Suicide is not a comfortable topic for any of us. Yet it is a grim reminder of the reality of the world we live in. Written in 1990 this article is still relevant today. Larry speaks with the experience of having lost his oldest son to suicide in 1986.
The National Suicide Prevention Lifeline is a 24-hour, toll-free suicide prevention service available to anyone in suicidal crisis. If you need help, please dial 1-800-273-TALK (8255). Their website is located HERE. The National Institute Of Mental Health (NIMH) has more up to date statistics located HERE.
2000 by Lawrence Russell Taylor, Ph.D
Suicide is not a subject anyone much likes to think or talk about, and whenever we suicide survivors bring it up, we are thought to be obsessed by people who wish we would “just get over it and move on”; and simultaneously thought to be less than edifying by fellow believers. Assuredly, we are moving on with our lives in ways that are hopefully meaningful, and, as ministers of the Gospel, it is certainly our desire to uplift the Body the Christ. However, edification of the believers does not involve ignoring and refusing to address the problems in society; indeed, our biblical mandate is to directly confront society’s ills with the healing of Christ. There may be no balm in Gilead, but there certainly is in Jesus. Those of us who have lost loved ones to suicide are not obsessed or unable to move on, we are personally aware of an area where the church has historically failed to minister appropriately and biblically. Our concern is no different than the concern of those who have a loved one with Alzheimer’s disease, had a child killed by a drunk driver, or who are involved for personal reasons in the American Heart Association or in promoting cancer research and cures. We are seeking to comfort others with the same comfort with which God has comforted us, and we are simultaneously seeking to educate those not touched by our tragedy so that, cognizant of the need, they can respond biblically.
Suicide is a monumental problem in American society, and the epidemiological information becomes particularly poignant when we take the time to realize that every suicide statistic represents a wasted life and a death that left behind scores of hurting people. Death certificate information from the National Center for Health Statistics, coupled with population based psychological autopsy studies, show that suicide is the eighth leading cause of death in the United States (as of 1999 – the last year for which statistics are available), up from ninth place five years earlier, and now ranking behind heart disease, cancer, cerebrovascular diseases, chronic obstructive pulmonary diseases, accidents, pneumonia and influenza, and diabetes mellitus. In 1999, there were 30,535 deaths by suicide, which is an age-adjusted death rate of 11 deaths per 100,000 population – a number that is probably lower than reality because suicide is sometimes underreported to protect the reputation of families. Suicide rates are highest in the mountain areas of the western United States, with Nevada having the highest overall rate, and Alaska the second highest; they are lowest in the Mid-Atlantic and New England regions. Speculation abounds as to why the western area of the country is higher than the rest of the nation in suicide rates, with theories including the ready availability of firearms, western individualism, displaced families and lack of support systems due to transience.
Although women attempt suicide more often than men, men complete suicide far more often than women because men generally choose more lethal means, usually firearms, while women more often attempt suicide by poisoning themselves with medications which allow for medical intervention. Nationwide, about 60% of all suicides are completed using firearms. The highest rate of suicide in African-American, Native American and Native Alaskan populations occurs in men between the ages of twenty and twenty-nine. The rate of suicide among children and adolescents has risen dramatically over the last forty years – quadrupling between 1950 and 1990; it is the fourth leading cause of death (after accidents, cancer and homicide) in adolescent and young adult females, (age 15-24), the third leading cause of death among males age 15-24 (behind accidents and murder), the sixth leading cause of death (after accidents, malignancies, congenital anomalies, homicide, and heart disease) in girls age five to fourteen, the fourth leading cause of death among boys age 5-14 (after accidents, cancer and murder), the fifth leading cause of death among female 25 to 44 year-olds (after cancer, accidents, heart disease and HIV), the third leading cause of death among males age 25-44 (after accidents and heart disease), the ninth leading cause of death among women age 45-64 (after cancer, heart disease, cerebrovascular disease, chronic obstructive pulmonary disease, diabetes, accidents, liver disease, and pneumonia/influenza), and the seventh leading cause of death among men age 45-64 (behind heart disease, cancer, accidents, cerebrovascular disease, liver disease, and diabetes). Suicide is the ninth leading cause of death among African American children age 5-14 (after accidents, murder, cancer, congenital anomalies, heart disease, chronic obstructive pulmonary disease, HIV, and anomies.); the third leading cause of death among black people age 15-24 (after murder and accidents); and the seventh leading cause of death among African Americans age 25-44 (after HIV, heart disease, accidents, murder, cancer, cerebrovascular disease). The rate of suicide in older adolescents has doubled in the last few years. It is the second most common cause of death among white males ages 15-44 (behind accidents), the second leading cause of death among white females age 15-24 (after accidents), the fourth leading cause of death among white women age 25-44 (after cancer, accidents and heart disease), and the third leading cause of death among white boys, age 5-14 (behind accidents and cancer).
A “one size fits all” approach to preventing suicide will not work. The causes of suicide are ubiquitous, and in the professional literature appear to include the increase in alcohol and drug abuse, the increase in depression, the increased availability of firearms, increased rates of divorce and family dissolution, increased numbers of working mothers, greater family mobility which cuts people off from larger extended family support systems, societal pressure on adolescents to act “grown up”, the breakdown of predictable support systems, the stratification of the social classes, society’s tolerance of violence, and the decline in religious practice and observance. In addition to suicide, other self-destructive behaviors are proliferating in adolescents – alcohol and drug abuse, smoking, self-mutilation, eating disorders, and dangerous and demeaning sexual practices, to name a few. Although suicide cannot be predicted in many instances, nor, sadly, prevented in all, it can be prevented in some.
In a recent paper entitled “Can Suicide Be Prevented? A Professional Journey” by Pamela Cantor, Ph.D., republished in the Harvard Medical School “Guide to Suicide Assessment and Intervention” (Douglas G. Jacobs, M.D., Editor, Jossey-Bass Publishers, San Francisco, 1999), Dr. Cantor, a lecturer in psychology in the Department of Psychiatry at Cambridge Hospital, Harvard Medical School, former syndicated columnist for the LA Times, and a renowned expert on teen suicide, lists twelve likely factors involved in the possible prevention of suicide, viz.:
- Having a specific plan that is lethal combined with the availability of the means to complete suicide makes a person at very high risk. Somewhere between 18 and 38 percent of those who commit suicide have made a prior attempt, yet 90% of those who attempt suicide do not die that way.
- The more impulsive, anguished and agitated a person is, the greater his risk of suicide.
- Those unable to see any solution to their problems are at risk for suicide because they feel overwhelmed and have lost hope.
- Access to a lethal weapon, especially firearms (and most especially hand guns) increases the risk of suicide dramatically. In England, a popular method of committing suicide was by asphyxiation with home heating gas. By changing the lethal coke gas to a less lethal natural gas, the suicide rate dropped 33%, proving that suicidal people will not often switch to another means of killing themselves when their method of choice is denied them. Removing access to weapons, especially from the hands of impulsive teenagers, would most likely save lives just as the epidemiologists claim.
- Depression carries a lifetime risk of suicide of 15%.
- The suicide rate for those with panic disorders is high.
- Schizophrenics have a 10% lifetime risk of suicide.
- Borderline Personality Disorder carries a 7% lifetime risk.
- Alcoholism carries a 3% lifetime risk.
- Anyone who has identified with or witnessed someone who has committed suicide is at risk – the so-called “copy-cat” syndrome that occurs when a rash of suicides follows the suicide of a classmate or rock star.
- Post-traumatic stress disorder carries an increased risk of suicide.
- Anyone abusing alcohol or drugs is at high risk for suicide.
In other words, a person is at risk for suicide if she has no inner psychological strength to cope with problems, cannot envision a brighter future, and is convinced suicide is a viable option to end the misery. The suicidal person may be frustrated, angry, depressed, anxious, mentally ill, physically ill or disabled, but not necessarily. Her risk increases if she has a history of suicidal behavior, a family history of suicide, has witnessed a violent death, and has access to lethal weapons. The combination of being impulsive and angry is deadly in adolescents.
Although the scientific literature does not yet support my conclusions because few if any controlled studies have been done, I am convinced that other risk factors for increased suicide besides those mentioned above include suicidal music, occult oriented games like “Dungeons and Dragons”, occult and violent “slasher” films, the demise of the family unit and of organized religion, and the pervasive philosophy of biological science that asserts a naturalistic, mechanistic, materialistic view of the universe.
While recognizing that many suicides defy explanation and others do not fit into any specific categories, it appears, based on the best available evidence that the most common causes of suicide include:
- Agitation, anger and/or anguish coupled with impulsivity.
- The collected stress of difficult circumstances out of which the individual can see no hope of relief.
- Mental illness.
- Drug and alcohol abuse.
- A family history of suicide.
- Occult/violent games and themes in literature, music and entertainment.
- Access to lethal weapons.
How then can we help those around us who may be suicidal?
- First, determine the lethality of the one to whom you are speaking. If a person has a viable plan with which to kill themselves, as opposed to a vague unspecified death wish, and has the means to carry out that plan, they are highly lethal and should not be left alone. Instead, accompany them as quickly as possible to a mental health clinic, psychologist or psychiatrist who can assess the need and take appropriate action.
- Next, remove any means of committing suicide as much as you are able – clear the person’s home of guns and lethal weapons, alcohol and drugs, for example.
- Third, make the person aware of the sinfulness of her decision, and of its devastating and life-long effect on loved ones.
- Fourth, give them hope in the form of the Good News of Jesus Christ, who alone can fix any problem, and turn around any life. He is able to restore, forgive and redeem in the most adverse of circumstances.
- Help the person locate, afford, get involved with, and stay committed to high quality professional psychological and/or psychiatric intervention, including the diligent use of prescribed medications.
- Over the long term, be a friend – supportive, caring, listening to feelings, concerned, and forgiving of wrongs without allowing the suicidal individual to become unhealthfully dependent on you.
- Finally, involve yourself in the greater community-wide effort to reduce the number of suicides.
What then are the practical steps individual Christians and congregations of believers can take to help reduce the number of people who choose to end their lives?
- We can arrange our own homes, and encourage others to arrange theirs, so that no child, teenager, or impulsive, depressed, or mentally ill adult can ever have any access to any firearms. We need to be certain that not only are our homes gun-proof, but that the homes our children and teenagers visit are as well.
- We need to clear our homes of any Internet, television, video, musical, or other reference to the occult, suicidal ideation, and violent material.
- Together, we can campaign for and politically support candidates and legislation that will restrict the access of lethal weapons by teenagers and children, reduce the graphic violent content of music, videos, games, television and the World Wide Web, and increase suicide prevention interventions in communities.
- We can use our influence as family members, clergy and coworkers to strongly urge those around us who appear agitated or depressed to seek medical intervention and faithfully take any medication prescribed. Medical researches have recently discovered that low serotonin metabolite 5-hydroxy-indole-acetic acid (5-HIAA) and homovanillac acid (HVA) levels in the cerebrospinal fluid are associated with violent and aggressive behavior, depression, obsessive-compulsive disorder, migraine headaches, premenstrual syndrome, and suicide. Although psycobiochemistry is in its infancy as a science, these discoveries are almost certain to lead to effective medications that can be used to balance the brain chemistry of some suicidal people and thereby prevent death in some instances. Mental illnesses like schizophrenia and bipolar disorder (manic depression) have long been successfully treated with medications.
- Together, we can campaign and lobby for an ubiquitous variety of effective interventions ranging from advertising and educational campaigns to treatment options, targeted at reducing substance abuse, particularly alcoholism.
- On the local level, we can influence the public and private schools in our neighborhoods to open their doors to suicide prevention and anti-violence education taught by both experts and people who have been personally affected by suicide.
- We can strive for more solid marital commitment to prevent divorce and family dissolution, teach coping techniques to married couples, and increase our involvement in the community of believers we call the church.
- We can teach our children and the adults in our churches the sinfulness of suicide, and its devastating effect on those left behind.
Indeed, suicide is a dreadful sin – it is probably the single most self-centered act a person can commit; an act that devastates innocent spouses, children, parents, siblings, friends and relatives, and breaks the heart of the God of life. As believers, our response to the sin of suicide needs, however to reflect the love and infinite grace of the Cross by tenderly and effectively ministering to the broken and hurting, rather than condemning those weaker than the majority. The church’s response to suicide has historically been dismal. In the middle ages, the Church had accepted the doctrine that salvation came via good works and that therefore a person who committed suicide, because he did not have time to receive last rights, would be forever tormented in hell. Those who committed suicide were denied church funerals and burials, their property was confiscated, and their families were banished in disgrace. The Protestant church after the reformation did little to correct these errors, but instead continued with many of the same practices. Both the Roman Catholic and Protestant churches have since corrected their doctrine, but the disgrace of suicide remains in society today. It is precisely that disgrace that causes the powerful stigma associated with suicide and ruins the reputations of bereaved families. In formulating a Christian response, we first need to explore what the Scriptures say about suicide.
It is noteworthy that there are seven instances of suicide in the Bible that are recorded without comment as to the wrongness or sinfulness of the action, and with no mention in any case of what happened to the suicidal person’s soul after their self-imposed death. They are:
- Abimelech, a judge of ancient Israel, was mortally wounded when a woman of Thebez dropped a millstone on his head, and then asked his armor bearer to kill him so that he could avoid the disgrace of being killed by a woman. (Judges 9)
- Samson, blinded, defeated and bound by the Philistines due to his own rebelliousness to his Nazarite vow, killed himself by pulling the pagan temple down on himself and his enemies. (Judges 16)
- King Saul, defeated by his enemies, given to insane fits, fighting to maintain a position he should have resigned, fell on his own sword. (1 Samuel 31)
- King Saul’s armor bearer likewise fell on his sword out of loyalty to his master. (1 Samuel 31)
- Ahithophel, David’s counselor, was disgraced after he betrayed David to the usurper Absolom who then did not follow his advice, so he hanged himself. (2 Samuel 17)
- Zimri, a wicked king, died when he burnt down his own palace. (1 Kings 16)
- Judas, having betrayed Jesus, went and hanged himself, then his body fell and was broken on rocks below. (Acts 1)
Nowhere does the Bible indicate that a person who commits suicide is in hell; in fact, the eternal salvation of a person is not determined by how he dies, but by the atoning death and resurrection of Christ. Our salvation depends on what Jesus did, not what we do. Probably most believers die with some unconfessed sin of which they were not cognizant (and some they were aware of). Salvation is by grace, a free gift, not determined by a person’s ability to understand and confess sin. That is not to imply that suicide is all right; conversely, it is a hideous and selfish sin that wounds hearts deeply, but it is not an unforgivable sin. The only sin God cannot forgive is the refusal to be forgiven. In seeking to prevent suicide, I do not tell people they will go to hell if they kill themselves (who am I to make that judgment in any case?), but I do point out to them how deeply such an act will wound the innermost heart of God and all the people around them, and, if they are parents, how such an act will forever teach their children to escape life’s difficulties with self-violence. When I talk to those left behind after suicide, I can assure them of God’s infinite omnibenevolence and mercy, of His profound understanding of all the factors that go into the making of a particular human being, and that He is ready to forgive and embrace both here and in eternity on the other side of the veil of death.
In 1986, my oldest child Elliott killed himself at home with a 22-caliber rifle. He was not insane, had no history of mental illness or violent behavior, and gave no warning to his friends or family. His death was sudden, shocking and impulsive, and resulted in years of heartache, intrapsychic pain, familial trauma, social stigma, confusion, depression, anxiety, phobia, anger, sadness and grief for his siblings, parents, extended family and friends. Elliott’s decision to end his life while a junior in high school was a tragic, sinful, self-centered, hateful, wrong decision, but it was his decision, for which no one can take blame but him. Sinful as it was, however, it was not an unforgivable sin – his family has all forgiven him even though he wounded us deeply, and we are certain God has forgiven him also. After all, God’s willingness and ability to forgive far outshines ours.
One day, some months after his death, I was standing at his graveside weeping and hurting more deeply than I could have imagined possible, when I became somehow mystically aware of a holy Presence – Jesus was with me. I did not see or hear anything, no hallucinations or visions occurred, it was more an inner feeling than anything else – a feeling a skeptic would attribute to my parental grief. Nevertheless, in my heart I know the Presence was real and that my Lord was sobbing with me, doubled over with His arm about my shoulder, He wept like He did at Lazarus’ tomb, and in that instant, I knew that Elliott’s tragic decision had wounded the heart of God as deeply if not more deeply than it had my own. In a profound yet ineffable way, I understood that the universe was hard-wired in such a way that prevented God from preventing such tragedies, but that, far from aloof, He was touched by the feeling of our infirmities, a Man of sorrows and personally acquainted with grief who participates with us in our suffering with an empathy that is deep and lasting. At that realization, I stopped ranting against God for His failure in preventing Elliott’s death, and began to accept the participatory fellowship of His love.
In spite of our best efforts and most fervent prayers, some suicides will not be prevented and loved ones will be left behind to cope as best they can. When a person in your circle of acquaintances loses a loved one to suicide, you can help by:
- Being present with the bereaved person – just be there; you do not need to know what to say, in fact, you do not need to say anything, just be there and stay there; hold them, cry with them, hug them, weep with those who weep.
- Doing little things to help. When a loved one dies suddenly and tragically, we often feel overwhelmed and in a state of shock that makes even the most menial tasks difficult to accomplish. Having someone there to take out the trash, fix the meals, wash the dishes, do the laundry, pay the bills, and change the oil in the car, can be a great comfort.
- Knowing the stages of grief. Bereaved people universally feel hurt, sorrow, sadness, loneliness, loss, emptiness, isolation, confusion, anger, intrapsychic pain, fear, anxiety, numbness, seasons of denial, self-blame, victimized, and hopeless. Because everyone is an individual and no one had precisely the same relationship to the deceased other than the particular bereaved, everyone grieves differently – some feel all of the motions listed above intensely and profoundly, others feel them sequentially, others seem to major on one for long periods of time, some show their feelings, others hide them well; but, unless there was no love, all grieve. It is normal for bereaved parents who have lost a child suddenly and unexpectedly to feel these feelings intensely for at least five years after the death of their child. Spouses typically feel these losses for at least three years. There is no time-limit on grief – people need to feel whatever they are feeling for as long as they feel it, and they need to have someone with them for the journey who accepts the validity of those feelings, is nonjudgmental and forgiving, and can offer more love and support than hollow answers or well intentioned Bible verses.
- Speaking of the Bible, I have discovered personally and seen it confirmed in the lives of others, that most often believers are most profoundly affected by the Book of Psalms as they journey through the difficult work of grief, because the Psalms contain the entire spectrum of human emotion without religious platitude.
If we are willing to courageously face the problem of suicide directly and collectively confront it politically, pedagogically, sociologically, psychologically, medically, and religiously, we will positively impact our world with the healing ramifications of the Gospel by which we live, and in the process save lives and alleviate the suffering of the bereaved around us.
(Statistics and professional information for this article were taken from the Harvard Medical School “Guide to Suicide Assessment and Intervention” (Douglas G. Jacobs, M.D., Editor, Jossey-Bass Publishers, San Francisco, 1999) and from the National Center for Health Statistics of the United States government, “National Vital Statistics, Volume 47, Number 19, June 30, 1999”).