This month the New York Times reported “ Sweeping Pain” as suicide has surged to the highest levels in nearly 30 years. Of great concern is that the increase spans every age group with the exception of older adults, which remains consistently high. There was even an alarming increase in the rate among girls 10 to 14 which had tripled, going from 50 in 1999 to 150 in 2014.

The cause for concern is without question as is the impetus to unlock the reasons for such desperation. While evidence is emerging between the links between poverty, hopelessness and health, there is a need to consider any steps toward prevention and intervention.

Identified Risk FactorsiStock_000018842070_Medium

A recent study reported in the British Medical Journal in January 2016, identified two risk factors that have the potential to inform prevention. These include the loss of a friend as a risk factor for the bereaved and the impact of social stigma on increasing suicide risk.

The study was conducted with 3432 staff and students at UK universities between the ages of 18 and 40 years old. Of this group 614 had lost a friend or relative to suicide, 712 had lost a friend or relative to death by sudden unnatural causes and the remaining 2106 had lost a friend or relative to death by sudden natural causes.

The likelihood of attempting suicide as a reaction to the loss was higher among those bereaved by suicide than those who had lost a friend or family member to sudden natural or unnatural death.

Friends as Well as Family at Risk

The loss of a family member to suicide has been a recognized risk factor. This study expands our recognition to the impact and risk for friends because it finds no difference in the impact and likelihood of attempted suicide when comparing friends or family members who have lost a loved one to suicide.

Reflecting the impact of losing a friend or relative to suicide is the additional finding that those bereaved by suicide were 80% more likely to drop out of school or work.

Perceived Social Stigma

Crucial to intervention and prevention is the additional finding that a person’s perception of social stigma after the loss of a friend or a family member to suicide is, in fact, the most significant risk factor.

Understanding and Addressing Social Stigma

This finding is crucial in turning our attention to the fear of stigma and actual stigma that exacerbates the experience of loss, doubt, self-blame and anguish suffered by family and friends after the suicide of a loved one.

Suicide is complicated and traumatic loss. Sharing the pain is very difficult, as the bereaved friend, sibling or spouse is often filled with confusion, anger and loss. The nature of the death for a time can seem to disqualify grieving, much less the positive memories and longing. In a sense those bereaved by suicide need more support and more concern. The problem is that it is difficult to find the words or take the risk of reaching out and too often it is not available.

Painful Examples

A painful example is the devastation and danger of being silenced as a survivor of suicide. In their book Devastating Losses, written in the aftermath of losing their son to suicide, Bill and Beverly Feigelman describe a bereavement group at which a parent is told that the group is only for those whose children have died by natural means. They report the case of a neighbor who crosses the street in order not to speak to a parent who has lost their child to suicide. They describe the silence borne of assumed judgment, self-stigmatization, and the social ambiguity that leaves some family, friends and neighbors concerned-but not knowing what to say.

Intervention and Prevention

Given the increase in suicide rates, the the impact of suicide on bereaved friends as well as family and the critical factor played by social stigma, there is reason to consider ways to alleviate the pain as well as the stigma that survivors of suicide face.

Understanding to Reduce Blame

  • Trapped by the pain and the “ why?” of suicide, survivors often feel they need an answer in order to connect and heal.
  • While there is no perfect answer, it helps some to know that undiagnosed depression is a prime cause of suicide. No one chooses to be depressed and suffer. The despair can feel unbearable especially if no help is sought or used. There is always someone who wants to listen on the National Suicide Prevention Hotline 1 (800) 273-8255.
  • Consistent with this is suicide expert, Edwin Shneidman’s definition of suicide as a misguided solution to unbearable psychic pain. When there is unbearable psychic pain, a person’s thinking becomes constricted. There is tunnel vision that precludes judgment. Most people don’t want to die—they act to end the pain perceived as Intolerable, Interminable and Inescapable.

Groups As an Antidote to Social Stigma

Survivors can reduce their own risk and that of other friends and family members by using the support and validation of others who have walked in their shoes. There are survivor Groups like American Foundation for Suicide Prevention and TAPS for Suicide Survivors that offer resources and connection. These groups are antidotes to feared or experienced social stigma.

To sit with groups of survivors at the American Foundation for Suicide Prevention Day, and witness those who have suffered help others make meaning, feel entitled to grieve, find the words to speak to others and feel the blame lifted off them, is to witness a response to stigma and a place to heal.

Thousands have participated together in “ Out of the Darkness Walks” in which they carry lights and walk publicly in the name of their loved one. Many report the experience frees them to grieve with less pain and judgment.

The Society for the Prevention of Teen Suicide offers valuable educational material for teens, parents, teachers, families etc. Their mission is to help youngsters and their parents know about and talk about suicide. What are most powerful are the videos of parents telling their stories of their own loss—in the hope of preventing the loss of another parent’s child.

Stepping Over Fear and Judgment

If you are aware of someone who has lost a friend or relative to suicide, take a step closer. To share that you don’t know what to say but that you are there to support in any way- is a big step in reducing the risks of suicide.