The Crisis of Lethality: Suicide as a Health Issue

Table of Contents

Introduction

Suicide is a leading cause of death globally. Nearly 1 million cases of suicide are reported worldwide every year (Roberts, 2005). In the U.S alone, between 30,000 and 35,000 suicides are reported in a year. However, these are conservative estimates and experts agree that the figure could be as high as 60,000 (Doessel, Williams & Whiteford, 2009).

Suicide and Moral Dilemma

Compared with the other types of death, suicide is least forgivable as there is no pardon or sympathy for the dead person. It is considered a form of moral flaw and hence sinful. In the Eastern culture, death by suicide might be seen as a solution to humiliation and shame for both an individual and his/her family (Roberts & Ottens, 2005). However, this is not the case in the Western world. Nearly every religion views suicide as a sinful act. Civil authorities view suicide as a form of “self-murder” and hence a negation of one’s duty to serve the state. Those who committed suicide in England in the Middle Ages were deemed to have offended both nature and the king. The king ordered that all goods and lands of the deceased be surrendered to the crown. Such a person was also denied a Christian burial.

Dynamics of Suicide

According to Freudian inward aggression theory, excessive psychological stress causes intra-psychic conflict, thereby triggering suicidal thoughts. On the other hand, the escapist theory holds that those who commit suicide do so in order to escape from an intolerable situation (Nock et al., 2008). This observation is similar to the hopelessness theory which states that people committing suicide see it as the only escape from unchangeable life situations.

According to developmental psychology, suicide can be examined in terms of stages of life. When a person fails to sail through life stages successfully, he/she may become guilt ridden, isolated, mistrustful, and could decide to commit suicide. Durkheim’s social integration theory holds that suicidal behavior is dependent on social regulation and societal integration (Roberts, 2005).

The theory further identified four forms of suicide:

  • Egostic suicide occurs when one fails to identify or integrate with a social group.
  • Altruisitc suicide is linked to real or perceived social solidarity, such as the suicide attacks carried out by Islamic extremists.
  • Fatalistic suicide arises from despair under an oppressive or intolerable situation, such as a concentration camp.
  • Anomic suicide is caused by real or perceived collapse of societal norms, such as the economic and financial ruin occasioned by the Great Depression

How is Suicide Similar to Homicide?

Suicide draws a lot of parallels with homicide. For example, between 10 and 20 percent of individuals with violent behavior also tend to be suicidal (Nock et al., 2008). Murderers tend to have long histories of aggressive and violent behavior, and most of them end up taking their lives anyway. The occurrence of suicide/murder in society underscores the similarities of the opportunity, motive, lethality, and means.

According to Nock et al. (2008), although there is a thin line between these two terms, not all individuals tend to be homicidal. However, under similar conditions, homicide may pass for suicide, and vice versa.

What are the Characteristics of Individuals Committing Suicide?

  • Relational characteristics: the person communicates an intent to commit the act
  • Cognitive characteristics: the person is in a cognitive state. in other words, he/she wants to commit suicide but at the same time would like to be rescued
  • Serial characteristics: the person is distressed, experiences psychological pain, and deep perturbation.
  • Motivational characteristics: By committing suicide, the person hopes to find a solution to their problems, but the goal is to end consciousness.
  • Situational characteristics: in-containable psychological pain acts as the stimulus, while the victim’s frustrated needs act as the stressor.
  • Affective characteristics: the person manifests helplessness and hopelessness

Triage Assessment Form

The triage assessment form is a summary of a model for evaluating the cognitive, behavioral and emotional elements of a crisis reaction (Myer, 2001). Examining the lethality of a suicide entails first establishing if the client has indeed initiated a suicide attempt. Once the crisis worker has established that the client has not attempted to commit suicide, he/she tries to determine the client’s vulnerability to self-harm. The crisis worker also needs to determine the client’s lethality of suicide plan and suicide history. He/she should be careful to take into account a number of risk factors like whether the client has undergone a profound loss like layoff or divorce.

Conclusion

Suicide is a global health issue of concern. The dynamics of suicide can be explained using various theories like the Freudian inward aggression theory which states that suicidal thoughts are trigged by psychological stress. Suicide and homicide draw a lot of parallels in terms of motive, lethality, and means. A suicidal person manifests affective, situational, serial, and motivational characteristics. Using a triage assessment form, a crisis worker can be able to intervene and address the lethality of a suicide attempt.

Reference List

Doessel, D. P., Williams, R. F., & Whiteford, H. (2009). A reassessment of suicide measurement. Crisis, 30, 6-12.

Myer, R. A. (2001). Assessment For Crisis Intervention: A Triage Assessment Model. Belmont, CA: Wadsworth.

Nock, M.K., Borges, G., & Bromet, E.J. Et al. (2008). Suicide and suicidal behavior. Epidemiol Rev., 30, 133-154.

Roberts, R. A. (2005). Crisis Intervention Handbook: Assessment, Treatment, and Research. Oxford, Mass.: Oxford University Press.

Roberts, R. A., & Ottens, J. A. (2005). The Seven-Stage Crisis Intervention Model: A Road Map to Goal Attainment, Problem Solving, and Crisis Resolution. Brief Treatment and Crisis Intervention, 5(4), 329-339.

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