A suicide epidemic

When I first drafted an idea for this article, there had been widespread comment about 12 suicides of young people in and around the small Welsh village of Bridgend within the year. As I began researching it, a 13th occurred. The current total, as I finish this piece, is 17. Something is happening. But what, and what can we learn from this?

The facts
First, the facts. Bridgend is a small, former mining town, with a population of under 40,000. There's a high level of unemployment, and the suicide rate has tended to be a bit above the national average.

But the victims in this rash of suicides seemed to have known each other, and some had posted pages on the Facebook-style website Bebo. Six seem to have had possibly recognisable motives, and are not known to have known each other. For instance, one (26) hung himself after breaking up with his girlfriend, and another (19) had been convicted of drink-driving and assaulting a policeman.

More worrying were those who knew each other, who had absolutely no apparent reason for killing themselves, and who left no suicide notes. The proportion who used hanging is unusually high.

In January 2007, DC, 18, hanged himself in a deserted warehouse. In February, DD, 19, his friend hanged himself. A week later, TD, 20, a friend of both lads, hanged himself in a park. In August, 17-year-old ZB hanged himself: he, too, knew the earlier victims. In December, LC, a friend of DC, was found hanged in a park. GM, 27, LC's friend, died in January this year. NR, 17, another friend, hanged herself the same month, two days after posting a tribute to him on her Bebo page. In February, NP, 15, was declared dead after a suspected suicide, and only hours later his cousin, to whom he was close, KS, was found hanged. One of her Bebo pages contained tributes to three of the other suicides in this group. Later in February, JP, 16, a close friend of at least one of the others, was found hanged.

The victims had less than compelling problems, and gave no warning. The mother of TD, who apparently hanged himself with a "Tarzan" rope he'd found on a tree in the park, showed no premeditation. That morning he'd got out his best trousers to attend the funeral of DD, and left a message that he'd see his mother later. The mother reported that she'd said: "You wouldn’t do that to me, would you? Kill yourself like those two boys?" and that he'd replied: "I love you too much for that, Mammy." He'd had problems looking for work, and had some previous troubles with the law, but no immediately pressing crisis.

Internet memorials
The role possibly played by the internet has caused concern. For instance, within hours of the death of NR, a site appeared, dedicated to her, containing pictures, poems and tributes. It attracted some 3,000 visits in the first days. A sample entry reads: “Love you loads your a star && always well be 4eva xx.”

Some suggested that in some macabre way some young people might think it "cool" to have a memorial website, and feel it gives them a measure of prestige. Exploring some of these sites, I am struck by the extent to which they attract messages of praise and love, even from people in distant lands who cannot possibly have known the individual. And the deceased are often described as "angels" and are in some way expected to continue to be present.

There was concern that some unhappy kids might use social networking sites as a way to gather and share their gloom virtually, and maybe receive a degree of encouragement towards suicide, even if not explicitly stated.

This situation led to widespread alarm and demands that something must be done about it, without any clarity as to what was needed or useful. Such sad events can happen, anywhere and at any time, and have occurred throughout history. A group of three young schoolfriends in Northern Ireland killed themselves last year in a suicide pact; and there have been similar groups of suicides in the US and Japan.

A cluster, not an epidemic
This is not an epidemic in the sense of a contagion that can spread and infect almost anyone. And some of the explanations put forward so far have been just plain daft.

Witchcraft is not involved, nor is any sinister plot or general malign influence of social networking sites. There is no evidence, thus far, of a "suicide pact" in which a couple or small number of people mutually agree to commit suicide and do so at around the same time. This is a higher than expected number of suicides within a particular small area and within the space of a year, with a larger than usual number of those affected knowing each other.

That most have chosen hanging as the method is curious, and suggests that apart from relative inaccessibility of other methods, there does seem to have been a strong mutual influence within this community. And from what we know, it is unusual that everyone in this group ended up dead, with no survivors we know of. What does seem to have happened is a cluster of suicides, showing features of psychological contagion.

"Putting the idea into his head"
One of the families, in an inadvisable press conference, foolishly implied that the press is to blame for "putting the idea of suicide" into their son's head. Nobody of any sense has failed to realise the possibility of suicide, and most of us have contemplated it at times, even if we had no intention of acting on the thought. Nobody ever hears in the media of a suicide and thinks to themselves: "What an interesting and appealing idea - I shall do that this afternoon!"

It is quite possible that these youngsters knew each other and communicated in part through social networking sites, but if so, this was merely a convenient way for them to do so. Most lived near each other, and could just as well have made direct contact - though perhaps the special situation of the web enabled them to be more frank and intimate online than they would have been in person. The web, like the telephone, enables you to whisper in someone's ear, from a long way away.

What does happen, and may well be significant in these sad events, is that people who are miserable enough to be suicidal may be influenced by news of another suicide, especially if it is publicised in ways that makes it seem celebrated and cool. There can be a copycat element in such events, but only when the person is almost ready to harm themselves anyway.

The Werther Syndrome
There have been previous notable examples in history, such as the spate of suicides by gunshot by young men imitating the death of young Werther, the hero of a novel by Goethe, and the outbreak of self-poisonings after the much publicised suicide of the young poet Chatterton at 17, back in 1770.

American researchers found that within two months of a suicide given significant publicity on the front pages of newspapers, more people than usual killed themselves; and there was also a rise in car crash fatalities and other deaths that could be oblique suicides. There were a lot of deaths following the suicide of Marilyn Monroe, for instance. Later studies suggested, interestingly, that there was not an unusually large number of suicides that year, but that instead more of the usual number clustered close in time to the much-publicised death, and more used the publicised method.

The internet factor in suicide
There have been unpleasant examples of suicide in which the web was used. Last year a lad in Britain committed suicide live on webcam, and in 2001 another was communicating with others on a suicide chat room right up to the point at which he killed himself.

Less extreme, but still reason for concern, is the more general potential impact of the web on suicide. In chat rooms, websites, and social networking sites, it can "normalise" self-destructive acts, making them seem more everyday and less extreme than they actually are. It may focus the attention of a severely depressed individual more exclusively on the "how and when" rather than the "why", and turn their attention away from alternative ways of dealing with their problems.

Other research showed that lethal behavioural copying was most likely where the individual felt significantly similar to the publicised person. This is where social networking sites may have potential sinister effects when suitably suicidally primed individuals use them. They effectively offer a way for loners to feel connected, and for people to simulate closeness and connectivity with others whom they consider similar to themselves. The similarities might be genuine, or they might be simulated or exaggerated, but they are nonetheless potent.

Enjoy your own memorial
There is also the potential, illustrated in the Bridgend cases, for an unfortunately sentimental and over-the-top glorifying culture to develop around the suicide victim. It resembles what I have called the Tom Sawyer Syndrome, where Tom and his pals, having gone missing on the river and are presumed dead, sneak back into the church and hear themselves being extravagantly praised at their own funeral. Some suicides seem to enjoy a similar fantasy, neglecting the fact that the memorials would only arise when they were too dead to enjoy them. It also makes one wonder whether some of these young people have yet reached an adult understanding that death is permanent and irreversible.

The Japanese response
In Japan, after a notable internet-based suicide pact in 2003, there was a flood of suicide sites and forums, and a serious state response to these - they developed cyberpatrols, encouraged whistle-blowing from web users, and a special online suicide-watch police division. There was even the development of special software to monitor chat rooms for keywords suggesting imminent suicide. Although Japan is a nation with a high suicide rate, the flood of internet-related suicides was ended.

Grooming for death
There are also malignant web-pages that aim to encourage suicide and make it seem appealing, even providing recipes and advice on methods. Maybe the authorities need to take note of such sites when considering their various clampdowns on freedom of the web. Why do we single out child pornographers, yet ignore those people seeking to groom others for death?

And what can we learn from all this?
The media need to be sensitive in how they report suicides, and be aware of the consequences of sensationalising or glorifying the victim.

In addition to the eternal importance of parents maintaining good and frank communication with their children, it's important in to be familiar with the technology they use. Your parents and grandparents had to learn to pay attention to the telephone calls children made. Now effective parents have to be conversant with the internet, e-mail, SMS, and other such forms of communication, and encourage their children to be open about how they are using these media. Be proactive in starting conversations (rather than inquisitions) about topics that seem likely to be troubling. And in case they don't feel able to approach you about some of their sorrows, make sure they are aware of help-lines and websites where they can get suitable advice and support.

Spontaneous memorial mounds – a new custom
I think this relates to some extent to the very recently developed modern custom of creating gaudy memorials at sites where someone died, especially if they were young or died violently. We remember the mounds of flowers left in various places after the death of Princess Diana, but the custom has grown curiously. It only happens when the death has been publicised, and now it's not merely flowers that accumulate, but candles, party balloons, cuddly toys, messages, drawings and photos, even gaily twirling whirligigs and paper windmills, footballs and scarves, and so on.

This is a historically and culturally strange creation, gathering tributes from people who knew the individual only through the media, and yet in their messages conveying a sense of intimacy and love, heaping unearned praises on this stranger, often with hollow promises that they will never be forgotten.

As a method for a community to build a temporary shrine for a stranger, expressing sympathy and a sense of connection, this is a unique and new custom.

(Professor M.A. Simpson, Health24, March 2008)

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