If desperation is a spectrum, suicide is at its gut-wrenching extreme. Thankfully, as with most extremes, it is rare. Yet a raft of official statistics emerging from health authorities in different countries tells us that suicide is sadly not staying rare. It is becoming considerably more common, and the increased prevalence is in fact speeding up, not dropping off.
Furthermore, this most extreme form of desperation is now claiming younger and younger lives, particularly teenagers, with the latest data showing how girls are at risk. In short, what has long been considered an instance of exceptional personal tragedy – the taking of one’s own life - is fast becoming an urgent public health issue for policy teams around the world.
UNICEF, which has raised the alarm about mental ill health in adolescents, says that every year 46,000 children and young adults aged 10-19 years choose suicide. That is one every 11 minutes. Tracking the change, figures show suicides increased by 57 percent among those aged 10-24 from 2007-2018. According to the Centre of Disease Control and Prevention, in the Spring of 2021, suicide attempts among girls aged 12-17 were 50 percent higher than at the same time two years earlier. And according to the American Foundation for Suicide Prevention, suicide is now the third most common cause of death among young people and the second most common cause of death among college students.
Suicide is not something that can be ‘understood’ through articles. States of mind are difficult to describe at the best of times; to describe the state of mind of someone about to kill themselves is almost impossible. When someone sees death as their best option, what must their other options look like? Some commentators have used the example of people jumping from burning buildings. It is not that they are no longer scared of falling to their death; it is that being burned alive appears worse.
It can take very little time for someone to shoot up that desperation spectrum, to believe that killing themself is their least-worst option. By way of example, in the United States this summer, a busy father was supposed to drop his sleeping baby off at nursery before he went to work on a fiercely hot day. He forgot and instead drove straight to the office, did a day’s work, and only then realized that he had left his baby in the back of the car the whole time. Within four hours of discovering that his baby had died in the heat, the father killed himself. Reaching the extreme of desperation need not take months, weeks, or even days.
The mental processes underpinning suicide are complex and varied but can include feelings of hopelessness, frustration, loneliness, a lack of purpose, a feeling of being a burden, being trapped, having no longer control, being in unbearable emotional or physical pain, or some toxic maelstrom combination.
Increasingly, suicide is ‘attempted’ or ‘completed’. The phrase ‘committed’ stems from it being deemed not only immoral but illegal and this language does nothing to help grieving families. The unbearable pain experienced by the person can quickly transfer to the family of the deceased, who can typically and immediately be filled with questions, and who may never find the answers that they need to find peace. The loved ones of those who kill themselves often ask: could I have prevented it? Often, they blame themselves in full or in part. ‘Closure’ can be hard to come by.
Health practitioners believe that suicide is often the result of undiagnosed mental ill health. UNICEF reckons that one in seven adolescents live with a mental disorder, including behavioral abnormalities, anxiety disorders, and/or depression, but diagnoses can be difficult, especially given the ‘normal’ growing pains and mood swings common in this age group for reasons of hormone changes. When is a moaning, morbid, or moody teenager issuing a cry for help, and when are they simply being a teenager? It can be hugely difficult to know. Likewise, a feeling of inadequacy compared to one’s peers may be both normal and deeply problematic, depending on how the person deals with those feelings and that pressure.
There are - and have ever been - myriad causes of angst in young people, who feel they need to perform amongst their peers, perhaps a pressure to achieve (whether in grades or desired social status), to deal with questions about sexual orientation, to overcome loneliness, or bullying, or a more fundamental lack of support in the home, or countless other potential sources of mental ill health. Sometimes, nature does not help. Depression can run in families. Likewise, a global pandemic was never going to be good for the soul. Teens, in particular, need to socialize face-to-face, but repeated lockdowns shifted interaction online, where teens can easily fall down dangerous digital rabbit holes.
Suicide prevention is becoming a huge area of study, with the focus understandably on the earlier and better diagnosis of conditions that may lead people to feel that life is no longer worth living. Any solution must also aim to increase awareness of early warning signs, including what these are and what to do about it. Progress is being made in some schools, that invest in trained counselors who help children who struggle, and who help teachers with early-stage intervention. But good practice is sporadic. Across the board, not enough is being done. Clinicians working with mental ill health in children are already overwhelmed with unmanageable caseloads. Delays in getting help can therefore be dangerously drawn out.
Governments increasingly understand that this is an area in which they can positively influence outcomes. The number of ministers with mental health in their portfolios is one outward sign of this. Increasing budgets are another. However, experts worry that money is going only towards the extremes of desperation when they know that people don’t start off there. Prevention may lie earlier along the spectrum, while the person still sees that there are other viable options. Because to talk someone off a bridge is to talk to them far too late.