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after starting to improve. (e) “It’s the rich and beautiful (or others
think the poor and unattractive) that do it.” In fact, the suicide rate is
basically the same for the rich and the poor and for the attractive and
the unattractive. (f) “Don’t ever ask a depressed person about their
suicidal thoughts or plans, it gives them ideas.” There is no evidence
for this belief but there are strong reasons to believe that considering
suicide a taboo topic has increased the number of suicides. One of the
big debates in school systems is whether it is advisable to have a
program about suicide after a student has died. (Probably depends on
the content of the program, don’t you suppose?)
Predicting suicide is very complex and very difficult
It is a very important prediction—one of the most important
decisions a family, a friend, a psychologist or psychiatrist or counselor
or a patient him/herself will ever make. There are so many barriers to
making accurate decisions. There are no reliable tests for suicide—
there are tests of depression, of pessimism, of hopelessness, of low-
self-esteem, of anger or conflict, but many people have high scores on
those tests without being a suicide risk. There are no interview
questions to ask that can be safely relied upon and no “I-Won’t-Kill-
Myself-Before-I-See-You-Again” contracts to sign that insure staying
alive. For one thing, there is no reason to believe a suicidal person will
tell their interviewer the truth. About 25% of suicidal patients never
admit being suicidal (Psychiatric Times, September, 2002). Indeed,
the seriously suicidal person may view the interviewer as an enemy
who is likely to oppose his or her plans.
One of the ironies of suicide is that it is both so important and so
secret. These lethal thoughts are perhaps most likely to be changed by
considering a different point of view; yet, suicide is one of the most
private secrets many people will ever have. Plans for suicide are often
kept very secret, yet the usual immediate and long-term consequences
in other peoples’ lives are enormous. People may kill themselves
feeling unloved, totally alone, and deeply ashamed, while, in the eyes
of others, they are loved, genuinely cared for, and would be
completely forgiven if their shortcomings were disclosed in detail. Dr.
Shawn Shea (1999), the Director of the Training Institute for Suicide
Assessment, has skillfully discussed these dilemmas in his interesting
and excellently written book, The Practical Art of Suicide Assessment.
He also mentions philosopher Schopenhauer’s interesting observation
of another paradox about suicide, namely, a conscious mind that seeks
death may often hope to answer questions about the afterlife and
God…i.e. after consciousness is destroyed. Giving up life to test
religion hardly seems wise. Although his book is mostly for
professionals, I’ll mention Shea again a little later.
Remember that surely 20% (maybe a lot more) of people have
thought of death as a solution, but only 1 out of 600 who have had
suicidal thoughts actually kills him/herself. That low frequency also
makes predictions very hard to calculate. Science is learning more and
more about predicting, preventing, treating and understanding the
