Public discussion about suicide is dominated by particular types of narratives. Media outlets tend to focus on celebrities who, despite outward signs of success, are tragically driven to despair. Other news stories tell heartbreaking tales of young people who end their lives after experiencing readily identifiable stressors. This coverage is important, and compassionate media depiction is crucial for public understanding. However, discourse that’s constrained to certain kinds of stories obscures two key points: 1) suicide is really complicated and 2) it can affect anyone. With a trend of , we need to expand our conversations and make more room for nuance.
Five years ago, I heard a story about a suicide attempt that broke the typical media mold. It was this powerful , Kevin Briggs, who before he decided to climb back to safety. Berthia’s life was saved, but his struggles continued for years. In , he wrote, “Reporters are always after the happily-ever-after ending.” This coverage stands out because it includes his backstory and the moment-to-moment details of Berthia’s path toward, and ultimately away, from suicide., who was extremely close to jumping off the Golden Gate Bridge. In under three minutes, listeners learn that Berthia suffered from depression throughout his life and that this escalated to suicidal thinking when he couldn’t pay for his infant daughter’s enormous medical bills. This triggered embarrassment, self-directed anger, and feelings of failure. Filled with urgency to escape his overwhelming pain, he got directions to the bridge and climbed over the railing. He was stopped by an empathetic police officer
Suicide is the result of a culmination of factors pushing people into excruciating states where death is viewed as relief. Suicidologists acknowledge that diverse pathways lead to suicidal desire and seek to identify commonalities among people in acutely risky states. For example, Berthia had pre-existing vulnerabilities related to growing up and in a neighborhood where he was pressured to hide his depression. Then, compounding the uniquely jarring worry of having a child in compromised health, Berthia also blamed himself for not being able to foot medical bills to the tune of a quarter of a million dollars. This propelled him to the Golden Gate Bridge with the thought, “ .”
Between StoryCorps and the Guardian article, we get a sense of several contributing factors and potential intervention points that are generalizable beyond Berthia’s individual situation. For example, there seems to be a. And while the Affordable Care Act sought to partially address the , additional changes are desperately needed to overhaul a system that leaves people struggling to meet basic physical needs. A comprehensive suicide prevention initiative would address these and other empirically-linked risk factors , and
Berthia’s experience appears to fit within the 3ST. The first step proposes that people desire suicide in the presence of pain and hopelessness about the future, “If someone’s day-to-day experience of living is characterized by pain, this individual is essentially being punished for living, which may decrease the desire to live and, in turn, initiate thoughts about suicide” (pp. 116-117). Within the 3ST, suicidal desire could be reduced by targeting both distal factors (e.g., eliminating environmental factors that increase the probability of emotional pain) and proximal factors (e.g., and ). People advance to the second step of increased suicidal intensity if their pain overpowers meaningful connections to life. In the moment Berthia was about to jump to his death, Briggs emphasized Berthia’s connection to his daughter and the suicidal intensity decreased, A society seeking to prevent suicide would foster these kinds of connections, at multiple levels, for as many people as possible. The 3ST makes the case, building on , that the survival instinct prevents most people from attempting suicide even if they desire it. The third step usefully identifies three facets of a capacity to override this survival instinct: dispositional (e.g., ), acquired (e.g., experiences that result in decreased pain sensitivity and lowered fear of death), and practical (described as – e.g., in Berthia’s case, getting the directions to the bridge and ). The practical aspect of capability for suicide has been the focus of initiatives to in times of suicidal crises (e.g., ). Increasing safety at times of suicidal crisis can have long-lasting positive effects, as most suicide attempt survivors do not go on to die by suicide.
Suicide is complicated and that contributes to widespread misunderstanding. Science can guide us away from investing resources in domains that have Research illuminates potent risk factors and makes our understanding of suicide more precise. Suicide prevention advocates have increased and . Recently, there have been excellent examples of compassionate, realistic and of suicidal behavior. Altogether, this suggests that the public has the will to prioritize suicide as a public health problem. Scientific frameworks like the 3ST can steer us in productive, solution-focused directions.and toward those that have .
You can hear more of Kevin Berthia’s story here:
You can hear Kevin Briggs speak about Berthia’s story here.