The Darkness Around Suicide

The tragic death of the nurse who was the victim of a prank call at Kate Middleton’s hospital a few days ago highlights how little is known, or understood, about the complex issue of suicide.

After the news broke that Jacintha Saldanha had killed herself, the world was enraged. Twitter immediately turned into a violent storm of accusations and hatred, and the accounts of the culprits were quickly deleted. Many people stated that the two Australian DJs had «blood on their hands» and needed to be charged with manslaughter. They were to blame for what happened.

I am deeply sorry for the death of this woman, a married mother of two. But the pranksters cannot be blamed. While shame is a powerful motivator for suicide, a single event is almost never enough. Very few media outlets bothered to call a psychologist to comment on the events in their first round of reporting. Fox News, not a news source I normally admire, had the president of the American Psychologist Association correctly suggest that the call might have been «a final straw» that led Saldanha to take her own life.

No one is directly to blame. You could say that the hospital director should have know better than to put a vulnerable person in charge of the phone when he had the world’s most famous patient under his care. And you can question the taste, the timeliness and the motives of the pranksters, but those observations should stay the same regardless of what happened as a result. Prince Charles himself had a laugh about it, before tragedy struck of course, by saying «How do you know I’m not a radio station?».
If you listen to the call, the intentions of the hoaxers are pretty clear: «We thought a hundred people before us would have tried it, we just thought it was such a silly idea, and the accents were terrible», they explain in a video interview, «Not for a second we thought we would actually get to speak to anyone at the hospital. We wanted to be hung up on». The joke was stupid to start with, but it spiraled out of control.

Suicides only make the news under certain conditions, chiefly when they follow a murder, or when they are linked to fame. Not necessarily a celebrity: in 2010, Chinese manufacturer Foxconn, who builds tech gadgets for Apple and other leading brands, made magazine covers after a slew of suicides. There were 14 registered self-inflicted deaths among Foxconn’s 930,000 employees that year. Sadly, those were actually pretty good numbers compared to China’s national rate of over 22 suicides out of every 100,000 people each year (Foxconn only suffered 1,5). That didn’t stop the company from responding to the public outcry by installing nets in its dorms to discourage workers from jumping out of windows. Bad publicity kills good business.

What this shows is that not only suicide is questionably treated by the media, but that we are extremely unfamiliar with the numbers surrounding it. China has, admittedly, one of the world’s highest suicide rates: a staggering 287,000 people kill themselves each year, out of a population of 1,3 billion. That’s about 786 people a day, a figure that’s hard to swallow. You’d think that has mostly to do with China. But it doesn’t.

The United States have one of the highest rates of homicides among developed countries: in 2009, there were 16,500 deaths by murder. And how many deaths by suicide? Over 36,000. More than twice as many people kill themselves each year in the US than are killed by others. In the same year, 2009, suicide has surpassed car crashes as the leading cause of death by injury. And more American soldiers routinely die by taking their own lives than are killed in combat. In India, another country with elevated rates, suicide is now the second leading cause of death among young people (15-29 years of age) after transportation accidents, with around 187,000 fatalities in 2010 alone.

The puzzling numbers are not the end of the story. One commonly held belief is that suicide rates peak around holidays, especially in the winter. But that’s hardly the case: people commit suicide far more frequently during springtime. Why? There are many theories, but increased social interaction may be a leading factor: it’s just when you hope that things might get better, like the weather outside, that you get depressed the most if they actually don’t. Also, it’s easier to feel socially disconnected when everybody else is out having fun. The intricate inner workings of suicidal tendencies are also based upon cultural or racial differences: African-americans are half as likely to kill themselves and six times more likely to be murdered. But some of those homicides may be suicides in disguise: psychologists say this is due to the fact that white and black people externalize their frustrations about life differently, because of cultural heritage. There’s a type of murder called “victim-precipitated homicide”, which happens when someone engages in violent or reckless behavior that gets them killed. An estimated 30 percent of urban homicides may belong to this variant, which is not recognized as a form of suicide.
A similar thing happens after news break that a celebrity has committed suicide:
not only you get a spike in actual suicides out of emulation, but the number of fatal car accidents involving a single person also spikes. Many of those are people killing themselves.

In the end, nearly all suicides go unnoticed and undiscussed, because this is a taboo topic across all cultures. But there’s another reason why so few are reported in newspapers: even common people committing suicide, for example subway jumpers, inspire emulators. Especially individuals demographically similar to the person who died, and who lived in the same geographical area. It’s called the Werther Effect, after Goethe’s novel. The result is that media outlets in many countries self-regulate against reporting suicides to deter copycats.

Suicide is not a rare thing, it’s a common thing. It can hardly be caused by a single event, however devastating: it’s a cumulative problem often linked to mental illness. There’s not nearly enough awareness around it, compared to other similarly life-threatening issues. All the time and effort that have been spent over the last few days chastising two hapless idiots who didn’t know what they were doing, could have been better spent exploring the real problem. Awareness can save lives. Ruining those of two additional people accomplishes nothing.