When someone talks about taking their own life, it’s very often an anguished distress signal. But sometimes repeated suicide threats are used as the ultimate means of control in a coercive relationship. “If you leave me, I’ll kill myself” is a form of emotional abuse that can make it feel impossible to walk away.
It is because suicide is such a terrible and tragic thing – that someone might be experiencing such mental torment that they cannot see another way out – that the threat of killing oneself is so potent in abusive relationships. And it is also a reason why we have to be so careful about the way we publicly discuss suicide, its causes and how it can be prevented. Because it is so powerful, there is a risk that it gets wielded by well-meaning social campaigns in ways that not only distract from effective suicide prevention, but can do real harm.
Suicide prevention charities like the Samaritans are clear that talking about suicide openly is overwhelmingly positive because suicide is preventable, and removing some of the stigma and shame can make it easier for people feeling suicidal to reach out for help. But framing conversations about suicide in the wrong way can have ill effects.
The causes of a particular suicide are invariably complex and multifaceted – and can include external sources of stress and how easily someone is able to access help and support, as well as issues with their own mental health that may be hidden from their loved ones. Speculating about a single cause or trigger of a suicide oversimplifies what happened and can appear to paint suicide as an inevitable outcome of a particular event. It is particularly important to avoid this given the risks of suicide contagion, when one suicide leads to a spike in suicides in a particular community or as a result of media reports.
This important ground rule is not always respected by the media and civil society organisations. The most obvious case in recent months has been in relation to the tragic death of the headteacher Ruth Perry, who took her own life following an Ofsted inspection that downgraded the school from “outstanding” to “inadequate”. It is entirely understandable that her relatives have wanted to speak out about the circumstances of her death. What is concerning, however, is the extent to which her suicide has become a focal point in the arguments for reform of Ofsted; teaching unions called for a pause in inspections and some teachers effectively blamed the schools inspectorate for her death.
I believe there is a strong case for reforming the system of school inspection in a way that would make its judgments more useful as well as lowering the stakes and therefore the stress it causes for teachers. Staff are also under huge pressure as a result of the effects of the pandemic on children’s education and wellbeing, cuts to school budgets and shamefully under-resourced mental health and family support services. Many in the profession are angry about the death of a much-loved and valued colleague.
But it is wrong to call for an immediate pause in Ofsted inspections after a suicide, as though that might help save lives, when there hasn’t even yet been an inquest. To do so is to imply a simple causal link that we do not know exists. It risks creating the impression that it might be an expected consequence of an inspection, or even sending the broader signal that suicide can lead to big and sorely needed policy changes that would benefit others.
Teacher wellbeing is of course an entirely legitimate consideration in how to reform Ofsted, but there are other important factors, and an optimal outcome is more likely if the conversation is grounded in its impact on stress levels rather than a fraught conversation about a particular suicide that can make it difficult to provide a counter perspective for fear of seeming uncompassionate.
There are other debates where there has been an unhelpful focus on suicide rather than psychological wellbeing. The evidence suggests that, if anything, suicide rates fell during the pandemic itself (not altogether unexpected, given evidence they fall at times of national crisis like war). This has not stopped anti-lockdown campaigners using suicide as an argument against social restrictions and blaming government policy for the deaths of particular individuals who took their own life.
There are certainly ways in which social restrictions could have been adapted to minimise mental health impacts – for example, introducing support bubbles earlier and allowing more outdoor mixing – but it is wrong to use stories of suicides to make the case that lockdowns were an unambiguously bad moral choice. Misuse of suicide statistics has also been an issue in healthcare. Research suggests that children experiencing gender dysphoria are a psychologically vulnerable population at an elevated risk of suicide, but that, overall, the risk of suicide for this group is, thankfully, vanishingly rare; a message reinforced by the NHS.
Yet charities campaigning for greater access to unevidenced and potentially harmful medical interventions for gender-questioning children have made claims about the risk of suicide based on unreliable and unrepresentative surveys, including that almost half of young people with gender dysphoria have attempted suicide.
Last week, Keir Starmer announced that reducing suicide rates would be one of three key health targets for a Labour government. This is very laudable and has been welcomed by suicide prevention charities. But there are also risks in making it a high-profile objective: that well-intentioned activists use it to question ministers’ commitment to reducing suicide rates unless they take up the policy they are calling for. Labour will have to be careful to keep the focus on evidence-based suicide prevention.
We live in a world where political discourse and social campaigning increasingly take place in polarised online spaces, creating incentives to cast those you disagree with as morally repugnant. This is particularly dangerous in relation to the fraught issue of suicide.
It doesn’t matter how well-meaning the intention, or how important the cause: it is never OK to link a particular suicide, or an exaggerated risk of suicide, to a desired policy outcome. It detracts from informed discussions about how to prevent suicide and has unsavoury shades of the emotional manipulation of a coercive relationship.
• Sonia Sodha is an Observer columnist
• International helplines can be found at www.befrienders.org. In the UK and Ireland, Samaritans can be contacted on 116 123 or email jo@samaritans.org or jo@samaritans.ie. In the US, the National Suicide Prevention Lifeline is at 800-273-8255 or chat for support. You can also text HOME to 741741 to connect with a crisis text line counselor. In Australia, the crisis support service Lifeline is 13 11 14.
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