I grew to love the hospital’s intercom announcements. Code Blue for cardiac arrest; Code White for a violent patient; Code Yellow for a missing person, an elopee, as they’re called, a runaway for whom I’d silently cheer. Go, sixty-eight-year-old Caucasian man with short brown hair last seen wearing hospital pants and a brown wool cardigan and no shoes! Run! (...)
I was sure if I just acted normal enough they would let me go. I tried to be courteous, lucid and calm but not suspiciously upbeat. I didn’t weep or scream at my own frustration or impotence or exhaustion or insomnia or self-loathing. I met, as required, multiple times a day with nurses and social workers. And my I’m-totally-fine, suicide-was-a-one-time-aberration ploy almost worked: I was almost set free by the first psychiatrist I saw within a week of my admission without so much as a follow-up appointment.
This isn’t, incidentally, best practice: it’s a great way to ensure people fall through the cracks and (if they’re lucky) wind up back in hospital in worse shape than before.
Unbeknownst to me, as I paced by my bed and prepared for life outside the windowless ward, my parents had pushed for a second opinion, my dad writing desperate, pleading emails at three o’clock in the morning. The second psychiatrist was smart and sardonic and treated me like someone capable of communicating in multisyllabic sentences. He also had a far better bullshit detector. He did not buy my argument that this whole suicide thing was an anomalous one-off, a mental misunderstanding, never to recur. He decided I had major depression. And that I was fucked up enough to merit more time locked up lest I try to off myself again.
This isn’t, incidentally, best practice: it’s a great way to ensure people fall through the cracks and (if they’re lucky) wind up back in hospital in worse shape than before.Unbeknownst to me, as I paced by my bed and prepared for life outside the windowless ward, my parents had pushed for a second opinion, my dad writing desperate, pleading emails at three o’clock in the morning. The second psychiatrist was smart and sardonic and treated me like someone capable of communicating in multisyllabic sentences. He also had a far better bullshit detector. He did not buy my argument that this whole suicide thing was an anomalous one-off, a mental misunderstanding, never to recur. He decided I had major depression. And that I was fucked up enough to merit more time locked up lest I try to off myself again.
Eight hundred thousand people around the world kill themselves every year, which means about 2,200 a day, or three every two minutes. Statistically, two dozen people killed themselves in the time it took you to get out of bed, showered, and caffeinated. Maybe forty-five during your commute to work, another ninety in the time you spent making dinner. Unless you, like me, take an eternity to do any of those things, if they happen at all. In which case, think of it this way: every time you mull killing yourself and manage to talk yourself down because you have more to do and more to ask of life, a handful of people have lost that internal, wrenching wrestling match and ended it.
In Canada, where eleven people kill themselves daily, you’re almost ten times more likely to kill yourself than you are to be killed by someone else. About 120 Americans kill themselves every day: Americans are more than twice as likely to die by their own hands as someone else’s. Victims of America’s gun epidemic are almost twice as likely to have shot themselves to death than have been shot to death by someone else. If you die young, suicide’s much more likely to be the cause: in 2016 it was the second-leading cause of death for Americans between ten and thirty-four years old. Many, many more people try to kill themselves than actually do it—about half a million Americans are brought to emergency rooms every year after having tried to end their lives.
The reality is likely even worse: evidence indicates we’re undercounting suicides by a significant amount—by as much as a third, depending how you guesstimate. For one thing, despite the supposed decrease in shame in having a family member kill themselves, our persistent societal freak-out regarding suicide can make both relatives and authorities hesitant to classify deaths as such. There’s a very high burden of proof required for coroners and medical examiners to classify a death as a suicide. There’s rarely incontrovertible evidence: most people don’t leave suicide notes, and not everyone talks about killing themselves before killing themselves. Even if they had at some point in the past, how do you know this specific incident was a suicide? If someone is depressed, even suicidal, but also misuses drugs, how do you know for sure whether an overdose is purposeful? How do you know for sure whether a single-vehicle crash was careless driving or driven by a need for death? How can you be certain whether someone slipped or jumped?
You’re more likely to find suicides when you look for them. And, much of the time, we don’t. Grieving families would frequently prefer not to touch the issue. “The underreporting of suicide is a recognized concern in Canada and internationally,” reads a 2016 study based on data from the Public Health Agency of Canada. Suicide deaths are also examined a lot less closely, on average: a 2010 report found that about 55 percent of US suicide deaths get autopsied, compared to 92 percent of homicides. (...)
This has been a known issue for a while. The consequences of underreporting extend beyond public-health nerds who get off on accuracy. Undercounting suggests something is less of a problem than it is and therefore less deserving of our attention and our dollars. Which is convenient, given how icky suicide makes us feel in the first place. Finding fewer suicides can make it seem like suicide is less of an issue. “If you think about it, society hasn’t been that invested in suicide prevention,” Rockett points out. “If you more accurately portray the self-injury deaths and say, ‘This is mental health,’ there’s potential for rather more resources to be directed toward the problem.”
Botched suicide attempts also go underreported: many people who try to kill themselves either don’t seek medical help or lie about why they are seeking it. I’ve done both those things. I’d do them again. As I’ve said, telling anyone you’ve tried to kill yourself, let alone someone you don’t know, let alone someone who could suspend your right to freedom of movement, gives one enormous pause. (Not that telling someone you love is any easier.)
In Canada, where eleven people kill themselves daily, you’re almost ten times more likely to kill yourself than you are to be killed by someone else. About 120 Americans kill themselves every day: Americans are more than twice as likely to die by their own hands as someone else’s. Victims of America’s gun epidemic are almost twice as likely to have shot themselves to death than have been shot to death by someone else. If you die young, suicide’s much more likely to be the cause: in 2016 it was the second-leading cause of death for Americans between ten and thirty-four years old. Many, many more people try to kill themselves than actually do it—about half a million Americans are brought to emergency rooms every year after having tried to end their lives.
The reality is likely even worse: evidence indicates we’re undercounting suicides by a significant amount—by as much as a third, depending how you guesstimate. For one thing, despite the supposed decrease in shame in having a family member kill themselves, our persistent societal freak-out regarding suicide can make both relatives and authorities hesitant to classify deaths as such. There’s a very high burden of proof required for coroners and medical examiners to classify a death as a suicide. There’s rarely incontrovertible evidence: most people don’t leave suicide notes, and not everyone talks about killing themselves before killing themselves. Even if they had at some point in the past, how do you know this specific incident was a suicide? If someone is depressed, even suicidal, but also misuses drugs, how do you know for sure whether an overdose is purposeful? How do you know for sure whether a single-vehicle crash was careless driving or driven by a need for death? How can you be certain whether someone slipped or jumped?
You’re more likely to find suicides when you look for them. And, much of the time, we don’t. Grieving families would frequently prefer not to touch the issue. “The underreporting of suicide is a recognized concern in Canada and internationally,” reads a 2016 study based on data from the Public Health Agency of Canada. Suicide deaths are also examined a lot less closely, on average: a 2010 report found that about 55 percent of US suicide deaths get autopsied, compared to 92 percent of homicides. (...)
This has been a known issue for a while. The consequences of underreporting extend beyond public-health nerds who get off on accuracy. Undercounting suggests something is less of a problem than it is and therefore less deserving of our attention and our dollars. Which is convenient, given how icky suicide makes us feel in the first place. Finding fewer suicides can make it seem like suicide is less of an issue. “If you think about it, society hasn’t been that invested in suicide prevention,” Rockett points out. “If you more accurately portray the self-injury deaths and say, ‘This is mental health,’ there’s potential for rather more resources to be directed toward the problem.”
Botched suicide attempts also go underreported: many people who try to kill themselves either don’t seek medical help or lie about why they are seeking it. I’ve done both those things. I’d do them again. As I’ve said, telling anyone you’ve tried to kill yourself, let alone someone you don’t know, let alone someone who could suspend your right to freedom of movement, gives one enormous pause. (Not that telling someone you love is any easier.)
by Anna Mehler Paperny, The Walrus | Read more:
Image: Paul Kim
