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Another 9/11 Commemoration: World Suicide Prevention Day

Today is the 11th annual World Suicide Prevention Day, co-sponsored by the International Association for Suicide Prevention (IASP) and the World Health Organization (WHO). With suicide claiming more lives than war and homicide combined, the event will call attention to the treatable mental health issues that underlie most suicide attempts.

Suicide rates have risen in the United States over the past decade, after declining over the previous 10 years. This spring, a study from the Centers for Disease Control and Prevention showed a sharp increase in suicide among middle-age Americans, with the rate rising by almost 30 percent for people ages 35 to 64 between 1999 and 2010.

Many societal factors, including the long-term economic downturn and greater access to opioid drugs such as OxyContin, may help explain the increase, CDC researchers told The New York Times.

Meanwhile, rates of suicide among younger people have leveled off, suggesting that prevention efforts, which have traditionally targeted young adults and the elderly, have had some positive effects, said Robert Gebbia, president of the American Foundation for Suicide Prevention (AFSP), which is coordinating the World Suicide Prevention Day events in the United States.

Today’s events, occurring in at least 60 countries, range from public awareness activities to seminars and walks for survivors. Hundreds of thousands of organizations, including local hospitals, psychiatric units, crisis centers and hotlines, are taking part.

To learn more about this difficult topic, read my previous post exploring the subject

 

Weekly News Wire

  • Is rapid population growth to blame for rising violence and terrorism in certain countries? An article in Foreign Policy cites a correlation, suggesting that the that problem requires not a military solution, but a public health one. 
  • A recent study shared by Raw Story found that, contrary to popular belief, men aren’t from Mars and women aren’t from Venus – in other words, neither gender is inflexibly different from the other. While gender differences exist to some degree, they’re hardly iron law.
  • The BBC reports that bonobo apes, long known for their human-like display of empathy and emotion, demonstrate seemingly complex emotional behaviors – such as hugging and having sex for pleasure – even at a young age. It was previously believed that it would take sophisticated cognitive skills to do such things.
  • NBC has obtained a chilling Department of Justice memo that outlines the legal case of assassinating American citizens through drone strikes. The document concludes that the US government can order the killing of American citizens if they are believed to be “senior operational leaders” of al-Qaeda or “an associated force,” regardless of whether there is any evidence that they are engaged in an active plot to attack the US.
  • A study by the VA , reported in the Washington Post, has found that veteran suicides have hit record highs. Most of these veterans are in their 50s and served in Vietnam. What’s even more distressing is that this reflects a much wider national trend – suicides in the US increased 11% between 2007 and 2010.
  • To make matters more complicated, another report in Foreign Policy raises questions about whether the growing media attention on veteran and military suicides is actually making the problem worse. Known as the “contagion” or “Werther”  effect this long-observed phenomenon links increased reporting and publicity of suicides to an increase in suicides. The reasons are poorly understood, but it certainly makes an already difficult issue more challenging.

Don Ritchie, the Savior of the Suicidal, Died in May

“A conversation can change a life.” – Donald Ritchie

I know it’s odd to publish a post about someone’s death this belatedly, but I had no idea that this wonderful man had passed on, and I think he deserves a posthumous mention. Also known as the “Angel of the Gap,” this brave and compassionate Australian devoted more than half his life to saving people from attempting to end their lives by jumping off a cliff  near his home. News.com reports:

Mr Ritchie spent 50 years coaxing desperate people back from The Gap, the notorious cliff at Watsons Bay where hundreds have died or thought about taking their lives.

He helped save 500 despairing souls – usually with little more than compassion, a warm smile and a hot cuppa.

“Those who knew him knew he was a very strong person and a very capable person,” Mr Ritchie’s daughter Sue said today.

Federal MP Malcolm Turnbull, whose electorate includes The Gap, added: “A true hero, one of our greatest Australians. RIP.”

Born in Vaucluse in 1926, Mr Ritchie died peacefully at home on Old South Head Road, Watsons Bay yesterday.

The former navy seaman turned life insurance salesman was never one to shout about his exploits.

He helped because he could.

Ms Ritchie said: “It was just something that he saw and that he had to do something about.”

New South Wales Mental Health Minister Kevin Humphries recalled when Mr Ritchie was named a Local Hero in the 2011 Australian of the Year Awards.

“Upon accepting the award Mr Ritchie urged people to never be afraid to speak to those most in need,” he said.

“Always remember the power of the simple smile, a helping hand, a listening ear and a kind word.”

A funeral will be held in Sydney on Friday.

Mr Ritchie’s family asked for donations to be made to the Black Dog Institute or to Lifeline.

As humble and simple as he was altruistic. The Global Post offered a more detailed account of his exploits, though it’s unfortunate that so few major media outlets mentioned him much before or after he died.

In his earlier years, Ritchie would physically restrain people from jumping off the cliff while his wife called the police, UPI reported. However, as he got older, he would simply offer distraught people at the edge of the Gap a cup of tea and someone to talk to.

Father Tony Doherty from Rose Bay Parish and a good friend of Ritchie’s told ABC News about the first time he saw Don literally talk someone off the ledge.

“I watched this figure gradually encourage [a man] to come back to the safety of the cliff,” said Father Doherty. “He has this wonderful soft, appealing voice that encouraged this little fellow not to jump.”

Ritchie won numerous community awards and a Medal of the Order of Australia for his efforts, and was named an Australian local hero of the year in 2011, according to the Telegraph. He also received gifts, Christmas cards, and letters from those he saved, sometimes a decade or two later, the Telegraph reported.

“Those who knew him knew he was a very strong person and a very capable person,” Ritchie’s daughter Sue told AAP News on Monday. “It was just something that he saw and that he had to do something about.”

However, Ritchie was not always successful in his attempts to stop suicides, according to the Telegraph. He saw several people jump, including one instance where he spoke to a quiet young man who “just kept looking straight ahead,”  Ritchie told The Sydney Morning Herald in 2009.

“I was talking to him for about half an hour thinking I was making headway,” said Ritchie. “I said ‘why don’t you come over for a cup of tea, or a beer, if you’d like one?’ He said ‘no’ and stepped straight off the side his hat blew up and I caught it in my hand.”

Whether he saved 160 people or 500 doesn’t matter – even saving a single human life is incalculably valuable. Mr. Ritchie has left behind quite a legacy: imagine having over a hundred people go on with their lives because you did nothing more than offer them an ear.

Not only is a wonderful example of the best aspects of humanity, but he offers an important lesson about what it takes to help another human being. All any of us want as humans, whether we’re suicidal or not, is someone to talk to and care. A small show of kindness or a simple offer to hear someone out could literally be all it takes. As Mr. Ritchie was found of saying, “a conversation could change a life.”

Indeed, he changed far more than many of course ever hope to. I hope more people take his lesson to heart. Think of all the lives we could improve or even save.

(To be clear, I’m not making light of suicidal and other morbid mental illnesses; obviously, certain individuals may require far more than human empathy to get better, as even Ritchie learned to his dismay. But the point is to at least make the effort. Taking a few minutes to check up on someone, be they friend or stranger, costs nothing but potentially save the most precious thing at all).

Finally, the Sydney Morning Herald also published an article that includes an interview with the charismatic but down-to-Earth Ritchie, whose sincerity and approachability makes it no mystery that he could coax people from the brink. As much as I’m tempted to mourn his death, I can’t help but feel happy that he lived such a full and accomplished life. I’m further consoled by the fact that there are many other low-key heroes just like him (including a very similar case in Japan).

 

Suicidal Ideation and Attention Seeking

Whenever I’m helping out someone who is suicidal or struggling with mental illness, I’m often advised not to bother, because such individuals are most likely trying to draw attention to themselves, and I’ll only be wasting my time.

First of all, I’d rather make the mistake of assuming an attention seeker is serious about their problem, rather than the other way around – a lot of people have lost their lives that way.

Second, and perhaps most importantly, the fact that someone is so desperate for attention is itself a problem worth addressing. Anyone who threatens drastic actions such as suicide in order to get others to care about them clearly needs love and help. Obviously, their tactics will need to be confronted and addressed eventually, but ignoring them isn’t going to help.

I’m not a psychiatrist. I don’t always have good advice, or any real solution for that matter. Sometimes I don’t even know what to say. But more often than not, all anyone wants – and I say this as a sufferer of depression – is just someone else to talk to, someone who cares. That much I can certainly offer. It may not be enough, but it may also be everything. It never hurts to try.

This is just what I’ve learned from experience. People are welcomed to share their own views and perspectives on the matter.

Another Child Commits Suicide Due to Bullying: A Reflection

I’m not one to make any exaggerated pronouncements whenever a disturbing trend begins to emerge, but I’m tempted to call this recent spate in bullying-related suicides something of an epidemic.

Suicide rates are already rising in many parts of the world, with particular growth among younger people. Like most social and psychological phenomena, the causes are complex, but the well-documented cases tend to stem from social pressure, especially abusive behavior by peers both in person and, increasingly, online.

Consider this recent heart wrenching tragedy:

Rachel Ehmke, a 13-year-old seventh grader in Mantorville, Minn., died April 29 after hanging herself at her home. The months leading up to the tragedy were a whirlwind of peer abuse instances, her parents say.

Now following Rachel’s Friday funeral that was met with widespread community condolences, Rick and Mary Ehmke are speaking out against the bullying they say their daughter endured at Kasson/Mantorville Middle School and online.

Rachel’s family and friends say the teen fell victim to school bullying last fall when her chewing gum was stuck to her textbooks and the word “slut” was scrawled across her gym locker, the Austin Daily Herald reports. And while she was outgoing, athletic and friendly, the same group of girls reportedly threatened Rachel and kept calling her a “prostitute,” though she had never kissed a boy, according to KMSP.

Two days before Rachel’s death, an anonymous text was sent to other students at the school, KARE reports.

It was pretty explicit. Something to the effect of that Rachel was a slut and to get her to leave the Kasson-Mantorville School, forward this to everyone you know,” parent Chris Flannery told the station.

But after the text was reported to authorities, it was traced to someone who wasn’t a student at the school, according to Minnesota Public Radio. The district’s bullying policy prohibits threats both in person and online, and promises investigations within 24 hours of any reported bullying.

This wasn’t kind of bullying we popularly imagine, the sort of “boys will be boys” or “girls will be girls” kind of behavior we expect among unruly, still mentally-developing kids. This was outright abuse, because as far as we can tell at this point, the girl did nothing to merit this kind of treatment. This wasn’t part of a larger feud or a personal misunderstanding. It was a concerted, deliberate, and persistent effort to attack her and her reputation without any apparent motive (not that it would be any more justified if there was one).

A beautiful and unique human being is now lost forever because of the wanton cruelty of others, at least one of whom wasn’t even part of her school. The worst part is that Ehmke had to come to terms with another common and underrated challenge with bullying:

Rachel reportedly pleaded with her father not to mention the bullying to school officials, for fear of worsening the situation. A note that her parents found after her death read, “I’m fine = I wish I could tell you how I really feel,” alongside a picture of a broken heart, according to KMSP.

In almost every one of these circumstances, the victim refrains from taking action on their bullying for fear of reprisals. The most prevalent concern, especially for boys, is the perception of weakness or cowardice – “telling on someone” is a serious infraction in youth social norms.

So the social pressure is two-fold: not only are you repressed for being who you are (or not being who others want you to be), but you must bear with the subsequent suffering in silence, lest you get even more ostracized. This makes the agony of bullying even more unbearable, and the mental and emotional strain is what ultimately leads some to death.

Now this is where many people will make the inevitable claim that kids like these are too sensitive or even cowardly. In fact, the upward trend in bullying-caused suicides is being seen as a reflection of how weak-minded and spineless our younger generations are. The problem isn’t the cruelty of others, which has always existed, but the fact that kids don’t know how to take it anymore, due to softer parents, an overly sensitive culture, and other societal factors.

While it’s true that bullying has always been around, we need to keep in mind that the psychological and social context has changed considerably. We live in a world where personal image is everything, and people have all sorts of venues in which they can make themselves known – and from which they can be judged, attacked, and discriminated against.

In a society that places ever more importance on how you’re perceived, and that has made social interaction of some kind ubiquitous and nearly unavoidable (even if it is electronic), the kind of merciless assaults on your self-worth that Rachel endured can literally kill you. This is especially true of young people whose values and worldviews are still underdeveloped, and where peer pressure is even more pronounced and influential.

Furthermore, we need to consider that there is increasing evidence that certain preexisting biological and neurological factors increase one’s likelihood to end their lives (or to endure other pre-suicidal mental illnesses). People with lower levels of serotonin in the brain, for example, have a much higher chance of killing themselves. When someone points out how plenty of people get bullied, yet only a few kill themselves, it’s not evidence that those few were especially sensitive; it could very well be that they happened to have had the innate biological and psychological factors that bullying ended up being triggering.

At any rate, it’s counterproductive and callous to write off the psychological anguish of people as a mere matter of personal weakness. If anything, such assumptions only strengthen the motivations of bullies, who often base their actions on this social-Darwinist notion of survival of the fittest. They may even dismiss any responsibility they had for their victim’s death by claiming they were just being cowardly anyway.

At any rate, bullying is clearly a problem of some kind, even if it weren’t driving people into suicide.

Dodge County authorities plan to meet this week to discuss possible criminal charges, the Star Tribune reports. But Rick Ehmke says the family doesn’t plan to press charges against those who bullied his daughter.

“They’re kids. They made some horrible decisions. If these kids would’ve known this would happen I’m pretty sure they never, ever would have done what they did,” Rick Ehmke told Minnesota Public Radio. “Sadly enough, even those kids that know who they are will carry this bag their whole life. That’s a sad thing too, it really is.”

I’d like to think they’d have that much remorse, but who knows anymore. As I stated before, many bullies just see it as survival of the fittest: people like Rachel were too weak to take it, so they had what was coming to them.

He also notes that the school should have taken heavier measures against the bullies when the taunting was first reported in the fall, adding that technology like phones and social media may have worsened an already bad situation by allowing the bully to essentially follow students home.

Words hurt. Word can kill,” mother Mary Ehmke told KARE.

Community members have planned a prayer vigil and walk in Rachel’s memory for 2 p.m. May 19 at Mill Pond in Austin, Minn. The walk aims to show support for the Ehmke family and raise awareness for teen suicide and bullying.

The U.S. Department of Education has identified 16 “key components” in state bullying legislation, including a statement of scope, listing of enumerated groups, process of district policy review, definitions and reporting guidelines. Minnesota ranks last in the country with its state bullying law only covering two of the 16 components, according to an Education Department analysis of state bullying laws released in December. Nebraska ranks second-to-last by covering four of the 16 components.

Statement of scope, one of the most common components of state bullying laws, establishes where legislation applies and what conditions must exist for schools to have authority over student conduct.

According to the Education Department report, Minnesota is one of just three states — alongside Wisconsin and Arizona — that prohibits bullying but doesn’t define that behavior. The state also doesn’t provide for its districts a model bullying policy, and at a mere 37 words, its anti-bullying law is the shortest one in the country:

Each school board shall adopt a written policy prohibiting intimidation and bullying of any student. The policy shall address intimidation and bullying in all forms, including, but not limited to, electronic forms and forms involving Internet use.

So what kind of problem is bullying, and what sort of solutions should be implementing? Is it something that requires legal and political action, as discussed above? Or is it more of a sociocultural problem, as I’m more inclined to believe? Maybe it’s a bit of both?

It’s important to note that many cases of bullying hardly black-and-white: polls have shown that as many kids identify as being both victims and perpetrators of bullying as being just one or the other. The problem seems to be that kids in general are just cruel to each other, period, and that some unfortunate number of them is being pushed to the edge due to preexisting psychological issues – which raises another area of action, namely improving our understanding of mental illness and our ability to both discuss it frankly and treat it.

The sad fact, as with most social issues, is that we can’t save everyone. There will always be immorality, and thus there will always be victims of it. But that doesn’t mean we can’t try to lessen the toll. The question is how we should, or even could, go about doing it.

I personally think that a lot of this comes down to improving the ethics, behavior, and psychological wellbeing of children. We should make the teaching of these values mandatory at every grade level, and have it be far more immersive and intensive. We should expand the counseling services of our schools, which are often the first to get cut or reduced. I’m not saying any of this will end bullying, but it may certainly help. Plus, it’s important to learn these sorts of things in general, not just to prevent bullying.

Of course this is only the start: a lot of this comes down to parenting, as well as to influence of society as a whole. Look at the political and public rhetoric out there, and you see a lot of examples of what we could otherwise call bullying: people demonizing each other, being arrogant, and refusing to hear one another out. We value toughness, hyper-individualism, consumerism, and other behaviors that may encourage a more egoistic and selfish worldview. In many ways, bullying is just a manifestation of the same sort of obsession with competition and success that pervades every segment of society: asserting your social superiority, proving to others you’re the toughest and baddest person around, etc. Might any of this play a role?

These are just my opinions though, and I could be dead wrong. Anyone care to comment or set me straight?

The Global Decline in Crime

Good news is hard to come by these days, especially on the socioeconomic front. Declining education standards, growing inequality, increasing political apathy and cynicism – it seems everything is going wrong in our society, except for at least one auspiciously absent source of dismay: criminality.

A widespread sentiment in this modern age is that crime is worse than ever and morality is in steep decline (to which I’d ask, when hasn’t that been true?). In any case, this could only be expected to worsen in light of the worst recession in seventy years. With all the other social dysfunctions taken into account, delinquency and criminality should be at an all time.

But all the relevant data surprisingly suggests otherwise. Foreign Policy reports:

For all the grim news about the economy and jobs over the last few years, one indicator of the quality of life in the United States has stubbornly continued to improve. The latest Federal Bureau of Investigation data suggests crime rates went on falling through the first half of 2011, recession be damned. In 1991, the overall national violent crime rate reported by the FBI was 758 cases per 100,000 inhabitants; by 2010, that had dropped to 404 per 100,000. The murder and “non-negligent homicide” rate dropped by more than half over the same period. You wouldn’t know it from watching television — beyond the continuing conviction that “if it bleeds it leads” on local news, the number of violent acts on prime-time TV shows climbs ever-upward. But that rise in fake violence may have played some role in the real-life trend heading squarely the other way.

But what about the rest of the world, much of which is impoverished and politically unstable?

The United States isn’t alone in a trend towards people just getting along better — it’s a global phenomenon. In 2001, homicide killed more than twice the number of people worldwide who died in wars (an estimated 557,000 people versus total war deaths of around 208,000). But just as in the United States, violent crime rates have been falling across a large part of the planet. The data is patchy, but in 2002, about 332,000 homicides from 94 countries around the globe were reported to the United Nations. By 2008, that had dropped to 289,000. And between those years, the homicide rate fell in 68 reporting countries and increased in only 26.

Look at the really long-term picture and violent crime rates are way down. Institute of Criminology professor Manuel Eisner reaches all the way back to the 13th century to report that typical homicide rates in Europe dropped from about 32 per 100,000 people in the Middle Ages down to 1.4 per 100,000 in the 20th century. (Sadly, of course, for all of their decline, U.S. rates are still more than three times that — a rate above what Eisner suggests is the Western average for the 1700s.)

The global picture of the last few years, along with the historical picture covering the West over the last 800 years, both suggest that there isn’t just a constant proportion of bad people out there who will commit a crime unless you lock them up before they do it. And there’s a lot more evidence that whatever is behind declining violence it isn’t the number behind bars — or, indeed, the length of sentencing or the number of cops on the street.

Of course, you have to wonder how many crimes actually get reported in the first place. And even then, it’s important to consider whether the reporting standards of some countries are up to par. In many parts of the world, the police aren’t seen as trustworthy or competent enough to contact in the event of a crime.

Still, this data is all we have to go by, and if we can safely assume that crime is indeed going down (especially in those countries with trustworthy data), then what’s the cause? How is it that all these social, economic, and political problems haven’t eroded human behavior?

It is true that a Pew Center report suggests that as U.S. crime rates were declining, the national prison population increased from 585,000 to 1.6 million between 1987 and 2007. But the rest of the world hasn’t followed the United States down the path towards mass incarceration, and yet has still seen declining violence. The U.N. crime trends survey suggests that homicides fell in Britain by 29 percent between 2003 and 2008 alone, for example. And yet the incarceration rate in Britain was one-fifth as high as the United States, according to the Pew report. Again, within the United States, one of the places with the most dramatic drops in violent crime is New York City — the homicide rate is 80 percent down from 1990. But while the rest of the country was locking up ever more people, New York City’s incarceration rate fell by 28 percent over the last two decades.

What about harsh punishment? Statistics from MIT psychologist Stephen Pinker’s new book on global trends in violence show the United States used to execute more than 100 times the amount of people in the 1600s as it does today — and yet violence rates then were far higher than today. Think Clint Eastwood’s western, The Good, the Bad and the Ugly: Despite all of the authorized hangings, there was still a lot of unofficial shooting. More broadly, the number of countries using the death penalty has declined worldwide — along with violent crime rates.

In a survey asking “What Do Economists Know About Crime” for the National Bureau of Economic Research (NBER), Angela Dills, Jeffrey Miron, and Garrett Summers conclude “economists know little.” They suggest that it isn’t just incarceration or the death penalty — any link between lower crime and the number of police, higher arrest rates, and the stock of guns (whether more or less of them) is weak. Studies from Latin America have echoed that longer sentences are not linked to lower crime rates — although a higher probability of being caught may be related to less violence in the region.

At the same time, for those convinced that crime is a product of poverty and inequality, the recent trends for New York and the nation as a whole also pose a challenge: For all the growing estates of the plutocrats in Wall Street, neither growing inequality nor rising unemployment has reversed the downward path of crime. Similarly, Latin American evidence suggests that while rising inequality might be linked to increased violence in the region, average incomes are not — richer countries are no safer than poorer ones, all else equal.

What about drugs, then? Interestingly, the NBER survey notes that drug enforcement might increase crime. The authors suggest that “If government forces a market underground, participants substitute violence for other dispute-resolution mechanisms,” — i.e., if they can’t go to court to settle their dispute over who gets which street corner, rival drug gangs will shoot each other instead.

As counterintuitive as it seems neither harsher punishment nor strong law enforcement necessarily reduces crime. Not even the death penalty or the availability of guns has any appreciable influence. At best these factors will have no effect, and at worst they will only make things worse. This is especially true of the war on drugs, which is a major contributor to our high incarceration rate:

New York’s experience suggests that it is possible to reduce the violence associated with drugs by taking those disputes off of the street. Franklin Zimring, a law professor at the University of California, Berkeley, suggests that one important factor behind the decline in homicide in New York was shutting down open-air drug markets. It didn’t slow sales, but it did eliminate 90 percent of drug-related killings over turf conflicts. Echoing the recent pattern in New York City, Eisner suggests that the long-term historical decline in Western homicide rates as a whole is associated with “a drop in male-to-male conflicts in public space.”

Given that decades of hardening our stance against crime has accomplished little, we could certainly use more innovative approaches like the one highlighted above. But even then, crime has been reduced across a variety of cities and regions that haven’t taken these effective approaches. So what gives? What’s ultimately causing crime to go down?

Over the sweep of centuries, Eisner suggests that cultural change — from “knightly warrior societies” to “pacified court societies” — is an important factor. So are we just getting more civilized, then? Indeed, the decline in violence coincides with global evidence of converging attitudes towards greater toleration. For example, the proportion of people worldwide who say they wouldn’t want to have a neighbor of a different religion dropped from 67 percent to 48 percent between the early 1990s and the mid-2000s. Turn on the television and you’d be sure to think that political dialogue is getting more rancid by day. And it might be, but people’s attitudes are actually becoming more pacific and tolerant.

Most socio-cultural trends are relative – yes intolerance and bigotry remain problematic, especially in some parts of the world. But it’s not as bad as it once was, nor does it lead to as much violence (if at all). Politics will always be dirty, but there’s no comparing the progressiveness of today’s average government and legal system with historical predecessors. On the whole, people are better educated, better governed, and more prosperous they their ancestors (even if improvements in these areas seem to be stagnating or declining).

But its gets more interesting:

Cultural factors are important, then. But before you rush to deride the Federal Communications Commission and the Supreme Court for their lackadaisical attitude to violence on television, note that the trend towards more — and more graphic — violence on TV doesn’t quite sync with the pattern of crime rates. A culture of violence and violence in popular culture are two very different things. In fact, one more element of cultural change that may behind declining violence is the substitution of fantasy violence for the real thing. French historian Robert Muchembeld argues in his book, History of Violence, that crime fiction and novels about war have given young men a way to indulge in violent fantasies without actually going out and stabbing someone. Or, over the last few years, they could stab someone playing Grand Theft Auto rather than stab someone while actually committing grand theft auto. This is the blood-and-gore version of the argument that more pornography leads to lower sexual violence.

There might be something to it. While exposing kids to the latest cadaver on CSI — or to Jack Bauer’s lessons in successful torture on 24 — is probably a bad idea, watching an action movie might in fact reduce violence among adults. A recent study in the Quarterly Journal of Economics suggests that violent crime rates actually dropped when a blood-splattered blockbuster was in the cinema in the United States. The authors Gordon Dahl and Stefano DellaVigna looked at data from 1995 to 2004 and concluded that violent movies deter almost 1,000 assaults on an average weekend in the United States.

Perhaps humanity will never completely abandon its lust for blood. But it appears that lust can in fact be sated using fake blood wielded by Hollywood special-effects technicians. And outside the theater, people respond to behavioral cues — if their friends don’t stab people to win an argument, they are less likely to do it themselves. They also respond to institutional cues — if they can use the courts to settle a dispute or address a wrong, they’re less likely to resort to blood feuds. All of which suggests the hope that, in years to come, there will be a lot more deaths on TV and movie screens than in the real world.

So there you have it. Our culture, from its values to its entertainment, has had mitigating effect on delinquency and immorality. Of course it’s more nuanced than that: our society also encourages a lot of consumerism and greed, while the public sphere is increasingly dominated by vitriol and partisanship. But again, it’s all relative, and today’s sociopolitical milieu is nowhere near as bad as it once was.

This doesn’t mean we should be complacent, given that cultures and society can always worsen or regress. But we should acknowledge that for all the problems we face, we’re improving in a lot of areas. We need to keep cultivating these sorts of principles so that more generations across the world can be positively influenced.

There’s also one grim fact to keep in mind: while global homicide rates have been decreasing precipitously, the number of suicides has climbed – more people kill themselves then are killed by others. And keep in mind that suicide tends to go underreported for religious and cultural reasons, so the margin between self-inflicted and interpersonal death may be even higher.

So as our societies move away from external conflicts with one another, we seem to be facing internalized struggles in their place. As I said, progress is always a nuanced thing.

Suicide: Facts and Figures

At one point in my life, I seriously considered pursuing a career in therapy, psychiatric medicine, or psychology. But for most of my life, up to this very day, I’ve remained very interested in these topics, as well as human behavior in general.

I befriended or otherwise became exposed to many people with a range of traumatic experience, mental illnesses, and social problems. Though I could scarcely relate with the bulk of them, my bouts of anxiety and depression, coupled with my own sense of social exclusion, gave me a certain sense of affinity towards these individuals.

I guess I was just interested in what the outcastes of society had to say, and where they were coming from, given how taboo these issues are (cruelly, society’s inability to discuss them openly and normally only makes the problem worse).

The issue of suicide is one that particularly interests me. Part of it has to do with my fascination with death, but most of it stems from trying to understand how and why a person would come to do something that, for all intents and purposes, seems the most counterintuitive imaginable.

To that end, I’m compiled an amateur “study” of suicide based on what I’ve read across a range of sources, from Wikipedia to government health agencies. Note that I’m not presenting anything here as rock solid, as I frankly haven’t had the time to glean through the reliability of this data.

Furthermore, suicide – like most sociological and psychological topics – is still poorly understood and very hard to measure. I’m only sharing this to give people a rough idea of some of the clearer things we know, and to raise attention to this growing and underestimated problem.

Challenges
Studying suicide can be very difficult, and not just because it’s a taboo subject (like everything related to death). The actual incidence of suicide will probably never be known, given that so many cases go unreported as a result of religious and social pressures. Even so, there are a few definitive trends that can still be gleaned from what we have been able to confirm.

Epidemiology
A 2006 report by the World Health Organisation (WHO) states that nearly a million people take their own lives every year, and another 10 to 20 million make the attempt. This would mean that at least one person somewhere in the world takes their own life every 40 seconds. This would me that more people kill themselves than are killed in military conflicts – in fact, in many countries, the rate of suicide is higher than that of homicide. Suicide is anywhere from the 10th to 13th leading cause of death worldwide.

Suicide Rates Around the World
The rates of suicide by region and country vary wildly based on the data. Overall, it appears that the Baltic states, the former Soviet Union (especially the Slavic parts), andEast Asia have the highest rate of suicide. In some cases, the Pacific Islands, South Asia, and Sub-Saharan Africa also seem to top the list.

Western Europe, North America, and Oceania (namely Australia and New Zealand) are somewhere in the middle, while Latin America, the Caribbean, North Africa, Central Asia, and Muslim-majority countries have among the lowest. Overall, however, suicide rates have grown across the world, including in developing countries.

In terms of individual countries, Lithuania, Belarus, Ukraine, Russia, Japan, and South Korea generally top the charts as far as suicide rates.  Other countries currently at the top of the list (again, depending on the source) include Guyana, Sri Lanka, Kazakhstan, Hungary, Slovenia, and China.

Contrary to popular belief, the Scandinavian nations do not have a particularly high rate of suicide, with the possible exception ofFinland(more on that later).

Suicide Clusters
According to the National Institute of Mental Health, suicide contagion is a serious problem, especially for young people. A phenomenon known as the Werther Effect describes the tendency for copy-cat suicides to emerge following a well-publicized case of suicide on the media. The exact psychological and social mechanics of this are still unknown.

In the United States, males are four times more likely to die by suicide than females, although women are four times more likely to attempt it. The most recent data found that in the US, suicide was the 8th leading cause of death for males, and the 19th leading cause of death for females (in general, it may be the 6th leading cause of death for Americans).

This isn’t unique to the US however: male suicide rates are higher than females in all age groups, and among nearly all countries. The former Soviet Union sees a particularly high imbalance: the overwhelming majority of suicide victims are male (as high as 90% inBelarus, and close to it in Russia, Ukraine, and Lithuania).China is the only country in which the rate between men and women is more or less the same.

The reasons for this imbalance may have a lot to do with methodology, as males tend to use far more violent means to end their lives (such as firearms) then females (who generally prefer overdoses, which have a comparative lower chance of mortality than a gun).

It may also have to do with the social pressures that are placed upon men, who have higher expectations of being emotionally strong or financial independent: males generally take unemployment, infirmity, and other “signs of weakness” far worse then women, leading to more psychological distress and, subsequently, a higher rate of suicide.

Finally, there may be a biological aspect involved: testosterone generally leads to greater impulsivity and risk-taking (though not aggression, as is popularly believed). This tendency may lead men to reach the final tipping point in ending their lives.

Race, Ethnicity  and Suicide
As of 2003, American whites were nearly 2.5 times more likely to kill themselves than were blacks or Hispanics. It’s unknown why suicide, and mental illness issues in general for that matter, seem to be more of an “Anglo” problem (similar racial discrepancies have been observed in other Anglophone countries such as the UK, Canada, and Australia).

Suicide rates are higher – and steadily increasing – among many East Asian Pacific-Island countries, despite the fact that Americans from these regions don’t have particularly high rates, thereby suggesting that domestic and social dynamics within those nations play a larger role.

I’ve read elsewhere that Native Americans, Multiracial Americans, and Filipino Americans have the highest risk of suicide, though I can’t confirm the veracity of this claim. It is certainly true that indigenous people in Anglo countries have higher rates of social and mental problems, which would put them at greater risk of suicide and other self-destructive behavior.

The Finno-Ugrian suicide hypothesis suggests that there may be some sort of genetic element that determines suicide risk. The Mari and Udmurts ethnic group have been found to have three times the suicide rate of closely related Finns and Hungarians, who also have relatively high rates. The genetic ties originating among Finno-Ugric these groups suggest that perhaps there is some sort of allele that predisposes people towards suicidal behavior.

Sexual Orientation and Suicide
LGBT people have a higher chance of suicide than heterosexuals and non-transgendered people. Additionally, lesbians are more likely to attempt than gay or bisexual males.

There’s also a dynamic regarding race and age: male whites have higher incidences up until the age of 25, after which their risk is down to less than half of what it was; black gays, on the other hand, will see their risk continue steadily past that point. Throughout a lifetime the risks are 5.7 times higher than heterosexuals for whites, and 12.8 for black gay and bisexual males.

With regards to lesbian and bisexual females, the opposite is true: there are less attempts in their youth compared to young heterosexual females. Throughout their lifetime the likelihood to attempt are nearly triple the youth ratio for Caucasian females, though for black females the rate is affected very little, as heterosexual black females have a slightly higher risk throughout most of the age-based study.

Gay and lesbian youth who attempt suicide are disproportionately subject to anti-gay attitudes, lack the skills for coping with subsequent discrimination, isolation, and loneliness, and were more likely to experience family rejection than those who do not attempt suicide. Another study found that gay and bisexual youth who attempted suicide had more feminine gender roles, adopted an LGB identity at a young age, and were more likely than peers to report sexual abuse, drug abuse, and arrests for misconduct.

In other words, being homosexual in itself doesn’t raise the risk, but the way your loved ones – and society as a whole – regard it. Homosexuals who feel accepted are obviously going to suffer less abuse, and thus psychological trauma, than those who don’t.

On the other hand, one study among Norwegians found that homosexual behavior, but not homosexual attraction or homosexual identity, was the determining factor for suicide among adolescents. InDenmark, the suicide risk for men in registered domestic partnerships was nearly eight times greater than for men with in healthy heterosexual marriage, and nearly twice as high for men who had never married. Given the biological origins of homosexuality, it’s possible that certain psychological factors are congenital with those that influence sexuality.

Risk Factors of Suicide
Clinical studies have shown that underlying mental disorders are present in 87% to 98% of suicides; however, there are numerous factors that correlation with (though may not necessarily cause) suicide risk, including drug addiction, availability of means, family history of suicide, or even brain injury.

Socioeconomic
Suicide rates rise during times of economic uncertainty, and although poverty is not a direct cause, it can contribute to the risk of suicide given that depression rates are high among the poor. Most studies show a relationship between suicide or suicidal behavior, and socio-economic distress, which includes low educational achievement, homelessness, unemployment, economic dependency (whether on loved ones or the state), and brush ups with the law. A history of childhood physical or sexual abuse, and time spent in foster care, are also factors.

One study among prison inmates found that suicide rates were higher among those who had committed a violent crime. It’s possible that the trauma of violence, or the preexisting mental problems that lead to violent behavior, influence “self-violence” as well, in the form of suicide and other destructive behavior.

Emotional
Despair, a belief that there is no prospect of improvement in one’s situation, is a strong indicator of suicide, with the results of one study showing that 91% of those who scored a 10 or higher on the Beck Hopelessness Scale would eventually commit suicide.

A feeling that one’s existence is a burden to others, namely caregivers and loved ones, is often coupled with despair. In fact, several studies have found this sentiment to be a very prominent risk factor: it is believed that the lethality of a suicide is higher when it is done out of “altruism” – e.g. removing the burden on others – then when driven by other factors. In a similar vein, non-lethal self-injuries, be they self-injury or para-suicide, are characterized by feelings of anger or self-punishment. It’s sad to imagine that our capacity for caring about one another is strong enough to be the greatest incentive for taking our own lives.

Loneliness is a major factor in suicide, whether it is emotional (feeling isolated) or real (living alone or lacking friends and a social network). After despair and burdensomeness, a feeling of not belonging is strongly present in those expressing suicidal ideation.

Intelligence may also be a factor, as a relationship between high IQ and suicide has been found in a number of studies. This fits with the wider pattern of intelligent people having higher rates of depression and psychological distress. A classical argument is that it takes a certain amount of intelligence to commit suicide – existential contemplations, or an intimate understanding of the negative aspects of reality (war, poverty, etc), may drive someone into experiencing the feelings that precipitate suicide, such as despair. However, intelligence in itself is not an accurate predictor of suicide, as near as we can tell.

According to the American Psychiatric Association, “religiously unaffiliated subjects had significantly more lifetime suicide attempts and more first-degree relatives who committed suicide than subjects who endorsed a religious affiliation.” Moreover, individuals with no religious affiliation were found to have fewer moral objections to suicide than believers – unsurprising, given that nearly every religion treats suicide as a taboo (especially the Abrahamic ones).

However, it should be noted that the largely irreligious societies of countries such as Australia or Sweden do not have particularly high rates of suicide. It may be that, like homosexuals, the nonreligious experience higher rates of distress in environments where their identity is marginalized or isolated (such as in highly-religiousAmerica).

Medical Conditions
A significant link has been found between suicidal ideation and certain medical conditions such as chronic pain, physical disabilities, infirmity, and brain injury. Even after adjusting for other factors, such as depression, patients with these conditions still had a high risk of suicide. The risk is particularly greater when there are multiple conditions.

The most common medical conditions associated with psychiatric problems in general include, by order of frequency: infectious, pulmonary, thyroid, diabetic, hematopoietic, hepatic, and neurological diseases. At a minimum, around 10% of all psychological symptoms may be attributed to undiagnosed medical problems, and one study suggested that about 50% of individuals with a serious mental illness also suffer from an untreated that may contribute to or cause psychiatric problems. This has lead to the suggestion that general medical settings should also consider signs of suicidal ideation.

A lack of sleep, especially when resulting from chronic conditions such as insomnia and sleep apnea, have been cited in various studies as risk indicators for depression and suicide; in fact, sleep disturbances alone can increase the risk of suicide, a consequence of the mind’s impaired judgment and cognition resulting from a lack of rest.

Mental Disorders
Certain mental disorders are present in those that attempt or commit suicide – it is estimated that 87% to 98% of suicides are committed by people with some type of mental disorder. The most common are mood disorders like depression (accounting for 30% of cases), substance abuse (18%), schizophrenia (14%), and personality disorders (13%).

Unsurprisingly, depression (whether clinical or as part of bipolar disorder) is the most common factor in suicide attempts, and the risk is particularly high for those in the earlier stages of the condition. Depression along is among the most commonly diagnosed psychiatric disorder, affecting 17.6 million Americans (roughly 1 in 6 people) and millions more worldwide. If current trends persist, than within the next two decades, clinical depression may become the leading cause of disability in developed nations and the second leading cause of disability worldwide.

Though no longer classified as suicide attempts, incidences of self-harm have been correlated to increased suicide risk, though this may have less to do with causality and more to two with both suicide and self-injury being symptoms of broader depression. Deliberate self-harm and is most common in younger people, but recently begun rising among all age groups.

The majority of people who attempt suicide fail at their first try; but a history of suicide attempts leads to an increased likelihood that the individual will eventually succeed.

Biological 
Some of the aforementioned mental disorders that increase suicide risk often have an underlying biological cause. The hormone serotonin is a vital neurotransmitter for facilitating brain function; those who have attempted suicide have been found to have below-normal serotonin levels, while those who succeeded had even less. An alteration in the serotonin activity in the ventromedial prefrontal cortex has been found to be a risk factor for suicide, regardless of other factors, including depression.

There is also a neurobiological basis for suicide risk that is independent of the genetic factors that cause high-risk mental disorders. A level of heritability has been found among suicidal individuals, so that a family history of suicide – especially if a parent has committed the act – raises the likelihood. This may also be related to epigenetics, in which environmental factors alter gene expression (but not genes themselves), leading to a change in one’s biology that increases suicide risk.

Evolutionary Psychology
One explanation is that suicide may be informed by an evolutionary drive to benefit one’s kin. Similar to the burdensomeness factor, people who perceive their existence to be detrimental to their family may take their own lives to preserve their loved ones’ own wellbeing. However, many healthy or otherwise productive people commit suicide as well, so this explanation may insufficient, at least as far as addressing all causes of suicide.

Society
Generally, higher levels of social and national cohesion reduce suicide rates. Suicide levels are highest among the retired, unemployed, impoverished, divorced, the childless, urbanites, empty nesters, and other people who live alone. However, it should be noted that even communitarian societies, such as those of East Asia, have high suicide rates, so social cohesion alone is not a sufficient predictor of risk.

Social attitudes towards death or suicide may also play a role: broadly speaking, Japan and Korea have a less taboo view of suicide than many Western nations do. Countries with high rates of death, such as much of the formerSoviet Union, may have a social milieu that places less value on life.

Believe it or not, war is traditionally believed to be associated with a fall in suicide rates, though this has been questioned in recent studies that show a more mixed influence. It’s certainly true that among those who are actually participating in war, suicide rates are higher, due to mounting psychological trauma and a military culture that is not conducive to expressions of “weakness.”

Substance Abuse and Suicide
In the United States 16.5% of suicides are related to alcohol, and alcoholics are 5 to 20 times more likely to kill themselves. In fact, about 15% of alcoholics commit suicide, and about 33% of suicide by people under 35 is tied or alcohol or substance abuse – over 50% of all suicides in general are related to alcohol or drug dependence. This correlation is particularly pronounced among adolescents, as alcohol or drug misuse plays a role in up to 70% of their suicides. The misuse of any drug increases the risk 10 to 20 times among all groups.

Time and Season
The idea that suicide is more common during the winter holidays, particularly Christmas, is actually a myth, generally reinforced by a confirmation bias among the media: suicides during this period are given disproportionate attention, most likely because the act is more sensationalized and tragic given the pervasive holiday spirit.

On the contrary, the National Center for Health Statistics found that suicides drop during the winter months, and peak during spring and early summer. Considering that there is a correlation between the winter season and rates of depression, there are theories that this might be accounted for by capability to commit suicide and relative cheerfulness – people commit suicide after the long period of depression from the proceeding winter.

The variation in suicides by day of week is actually greater than any seasonal variation. In the United States, more people die by suicide on Monday than any other day, while Saturday is the day with the least number of suicides.

Certain time trends can be related to the type of death. In the United Kingdom, for example, the steady rise in suicides from 1945 to 1963 was thereafter reduced to some extent by the removal of carbon monoxide from domestic gas supplies, which occurred with the change from coal gas to natural gas during the 1960s.

Cultural Variations in Methodology
Methods vary across cultures, depending on the access to certain lethal substances and means. In the United States for example, self-inflicted death by firearm is the most common method, due to the wide availability of guns. In many developing countries, the use of pesticides is more popular, due to the abundance of agricultural activity.

Weight and Body Type
Apparently, suicide rates are markedly lower among obese people, and the risk of suicide seems to decline as one’s weight increase. It’s unknown why this is the case, but it’s been hypothesized that a larger body weight leads to a higher circulation of hormones such as tryptophan, serotonin, and leptin, all of which reduce impulsive behavior.

Global Trends
It is estimated that global annual suicide fatalities could rise to 1.5 million by 2020. As it stands, globally-speaking, suicide ranks among the three leading causes of death among those aged 15–44 years. As I noted earlier, it’s already the 10th to 13th leading cause of death in general.

Furthermore, suicide attempts are up to 20 times more frequent than completed suicide, suggesting the suicidal tendencies in general are rising. Once again, keep in mind that these are just the reported cases: many suicides could be deliberately or accidentally recorded as a result of unintentional injury.