- How to stop people killing themselve
SUICIDE is often born of despair, but suicide prevention is far from hopeless. What is required is a better understanding of the suicidal brain, says Dan Reidenberg of SAVE, a non-profit organisation. Research suggests that people cannot remain acutely suicidal for much more than an hour, and that half of those who do commit suicide take the final decision less than ten minutes before killing themselves. Yet what goes on in the brain in those minutes remains a mystery. It is one that is worth trying to solve, since a new report from the Centres for Disease Control and Prevention (CDC) shows a sharp spike in suicide across the country
Thank you for reading this post, don't forget to subscribe!In practical terms, measures that increase the distance between a suicidal thought and access to lethal means can make a big difference. After the Australian government reduced the country’s stock of guns by around one-fifth through a gun buy-back programme in 1997, the rate of suicide by gunshot dropped by almost 80%. America is unlikely to follow Australia in the near future, but even a requirement to store guns safely at all times could help; half of all American suicides are by gunshot. Pharmacists still sell painkillers loosely in pots, enabling people to pour the whole lot down their throats in one movement. They could follow Britain, which in 1998 switched to blister packs that require users to punch pills out one by one. Deaths from overdoses of paracetamol (the active ingredient in Tylenol) dropped by 44% in 11 years.
In theory, all suicides are preventable until the last minute of life. Robert Gebbia, head of the American Foundation for Suicide Prevention, would like the federal government to provide $150m for research into prevention. He would also subsidise the 160 local call centres that serve the national suicide-prevention lifeline, and tend to operate on a shoestring. (On June 30th Crisis Connection, Minnesota’s hotline, which handles 50,000 calls a year, will be forced to shut down for lack of funds.)
One idea is a bill currently being considered by Congress, which would change the 11-digit number of the suicide lifeline to a more easily memorised three-digit number, like 911, the nationwide number for emergencies. Studies suggest that celebrity suicides can have a “Werther effect” (named after Goethe’s novel): a spike in copycat suicides. In the days after the deaths of Kate Spade, a handbag designer, and Anthony Bourdain, a foodie, writer and presenter (see Obituary), calls to the lifeline increased by 63%, further evidence both for the Werther effect and for the importance of hotlines. According to the CDC, suicide rates increased for all age groups younger than 75, with the group aged 45 to 64 reporting the largest overall increase (from 13 per 100,000 people to 19 per 100,000) and the greatest number of suicides (232,108). Native Americans and elderly white men seem to be particularly vulnerable.
Many still see suicide as a choice rather than a public-health problem, which is why initiatives to prevent suicide are much newer (a national strategy was first devised in 2001) than those aiming at the prevention of cancer or heart disease. They are also far less generously funded compared with other leading causes of death. The suicide-prevention grants named after Garrett Lee Smith, the son of a senator who killed himself, have been funded at the same rate of $35.4m since 2013. The national suicide-prevention hotline, which has helped more than 6m people since it started in 2005, has also been funded with the same $7m a year for the past five years.
The most effective help, though, remains the support of friends, family and neighbours, especially if they can learn to detect warning signs such as withdrawal, talk about wanting to die or the sudden misuse of booze or pills. “The solution lies in social, economic, spiritual and other connections,” says Jerry Reed of the National Action Alliance for Suicide Prevention, echoing Émile Durkheim, the sociologist who wrote the first study that treated suicide as a health problem, rather than a religious or moral one.
Melancholy suicide is a state of great sadness “causing the patient no longer to realise sanely the bonds which connect him with people and things around him”, wrote Durkheim in Le Suicide at the end of the 19th century. At the time, doctors prescribed buckets of cold water thrown over the head to combat suicidal thoughts. The Western world has made progress in treating mental illness since, but a few buckets of icy water over the heads of America’s lawmakers might do some good.
