Today is the 15th World Suicide Prevention Day. Which means this 'day' did not exist when I lost my mom and sister in 2000. Maybe every day being a 'day' for some cause or quirk or hobby became a thing once the internet provided a truly mass market platform? Or maybe stigma against conversation about suicide had the upper hand until the internet made less personalized discussion possible?
Stigma-- do we think that's changed? Do we think it should? I don't want a world where suicide becomes a normalized, much less accepted, response to despair. But I do want a world where those who are at risk but are not yet suicidal are able to access effective intervention for whatever is contributing to their risk, and where more of those who are acutely suicidal are able to see a way out of their desolation. I want a world where we do better at teaching emotional coping skills to our children. I want a world where those who have gotten past their own suicidal crises talk about it as much as those who have survived cancer or heart attacks or other deadly diseases do now. I've seen commercials with celebrities encouraging screening and treatment for all manner of illnesses that almost killed them or someone they love. I've never seen a commercial with a celebrity acknowledging how suicide, attempted or completed, has affected their life. I know such things exist on the internet. But I've never seen it on television.
There is a lot to learn– about why suicide rates are higher in some racial and ethnic groups than others– what are the protective factors? About why, in the US, men complete suicide at considerably higher rates than women, even though women attempt consideraby more often. (Choosing more lethal means is a definite factor, but why do men choose those methods more?) About why primary care providers continue to under-screen for suicidal ideation and depression, even though data suggests that 1/3 or more of those who attempt suicide had an appointment with their PCP within the week prior to attempting, and almost 2/3 had an appointment in the preceding month. There is a lot to learn.
But I suspect that suicide will always be hard to discuss. In late 2002, in one of the moments where we suicide survivors search for answers to the unanswerable, I wrote "... I am left with the hollow, sterile explanation of mental illness. Soul illness. A malfunctioning of such extreme magnitude that life turned on itself. A malignancy not of any cell or tissue, but of the very will to be." Suicide is different from other deaths. It makes people use words like "how could he/she be so selfish?" It makes people question, in ways few other kinds of death do, their own culpability for someone dying. "If only I had __________." It makes people unsure of how to answer when someone asks them how their loved one died, because the survivor knows the word "suicide" will frequently make the inquiring person feel awkward and off balance. And so the survivor will often deflect or even lie to protect the other person from that palpably uncomfortable next several moments of conversation. They say we need to be able to be open about suicide to reduce the stigma. And that makes sense. But maybe it's not just stigma. Because I can respond to that question without shame. But I don't think the day will come when hearing that answer won't elicit a wince, or flinch. Inwardly if not openly. In many ways our culture trivializes the word suicide. But in actuality, the enormity of the act of self-destruction will always cause the person suddenly forced to contempate it a moment of disorientation. A startle of reflexive, instinctive fear. We are made to live.
Rates of attempted and completed suicide are, however, increasing. Or else we're reporting them both more accurately. But either way, they aren't diminishing. Which means these 15 years of World Suicide Prevention Days have not succeeded. Perhaps we should rethink the goal. Perhaps it should be World "Prevention and Treatment of Things That Increase Risk for Suicide" Day. I don't think society is interested in investing in that endeavor though. Definitely not financially. Perhaps not emotionally either.
And in the meantime, hundreds of lives were ended and thousands of lives were forever changed across the world by a suicide today. And every life lost is a tragedy. Even if no one is left behind who mourns them. Maybe especially if no one is left behind who mourns them. And to those hundreds who are gone and those thousands who are staring into the abyss of grief today, I stand in sorrowful witness. And to the thousands upon thousands who are weeks or months or years beyond that first day, I walk in kindred solidarity. And I wish me, and you, and the one you loved and lost, peace. Wherever we, and they, may be.
