It has become increasingly obvious that suicide attempts and deaths have both social and psychological causes. Though people in general are more familiar with the idea that psychological problems, such as depression, can put someone at risk of suicide, exposure to messages about suicide through our personal relationships or through the media also can increase an individual’s vulnerability to attempting suicide by making suicide seem like more of an option. Comedian Robin Williams’ suicide – and comments made online about his tragic passing and amazing life - illustrated the tension between our seemingly-innate desire to talk about and make sense of why people take their own life and the danger that irresponsible reporting or romanticizing comments may pose. Given the possible risks of suicide contagion, there is a very real need to understand how it works and who is most vulnerable so that we can better prevent it from transpiring. With our recent study, we sought to address some of the critical unanswered questions about suicide contagion with an emphasis on identifying the most vulnerable groups.
A fundamental issue that is much debated is whether exposure to the suicide attempt of someone a person cares about actually changes an individual’s risk of suicide. It may be that only individuals who are already depressed or suicidal prior to the exposure are vulnerable to contagion. The question then is whether exposure to a friend or family member’s suicide attempt or death is actually triggering something new in a person or whether the pre-existing risk factors shared by both people are actually driving the likelihood of suicide. With our study, we examined this question using nationally-representative longitudinal data from the National Longitudinal Study of Adolescent Health. We found that teenagers with no history of suicidal thoughts or attempts are in fact vulnerable to developing new suicidal thoughts and, in the case of adolescent girls, suicide attempts when exposed to a friend or family member’s suicide attempt or death. We also assessed how long this risk lasts: the effects of the exposure appear to be most dangerous in the year following a friend or family member’s attempt; however, young women’s mental health suffers for up to six years after the exposure.
These findings suggest how important it is to address suicide contagion as a significant social risk factor for suicide, particularly in adolescence. Exposure to the suicide attempt or death of a close friend or family member changes youth’s likelihood of seeing suicide as an option for coping with the emotional turmoil that often defines adolescence. We also found that this vulnerability is somewhat different for teenage boys and girls. For instance, we found that teenage girls are especially vulnerable to the suicidal behaviors of their friends – it could actually trigger suicide attempts among girls (whereas for boys the risk was only observed for the development of suicidal thoughts). Attempts are much more serious than suicidal thoughts, thus this is an important finding for targeted prevention efforts. Sociology provides some insights into why young women may be more vulnerable. For one, in the US, young women tend to have fewer but far more emotionally-intense and intimate friendships than young men. Women, generally speaking, are often socialized to be more attuned to their friend or partner’s emotions, attitudes, and behaviors, making them more likely to adopt their attitudes or behaviors, even when negative or harmful.
Admittedly, in the U.S., men are 4 times more likely to complete suicide than women, though women are more likely to report non-fatal suicide attempts than men. Certainly, just because a person attempts suicide does not mean they will go on to complete suicide; a finding which has often led researchers to downplay the severity of suicidal attempts as well as other self-harm behaviors such as cutting. Our research – which reveals the lingering mental health consequences of the suicide attempt or death of a friend – clearly points to the need to rethink this argument. Suicidal behavior, like any violent behavior, is traumatic. For teenagers this may be especially true. Their lack of stable self-identity, their developing self-esteem and sense of self-efficacy, their intense attunement to their peers, and their inability to see far into the future make them susceptible to scarring. Considering this, we as a society should be concerned with both preventing adolescent suicide more specifically and promoting adolescent wellbeing more generally. Underestimating the importance of suicidal thoughts or attempts misses the larger problem of adolescent suffering and also carries with it an assumption about the difference in intent or emotional distress behind fatal and non-fatal suicide attempts – something we simply cannot know with existing research.
So what can we do to disrupt suicide contagion? That is perhaps the most important question. While our study has shown the risks associated with exposure to the suicide attempt or death of someone an adolescent cares about, we can turn to other research for insights into how to prevent contagion. The danger of contagion is that it can make suicide seem like more of an option to an adolescent; thus, how suicide is discussed becomes a key part of prevention. Niederkrotenthaler and colleagues (2010) found that exposure to stories where an upset individual explicitly rejects suicide as an option and instead uses other methods to cope with their distress can be protective. Thus, the stories we tell about suicide, particularly after the death or attempt of a friend or family member, can shape youth’s interpretations of suicide and perceptions of both good and bad coping mechanisms. Teaching youth how to cope with tragedies in a healthy manner – and how to get help if it gets to be too much – would greatly help prevent suicide contagion and promote healthy adolescent development.
For more information on suicide prevention, including how to get help for yourself or someone you care about, please check out these resources:
For immediate help, call the National Suicide Prevention Lifeline anytime: Call 1-800-273-TALK
For parents and school personnel supporting a child through suicide bereavement see AFSP’s A Toolkit for Schools. It has helpful information on how to talk to youth about suicide after a suicide death: https://www.afsp.org/coping-with-suicide-loss/education-training/after-a-suicide-a-toolkit-for-schools
American Foundation for Suicide Prevention: http://www.afsp.org/
American Association of Suicidology: http://www.suicidology.org/
National Alliance on Mental Health (NAMI): http://www.nami.org
This post has been jointly written by Seth Abrutyn and Anna S. Mueller, Assistant Professor of Sociology at the University of Memphis.