A culture's careless handling of suicide
The week before last, Karen Dunne-Maxim was watching "CSI: Miami" when she nearly jolted out of her chair. For no reason she could fathom, a young adult character commits suicide.
As suicide has become part of our everyday vocabulary (think suicide bombers), it has also become more common in the popular culture ("Master and Commander"; the UPN-TV sitcom "Veronica Mars"). "Thelma & Louise," which ends with a double-suicide, is very popular among teens (probably because it features a young Brad Pitt). "Groundhog Day," a video favored by preteens, has a running dialogue about it.
Almost always, the portrayals of suicide are gratuitous, showing it as a solution to problems, without context or explanation. That really gets to Dunne-Maxim, an author and international lecturer on adolescent suicide prevention.
"Suicide gets normalized and glamorized," she says.
To punctuate the point, she tells of visiting recently with an 11-year-old who was playing a video game. Suddenly, he began shouting, "I'll suicide! I'll suicide."
"When the concept has seeped into preteen's game strategies, we've got a problem," she says.
Teen suicide is one of those subjects most parents worry about ("Please, God, not my child.") and for good reason. Nationwide, it's the third-leading cause of death for 15- to 19-year-olds (behind accidental injury and murder), according to the Centers for Disease Control and Prevention. In 2002, the most recent year for which statistics are available, 1,513 teens in that age group killed themselves. What most parents may not know is this: Many more teens think about it.
A CDC study estimates that 16 percent do, but clinicians tend to think it's far higher. South Natick clinical psychologist Pamela Cantor, who specializes in adolescent self-destructive behavior and consults to schools, says 75 percent is a conservative estimate. McLean psychologist Michael Hollander, who works with teens at risk for suicide, puts it even higher.
"The vast majority of adolescents think about suicide," he says.
He describes the thinking as a kind of intellectual muscle-flexing that comes from reaching a new level of abstract thinking. "They're able to imagine all sorts of possibilities: potential career choices, awards they could win, crimes they could commit, what it would be like to kill themselves."
That's different than wishing you could do it, or contemplating how you would do it. But here's the thing: Given the impulsive nature of adolescence and the increased visibility suicide has in the popular culture, who knows what might tip a teen from thinking about it in the abstract to thinking about it for real?
The teen most likely to contemplate or attempt suicide has a mental illness, often undiagnosed. Some teens, however, do not. For them, it typically boils down to poor problem-solving skills.
"I've seen incredibly well kids -- class presidents, athletes, popular students, A students -- who hit something that overwhelms them," says Cantor. Often, it's a breakup or a college rejection. "They don't have the life experience to know that things change over time. If they don't get the appropriate help at the critical time, they may act impulsively."
Ironically, the best preventative medicine is one parents aren't likely to take: talking to our teens about suicide. "Most parents are afraid they'll plant a seed," says Kim Kates, a spokeswoman for Samariteens of Boston, which offers telephone counseling for teens in crisis.
There's no more truth to that, she says, than to the common belief among teens that once you contemplate suicide, it will always be something you think about. Not that you want to start a conversation out of the blue, but when there's an opportunity, use it, says Kates. For instance: "I read this article on suicide. It made me realize we've never talked about it."
There are three messages to convey: Suicide is a permanent solution to a temporary problem; there are always ways to get help; if you know of someone at risk, including yourself, tell an adult you trust. Parents also typically don't know what to say to a teen who knows someone, or even just knows of someone, who commits suicide. Dunne-Maxim says this teen typically has two worries: Could this happen to me? Is it my fault?
Address the first question even if it doesn't get voiced: "There was something that clouded his thinking, that prevented him from realizing he could get help. It's so tragic, and I want to make sure that no matter what problems you have, you know to find someone to talk to. If you didn't want to talk to me, I could help you find someone else."
To the second question, which is more likely to be spoken, psychiatrist Douglas Jacobs might say: "Suicide is very complex. It's never just about one thing."
Jacobs, who is executive director of Screening for Mental Health (mentalhealthscreening.org) based in Wellesley, is founder of a suicide prevention program used in 1,500 high schools nationwide. One of his goals is to make sure teens know to consider it an emergency when another teen talks about suicide. Often, they don't know what to do, he says, and treat seriously a friend's request for secrecy. He tells teens: "It's better to have a mad friend than a dead one."
In a video he's developed, he offers two scenarios. In the first, a teen complains, "My SAT scores are awful, my life is over. My parents won't talk to me." The friend says, "Yeah, but you're a good athlete. It'll all work out in the end."
In the second, the friend says, "This sounds serious. You should talk to someone."
"Yeah, but I can't talk to my parents."
"What about Coach Jones? Let's go find him."
Now if only we could get more scenes like that one onto the big screen.
Contact Barbara Meltz at firstname.lastname@example.org