Life After Suicide
How emergency responders can assist those left behind
In the U.S., 80% of all suicides involve adult males from their early 20s to their late 80s. Suicide risk among men rises with age, and those age 65 and older account for about 20% of all suicides. Men ages 80-84 have the highest suicide rate.
Women complete suicide less often than men because they tend to be less involved with alcohol, they use different means and they seek help. Older women rarely complete suicide; however, females attempt suicide more than males. Many of these attempts require emergency medical care.
In regard to race and ethnicity, the overwhelming majority of suicide victims are white, although suicides in the African-American community are increasing. Suicide rates are low among Asians and most Latinos (except teen girls). Suicides among non-white women are uncommon.
Firearms are used in most suicides. Guns are involved in 65%-70% of male suicides and in 40%-45% of adult female suicides. They are part of the reason more males die by suicide than females.
Veterans account for 20% of U.S. suicides. All have some familiarity with firearms, many have experienced trauma, and alcohol misuse may be a problem. The risk for suicide is highest in younger, white, male veterans ages 18-44. Physically and emotionally disabled veterans are also at high risk.
Most suicides involve an adult white male who dies violently in a location where he will most likely be found by someone who is very close to him in life. He will leave 6-8 folks behind who will have a very hard time dealing with the loss. These are the people who will need postvention and your help.
MISCONCEPTIONS ABOUT SUICIDE
Attitudes about suicide affect how emergency responders behave toward those close to the victim. They may share many popular myths about suicide or be influenced by beliefs about suicide that are part of professional cultures. Attitudes may also be shaped by encounters with individuals who repeatedly threaten suicide or make low-lethality attempts. (Such behavior is usually indicative of a serious personality disorder and can lead to more dangerous suicidal acts.)
When emergency responders believe suicide is the result of personal weakness, it may lead to judging the victim and marginalizing him as a "loser." This attitude may come across even if nothing is said.
Emergency responders may also see suicide as "normal" in cases of devastating illness, disability, legal or financial problems. Suicide is never rational. Saying someone "committed suicide" conveys the notion that he was in control. Acutely suicidal people are driven by a desire to die that is beyond their control, which is why they may be involuntarily hospitalized, if they are so fortunate.
Mental illness, drugs and alcohol are often seen as causes of suicide. These factors increase the risk of suicide but do not cause it. People with mental illness do take their lives, but their deaths are the result of a combination of factors.
Another myth is that suicide attempters "really want to die" and will "do it" sooner or later. Those who are suicidal do not necessarily want to die; they just want to end unbearable emotional pain. Being acutely suicidal is not a permanent condition. Crisis intervention often works with suicidal people.
WHAT IS DIFFERENT ABOUT SUICIDE LOSS?
One way to understand suicide loss is to think of it in terms of the layers of grief it involves. The baseline is the same grief we all feel when we lose somebody we love or care for a lot.
The first layer relates to suicide being avoidable. Survivors feel responsible and guilty because they "didn't do anything." Parents agonize that they let their child down. Blame for the loss may be put on third party (e.g., a therapist, counselor, school, friends, etc.) who knew of the risk, but didn't act.
The second layer relates to the seemingly intentional nature of suicide. Those left to grieve may feel the victim chose to leave them. This can generate anger and a sense of abandonment, betrayal or rejection. Emergency responders may hear these feelings expressed.
