The recent public frenzy about bullying, along with multiple teen suicides, creates understandable grief and stress for everyone.  The word “bullycide” and claims of kids being “bullied to death” have filled the media airwaves and newspapers, blogs, and Twitter in recent weeks. Bullying has been increasingly politicized by special interest groups and all the way up to the White House, further clouding some of the issues.

But a number of questions remain:  

1. Can bullying itself be the cause of suicide?
2. What role, if any, do underlying mental health issues have in suicide cases?
3. Is there a risk of the contagion effect with all the publicity?

So I went to my long-time friend and respected colleague, Dr. Scott Poland, for some answers.  Scott is Associate Professor at the Center for Psychological Studies at Nova Southeastern University, Past President of the National Association of School Psychologists, member of the National Emergency Assistance Team, and Prevention Division Director for the American Association of Suicidology. 

Question: I have read that 90% of the people who commit suicide had diagnosable mental health illnesses. In your opinion, can bullying be a single, direct cause of a child taking his/her life, or are there underlying mental health issues? Is it oversimplifying it to say these kids are bullied to death, implying or stating that the sole direct cause of the suicide is bullying?

Dr. Poland:  The key to prevention is greater awareness of suicidal warning signs and getting mental health treatment for suicidal youth. In addition families must ensure that guns are not readily accessible to suicidal youth. One Houston teenager stated in her good bye note to parents, “Why did you leave this gun so available to me!”

The U.S. Prevention Task Force in 2009 recommended that all teens who see their physician for any reasons be screened for signs of depression and suicide. A short questionnaire should be filled out as part of their doctor visit and should be scored before the teen leaves the office.

The vast majority of youth who die by suicide had a diagnosable mental health disorder (usually depression) and they had traveled a long road. Their death is everything in their life and everyone’s fault, and yet it is no one’s fault. A precipitating event commonly precedes a suicide attempt as the young person had previously thought about how they might end their life and then one more thing causes them to act on their suicidal thoughts. The most common precipitating event is a severe argument with parents or a break up of relationship. A severe bullying incident, especially one that is very public and humiliating such as cyberbullying, could serve as the final straw or the precipitating event.

Question: Is there a risk of the media and anti-bullying activists contributing to a contagion effect with the extensive and dramatic media coverage we have seen of the spate of recent suicides?  Is contagion a possibility? 

Dr. Poland:  Yes, the literature emphasizes that teens are the most susceptible to imitate suicidal behavior. One of the first documentations of this occurred in Europe around 1900 when a young man named Werther jumped in front of a train and died by suicide. His death received extensive media coverage and subsequently several more teens that lived in that location died by jumping in front of trains. The term the Werther Effect was coined to explain this phenomenon which we now call suicide clusters or contagion.

I have personally been invited to several communities where suicide clusters have occurred and I believe there are many more clusters than schools and communities are willing to acknowledge. The aftermath of a suicide is a very challenging time for schools and communities and it is important to do something to promote greater awareness of resources for suicide prevention and, to help students with their grief and confusion.

The best postvention involves the school and community agencies such as mental health, law enforcement, physicians and religious leaders working together. It is also very important to focus on the living and not to glorify the suicide victim through special dedications and dramatic memorials. Many schools are confused about what to do and concerned about glorification or do not accept their responsibilities for mental health and they often do nothing when the aftermath of a tragic death by suicide is an opportunity to work to prevent more suicides.

Several organizations including the American Association of Suicidology, of which I serve currently as the Prevention Division Director, have published excellent guidelines for the aftermath of a suicide and media coverage in the form of the Do’s and Don’ts. More information is available at www.suicidology.org

I appreciate Scott’s responses and genuine commitment to school and youth safety.  The world is a better place with Scott in it!

Ken Trump

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