Let's Keep Talking About Suicide


A national discussion on a public health crisis is slowing down before it can even really start — again.

Famous suicides already hit in a way that knock the wind out of you. But the developments of last week felt like waves crashing — before you have a moment to catch your breath, another wave hit, and then another. It was enough patterned blows to make you wonder if it would actually stop.

Kate Spade died from suicide. Then the US Centers for Disease Control and Prevention reported suicide rates raised in 49 states since 1999. And then Anthony Bourdain killed himself, too. In a single day, suicide went from being the thing people wanted to talk about, to the only thing people could talk about.

And those conversations were good. Starting to talk about it was the right step to take. But it’s also the step we keep taking.

You can practically pick out the dates of celebrity self-inflicted deaths by looking at Google search trends for the word “suicide.” A linear graph depicting the phrase’s interest over the last 5 years has sharp peaks that denote memorable deaths: Robin Williams in August 2014, Aaron Hernandez in April 2017, Chester Bennington in July 2017, and finally Spade and Bourdain last week. Save for the release of the film Suicide Squad in August 2017, the height of online conversation on suicide is centered around fame.

But there’s also the drop. In every instance of suicide entering our rhetoric by way of a celebrity, there’s also its sudden, steep exit within mere days. This could be attributed to so many things: our cyclical consumption of news, the desensitization of tragedies due to constant media access.

That doesn’t explain the similar pattern reported in calls to the National Suicide Prevention Lifeline last week. And from my own perspective, there was a similar peak among physicians discussing suicide on Twitter. By now — as some even prophesized — people have moved on:

The world seems to pay a lot more attention to #mentalhealth when famous people battle issues & when they die to suicide. Let me tell you the dark truth. Many, many tens of thousands who you don’t know of and never will hear about do each month around the world. I care for them.

— Sumit Patel (@S_P_MD) June 8, 2018

Suicide is among the 10 leading causes of death in the US, with research speculating it’s still an underreported issue. Half of all states have seen an increase of at least 30% in just 17 years. There’s roughly 1 million suicide attempts in the US annually — and those are just the ones that get reported.

These are the characteristics of a public health crisis that continues to be slept on. According to the National Institutes of Health’s categorical spending rates, estimated 2019 funding to research and data on suicide is approximately $68 million. Estimated funding to the 9 other leading causes of death in the US will range from $5.3 billion (cancer) to $107 million (chronic obstructive pulmonary disease). Even depression ($437 million) or major depressive disorder ($104 million) would not rank among the most-funded conditions next year.

The only thing that has killed more of my friends, family, former classmates, and coworkers than suicide is cancer. And I’ve in run 5K races for cancer. I’ve donated money to leukemia research, worn ribbons for people I’ve lost, and have treated cancer with equal parts respect and fear. Last week, at the height of national suicide conversation, I shared an article I wrote about the subject, read a few columns about Bourdain, and checked in how a loved one was doing.

For as frustrated as I am to see people naturally move on from the conversation, I know I did the same — if you could even qualify my minimal efforts as being engaged in the conversation. I know to share the prevention lifeline phone number, to look for the same warning signs in people that I learned about from a young age. But I don’t know where to go beyond that, and I’m certain I’m not the only one.

Depression isn’t infectious. A sour mood can rub off a little but you won’t catch suicide from someone contemplating suicide. Depressed people generally feel like they are covered with depression mites. Don’t put on the yellow paper gown when you talk with your friend.

— Mark Reid, MD (@medicalaxioms) June 8, 2018

What’s missing in general from the national conversation on suicide is the extraordinary role of alcohol and substance use disorders in increasing suicide risk ...by most estimates at least ten-fold.

We also ignore role of etoh in breast cancer.

We need to talk about this.

— Omar S. Manejwala MD (@drmanejwala) June 8, 2018

#KateSpade #anthonybourdain maybe we need to recognize that the ages of 45-64 are an especially vulnerable time in terms of human mental health, when #suicide rates are at their highest. pic.twitter.com/zA78QaNuGm

— Prof Peter Hotez MD PhD (@PeterHotez) June 8, 2018

But physicians seem to know. Never a group to comply with society’s navigation around a taboo topic, doctors shared fresh and honest perspectives on suicide last week.

These are jumping-off points — substantial truths learned from people that are not only routinely treating depression, anxiety, and suicidal actions, but are facing it as an epidemic in their own field. The stigmas of mental health and the silence that shrouds it are perpetuated by people who have either never been exposed to such issues or never been taught the facts surrounding them. Who better than the most exposed and the most informed to correct this trend?

Last week, people participated in an exemplary conversation about suicide. Regardless if it were only due to trending news, we’re back in a place where suicide looks like the crisis it has actually become. Let’s stay here long enough to push the rhetoric, to set a new standard for progress in prevention.

I don’t want to have the same conversation about suicide. I want to have the ones that follow it.

Editor’s note: This is a column written by associate editor Kevin Kunzmann. His analysis reflects his views, not necessarily those of the magazine.

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