By Dr. Jo Bell, Senior Lecturer, Faculty of Health Sciences, University of Hull
World Suicide Prevention Day WSPD2021 – IASP promotes worldwide commitment and action to raise awareness of suicide and suicide prevention. It urges us to remember all those who have died by suicide, and reflect upon what it means, and how it affects us. According to the International Association for Suicide Prevention [IASP], every 40 seconds someone, somewhere in the world, takes their own life. This amounts to approximately 800,000 people per year. We know that for each of these deaths, many people are profoundly affected. Schniedman1 first estimated that for each person who dies by suicide, six people are profoundly affected. This figure was later increased to sixty2,3. More recently, an estimate of 135 in the US was suggested4. Those exposed to suicide can feel stigmatised, traumatised, and can suffer from suicidal ideation5,6.
Exposure to suicide can take many different forms and research has also shown that in the aftermath of a suicide, many people use social media to express their sense of loss7,8,9. How people talk about suicide via media and social media, impacts suicide contagion (copy-cat suicide). Young people in particular are susceptible to this by the words, images and prominence of suicide stories. When exposure via social media is considered, the number of people affected is exponentially higher than previously suggested and far more difficult to quantify10. Local news stories of suicide can now reach a global audience within days through sharing. In one of my forthcoming articles11 I highlight how a 20-year-old man spoke of his heartache after breaking up with his girlfriend in an emotional post on his Facebook page and shortly afterwards took his own life. He ended the post by begging Facebook to not remove his post. In the days that followed, it was reported that the post went ‘viral’. Over 20,000 people viewed the letter (and Facebook page), which was shared around 11,500 times, and over 50,000 people responded to the post12. Social media, it seems, brings suicide closer to everyone.
Health and social care professionals have an important role to play in supporting those at risk of suicide and their families and friends in the aftermath. Suicide Postvention is a NHS and Public Health priority and a key objective of the Suicide Prevention Strategy 13. Postvention refers to support, procedures and interventions that take place after a suicide to alleviate the distress of bereaved individuals (survivors), reduce the risk of imitative behaviour (copycat suicides), and promote the recovery of the affected community. As part of Government investment through the NHS Long Term Plan, 18 regions in England have received funding to establish suicide bereavement services by 2024. I have been involved recently in the development of a new Postvention support service set up in direct response to this priority. The service, managed by MIND, is available to anyone who identifies as being bereaved or affected by suicide. It offers proactive needs-led support, delivered by trained volunteers -most with lived experience of having lost a loved one to suicide. In the course of this and my other work and research in this area, spanning over 15 years, I have spent many hours speaking with people who have been affected by suicide. I am often haunted by stories of loss, bewilderment, distress, and overwhelming pain. When someone takes their own life, they leave broken hearts behind. But more importantly they leave a question: why? Why is the great mystery of suicide – and for many people that unanswered question can torment them for the rest of their lives, robbing them of any chance of peace or closure.
Whilst reflecting upon Postvention efforts in my current work with colleagues, I was reminded of a short simple poem by English poet John Donne (1572 – 1631). For whom the Bell Tolls / No Man is an Island addresses the nature of death and the connection between all human beings. He uses the image of a church bell tolling to symbolise death. ‘Send not to know for whom the bell tolls’ is a powerful quote which suggests the bell tolls not just for the person who has died, but for everyone. Donne’s words have stood the test of time. Death affects us all: a death by suicide affects us in particularly profound ways. Spare a thought or light a candle on September 10th for all ‘for whom the bell tolls’. Suicide affects everyone – individuals, families, communities and societies across the world – and suicide prevention and postvention is everyone’s business.
- Shneidman, E. S. (ed.). (1972). Death and the college student. New York: Behavioral Productions.
- Clark, S.E., and Goldney, R. (2000). The impact of suicide on relatives and friends. In: Hawton K, Van Heeringen K, (eds.). The International Handbook of Suicide and Attempted Suicide. Chichester: Wiley, 2000: 467-84.
- Berman, A.L. (2011). Estimating the population of survivors of suicide: Seeking an evidence base. Suicide and Life-Threatening Behaviour, 41, 1, 110–116.
- Cerel, J., Brown, M., Maple, M., Singleton, M., van de Venne, J., Moore, M., & Flaherty, C. (2018). How many people are exposed to suicide? Not six (2018). Suicide and Life-Threatening Behaviour, 49, 2, 529-534.
- Bell, J., Stanley, N., Mallon, S., & Manthorpe, J. (2012). Life will never be the same again: Examining grief in survivors bereaved by young suicide. Illness, Crisis, and Loss, 20, 1, 49–68. Doi:10.2190/IL.20.1.e
- Cerel, J., Maple, M., van de Venne, J., Moore, M., Flaherty, C., & Brown, M. (2016). Exposure to suicide in the community: Prevalence and correlates in one US State. Public Health Reports, 131, 100–107.
- Bailey, L., Bell, J., and Kennedy, D. (2014). Continuing social presence of the dead: Exploring Suicide Bereavement through Online Memorialisation. New Review of Hypermedia and Multimedia http://www.tandfonline.com/doi/full/10.1080/13614568.2014.983554.
- Bell, J., Bailey, L., and Kennedy, D. (2015). “We do it to keep him alive”: Bereaved Individuals’ Experiences of Online Suicide Memorials and Continuing Bonds, Mortality. DOI:10.1080/13576275.2015.1083693.
- Bell, J., Stanley, N., Mallon, S., and Manthorpe, J. (2015) Insights into the Processes of Suicide Contagion: Narratives from Young People Bereaved by Suicide. Suicidology Online, 6, 1, 43-52. http://www.suicidology-online.com/pdf/SOL-ISSUE-6-1.pdf.
- Bell, J., and Westoby, C. (2021). Suicide Exposure in a Polymediated Age, Frontiers in Psychology, 12, 1-11 https://doi.org/10.3389/fpsyg.2021.694280
- Bell, J., and Westoby, C. (forthcoming). The Aftermath of a Suicide: Social Media Exposure and Implications for Postvention. In Pompili, M (ed.). Suicide Risk Assessment and Prevention. Springer Publications
- Hamlienko, S. (2016). Dumped boyfriend found dead left heartbreaking last Facebook post telling ex-girlfriend where to find Christmas presents.The Mirror. http://www.mirror.co.uk/news/uk-news/dumped-boyfriend-20-found-dead-9471638 (accessed 13.9.2017)
- Department of Health (2012). Preventing suicide in England: A cross-government outcomes strategy to save lives: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/430720/Preventing-Suicide-.pdf