Suicide Coverage: Caution is Warranted If We’re Serious About Prevention

(Trigger warning: If you're in tender space related to suicide, grieving, recovering, or feeling vulnerable, feel free to move on.)

Cindi E Deutschman-Ruiz published a well-researched article in 2003: Reporting on Suicide.  One of the resources she used was a World Health Organization document, from which she drew these points:

  • Suicide is never the result of a single incident.
  • Details of the method or the location a suicide victim uses may lead to copycat suicides.
  • It's vital to use statistics and mental health information very carefully.
  • Suicide coverage is an opportunity to provide the public with information and resources that could save lives.

Of particular interest in the context of youth suicides after bullying, from the WHO doc (emphasis mine):

Overall, there is enough evidence to suggest that some forms of non-fictional newspaper and television coverage of suicide are associated with a statistically significant excess of suicide; the impact appears to be strongest among young people.

Repeated and continual coverage of suicide tends to induce and promote suicidal preoccupations, particularly among adolescents and young adults.

 A couple of quick points here:

  • I detest the term copycat suicide.  To me, it marginalizes the very real pain a suicide victim experienced, implying that they just wanted to be trendy. The more accurate term is suicide contagion.
  • I lost my partner Dale to suicide a decade ago, so the lessons learned which inform the following are borne of real, raw experience.

What does this mean to us as we grieve the loss of too many young lives where bullying has contributed, and press for bullying and suicide prevention?  I have more questions than easy answers, after the jump.

Never the result of a single incident

The WHO expands on the concept:

[Suicide] is usually always caused by a complex interaction of many factors such as mental and physical illness, family disturbances, interpersonal conflicts and life stressors.

This certainly isn't the way we've often acknowledged youth suicide lately where bullying has been a factor, right?

  • GLSEN refers to [name redacted by me]'s suicide due to bullying.
  • Equality Forum's press release yesterday: It is estimated that about 500 gay teens each year or 40 gay teens per month take their lives as a result of homophobia. 
  • Karen Ocamb: Another Teen Commits Suicide Because of Bullying
  • Americablog Gay: …the horrible suicide of gay teenager [name redacted] due to bullying…

I'm not picking on these good folks, as much as noting that bullying-triggers-suicide seems to be an accepted, little-questioned meme.

I'm also not denying that bullying has been a significant contributor to the deaths of youth and young adults by suicide.

But we need to ask ourselves, Is suicide after bullying distinct from other suicide?  Is there evidence to suggest that bullying is a more unitary cause or a more direct trigger than other contributors?

Checking in with experts on the evidence.'s Emily Bazelon published an in-depth piece about a young woman lost to suicide that I won't link to out of personal discomfort with investigative reporting on suicide victims.  Public health social worker Elana Premack Sandler has written about the Slate piece, though:

The truth about bullying and suicide
Why suicide is never simple

She had earlier quoted a parent whose son died in 2003:

“I want to be very clear. I don't blame Ryan's suicide on one single person or one single event. In the end, Ryan was suffering from depression. This is a form of mental illness that is brought on by biological and/or environmental factors. In Ryan's case, I feel it was the ‘pile on effect' of the environmental issues mentioned above that stemmed from his middle school life.

“We have no doubt that bullying and cyber bullying were significant environmental factors…”

While she noted:

We can't say, empirically, that bullying causes suicide.

Discussing the Slate piece, Premack Sandler concludes (emphasis mine):

As much as it's been beneficial to have [name redacted]'s story in the media as a way of raising awareness about teen suicide prevention […] and as much as linking bullying to suicide helps both kids who are bullied and kids who are suicidal, the simplification – that bullying was the cause of [redacted]'s death – has been a problem for suicide prevention. Suicide as an outcome is never simple.

The evidence-based answer

So, we've got a painful, uncomfortable, answer to the question: Suicide after bullying is not something set apart, simpler, or more easily prevented than suicide in general.  In fact, while increasing awareness of bullying and suicide is helping, some of the most vulnerable in our families and communities may be harmed by the use of an oversimplified bullying-causes-suicide meme.

My perspective as a layperson

I wrote yesterday from a more personal, less evidence-based POV at my blog.

One of my observations as a SOLOS (Survivor Of a Loved One's Suicide) is that distorted thinking seems to be an essential contributor to suicide.  And, one of the common distorted thoughts of suicide victims is that dying by suicide will serve a greater good than living would have.  It strikes me as essential, when we're talking about suicide and bullying, to call this out as false. As Deutschman-Ruiz wrote in 2003:

Suicide is not a rational act.  It is an act of desperation, carried out after a monumental struggle.

In the middle of the monumental struggles of many more than those we have lost to suicide, it seems to me we need to be thoughtful about how we memorialize victims.  (I consider suicide victims to be primarily the victims of mental illness, complicated by other factors.)  While we do everything possible to honor them and draw strength and motivation to eliminate bullying and promote good mental health, it's crucial that we're not inadvertantly contributing to the already-distorted thinking of other folks of any age who are suffering or living with despair.

One layperson's language preferences

Where do we go from here?   I don't have easy answers.  I'm not a journalist or a suicide expert.  I don't want to see a new wave of politically-correct language police rise up and nitpick writings on suicide.

So, my preferences don't carry any more weight than the thoughts of one guy who has a heart for youth and adults who are struggling.

But, here they are:

  • De-couple bullying and suicide.  At best, describe suicide as following bullying, or where bullying appears to have been a factor. Retire the word bullycide permanently.
  • Minimize/downplay suicide methods.  The death indicates severe desperation was at play; the choice of method neither adds or subtracts, and talking it up may contribute to contagion.
  • Drop “committed.”  People commit to jobs or relationships, or commit crime or heroic acts. Saying that my partner Dale died by suicide states the fact without judgment.
  • Honor the victims' lives: We needed you with us longer. We would change it if we could.  Speak to them as we would those who are still with us but struggling.
  • Empathize with families and loved ones: We cannot imagine your pain.
  • Take responsibility: We, as your community, may have failed you in some fashion, given the collapse of your mental health.
  • De-couple memorializing and advocacy: Use limited photos and details when expressing condolences or memorials; swap in statistics and evidence whenever workable while pressing for change.

LGBTQ communities have a terrific opportunity related to suicide.  Like awareness of HIV and open, nonjudgmental discussion of sexual health issues has exploded because of our communities' legacies, we have an opportunity to promote awareness of comprehensive mental health. Coming out, surviving, and thriving had propelled a lot of us to get evidenced-based mental health care.

It's time to continue dismantling stigma and stereotypes by promoting the fact that comprehensive mental health care saves lives.

Pam’s House Blend – Front Page

—  admin

SLDN advises caution despite Pentagon announcement; Dan Choi attempts to re-enlist

Despite the Pentagon’s announcement Tuesday that military recruiters have been told they must accept gay applicants, the Servicemembers Legal Defense Network continues to advise caution.

“During this interim period of uncertainty, service members must not come out and recruits should use caution if choosing to sign up,” SLDN Executive Director Aubrey Sarvis said in a statement Tuesday afternoon. “The ‘don’t ask, don’t tell’ law is rooted in any statement of homosexuality made at anytime and to anyone. A higher court is likely to issue a hold on the injunction by Judge Phillips very soon. The bottom line: if you come out now, it can be used against you in the future by the Pentagon. As the DOJ fights to keep this unconstitutional and oppressive law, we are monitoring active-duty clients’ cases and fielding calls every day to our hotline. Given the uncertainty in the courts, we urge the Senate to act swiftly next month on repeal when they return to Washington.”

Of course, if you’ve already been discharged for being gay, you don’t have much to lose. Among those who plan to try to re-enlist in the wake of the Pentagon announcement is Lt. Dan Choi, according to his Twitter feed:

—  John Wright

Some radical ideas about the DADT ruling

This week, a federal court judge issued an extreme ruling regarding “don’t ask don’t tell”: An injunction, forbidding the U.S. military from enforcing the policy worldwide. As part of the ruling, she gave the government up to 60 days to appeal. Attorneys for the Log Cabin Republicans, which brought the lawsuit, have counseled caution, discouraging servicemembers from coming out.

Now, it’s been a long while since I practiced law actively, but I have some ideas radical ideas about how those in the military should approach this ruling.

COME OUT NOW. I know the LCR doesn’t think it’s a good idea, but here’s the thing: It is, for now, the law. Just like years ago, when San Francisco and New Paltz, N.Y., declared they would recognize same-sex marriages and performed dozens of them, the act itself has repercussions. The courts had to decide the legality, but in the interim, who could say they were not legal?

Relatedly, everyone who got married in California after same-sex marriage was allowed but before Prop 8 was passed were deemed to be legally and forever married. Those unions were not negatively affected from legal recognition by Prop 8. I would argue that anyone who does come out in reliance on a federal ruling cannot later be discharged, anymore than someone who drives 30 mph can be given a ticket a year retroactively later when they change the speed to 25.

It also provides the Obama administration with political cover. Obama claims to want to discontinue DADT, but is relying, disgustingly, on some bullshit “study” before acting. (The details of that study offend me to the core, as it will evaluate such things as whether gay troops should be given “separate living facilities” or whether the other servicemembers will be “OK with it.” Since when did the military care what grunts think, or act like a democracy? What if a soldier is gay but doesn’t want to come out — should he be forced to so he can be segregated in the pink barracks? It’s really very easy: The ruling should be “gay troops are no different than any others; effectively immediately, they are treated identically.” So if they wouldn’t do something for single gays or gay couples they do for straight singles or couples, don’t do it.) But Obama does not have to appeal the ruling; he shouldn’t. Let the courts decide it for him. Continue on with the legislative agenda just in case, but don’t appeal the ruling.

HOLD OBAMA TO HIS PROMISES. I mean this in the most threatening way possible. If the Obama administration does appeal the ruling, I personally will do everything in my power to throw my support to someone else. If a black man who is president cannot stand up for minorities and keep the promises he made the gay community as a candidate, he does not deserve my financial support. Or my vote. This is a test, Brarack: If you fail it, do not expect to get extra credit from me.

I know there are many out there who’ll say, “you’d prefer a Republican over a Democrat in the White House?” No. But I know this: If my rights are trod by someone who doesn’t have the political will to respect me, I don’t care what political party he or she is a member of. Keep in mind: DADT and DOMA were signed by Clinton; the first sitting president to express any support for civil unions for gays was W. (Granted, W did it in the context of opposing marriage, but Clinton never came out in favor of it, and even counseled John Kerry in 2004 to come out against civil unions! “The gays will forgive you and it might help you win,” he supposedly said. Shameful.)

We are at the brink of huge changes in the law and recognition for gay rights at a level I could not have conceived when I was a college student. This is no time to back down. This is the time to fight. Bloody some noses. Shame people into acknowledging their own bigotry. Because I assure you, in 50 years, public high school students will look back on how the current culture treated gays with the same puzzled disgust that we look on Jim Crow laws. Orville Faubus and George Wallace were probably more popular in public opinion polls in their day than Rosa Parks and Martin Luther King Jr. And how many streets have you seen named after Faubus and Wallace?

This is the time to create our heroes, our Rosa Parkses. Don’t shy away, guys. Don’t go to the back of the bus. Come out and say “In accordance with a federal order, I am saying I am gay. What are you gonna do about it?” Because right now, they can’t. And even if they can down the road, they will appear vindictive to discharge those with the courage to come out later.

Obama pledged change we can believe in. We’re ready for the change, Mr. President. Keep your word.

—  Arnold Wayne Jones