by Michael D. Anestis, M.S.
A sad situation has unfolded on the campus of Cornell. A number of student deaths have been ruled as suicides or are under consideration as possibly fitting within that category. The distressing nature of this clustering of deaths by suicide has been amplified by the method of those who have died, as a number of students have jumped to their deaths from bridges on campus. Writers all over the internet have discussed this situation and I first learned about it when a colleague emailed me an article in the New York Times (click here to read that article).
I do not want to spend today discussing the personal situation of those who have died or of their grieving families and I ask that anyone who responds to this article maintain that same level of respect. The approach I want to take instead is to reflect upon some issues that I have either seen come up in coverage or anticipate will come up as time goes by. For some of these issues, I will link to articles we have previously written on PBB. For topics not yet covered on the site, I will briefly explain what we know from research. In the meantime, I also encourage you to click here to learn more about Cornell's efforts to address this situation.
Is suicide contagious?
We have previously written about the idea of suicide contagion (click here to read our original article on this topic). When a number of deaths by suicide occur in a short period of time within a small area, people understandably begin to fear an epidemic. Implicit in this fear is that idea that, had one individual not died by suicide, another individual who subsequently died by suicide would not have attempted. In other words, the idea is that one individual "catches" the behavior from another like people catch physical illnesses through exposure to the germs of other individuals. As it turns out, the evidence for this idea is at most ambiguous and seems to favor a very different idea: that deaths by suicide cluster together but are not contagious.
So, if suicide is not contagious, does that mean that we are saying that the death of one individual did not impact the other individual who later died by suicide? Not at all. The loss of a peer, whether by suicide or any other means, constitutes as severe life stress and, in the presence of stress (and the absence of social support), risk for suicide increases. The thing is, if an individual is not already vulnerable in the first place - perhaps due to a diagnosis of a mental illness - this stress is highly unlikely to result in a suicide attempt. In an earlier article, we discussed the diathesis-stress model of mental illness, which says that a combination of innate vulnerabilities and environmental stress represent the clearest path to problematic mental health outcomes. I would recommend clicking on this link and reading that article to develop a clearer sense of what I mean here.
Could developing a campus-wide risk assessment procedure be dangerous?
Here again, a lot of people express an entirely understandable concern: could assessing for suicide risk cause people to think about suicide when they otherwise would not? It would obviously be a horrific idea to assess for risk if our efforts to increase safety were actually doing harm. Fortunately, research indicates that this is not the case. In earlier PBB articles, we discussed landmark studies by Madelyn Gould and PBB contributor Craig Bryan demonstrating in a number of different samples that assessing for suicide risk and educating people about risk factors not only does not cause harm, but actually decreases risk (click here and here to read those articles). As such, Cornell's efforts to intervene are an excellent idea. Now, I am not aware of the specifics of the interventions taking place on that campus, so I can not speak to their procedures, but regardless, the data indicate that assessing for risk as absolutely the right thing to do. Openly discussing this topic, providing accurate, data-driven information, and offering effective treatment resources to those in need are healthy steps for a campus seeking to recover for a devastating series of events.
Once somebody's mind is made up to die by suicide, is there nothing we can do?
This is another important question to consider. Some people believe that, once somebody has decided to attempt suicide, nothing can be done. There are a couple of important points to consider here. If you have a loved one who considers or attempts suicide, it is not your fault and you should not carry the weight of the world on your shoulders. After all, even if we do everything right, we can not control the behaviors and thoughts of other people. That being said, there are steps that you can take to help that individual. For one thing, if an individual appears to be at risk to him or herself or to others, you can encourage them to seek help or, if risk is imminent, you can call the police or take them to a hospital for an emergency evaluation. Different states have different laws regarding involuntary mental health holds, so you should be sure to educate yourself on how your state handles these situations. Keep in mind that, unless you are trained to assess for suicide risk, it is a difficult procedure, particularly if you are close to the person at risk. That being said, in these types of situations, I highly encourage you to seek the help of professionals capable of providing informed guidance and intervening effectively. The National Suicide Prevention Lifeline, which you can reach at 1-800-273-TALK, provides anonymous, free support 24 hours per day, 7 days per week. Additionally, dialing 911 will connect you with authorities capable of providing help. So, you certainly cannot provide a full proof intervention to your loved ones, but there are opportunities to connect your loved one with professionals who can then provide evidence-based treatments to reduce risk.
Another consideration here is whether intervening simply delays the inevitable. Cornell is now posting monitors on campus bridges to watch for students at risk. This type of situation and intervention is not unique. In fact, at the Golden Gate Bridge - which is the location with the most suicides worldwide - individuals have debated whether installing larger fences would reduce suicide rates or simply lead to individuals thwarted in their attempts finding another method. As it turns out, all the evidence points to the idea that restricting access to the intended method decreases risk without a subsequent rebound. In other words, when a common method is made unavailable, individuals who would have used that method do not appear to then use alternative approaches (e.g., Seiden, 1978). The point here is not that posting monitors on bridges will make the suicide rate drop to zero but rather that doing so will substantially reduce the risk for a number of individuals.
The bottom line
Suicide is a heart wrenching phenomenon, but it is not nearly as mysterious as many believe it to be. Through science, we have learned a lot about this behavior and how to prevent it. Although it is certainly not the only perspective on suicide, I am a firm believer in the utility of Joiner's interpersonal-psychological theory of suicidal behavior and the data that supports it and I highly encourage you to click here and to type that phrase into the search bar at the top of the page in order to learn more about it. What you'll find is that there are a lot of people out there devoting their professional lives to uncovering more about suicide and that they are making substantial progress in that pursuit. We cannot control the thoughts, feelings, and behaviors of others, but we can educate ourselves on mental health issues and learn about the resources available to us and our loved ones. By equipping ourselves in this manner, we can be fully prepared to do everything possible to prevent tragedies from occurring.
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If you would like to learn more about this and other topics discussed on PBB, we encourage you to consult our online store of scientifically-based psychological resources.
Mike Anestis is a doctoral candidate in the clinical psychology department at Florida State University and an incoming resident at the University of Mississippi Medical Center.
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