Stigma of Suicide

Stigma of Suicide
and Mental Illness

Introduction

I first started to try to write about the stigma of suicide back in 1997 when a cyber-friend asked me to do a little blurb for her webpage. It seemed I could not pull my thoughts together and get anything down on paper. On Oct. 11, 1998, the Atlanta Journal Constitution published a series of articles dealing with breaking the stigma of suicide. This motivated me to start putting bits and peices in a computer file. Now that I have finally put this page together and linked it, I have gone back and read the newspaper article. Several good points were made. I am adding a few of these points to this page and will denote them by red font.

Definition of Stigma

Dictionary

What do people mean by the "Stigma of suicide?" or the "Stigma of mental illness?" The Dictionary defines stigma as: "(1) A brand as on a criminal. (2) A mark of disgrace or disrepute. (3)A mark, sign, etc., indicating that something is not considered standard."

Stigma of Suicide

Many people who have lost loved ones to suicide feel a silence or a hard-to-describe dreadful look that people get on their faces when they hear that their loved one took their own life.

Stigma of a Mental Health Diagnosis

Many people will not get help when they feel depressed or have other mental health symptoms because they have a fear of being branded as a mental patient.

Stigma Resulting from Violent Criminal Behavior

The news media reports terribly violent acts committed by persons with a mental illness without giving any balanced perspective that the vast majority of patients with a mental health diagnosis have no tendency to violence. I believe this fear of being branded as a violent person keeps many people from seeking treatment for depression or anxiety or other problems that fall into the mental health category.

Examples of Stigma

Stigma Encountered by Relatives of Suicide Victims

Some people do not want to hear the word "suicide". One of the toughest questions for us is, "How many children do you have?" If you tell them you lost a son to suicide, some people then get that dreadful look on their face which I always hate to see. It is like maybe if I had of said he was killed in a car wreck or something, they would say, "Oh good, at least he didn't commit suicide!" This will be followed by a long pause and silence. It is this dreadful look and cold silence which makes many survivors reluctant to speak of their loved ones.

A reader told me of the pain they endured because the church considered suicide to be the worst sin. They would not allow a church funeral. We have not experienced this directly even though religious views may be the reason for some of the silence. Personally, I feel that if there is a heaven at all, Paul will be one person that is there. He always treated everyone he met kindly and would truly not harm a flea. I know when he took his life he was not murdering himself but instead ending a pain so severe that he could find no other way.

Research indicates there may be a genetic link that causes an enabling gene for schizophrenia to be inherited. This causes a fear that if someone in their family had it, they may have it too. This is a complicated question which needs to be dealt with intelligently, rather than from fear. Studies indicate that among non-identical siblings, if one has the genetic element, the chances are only one in one hundred that the other will have it.

Stigma Encountered by Those Living with Mental Illness

The stigma of admitting to a mental illness prevents many people from seeking help that could prevent suicide. Maybe part of the stigma of living with the knowledge that your loved one took their own life is that people may think you have a mental illness. I know that not everyone who commits suicide necessarily has a mental illness even though it seems to me that the act is prima facie evidence that they are mentally ill. If no one had seen signs of an illness, I think it is because they are so good at covering up their thoughts and feelings.

I have received emails from people who are considering suicide and they seem to have the attitude that they would rather be dead that admit that they have a mental health problem. They do not realize that mental health problems can be treated and cured or at least managed in a positive manner.

Stigma of Physicians Treating Depression

One Associate Professor of Psychiatry at Emory University says, "There is still a stigma attached to treating mental illness in this country. Depression is not a character flaw. It is a bio-chemical disorder."

Where did the ideal that the mind and body are two separate entities get started anyway? I recently saw a movie, probably made in the 1940's, about the Romans of biblical times. Forgive me, I cannot recall the title. In the movie, a Roman physician had been asked to treat a person who was having delusions. He statement was, "I cannot help him. His problems are of the mind and not the body."

Many people still have this attitude today.

Problems Resulting from Stigma

How Much Detail?

How do you answer the question about the number of children you have when you had three and lost one to suicide?" Some people say the answer is simply two because you only have two living children left. Sometimes, if it is a casual question from a person with which I will have no relationship in the future, I will answer, "I have two daughters." But if it is a person I will be dealing with on a daily basis, I answer with, "We had a son and two daughters but we lost our son back in 1991." Then here comes the worst part. If they say, "I am so sorry, what happened?" I will usually say, "At age 22, he developed a mental illness which eventually led to his taking his own life."

I recall when a new supervisor came on at work, I asked if he had heard about the loss of my son. He had not so I told him he developed schizophrenia at age 22 and made the decision to end his life. His reply was, "Well, I will not hold that against you." I took that to mean that he felt that I was somehow damaged goods because of that fact. I wondered how little he knew about suicide or mental illness.

Another situation is when some friend you have not seen in many years asks you, "What is Paul doing these days?" Then you have to tell them that he has passed away. How much detail do you give? I think it depends on how close they were and how much time you have. I find that as time goes on, I feel less need to go into a lot of detail. I suppose the psychologists would say that is a good sign of my recovery from grief.

Silence

A cold silence is one thing all suicide survivors will tell you they have encountered. There may be many reasons for this. Immediately after Paul's death, I mailed a newsletter to friends and relatives about research on suicide prevention. Most said nothing but one friend said they did not want their son to read it because it might give him ideas. I thought that was the stupidest thing I had heard. How would reading about the pain and suffering of another person and their struggle with schizophrenia cause someone to make a decision to take their life? Do others out there feel that reading about a suicide might cause someone to decide to do it?

Some people will not speak about a suicide or admit that someone in their family has a mental health problem because they feel it is a family disgrace.

Denial that one has a problem that can be labeled "mental" is very common? In correspondence with my readers, I have encountered many instances of people who are obviously severely depressed. But the suggestion that they should seek help brings an immediate response that they are not crazy.

Some people are afraid to say anything about the lost loved one for fear of making you sad and causing you to slip back into your grief. Immediately after any death, there is a period of sadness and anger and it is natural that your friends and relatives would not want to trigger those emotions. But it seems to me with most deaths, after a period of time, there is a normal discussion of the deceased. But now, some seven years later, when I mention Paul's name in context of the conversation, I still get the feeling they would just rather not hear his name or think of the good memories we all could share.

I have dwelled a lot on the silence concerning suicide and mental illness. But lets turn that around and ask why would anyone want to talk about it? The article in the Atlanta Journal-Constitution put it best.

"Not too many years ago, the last thing a suicide victim's family would have wanted was to publicly discuss their private tragedy. Suicide, the eighth leading cause of death in the United States, was a source of shame, guilt, and religious condemnation. But now the death that dare not speak its name is finally being spoken about. A grass-roots suicide awareness movement is trying to dispel the stigma and ignorance associated with self-inflicted death as it lobbies the government to do more to attack suicide as a preventable public health problem. Much of the movement is growing out of Atlanta, through the anguished efforts of loved ones left behind struggling to find purpose in their pain."

A Few Opinions

Euthanasia

I know there is not universal agreement on this and that some people feel that if a person wants to take their life, they should have that right. You hear this argument mostly with older people who are suffering great pain. There may be cases where a logical decision to end a life in a humane manner can be made. But I have known several older people who have lost the will to live but then went on to recover their physical or mental health and lead full and happy lives for many more years. So I think older people need to be treated for depression before any decision is made to end their lives.

Criminally Violent Behavior

Some people think that when a madman goes on a killing rage, if you refer to him as mentally ill, that implies that all mentally ill people are likely to kill or commit violence. I cannot see that point of view myself. I feel that mental illness covers such a wide range of abnormal behavior that anyone who resorts to murder is probably mentally ill, but this in no way means that anyone with a mental illness would kill any more that the average person. It is my opinion that the greatest cause of violence in our society today is undiagnosed and untreated mental health problems. Or, as in many cases, there has been diagnosis but our healthcare system is totally inadequate to meet the needs.

I think many normal people have murderous thoughts in a moment of rage or anger. However, a person with a healthy mind recognizes that this kind of thinking is destructive and if carried out would be considered criminal, so when their mind wanders in that direction, they make a conscious effort to think more constructive thoughts. However, I think a person who is unable to control their thoughts due to a mental illness might go ahead and plan it in his mind and then carry out in a period of time when his ability to control his inhibitions has been neutralized. But if he knows, he will be held accountable for any actions, it may be some deterrent. Of course, there are probably many murders committed by persons who really want to die themselves.

Legally Insane and Crazy

The word, "crazy" has no clinical definition and should be abolished from the language. "Insane" has a legal definition but in my opinion, there should be no such thing as an insanity defense. The idea that someone can be excused from committing horrible crimes by reason of a health problem seems to me to confuse the understanding of mental health issues. I could see a judge and jury taking into account someone’s health but there should be nothing automatic about it. I say this because I believe that suicide and murderous rages are the results of abnormality in the same area of the brain. One may be too little seratonin or dopamine and one may be too much for example. But in saying that a murderer is mentally ill, I do not want to excuse his actions. I believe most mentally ill people still know right from wrong.

Job Stigma

I recently attended a hearing where one lady told how police officers and firefighters were paying their own doctors bills that coud be covered by their employee health plan, but they were afraid of the stigma if their employer and fellow employees knew they were seeking help for stress and or depression. This is a good example of the need for education to eliminate this stigma.