Suicidal behavior has been found to cluster in and around certain areas and groups. For example, the nine western states that make up the “suicide belt” in the United States, including Arizona, Oregon, and Wyoming, consistently report higher suicide rates than the rest of the country. Research also finds that suicidal behavior can “spread” between individuals; when someone experiences a friend or loved one’s suicide, he is much more likely to attempt his own suicide. If suicide is contagious, how and why does it spread?
In their analysis of suicide contagion among young adults, Anna Mueller and Seth Abrutyn use network data from a national survey of adolescents to analyze how the disclosed and undisclosed suicide attempts of one adolescent affects the suicide attempts and ideation of that adolescent’s friends one year later. They find that when an adolescent knows about their friend’s suicide attempts, they are more likely to think about and attempt suicide themselves. However, they find that undisclosed suicide attempts and ideations do not result in suicidal attempts or ideation among their friends.
Mueller and Abrutyn conclude that when an individual shares their suicide attempts with their friends, it “transforms the distant idea of suicide—as something that other people do—into something that people like them use to cope with distress, sorrow, or alienation.” They argue that suicide spreads when it becomes a “cultural script” for coping with emotional distress; the more someone is exposed to suicidal behavior among their peers, the more likely the generalized idea of suicide will become an acceptable option for how that individual deals with her own distress. When suicide becomes prevalent enough in a peer group or culture to qualify as an option, it is much more likely to spread.
Jason — July 30, 2015
I work for the military and I've had hours and hours of suicide prevention training. There is even a funny pie chart about training in the military that labels 50% as "don't kill yourself training." People are encouraged to talk about their thoughts on suicide and share their ideations. I wonder, in light of the study mentioned, if sharing those ideations should only happen with a professional counselor.
Anna S. Mueller — July 30, 2015
Jacqui, thanks for the great summary of our article!
Jason, You bring up an interesting and complicated thing with regard to suicide. There is often a fear that if we talk about suicide we may inadvertently promote it; at the same time, if we don't talk about suicide we will certainly miss opportunities to help people who need help. There is so much shame/silence and stigma around suicide that my sense (and many suicidologists share this perspective) is that we should encourage people to be open about their mental health struggles, even if that means disclosing suicidality, because that will help connect people with the help they need.
I will also add two things that are more directly based on the study above (of which I am an author): (1) while adolescents who reported that a friend attempted suicide (a disclosed attempt) were more likely to report suicidality, we did not find the same for adolescents with friends who reported suicide ideation - so the difference between an suicide attempt and suicidal thoughts may be important, with exposure to a suicide attempt (or death) of a friend being significantly more harmful than exposure to a friend with suicide ideation. We could extrapolate from this to conclude that talking about suicide may not be as risky as having suicide modeled for an individual. Since suicide prevention trainings involve talking about suicide, I don't think they are risky per se (and some reasons has shown that some trainings, like QPR trainings, are effective at preventing suicide). Further, (2) Talking with trusted friends or mentors about our struggles can diminish our sense of isolation and increase our sense of social integration - both of which are known to prevent against suicide. I would not want people to stop talking about their struggles for fear of promoting suicide. That said, we should not leave youth (who were the focus of this study) alone to cope with their friend's suicide attempt and we should see this group as a vulnerable population. We discuss all of this in a bit more detail in the discussion of the paper. Thanks for sharing your thoughts! ~ Anna (@ProcAnna)
Jacqui Frost — July 30, 2015
Thanks so much for you response, Anna! You bring up really important points about the complexities of shared suicidal attempts and ideations and the importance of supporting both those who have attempted suicide and have suicidal thoughts and those who they share them with.