact holds.


From itgetsbetter.org:

Many LGBT youth can’t picture what their lives might be like as openly gay adults. They can’t imagine a future for themselves. So let’s show them what our lives are like, [sic] let’s show them what the future may hold in store for them.

The It Gets Better Project is a creative, non-coercive suicide prevention project directed at gay youth, who are at a highly elevated risk for suicide attempts. Folks are invited to make a pledge:

Everyone deserves to be respected for who they are. I pledge to spread this message to my friends, family and neighbors. I’ll speak up against hate and intolerance whenever I see it, at school and at work. I’ll provide hope for lesbian, gay, bi, trans and other bullied teens by letting them know that “It Gets Better.” [Bolded emphasis mine.]

Dan Savage, the creator of the project, says:

‘When a gay teenager commits suicide, it’s because he can’t picture a life for himself that’s filled with joy and family and pleasure and is worth sticking around for,’ he declared.

‘So I felt it was really important that, as gay adults, we show them that our lives are good and happy and healthy and that there’s a life worth sticking around for after high school.’

I find many things to be supportive of here:

  • It acknowledges how sucky life is for many gay kids;
  • Non-coercive methods are advocated;
  • It’s pro-gay and pro-freedom;
  • It’s kind of heartwarming and encourages people not to be ashamed of something it’s stupid to be ashamed of.

However, as much as I approve of these aspects of the project, I would not be able to make the above-printed pledge. “It gets better” is an empirical statement, and it is one I don’t think can responsibly be made so unequivocally. I think there is a great deal of evidence that it does not, in fact, get better. It is dishonest and cruel to prime children to expect better things from the future than the future in fact holds. We do it, I think, to feel better about the wrongs we allow or commit against children, both as parents and as a society that can only function with a high rate of reproduction. We are here told to tell the gay kids and the bullied kids that it gets better. But what we need to ask first is: does it get better?

For Kristin and Candace Hermeler, the Australian twin sisters who attempted to carry out a suicide pact (with limited success) in Colorado, “it” does not seem to have gotten “better.” An article in the New York Times indicates that the 29-year-old sisters were bullied as children, and chose to die at a shooting range in Colorado because of its proximity to the site of the Columbine massacre. For the Hermeler sisters (no word on their sexual orientations), being bullied in high school was not, apparently, followed by a happy life of contentment and adventure. It was followed by a mutual wish to die.

One question we need to answer empirically is whether gay suicide attempts in fact decrease dramatically with age. If they do, that’s some evidence that youth is just a tough period to get through. I haven’t dug up any data either way (let me know if you find some); the only study I’ve seen found that “first attempts” tend to cluster at young ages, but I don’t think that has anything to say about later-in-life suicidality.

“It Gets Better” makes the assumption that children are committing suicide because they irrationally think life is crappy and won’t get better. Many attribute the high rate of teen gay suicides to bullying and homophobia:

Beth Zemsky, director of the University’s Gay, Lesbian, Bisexual and Transgender Programs Office, said [a 1998 study indicating an increased risk of suicide for gay youth] is consistent with previous research. She also said our culture’s intolerance of homosexuality, which can often be violent, leads many to take their own life [sic].

“Suicide attempts are often caused by the stress of a homophobic society,” said Zemsky. “The study is in line with the American Psychiatric Association. People are not killing themselves because they are gay, but because they are dealing with a society that discriminates.” [Bolded emphasis mine.]

I have never seen the evolutionary psychology side of things considered with regard to the high rate of suicide among gay kids, but that nasty idea seems to require serious consideration here, if only to make better models to understand suicide. This may help us understand why gayness is a risk factor for male suicide attempts, but not female. (Personally, I took way more crap in high school for being a cheerleader and being on the math team than I ever have for being bisexual.)

The idea that youthful suffering is short-lived is an empirical proposition. There is some evidence that as people age, their ability to cope with life’s suffering increases. But not always. If the organizers of the It Gets Better Project cared about intellectual honesty, they’d call it the “It Might Get Better Project.”

But that wouldn’t be as catchy.

Written by Sister Y

November 22, 2010 at 8:55 pm

Does Suicide Contagion Exist?

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It is commonly accepted – I have been accepting it – that highly publicized media reports of suicides cause a phenomenon known as suicide contagion. That is, highly publicized suicides function as “social proof” that suicide is an acceptable option, and people in the area of publicity commit suicide using the publicized method in greater numbers. These are sometimes called “suicide clusters” and are apparently most common among young people.

The studies that provide the basis for the phenomenon of suicide contagion are, apparently, somewhat questionable. Many suffer from lack of control for important variables; those that are controlled suffer from problems with the control groups or small sample size. Using another method, some ecological studies have indicated that the suicide contagion phenomenon is real; others have contradicted those findings.

So say the authors of a 2001 study in the American Journal of Epidemiology, entitled “Is Suicide Contagious? A Study of the Relation between Exposure to the Suicidal Behavior of Others and Nearly Lethal Suicide Attempts” (Mercy et al., Am Epidemiol Vol. 154, No. 2, 2001). These authors set out to determine the strength of the suicide contagion phenomenon – whether suicidal behavior in parents or relatives, or (separately) friends or acquaintances, or recent media reports of suicide, affected serious suicidal behavior in young people.

The study authors interviewed 153 people, ages 13-34, who were “victims” of nearly lethal suicide attempts and who had been treated at local emergency rooms in the Houston, Texas, area. A control group of 513 subjects was similarly interviewed. The conclusion? Not only did the study fail to demonstrate any sort of “suicide contagion,” but the authors note a statistically significant protective effect when a subject heard a news report of suicide within 30 days prior to the suicide attempt or had a friend or acquaintance make a suicide attempt. That is, the ER suicide-attempt group was actually less likely than the control group to be aware of a recent media report of a suicide, or to have experienced the suicidal behavior of an acquaintance! The suicide attempt of a parent or relative had no statistically significant effect on suicidal behavior, whereas the usual “suicide contagion” sources had a statistically significant protective effect – the opposite of what the suicide contagion model predicts. The authors are, of course, careful to note that more study is needed “to understand the mechanisms underlying these findings,” but it does seem that the contagion hypothesis is worth questioning. The appearance of a contagion effect may be little more than apophenia, as with news reports attributing New York physician Douglas Meyer’s jump-from-heights suicide to a contagion effect from Ruslana Korshunova’s highly publicized suicide. From the study:

In this study, we found no evidence that exposure to the suicidal behavior of others is a risk factor for nearly lethal suicide attempts. Even among groups at relatively higher risk for suicidal behavior (i.e., males, alcoholics, depressed persons, adolescents), we found no indication of an effect. On the contrary, we found that exposure to accounts of suicidal behavior in the media and, to a lesser extent, exposure to the suicidal behavior of friends or acquaintances were associated with a lower risk of nearly lethal suicide attempts; however, this appeared to be evident only when the emotional and temporal distance between the exposed individual and the suicide model was greatest. . . . Greater temporal and emotional distance between an individual and a suicide model may enable a person to more fully appreciate the negative consequences of suicide. [Citations omitted. Emphasis mine.]

Note that this study also appears to call into question the statement of a psychologist, from the story I reported in my earlier post, that suicide contagion disproportionately affects those already severely depressed. This study found no effect, even among depressed people.

Much to their credit, the authors propose a couple of alternative readings of their data:

[W]e examined the effects of media exposure over a 30-day interval, in contrast to most prior studies, where media effects were examined immediately after exposure. It is possible that media exposure has its greatest impact on suicidal behavior immediately after the event and that its effects are diluted or even reversed as time passes. Alternatively, it is possible that suicide attempters may be more socially isolated than other groups and are therefore less likely to be exposed to suicide models in their social networks or in the media. [Citations omitted.]

Written by Sister Y

July 2, 2008 at 11:52 pm

Suicide Contagion, "Impulsive" Suicides, and "Excess" Suicides

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The work of sociologist D. P. Philips, and researchers after him, suggest that the suicide rate rises after the media widely publicize a suicide. (In addition, in a related phenomenon, the rate of automobile “accidents” and airplane “accidents” rise in the wake of a highly-publicized suicide, as well.) This phenomenon is known as suicide contagion, or the Werther Effect. Philips noted that the rate of suicide after a well-publicized suicide rises substantially for a few days to a week after the suicide, then falls back to normal levels – though not below the baseline level. This is taken as evidence that the suicides that follow a well-publicized suicide are “excess” suicides, needless suicides that could have been prevented and, by implication, should not have happened. (For an excellent popular description of this line of thinking, see chapter four of Robert B. Cialdini’s book Influence: They Psychology of Persuasion, the chapter on “social proof.”)

This idea of “excess suicides” is related to a widely-accepted notion in psychology circles, that of “impulsive suicide.” Impulsive suicide, the story goes, occurs when someone not fully committed to suicide by rational investigation commits suicide on an impulse, perhaps in response to a difficult life event (or to a news story about a suicide). The idea that some suicides are “impulsive” and, therefore, should be prevented, is rarely challenged.

It is my view that most people, non-suicidal themselves, have very little idea of the thought processes of a suicide. I explored in an earlier post one cognitive bias that might contribute to this. Based on this, I wish to explore the implicit model of the “good” suicide, that is, one accepted to be inevitable and non-preventable, as distinct from the “bad” suicide, one that is impulsive, ill-considered, and preventable. It is my belief that many suicides that appear to be impulsive and preventable (in response to life stresses, for instance) are actually well-considered suicides where the suicide needed an extra push to overcome improperly-placed practical barriers to suicide.

The idea of “excess suicides” or “impulsive suicides” implies, ipso facto, that some suicides are inevitable, and even well-considered and rational. (Note that this is farther than most people espousing an anti-suicide viewpoint are willing to go, at least explicitly.) Some suicides, on the other hand, are poorly-considered products of impulse, irrational, and by their nature preventable. A certain rate of suicide is inevitable, the argument goes, but some suicides – the “excess” suicides, the “impulsive” suicides – can be prevented, and preventing them is good, an end we should actively pursue.

This model presumes that the current set of barrier in place to prevent suicide – barriers for accessing prescriptions drugs or guns, or lack of information and education about how to successfully commit suicide – are set at an ethically ideal level. It ignores the possibility that it might be ethically superior to remove those barriers and raise the suicide rate to the natural rate – that is, raise the suicide rate so that it achieves parity with the percentage of people who genuinely want to die. Meanwhile, people who can’t bear, under normal circumstances, to overcome the barriers to suicide (set somewhat arbitrarily) – people who won’t or can’t shoot themselves in the head, slit their throats, or suffer the pain of poisoning with inferior poisons – genuinely want to die, and can’t. They live with their decision, but also live with feeling of ambivalence regarding their choice, since they can’t bring themselves to die in ways available to them. I would denote these people “would-be suicides.”

Would-be suicides, however, often wait in hope of a personal stress to push them over the edge and help them suffer the pain of overcoming the barriers arbitrarily placed in their way. A would-be suicide might wait for years for a personal tragedy to push him over the edge and give him the courage – the “push” – to slash his throat or jump from heights. A news report of a famous suicide might function in the same way as a personal tragedy or stress – pushing the well-considered but practically inhibited suicide toward a much-desired death.

We must recognize, above all, that many in our number deeply and genuinely desire death. The numbers of the “excess suicides” and “impulsive suicides” give voice to the number who desire death, but cannot, under normal conditions, achieve it.