It is well established that having strong social connections is a significant factor in lowering risk for mental illness and suicide. At birth, we are completely dependent on others for our sustenance and our survival. Small children continue to look to parents, caretakers, siblings and those surrounding them to learn about, make sense of and stay protected in the world. As we mature, we typically become more independent; but for most of us, connections to others continue to sustain us psychologically and emotionally.
The COVID19 pandemic and recent and upcoming holidays bring this concern with social and family connections to the fore. The power of connections among family and friends was sufficiently intense that many people were willing to risk their health and safety to travel to spend time with others over Thanksgiving. When positive, these connections make us feel safe and whole and the COVID pandemic has challenged us to find novel and creative ways to connect to others-sometimes safe but at times, even at some physical risk.
Our sense of support and connectedness to others can act as an impediment to suicide by helping us feel more supported and less hopeless and making us recognize that self-harm would hurt others we don’t want to hurt. Connections to others can act like a “safety net” and barrier to self-harm.
The Problem
Unfortunately, close connections can also be dangerous. I’ve been considering this while watching two recent documentaries about the NXIVM cult and how easily intelligent people could be pulled into powerful group ideologies when they felt embraced by a group and a seemingly powerful and protective-albeit exploitative and manipulative- leader. This problem arises in relation to suicide risk as well. We know that especially among young people suicidal thoughts and behaviors can be increased when they believe these to be more common among their peers. Even more so, there is growing evidence that suicide contagion can be enhanced by strong social connections.
Sociologist Anna Mueller recently presented her group’s research on a town that experienced a period of suicide contagion. They interviewed numerous people in the town over several years and several interesting observations emerged. They found that this mid-sized town had strong social connectedness among their youth resulting from homogeneity and stable population. The people in the town also had relatively similar values and ideals-there was little room for individuality, and there was significant negative feeling around getting help for mental health problems. Closeness and cohesion can produce a sense of support but also contribute to groupthink and intolerance for division and differences and a fear of not meeting community standards.
This paradox of strong group connections and cohesion emerges again when we examine the complicated relationship between religiosity and suicide. On the one hand, participation in religious groups that provide strong emotional support and religious prohibitions against suicide might be constraints on suicide but on the other hand, group cohesion and social pressures to conform may make personal differences less acceptable and help seeking more shameful, since in many strong social groups, mental health complaints or seeking professional help are seen as a statement that the group has failed to provide the necessary tools and supports the person might need.
Where does this leave us?
It is important to appreciate that groups can be a strong positive support for individuals but can also be a source of pain, exclusion and an impediment to individuality and self-expression. Groups also run the risk of producing psychological identifications and sympathies which can be dangerous in the face of an individual suicide. These risks are present in non-group situations as well. We have observed after the suicide death of celebrities or even in fictional portrayals of suicide of appealing characters such as occurred in the Netflix series 13 Reasons Why, that young people might be prone to feeling they are or would like to be, like the person who has died, thus increasing their risk of imitating the behavior of the admired person or character.
We need to understand the risk when a person in a tight knit community dies by suicide for those who feel psychologically connected or who might identify with the person who dies. We also need to be careful not to convey that suicide is a common or typical solution to life’s problems or for that matter that it is common among young people. Indeed, this raises the question central to many youth facing suicide prevention programs-how helpful or risky might it be to focus attention on suicide specific language in working with young people? The work on social norming and contagion suggest that we might be better served by not focusing too much of our attention or language in youth facing programming on suicide. This might seem strange but consider that when we try to help young people learn good health and nutrition habits, we try to message that developing these practices will make them generally healthier-not because it will lower their risk of heart disease, diabetes, stroke and cancer since young people are unlikely to see themselves as vulnerable to these “older people” problems-even if that is our ultimate goal. We need to educate and support young people in ways that build strength, emotional awareness, resilience, and positive connections to protect them against suicide-but it is not necessary to overemphasize the goals when programming with youth.