What Can We Do to Prevent Suicide?

Posted by - francisx

Someone once asked me why, if I have spent the last twelve years studying and writing about suicide in Micronesia, I don't make some recommendations on how to prevent suicide. I replied that I didn't believe in dealing with problems that way — writing out prescriptions like a doctor and then running off to see another patient. I always saw my role as working alongside others in the study of social problems in the community, doing anything possible to deepen my own and their understanding of the roots of the problem. As our awareness of the problem in all its complexity deepened, I always had faith that the community would sense how best to respond. And often enough it did.

As an educator, I always felt that I should raise questions, even annoying ones, and shed whatever light I could on these problem areas, always encouraging others to share in this effort and reflect on the issues before us. Community education was a joint effort, I felt. If people were convinced that the problem was real, if they could only grasp how and why the problem arose, then they could go quite far in working out solutions by themselves. This confidence in the resources of the community was the basis for lots of things besides our Micronesian Seminar; it was the principle underlying the old-fashioned credit unions and coops and the more recent educational efforts that go by the name of conscientization. It's a good principle, I think, and shouldn't be discarded lightly.

Nonetheless, I admit to owing the Micronesian communities a great deal for their help in my own long-term study of suicide. Probably far more than the communities themselves realize or than I have bothered to acknowledge. Let me, then, try to repay some of my debt — reluctantly, only because I would like to honor the old principle by which we educators have tried to live. Reluctantly also because these suggestions are based on probable but still tentative hypotheses made by someone who is very much an outsider looking in on Micronesia. Under conditions like these, we who fancy ourselves researchers get nervous at the prospect of climbing too far out on the limb of a tree. Yet, it may be only fair to share with people here in Micronesia what I think I have learned about what can aptly be called an issue of "life or death" today.

The suggestions for preventing suicide that are made here are based on the understanding of the problem that I have reached in the course of my work for the past twelve years. They will probably not be accepted by those who do not share this understanding with me. These suggestions represent several different levels of intervention, an approach that I feel is more sensible than attacking the problem at a single level only. Suicide is multi-dimensional, and our efforts to stem it should be a counter-attack on as many different levels as possible.

Any attempt to control impulsive behavior that may lead to suicide must take place long before the threat occurs. It requires training from childhood, and constant reinforcement during the difficult years of adolescence, that impulsive actions are a threat to the person and to the whole family. It also demands that the adults in the family support this teaching by avoiding such behavior themselves. Education programs within and outside of the schools can help here to some extent, but the main lessons are learned within the family. In the long run, the most effective means of guarding against such self-destructive behavior is the guidance that comes from a strong and healthy family.

And that last statement, one of the truest things said here, may be a fitting conclusion to this short paper on suicide prevention. When it comes right down to it, the best means of prevention is strong and healthy families.

1. I believe that the main single cause of the suicide epidemic of recent years is the breakdown of the extended family that has occurred almost everywhere since 1960. The old system had a nice little balance between the role of the matrilineage and that of the father and his lineage in raising children. There was a wide distribution of authority throughout the extended family and many relatives to provide support and ease tensions that arose. In recent years, for reasons that we will not discuss here, the old balance has been upset, many of the supports from the lineage lost, and the authority of the parents greatly expanded. The problem is not that parents today are spending too little time with their kids, but that they are forced to spend too much time with them. Their parenting role has become much larger and more complex than that of their own parents 20 or 30 years ago.

   Time will heal this difficulty to some extent as parents learn to adjust to their new roles as mothers and fathers today. In the meantime, however, we can help by educating the community — perhaps through radio program? — on (1) what changes have occurred in the family in recent years, (2) why they have occurred, and (3) what new parenting roles may demand of mothers and fathers today. We may not be able to turn back the clock and restore the old lineage in its fullness, but we can help people understand and adapt to the changes that are making them dizzy nowadays.

2. The old-fashioned family structure provided more than a tight authority system in the lineage; it also furnished older people with whom the young man or woman could talk about their problems. The counseling and support system was built into the family itself in most parts of Micronesia. There were certain kinfolk — aunts (in Palau), grandparents (in the Marshalls), maternal uncle (in Yap) — who had a more easy-going relationship with the young person and were a refuge in time of trouble. Much of this has changed. It is not as easy for a troubled young person to find an ear within his family today, and most do not feel comfortable seeking help outside the family to talk about problems with their parents.

   If we can't re-establish the old family network, we may have to create new mechanisms for providing this support within the family. In Hawaii and other parts of Polynesia the family gathers for a meeting each week or two to discuss its problems within the family circle. Could this be instituted here in Micronesia? Many Trukese families hold some such meeting on the occasions of funerals. Could this be done more frequently, perhaps every week or every month? Could this be combined with a family prayer session for those families that are active in their churches? Could older relatives other than parents initiate conversations with younger members of the family and encourage them to talk about their problems? This may require some cultural changes, but heaven knows we have already undergone plenty of other changes in customs in the past years. If none of this works, then we will simply have to rely on sources of support and advice outside the family such as counselors and crisis interventions centers. But these will be less effective than the family changes I have proposed here.

3. Young people who have had a history of troubled relations with their parents or their spouses often seem to devise impromptu "tests of love" for these people, unbeknownst to the people who are being tested. A boy who thinks that his father has always preferred one of his brothers to himself might ask his father for some money to see if his father really does love him. A married young man who has been away from home for a few weeks and has doubts about his wife's faithfulness in his absence might ask her to go out with him to a disco late at night. These demands may appear unreasonable, but the outcome often enough determines whether a potential suicide victim will actually take his life or not.

   Those who are being tested should not feel that they have to comply with the request, especially if there is good reason not to do so, as when a drunken son comes home to ask for more money to drink with his friends. But they should at least do these two things: 1) take the trouble to explain why they will not agree to the request; and 2) assure the young person in some appropriate way that they love him even if they must refuse what he asks. Merely doing these simple things could save many lives. Of course, there remains the larger and more difficult task of teaching young people that love should not be measured only in terms of food, or money or other gifts given. This may require a more sweeping attempt at re-education of the young.

4. It should be obvious to anyone, foreigner or Micronesian, that suicide has been romanticized by many of our young people today. This is particularly true in Truk, Pohnpei and the Marshalls, although there have been signs of the same thing at times in other parts of Micronesia also. Love songs mention suicide, youths discuss the subject openly among themselves and at times make suicide pacts with one another, and youngsters express admiration of those who have taken their own lives and are mourned so terribly by their families and friends. What is even more shocking, however, is that a number of adults in our communities seem to share the belief that these young people have died altruistic and even heroic deaths. If the majority of Micronesians really believe that suicide is an honorable option, then this paper is thoroughly useless and all of us had better resign ourselves to continuing high rates of suicide in the future. Young people, after all, are very quick in sensing the basic values of their elders. If they get the impression that we ourselves honor suicide, then they will be only too happy to oblige by hanging themselves.

   My own strong conviction has always been that suicide is a tragic waste of life, and I think I can say that with confidence the rest of the Catholic clergy in our diocese shares this conviction. Without trying to judge individual acts and the motives behind them, we support wholeheartedly the position that Bishop Neylon took three years ago when he wrote that "suicide is a selfish act, for it inflicts enormous grief on the families of victims and weakens the entire community." The Bishop reminded us in that same letter that "It is wrong to think of self- destruction as an act of love or a generous effort to reconcile the family." Many argue that suicide has always been a culturally acceptable option — an assertion that is by no means beyond dispute, in my opinion. But even if suicide were culturally approved in the past, this practice would still have to be judged in the light of the Gospel in the same way that headhunting expeditions and inter-clan warfare were. The Gospel is quite clear on the value and dignity of human life.

   What can we do to remove some of the romanticism associated with suicide? We would have to proclaim in some visible way that suicide is not an honorable death, but one that needlessly subjects others to misery. In the Middle Ages the people in some European countries cut down the body and left it in the middle of the road to be trampled by all who passed by. We don't have to go this far, but we certainly shouldn't provide full burial honors for the victim either. In his letter, the Bishop suggested that the burial of suicide victims be quick and simple with the absolute minimum of display. He also recommended that there be no church rites nor public prayers performed in connection with the funerals. The purpose behind this was to show the clear disapproval by the church, the family and the society of the suicidal act. Although this measure may be difficult on the family, it could discourage other young people from making the same foolish mistake in order to win recognition through their death. This is particularly essential in Micronesia where the funeral assumes such enormous proportions and such importance. It would seem logical that any attempts to de-romanticize suicide begin there.

5. As we progressed in our study of suicide, we began asking ourselves what sorts of things seemed to help steady the balance of the young person who experienced difficulties with his family. What made it possible for some individuals to endure the kind of problems that would lead others to take their own lives? Why was it that some young people seemed to be thrown entirely off balance by family tensions, while others could survive and even prosper amid the same kinds of tensions? It was not that the survivors loved their families any less than the suicide victims, we felt. Instead, it might be that some young people had many interests and areas of competence that seemed to cushion the blows that fell on them from the families. The basketball star, the academic genius, the boy who is involved in running youth groups — these seem to be people who are better protected than others from the ups and downs of family life. This is not to say that they are immune from suicide, as we know from some recent cases, but they do seem to fare better in general.

   Any community efforts to cultivate the kind of clubs, organizations and other activities that help young people develop competence in areas like these will also strengthen their self- esteem and make them more resistant to suicide. Developing competence and interests is like putting on armor; it protects us from the impact of the blows that we receive in the family. This, then, is the main value of youth clubs and basketball leagues as means of preventing suicide.

6. Alcohol is usually at the head of the list whenever causes of suicide are discussed, but its importance is sometimes exaggerated. Drinking does release the inhibitions, causing a person to display his emotions more openly, brood on them more easily, and act more recklessly than he would otherwise. No one questions whether drinking plays an important part in suicide — half of the suicide victims in Micronesia are drunk when they take their lives. But this raises the old question: does a person commit suicide because he got drunk, or does he get drunk so as to commit suicide? Which is the cause and which is the effect? Whatever the case, it is clear that better control of youth drinking would almost certainly mean fewer suicides. Measures that were effective in reducing drinking among young people would be a great step in preventing suicide.
7. Suicides in Micronesia may have their roots in long-standing conflicts within the family, but they are often very impetuous acts as well. A flare-up occurs between a young man and his family, and he rushes out of the house to end his life. There is no time for reflection, no time to seek mature and wiser counsel, no time to weigh the consequences of what he is about to do. If the family is lucky, they can send someone after the angy young man to stop him before he has finished the job. Aside from keeping someone on 24-hour duty as a watchman, there is little that the family can do to control such impulsive behavior. To count on intervention after the flare-up occurs is very risky business.