9.   AN OLD STUDY WITH INTERESTING DATA

10.   SUICIDAL SYMPTOMS IN POLICE OFFICERS

Previous studies refer to several symptoms detected (after the fact) in police officers who had committed suicide. A psychological autopsy of the suicides almost always pointed to the following behavioral signs:

1. A clear and obvious threat to commit suicide (which must always be taken very seriously)
2. Cries for help, but not necessarily clearly expressed, verbal pleas; sometimes distress signals were simply in the form of indications of impotence, despair, implicit and camouflaged pleas for help
3. Abrupt changes in behavior unexplained, weird behavior
4. Bad mood, aggression, irritability, violent temper
5. Confusion, illogical speech
6. Morbid fear
7. Feelings of persecution
8. Anxiety
9. Insomnia, loss of appetite, shaky hands
10. Isolation, an attempt to withdraw or seek solitude,
introversion
11. Friendships dripped
12. Appearance neglected
13. Lethargy
14. Sudden preoccupation with death and what happens   after
15. Tendency to give away property, particularly things of  value

Pay close attention to someone who appears to get his energy back after going through a period of depression or withdrawal, or after simply talking about suicide. The change in behavior might be due to the fact that decision to commit suicide has been made.

OUR RESEARCH

Our research focused on 27 cases of police suicide that occurred in Quebec between August 1973 and March 1983.

Let's look at the data gathered following the analysis of the various files consulted. Needless to say this data is in no way intended to incriminate the police departments, the personnel involved or the families. The statistics must be regarded from a scientific perspective only, bearing in mind that the purpose of this study is one of research and prevention. We are in no way attempting to relegate guilt or responsibility; we are merely trying to establish statistical standards regarding the circumstances, apparent causes and symptoms or early warning signs, in order to determine how best to prevent suicide, or at least recognize symptoms in time.

A)  The Circumstances Surrounding The Suicides of 27 Police Officers

1. Sex
        Men    27
        Women     0

2. Rank
        Constables    16
        Corporals    5
        Sergeants    3         Suicide can strike at any level
        Lieutenant    1
        Directors    2

3. Age
        20-24    4
        25-29    1
        30-34    5
        35-39    5                 Suicide can strike at any age
        40-44    5
        45-49    4
        50 and up    3

4. Marital status
        Married    11
        Common-law relationship    7
        Separated-divorced    6          Suicide does not depend on marital status.
        Separated-divorce twice    2
        Single    3

5. At the time of suicide:
        Was on duty or was on sick leave     14
        Was on sick leave    5
        Committed suicide immediately              Suicide strikes at any time.
            before going on duty     5                 
        Immediately after retirement     2
        Committed suicide soon after he went on duty     1
(It should be noted that only one individual killed himself while on duty.)

6. Season of the suicide
        Spring    13
        Summer    4
        Fall    4                           Suicide strikes in any season
        Winter    2
        Not specified in the file      4
(It should be noted, that spring appears to be a critical period.)

7. Day of the suicide
        Sunday    5
        Monday    1                   Suicide can strike on any day.
        Tuesday    2
        Wednesday    6
        Thursday    2                 However, Sunday and Wednesday appear to be
        Friday    2                     the most critical days.
        Saturday    2
        Not specified in the file    7

8. Time of the suicide:
       00:00- 3:59     1
        4:00- 7:59      0
        8:00-11:59     4                  Suicide occurs at any time but it would
      12:00-15:50    11                  appear that, the critical time is between
      16:00-19:59      0                 0800 and 1600
      20:00-23:59      2
Not specified in the file   9

9. Means used:
        Gun: Out of 21, 18 had used their service revolvers.
        Out of these 18, 2 had slashed their wrists before hand.
        9 mm automatic service pistol 1
        collector's item pistol 1
        22 gauge shotgun 1
        Hanging 3
        Asphyxiation 1
        Jumping from a great height 1
        Medication 1

Eighteen causes we cited following an analysis of the 27 files. These causes are listed below, in order of quantitative importance; i.e. starting with the most frequent causes.

1. Experienced professional failure (failed promotion exams, even repeatedly)     12
2. Experienced problems in adapting to a transfer, home sickness    10
3. Felt useless, did not like work, dissatisfied with work    9
4. Did not appear to fin into the police organization    8
5. Felt powerless (did not have what it takes to be a police officer - appeared limited)     7
6. Had major family problems    7
7. Had problems with alcoholism    6
8. Felt guilty about everything, not matter what it was    6
9. Used tranquilizer    5
10. Had emotional problems (woman problems, unlucky in love)    5
11. Had financial problems    4
12. Suffered severe deprivation during childhood    4
13. Had health problems or was injured while on duty; felt less useful    3
14. Was the victim of a shock (death of a close one, suicide of a friend)    3
15. Was guilty of reprehensible acts (killed someone, voluntarily or accidentally)     3
16. Raised in a depressed family environment    3
17. Combined the use of tranquilizers and alcohol     2
18. Had been shot before    1

C) Symptoms or Early Warning Signs of Suicide

Pay close attention to severe psychiatric, psychological or physical problems: 13 had lengthy psychiatric and/or psychological files; 7 had voluminous medical files.

Hence we can see that we must be very careful with such cases. It is not a question of discrimination; on the contrary, we should ensure that these people receive preventive care and follow-up tailored to their needs. For the sake of their own welfare, we must not be afraid to take away their guns and take them off the job, if necessary. We must ensure that they are psychologically ready before they assume their former duties, or assign them to new duties better suited to them.

Let us now take a look at the 28 symptoms or early warning signs that the 27 police officers showed, which we will now use to help others: these signs are visible to superiors, peers or colleagues, subordinates, family members (spouses, children) and, most often, to their partners.
(The signs are listed below in order of quantitative importance.)

1. For some time or for a few days, he has been depressed, not himself, he does not have any energy,  "pep" or motivation    19

2. He is no longer involved in sports and pays no attention to his
physical fitness    14

3. He is introverted, withdrawn, solitary, shy and even awkward, he does not say much any more, or says nothing at all, he does not confide in anyone     13

4. He is an alcoholic or is turning more and more to alcohol    10

5. He is given to having accidents with his personal car and his service vehicle (1,2,3 and even more accidents) ("accident-prone")    10

6. He is anxious, anguished    9

7. He looks very tired or is suffering from overwork    9

8. He has told others about his thoughts of suicide    8

9. He uses tranquilizers    8

10. He is emotionally unstable    7

11. He is having trouble concentrating and often hurts himself  (unlucky)     7

12. He has a discipline file (often very lengthy)    7

13. He is arrogant, aggressive, impulsive, violent     7

14. He is very proud and unable to deal with frustration    7

15. He often cries    6

16. He is nervous, or more nervous than before    6

17. He has talked about killing somebody.  Under the influence of alcohol or on an empty stomach.  He has talked about using a gun.  He has started to take out his gun (for no reason)    5

18. He is an insomniac    5

19. He appears to be very pensive    5

20. He has complexes (physical or other)    5

21. He is jealous    5

22. He is disillusioned    4

23. He suffers from high blood pressure    4

24. He has tried to commit suicide    3

25. He uses tranquilizers combined with alcohol (very dangerous)    3

26. He has written one or more strange letters to those close to him, in which he talked about life, death, the purpose of life, or he has made his last wishes known, in case something were to happen to him one of these days    3

27. He has written or rewritten his will and talked about it in a weird and unusual
way      2

28. He has let it be known, in a mysterious way, that he had something important to do (or something like that)     2                     


Here we have a list of the 28 symptoms, warning signs or signals that constitute a major police suicide syndrome.

It goes without saying, however, that the appearance of one of these symptoms does not automatically mean that a police officer is contemplating suicide!

However, it should be noted that, if the manifestation of one of these signs is sufficiently severe, or if several of these symptoms are evident in the same police officer, his family, social or professional milieu should take not, so that competent, trained specialists can intervene.

Jerry Dash and Martin Riser, in an article entitled "Suicide among police urban law enforcement agencies", explain why the suicide rate in the Los Angeles Police Department is low in comparison with other police forces.

The authors claim that it is the result of the rigorous screening and evolution of police personnel. Even their emotional stability is examined. Aspiring police officers who do not pass the psychological, physical, written and oral tests are eliminated.

The low suicide rate over the past few years is also attributed to the fact that a general program has been implemented to prevent mental health problems. Psychologists involved in the program provide training, organize group meetings and seminars and do personal and family counseling.

Los Angeles' example appears to answer the question of how to prevent police suicides. To be sure, if someone is dealing with the causes and symptoms mentioned previously, the prevention of suicide is almost automatically ensured.

Such prevention is beneficial not only to the suicidal police officers, but also to the police department, family and society as a whole.

This is why we strongly encourage the creation of a psychological services section of police officers by ensuring that applicants have the necessary psychological profile. Also, prevention counseling and treatment could be provided.

Thought should also be given to creating a special police suicide prevention service; a department that would be independent of police organizations and therefore absolutely impartial. This department should be run by competent individuals who are familiar with the police environment and related problems. We are therefore looking at a skilled and highly confidential service, a provincial service available to all police officers, whenever necessary.

It is recommended that the following steps be taken:

1. Establish an atmosphere of confidentiality.

2. Try to understand what the person is going through (the easiest way to do this is to simply ask the person directly) and have his talk about the problem; in other words, what hurts him so much that he wants to stop loving.

3. Assess the risk of the person committing suicide in the near future: talk to him about his desire for death; ask him when and how he plans to kill himself. if the method he has chosen is easily accessible at any time, the danger of his carrying out his plan is greater.

4. Try to find the best approach to talk with the person: should you be direct, tread lightly or be calm? Should you be authoritarian, tell him what to do or simply provide advice?

5. Avoid sermonizing: do not tell him to banish all thoughts of death from his mind; rather, talk about the issue, so that he realizes all of the implications of his act. Do not tell him that committing suicide would be bad or that he is crazy. Such comments serve no purpose and will not help him.

6. Do not give your recipes for happiness to the suicidal person, because everyone has his own way of living and being happy. depending on his background, personality, etc. Instead, try to see what he thinks would make him happy, try to find other solutions (aside from suicide) that would enable him to get through his crisis.

7. Try to pinpoint what activity the person likes or liked before things started deteriorating. Encourage him to pursue activities, to meet people, but at a rate that is in keeping with his current abilities.

8. Do not try to help the suicidal person by doing everything for him. He will then think that he is no longer able to take action, that you no longer trust him.

9. Explain to the individual that he does not have to make threats or attempt to commit suicide to make sure that you will understand how he feels and be willing to help. This is sometimes how a suicidal person expresses his despair. Explain that it is not necessary to resort to this techniques, that you are there, you understand and want to help.

10. Once again, if you fear that the person is really going to commit suicide, put the question to him directly, finding out when and how he plans to do it. In an emergency, contact your nearest suicide prevention center.

11. Do not forget to respect your limitations in what you can and cannot do as far as helping the suicidal person is concerned.

12. Remember that you are not responsible for what he does. He is the one who decides to kill himself, not you, regardless of what he may say.

These notions apply to any suicidal person in general and, therefore, to the police officer in particular.

I am not advocating that you assume the role of a trained specialist, but I am saying that everyone can do something.

10.   SUICIDAL SYMPTOMS IN POLICE OFFICERS

Previous studies refer to several symptoms detected (after the fact) in police officers who had committed suicide. A psychological autopsy of the suicides almost always pointed to the following behavioral signs:

1. A clear and obvious threat to commit suicide (which must always be taken very seriously)
2. Cries for help, but not necessarily clearly expressed, verbal pleas; sometimes distress signals were simply in the form of indications of impotence, despair, implicit and camouflaged pleas for help
3. Abrupt changes in behavior unexplained, weird behavior
4. Bad mood, aggression, irritability, violent temper
5. Confusion, illogical speech
6. Morbid fear
7. Feelings of persecution
8. Anxiety
9. Insomnia, loss of appetite, shaky hands
10. Isolation, an attempt to withdraw or seek solitude,
introversion
11. Friendships dripped
12. Appearance neglected
13. Lethargy
14. Sudden preoccupation with death and what happens   after
15. Tendency to give away property, particularly things of  value

Pay close attention to someone who appears to get his energy back after going through a period of depression or withdrawal, or after simply talking about suicide. The change in behavior might be due to the fact that decision to commit suicide has been made.

OUR RESEARCH

Our research focused on 27 cases of police suicide that occurred in Quebec between August 1973 and March 1983.

Let's look at the data gathered following the analysis of the various files consulted. Needless to say this data is in no way intended to incriminate the police departments, the personnel involved or the families. The statistics must be regarded from a scientific perspective only, bearing in mind that the purpose of this study is one of research and prevention. We are in no way attempting to relegate guilt or responsibility; we are merely trying to establish statistical standards regarding the circumstances, apparent causes and symptoms or early warning signs, in order to determine how best to prevent suicide, or at least recognize symptoms in time.

A)  The Circumstances Surrounding The Suicides of 27 Police Officers

1. Sex
        Men    27
        Women     0

2. Rank
        Constables    16
        Corporals    5
        Sergeants    3         Suicide can strike at any level
        Lieutenant    1
        Directors    2

3. Age
        20-24    4
        25-29    1
        30-34    5
        35-39    5                 Suicide can strike at any age
        40-44    5
        45-49    4
        50 and up    3

4. Marital status
        Married    11
        Common-law relationship    7
        Separated-divorced    6          Suicide does not depend on marital status.
        Separated-divorce twice    2
        Single    3

5. At the time of suicide:
        Was on duty or was on sick leave     14
        Was on sick leave    5
        Committed suicide immediately              Suicide strikes at any time.
            before going on duty     5                 
        Immediately after retirement     2
        Committed suicide soon after he went on duty     1
(It should be noted that only one individual killed himself while on duty.)

6. Season of the suicide
        Spring    13
        Summer    4
        Fall    4                           Suicide strikes in any season
        Winter    2
        Not specified in the file      4
(It should be noted, that spring appears to be a critical period.)

7. Day of the suicide
        Sunday    5
        Monday    1                   Suicide can strike on any day.
        Tuesday    2
        Wednesday    6
        Thursday    2                 However, Sunday and Wednesday appear to be
        Friday    2                     the most critical days.
        Saturday    2
        Not specified in the file    7

8. Time of the suicide:
       00:00- 3:59     1
        4:00- 7:59      0
        8:00-11:59     4                  Suicide occurs at any time but it would
      12:00-15:50    11                  appear that, the critical time is between
      16:00-19:59      0                 0800 and 1600
      20:00-23:59      2
Not specified in the file   9

9. Means used:
        Gun: Out of 21, 18 had used their service revolvers.
        Out of these 18, 2 had slashed their wrists before hand.
        9 mm automatic service pistol 1
        collector's item pistol 1
        22 gauge shotgun 1
        Hanging 3
        Asphyxiation 1
        Jumping from a great height 1
        Medication 1

Eighteen causes we cited following an analysis of the 27 files. These causes are listed below, in order of quantitative importance; i.e. starting with the most frequent causes.

1. Experienced professional failure (failed promotion exams, even repeatedly)     12
2. Experienced problems in adapting to a transfer, home sickness    10
3. Felt useless, did not like work, dissatisfied with work    9
4. Did not appear to fin into the police organization    8
5. Felt powerless (did not have what it takes to be a police officer - appeared limited)     7
6. Had major family problems    7
7. Had problems with alcoholism    6
8. Felt guilty about everything, not matter what it was    6
9. Used tranquilizer    5
10. Had emotional problems (woman problems, unlucky in love)    5
11. Had financial problems    4
12. Suffered severe deprivation during childhood    4
13. Had health problems or was injured while on duty; felt less useful    3
14. Was the victim of a shock (death of a close one, suicide of a friend)    3
15. Was guilty of reprehensible acts (killed someone, voluntarily or accidentally)     3
16. Raised in a depressed family environment    3
17. Combined the use of tranquilizers and alcohol     2
18. Had been shot before    1

C) Symptoms or Early Warning Signs of Suicide

Pay close attention to severe psychiatric, psychological or physical problems: 13 had lengthy psychiatric and/or psychological files; 7 had voluminous medical files.

Hence we can see that we must be very careful with such cases. It is not a question of discrimination; on the contrary, we should ensure that these people receive preventive care and follow-up tailored to their needs. For the sake of their own welfare, we must not be afraid to take away their guns and take them off the job, if necessary. We must ensure that they are psychologically ready before they assume their former duties, or assign them to new duties better suited to them.

Let us now take a look at the 28 symptoms or early warning signs that the 27 police officers showed, which we will now use to help others: these signs are visible to superiors, peers or colleagues, subordinates, family members (spouses, children) and, most often, to their partners.
(The signs are listed below in order of quantitative importance.)

1. For some time or for a few days, he has been depressed, not himself, he does not have any energy,  "pep" or motivation    19

2. He is no longer involved in sports and pays no attention to his
physical fitness    14

3. He is introverted, withdrawn, solitary, shy and even awkward, he does not say much any more, or says nothing at all, he does not confide in anyone     13

4. He is an alcoholic or is turning more and more to alcohol    10

5. He is given to having accidents with his personal car and his service vehicle (1,2,3 and even more accidents) ("accident-prone")    10

6. He is anxious, anguished    9

7. He looks very tired or is suffering from overwork    9

8. He has told others about his thoughts of suicide    8

9. He uses tranquilizers    8

10. He is emotionally unstable    7

11. He is having trouble concentrating and often hurts himself  (unlucky)     7

12. He has a discipline file (often very lengthy)    7

13. He is arrogant, aggressive, impulsive, violent     7

14. He is very proud and unable to deal with frustration    7

15. He often cries    6

16. He is nervous, or more nervous than before    6

17. He has talked about killing somebody.  Under the influence of alcohol or on an empty stomach.  He has talked about using a gun.  He has started to take out his gun (for no reason)    5

18. He is an insomniac    5

19. He appears to be very pensive    5

20. He has complexes (physical or other)    5

21. He is jealous    5

22. He is disillusioned    4

23. He suffers from high blood pressure    4

24. He has tried to commit suicide    3

25. He uses tranquilizers combined with alcohol (very dangerous)    3

26. He has written one or more strange letters to those close to him, in which he talked about life, death, the purpose of life, or he has made his last wishes known, in case something were to happen to him one of these days    3

27. He has written or rewritten his will and talked about it in a weird and unusual
way      2

28. He has let it be known, in a mysterious way, that he had something important to do (or something like that)     2                     


Here we have a list of the 28 symptoms, warning signs or signals that constitute a major police suicide syndrome.

It goes without saying, however, that the appearance of one of these symptoms does not automatically mean that a police officer is contemplating suicide!

However, it should be noted that, if the manifestation of one of these signs is sufficiently severe, or if several of these symptoms are evident in the same police officer, his family, social or professional milieu should take not, so that competent, trained specialists can intervene.

Jerry Dash and Martin Riser, in an article entitled "Suicide among police urban law enforcement agencies", explain why the suicide rate in the Los Angeles Police Department is low in comparison with other police forces.

The authors claim that it is the result of the rigorous screening and evolution of police personnel. Even their emotional stability is examined. Aspiring police officers who do not pass the psychological, physical, written and oral tests are eliminated.

The low suicide rate over the past few years is also attributed to the fact that a general program has been implemented to prevent mental health problems. Psychologists involved in the program provide training, organize group meetings and seminars and do personal and family counseling.

Los Angeles' example appears to answer the question of how to prevent police suicides. To be sure, if someone is dealing with the causes and symptoms mentioned previously, the prevention of suicide is almost automatically ensured.

Such prevention is beneficial not only to the suicidal police officers, but also to the police department, family and society as a whole.

This is why we strongly encourage the creation of a psychological services section of police officers by ensuring that applicants have the necessary psychological profile. Also, prevention counseling and treatment could be provided.

Thought should also be given to creating a special police suicide prevention service; a department that would be independent of police organizations and therefore absolutely impartial. This department should be run by competent individuals who are familiar with the police environment and related problems. We are therefore looking at a skilled and highly confidential service, a provincial service available to all police officers, whenever necessary.

It is recommended that the following steps be taken:

1. Establish an atmosphere of confidentiality.

2. Try to understand what the person is going through (the easiest way to do this is to simply ask the person directly) and have his talk about the problem; in other words, what hurts him so much that he wants to stop loving.

3. Assess the risk of the person committing suicide in the near future: talk to him about his desire for death; ask him when and how he plans to kill himself. if the method he has chosen is easily accessible at any time, the danger of his carrying out his plan is greater.

4. Try to find the best approach to talk with the person: should you be direct, tread lightly or be calm? Should you be authoritarian, tell him what to do or simply provide advice?

5. Avoid sermonizing: do not tell him to banish all thoughts of death from his mind; rather, talk about the issue, so that he realizes all of the implications of his act. Do not tell him that committing suicide would be bad or that he is crazy. Such comments serve no purpose and will not help him.

6. Do not give your recipes for happiness to the suicidal person, because everyone has his own way of living and being happy. depending on his background, personality, etc. Instead, try to see what he thinks would make him happy, try to find other solutions (aside from suicide) that would enable him to get through his crisis.

7. Try to pinpoint what activity the person likes or liked before things started deteriorating. Encourage him to pursue activities, to meet people, but at a rate that is in keeping with his current abilities.

8. Do not try to help the suicidal person by doing everything for him. He will then think that he is no longer able to take action, that you no longer trust him.

9. Explain to the individual that he does not have to make threats or attempt to commit suicide to make sure that you will understand how he feels and be willing to help. This is sometimes how a suicidal person expresses his despair. Explain that it is not necessary to resort to this techniques, that you are there, you understand and want to help.

10. Once again, if you fear that the person is really going to commit suicide, put the question to him directly, finding out when and how he plans to do it. In an emergency, contact your nearest suicide prevention center.

11. Do not forget to respect your limitations in what you can and cannot do as far as helping the suicidal person is concerned.

12. Remember that you are not responsible for what he does. He is the one who decides to kill himself, not you, regardless of what he may say.

These notions apply to any suicidal person in general and, therefore, to the police officer in particular.

I am not advocating that you assume the role of a trained specialist, but I am saying that everyone can do something.

Back to Chapter Seven Topic Index

11.   SUICIDE - LET'S TALK ABOUT IT

Suicide is an increasingly serious problem -- in our communities, our families, and our police forces. Suicide is more common than most of us realize. it now ranks among the ten leading causes of death in North America. In Metropolitan Toronto, for example, there are an average of 6 suicides each week. Since many suicides are not reported as such, experts believe the true number is considerably higher. Suicide is now the second most frequent cause of death among young Canadians between the ages of fifteen and thirty. And for every successful suicide there are several unsuccessful attempts.

Who tries to commit suicide? Why? What are the danger signals? How can we help? Despite the seriousness of the problem, surprisingly little research has been carried out. However, a number of facts are now known; a number of myths can be laid to rest.

SOME FACTS AND FICTIONS

False: People who talk about suicide don't do it.

True: Out of ten people who kill themselves, eight have given definite clues to their intentions. Suicide threats MUST be taken seriously.

False: Suicidal people are fully intent on dying.

True: Most suicidal people are undecided about living or dying. They "gamble with death", leaving it to others to save them. Almost no one commits suicide without letting others know how he is feeling. Often this "cry for help" is given in code.

False: Once a person is suicidal, he is suicidal forever.

True: Happily, individuals who want to kill themselves are "suicidal" for only a limited time. If saved from self-destruction, they can go on to lead useful lives.

False: Improvement following a suicidal crisis means that the suicidal risk is over.

True: Most suicides occur within about three months following the beginning of "improvement," when the individual has the energy to put his morbid thoughts and feelings into action. Relatives and physicians should be especially vigilant during this period.

False: Suicide strikes more often among the rich - or, conversely, occurs more frequently among the poor.

True: Suicide is neither a rich man's disease nor a poor man's curse. It is more common through all levels of society.

False: Suicide is inherited and "runs in a family".

True: Suicide does NOT run in families. It is an individual matter and can be prevented. However, the suicide of a family member can have a profound influence on others in the family.

False: All suicidal individuals are mentally ill, and suicide always is the act of psychotic person.

True: Stories of hundreds of genuine suicide notes indicate that although the suicidal person is extremely unhappy, he is not necessarily mentally ill. His overpowering unhappiness may result from a temporary emotional upset, a long and painful illness, or a complete loss of hope.

A CRY FOR HELP

Someone who is seriously thinking of suicide is undergoing a crisis in which he is not his normal self. He needs help just as surely as if he were fighting a severe physical illness.

Even a "mile" suicide attempt indicates a desperate need for sympathy and understanding. If help isn't forthcoming, a more serious attempt may follow. Every effort should be made to get at the cause of the unhappiness, and the individual should be watched carefully for at least 90 days after the suicidal period.

PREVENTION OF SUICIDE

A question sometimes thoughtlessly asked is, "If a person finds life so intolerable that he wants to commit suicide, why not let him?" Evidence shows that if a person is prevented from committing suicide, he is very thankful afterwards.

Every human life is precious. Our culture's humanitarian and religious beliefs place a high value on human life. This is reflected in the great effort we put into the control of disease, accident prevention, rescue operations, etc.

Suicide leaves a trail of tragedy. Sorrow over a death is always difficult to bear, but suicide places an unusually heavy burden on the survivors. Our society attaches a stigma to suicide which the victim's family must bear. This can be particularly difficult for children.

Then, too, those left behind may identify with the victim and become preoccupied with the fear that they too may resort to suicide if life becomes very difficult.

CLUES FOR PREVENTING A SUICIDE

Very often a suicide could have been prevented if the family had been able to recognize clues in the victim's behavior shortly before death. Here are some of the more common clues:

Repeated talk of death or suicide threatsRepeated talk of death or suicide threats.

The following remarks were made by people who later killed themselves:

"My whole family would be better off without me."
"I'm going to end it all; I can't stand it any more."
"I won't be around much longer for you to put up with me."
"I don't want to be a burden."
"This is the last straw; this is all I needed."
"I can't stand it any long. I want to die."

It's a mistake to take such remarks lightly. If a person has been ill, unhappy or depressed for some time, it's important to seek prompt professional help.

Planning for death or absence

Many suicides are carefully planned so that affairs will be left in order for surviving family members. Making a will, discussing insurance policies and organizing affairs can be warning signs if these actions are accompanied by suicidal talk and general unhappiness. Of course it is foolish to think that anyone who makes a will re discusses insurance is suicidal.

Other clues

Other warning signs are important if they occur along with any of the above symptoms. These may include chronic sleeplessness, loss of weight (through loss of appetite), withdrawal from social contacts, loss of sexual desire, loss of interest in hobbies. In short, any change in behavior which makes a person seem quite different.

WHAT TO DO FOR THE SUICIDAL PERSON

Family, loved ones and friends are in the best position to give emergency assistance. The first step is frank recognition that the person - no matter how healthy or stable he has been in the past - is now very unhappy and potentially suicidal.

It is a dangerous mistake to play "ostrich" or to delay in the hope that "things will get better." There is no substitute for professional assistance in the treatment of a suicidal crisis. If in doubt, call in expert help.

The Family Doctor. In most communities, the first source of emergency help is the family physician. If there is no family doctor, the local medical society may be called for suggestions and help. In larger centers, the general hospital usually maintains an emergency out-patient service.

Crisis Intervention Distress Center. There are now telephone distress centers across the United States and Canada; they have proven themselves to be a reliable suicide prevention resource. Some centers have been operating for as long as 10 years.

The name given to this method is "Befriending". In many cases the telephone lines are open 24 hours a day with trained lay people working in shifts. Most of the callers respond positively to a friendly voice at the other end of the line, and the workers have been trained to cope with referral or emergency situation.

The Psychiatrist. A psychiatrist is a medical doctor who has specialized in treating mental and emotional illnesses. Suicidal behavior is usually considered to be a symptom of pathological disturbance of emotions - in other words a mental illness.

Psychiatric Facilities. In addition to the family doctor and the practicing psychiatrist, there may be special mental health clinics and treatment facilities available in the community. These can be called on for special help, many cities the general hospital provides 24-hour psychiatric emergency services.

Religious Counselors. Surveys have shown that people concerned with personal or health problems go first to their minister, priest or rabbi - even more frequently than to their family doctor. Today many clergymen have had professional training as counselors, so they're able to assist with problems or at least locate other sources of help.

Social Agencies. In most communities there is a network of family case workers and social welfare agencies. They can be found in the telephone directory under such listings as United Way, Social Planning Council, Community Information Center, Social Service Organizations.

Remember, that "Cry For Help" should always be taken seriously. The best response is fast, professional help.

Back to Chapter Seven Topic Index

12.   TEENAGE SUICIDES AVERAGE 100 A WEEK IN THE UNITED STATES

12.   TEENAGE SUICIDES AVERAGE 100 A WEEK IN THE UNITED STATES

Few things wound the heart like the death of the young, and the death of the young by their own hands is immeasurably worse.

At age 14, David Eugene Harris, bright and friendly, a computer expert, was a child of hope. Earlier this year he came home to parents who loved him, put a pistol to his head, and snuffed out that hope. He was the seventh suicide in a year in Plano, a suburb of Dallas.

A week or so later, Christopher Ruggierro, 17, a star athlete, hanged himself in his bedroom closet. A few days after that, Arnold Caputo, a successful college student, was also found hanged. They were the fourth and fifth teenage suicides in less than a month in the Westchester County suburbs just north of New York City.

In any given week, 100 youngsters across the United States will kill themselves, and an estimated 1,000 others will try.

Statistics on suicide are always suspect, but federally-compiled figures show that the reported rate of adolescent suicide has more than doubled since 1960, from 5.2 per 100,000 population in 1981.

Nobody knows why.

The temptation is to point to superficial answers - the Harris boy was unhappy about the braces on his teeth, and young Ruggiero had been suspended from his hockey team. Or there is the tendency to over-generalize and blame drugs, alcohol, sexual permissiveness, even television and rock music.

Certainly the power of suggestion can not be ignored in places like Plano and Westchester County. After young Caputo hanged himself, Eugene Aronowitz, the mental health commissioner of Westchester County, said, "I suspect this could lead to another." Officials in Plano would agree.

But beyond the power of suggestion, answers are difficult to find. Studies tell us that more young teenage girls than boys will attempt suicide, and that more boys will succeed. They show that most of the deaths occur at home in the evening, and that more victims will be middle class, rather than very poor or very rich. But statistics fail to provide any logical pattern.

Are we facing an epidemic of teenage suicide?

Dr. Everett Dulit, director of child and adolescent psychiatry at Montefiore Hospital in New York City, who works with teenagers who have attempted suicide, says the higher rates are because more suicides are being reported as such, rather than being filed in other statistical categories. "There's no proof that it's anything but better data gathering," he says.

Judy Smith, program director at the Suicide and Crisis Center in Dallas, believes that the increase is real. "It's so overwhelming that it can't be just statistical manipulation," she says. "But it is probably reported better, so that colors the facts a little bit."

Dr. Susan Blumenthal, head of the suicide research institute at the national Institute of Mental Health, believes there is no real way to get a definitive answer. "Whether the rate increase is due to more active reporting or to more people killing themselves is not too clear," she says. "My hypothesis is that there is an increase, but there's no way to determine that."

Epidemic or not, parents are anxious to learn why an apparently popular child, doing will in school, should harbor such intense fears that life seems better off ended.

Judy Smith deals with the residents of what some consider an extreme modern pressure cooker: rootless, fast-growing Dallas. The seven suicides in affluent Plano, a suburb which has been described as particularly sterile, have forced the community to take stock of itself.

"The increase parallels a sociological change in our culture," she says. "The fast growth in communities, the change in stress, the transient nature of neighborhoods, all cause the uprooting of families and support systems. And the teen years are a vital time."

Dr. Graham Emslie, a Dallas child psychiatrist, says that upwardly mobile parents have less time to find out about ;the problems of their children. The increase in divorce also has added to the breakdown in communication between parents and their children, he believes.

Dr. Bill Blackburn, a Dallas clergyman who wrote the book What You Should Know about Suicide, says many stress-related factors can cause young people to kill themselves. "The loss of a relationship can be a major blow to the ego of a teenager." he says. He believes it is vital that parents do not make light of the depression felt by teenagers over seemingly trivial problems.

"We don't have a good many studies about young people, but we do know that it's just not an impulsive act," she says. "There is usually a history of psychiatric disorder, or many more stresses than you see in an average kid's background."

Dr. Dulit believes that "any serious study of suicide places the nexus in very private matters that are not vulnerable to social trends."

The number of suicide attempts, real and half-hearted, is much higher in teenagers than in adults, he says. For every teenager who actually commits suicide, he says, there may be 100 to 200 attempts, most of which are deliberately half-hearted.

"The population that completes the suicide attempts tends to be disturbed," he says, adding that disturbed youngsters represent about two-thirds of all adolescent suicides.

Miss Smith disagrees, saying this does not reflect her experience. "Of the cases we see and read about, the majority of both kids and adults who commit suicide do not have psychiatric problems," she says. "But our experience is at a crisis center, so we don't see the patients that a psychiatrist does."

Dr. David Waller, a psychiatrist at the University of Texas Southwestern Medical School in Dallas, says, "I would guess that the situation is even more dramatic than it is being portrayed. many adolescent deaths are being written off as accidental when they actually are suicides: This is a very real phenomenon."

While their opinions may diverge on the causes of teen suicide, the experts agree that there usually are clear warning signs that a teenager is contemplating suicide. Deep depression is the common denominator, both in adults and in teenagers, but it can show up in different ways in adolescents.

Says miss Smith, "In addition to the classic signs of depression - sleep and eating problems, lack of energy - there are other signs in kids. They can be very agitated and irritable. They ;may have trouble in class. Instead of crying and appearing sad, they may show signs of boredom and loneliness. They may express feelings of low self-esteem and worthlessness."

Parents should pay attention when a teenager with such problems begins to give away valued personal possessions or displays accident-prone behavior, such as driving recklessly, she says. And when an adolescent says, "I don't want to live," or "I want to go to sleep and never wake up." special attention should be paid.

"About 80% of adolescents who attempt suicide will communicate their intention in advance," Miss Smith believes.

Dr. Dulit's recommendation for a worried parent is to be direct. Ask if the youngster is feeling depressed and follow up with more pointed questions.

"Ask something like, 'life hardly seems worth living, does it?'" he suggests. "The child will probably say 'no.' What the parent should be alert for is an undercurrent indicating that the teenager has thought about suicide."

But Miss Smith admits that most of the desired answers to teenager suicide are not available.

"It's all theory now," she says. "What we need is an extreme effort in research to answer our questions."

There is one small thing that ordinary people might do for the young - stop pretending that the teens are "the best years of your life." For many people, those years between 12 and 19 are the worst years they will ever go through, barring war, illness, or the catastrophic loss of loved ones.

The pain of the young is essentially the pain of wondering if you are any good. If there are worse pains than that, they are few.

In those brief years, everything changes - sex, power, relations to parents and to the world, responsibility for yourself and for others. The pressure varies greatly from individual to individual, but for all it is there. It may be an adventure, but it also may be a terror.

Too many young people may feel that they are the only ones who are afraid. Actually, almost everyone is afraid. Consider:

"Always alone in the midst of men, I come to my room to dream by myself, to abandon myself to my melancholy in all its sharpness. In which direction does it lead today? Toward death... What fury drives me to my own destruction? Indeed, what an I to do in this world? Since die I must, is it not just as well to kill myself? Since nothing is a pleasure to me, why should I bear days that nothing turns to profit?"

The writer was 16 years old, a recent graduate of a military academy. His name was Napoleon Bonaparte.

It was the fashion in the late 18th century to toy with suicide in the manner of Goethe's sorrowing hero, Werther. But the supremely practical Bonaparte refused to act out such a self-destructive impulse, feeling that life had better things to offer than death. It usually does.

This may be a difficult thing to communicate to the young. If there was a Napoleon, they argue that they can never be another. If one is more modestly positioned, they argue, what's the use? Why bother?

It may be more important to listen to this argument than to win it. Perhaps the 16-year-old Bonaparte writing in his diary at his first post in Valence would have liked a listener. Perhaps in later years he might even have pointed out that one of the ways he got to be Napoleon was simply by hanging on when there didn't seem to be much point to it.

Efforts are being made to get that message to teenagers - hang in there, even if it doesn't seem worthwhile. In Plano, the schools have formed parent support groups and offer trauma classes to students. The churches in Plano now teach about suicide, grief and coping. The local crisis center has a hotline and comprehensive crisis intervention services.

Michael L. Peck, a psychologist and consultant to the Los Angel