Once a taboo subject, suicide is being talked about openly lately due to the Netflix series “13 Reasons Why” and a recent controversial court case in Taunton, Mass. in which a teenage girl was convicted of involuntary manslaughter for encouraging her boyfriend to commit suicide through text messages and phone calls.
Both the show and the court case have some disturbing traits. The show has been criticized for glorifying suicide; in the court case, just as Michelle Carter’s friend Conrad Roy III had a change of heart and decided to get out of his vehicle that he had filled with generator fumes, Carter talked him into getting back in and he died. This phone call followed a series of texts in which she urged her depressed friend to follow through on his threats of suicide.
The judge’s decision to find her guilty stunned many legal experts with its conclusion that words alone can be considered a cause of suicide – but not Institute of Living Medical Director Linda Durst, MD, who chairs the Harford HealthCare Behavioral Health Network’s Zero Suicide Initiative, which includes strategies to reduce suicides in behavioral health settings. She said that encouraging someone to follow up on suicidal thoughts can be a tipping point.
“People who have chronic suicidal ideation experience waves of impulse to act on their ideation,” Dr. Durst said. “At these points, they are ambivalent at best about acting on their suicidal thoughts. To avoid acting on these thoughts it is important to distract them until the wave or impulse is less strong or over. People are extremely vulnerable at these times.”
Dr. Durst said because of their vulnerability, the Veterans Administration developed a suicide prevention treatment plan with a hierarchy of distractions (including activities and people to call) to distract people until the intense wave of suicidal thoughts are over.
“At the same time, if someone was encouraged to engage in suicidal behavior during this very vulnerable time, it could tip an individual in the direction of self- harm and it would be extremely irresponsible, in fact , cruel to engage in such encouragement.”
Dr. Durst said if someone reveals that they are having thoughts of suicide, you have an opportunity to help them.
“Offer your support in getting them help,” she said. “Being critical or judgmental about their experience will only invalidate their experience and shut down their ability to communicate with you.”