New study supports suicide 'contagion' in teens
Having a schoolmate commit suicide significantly increases the chance that a teenager will consider or attempt suicide themselves, according to a new study in the Canadian Medical Association Journal (CMAJ).
The study surveyed more than 22,000 Canadian children aged 12 to 17. They were asked if anyone in their school, or anyone they knew personally had died by suicide and if they had seriously considered attempting suicide themselves in the past year. The researchers found that the risk of suicide was magnified even if the child did not know the deceased student personally.
Researchers found 12 to 13-year-old children were at greatest risk and were five times more likely to have suicidal thoughts than teens who had not been exposed to a death. According to the study, 7.5% of these children attempted suicide after a fellow student did, compared to 1.7% of adolescents in this age group who did not have a schoolmate attempt suicide.
"The bottom line is that the suicide contagion theory may be real," says senior author Ian Colman, the Canada Research Chair in mental health epidemiology and assistant professor at the University of Ottawa. "Being exposed to a suicide appears to be strongly associated with suicidal thinking and suicidal behavior and these effects may persist for a long time.
"This was remarkably common, at least in our study that is representative of the entire Canadian population. By the time these children were 16 or 17, one out of four were reporting that somebody in their school had died of suicide. That seems really high, but if you consider one child dies of suicide and they attend a school with 1,000 students, 1,000 students have been exposed to suicide."
Colman says suicide contagion, imitation or copycat suicides, has been around for a long time, but until now there wasn't strong evidence supporting the theory. Suicidal behavior is a global problem, he says. "It's the second leading cause of death among young people, and losing a loved one to suicide is incredibly distressing for the survivors."
In many cases, for years to come.
"We found that these effects weren't short-lived," Colman said. "The survey contacted the children every two years so we could follow up the reports of the school suicide to see if there was still an effect two years later. And in many cases, suicidal thinking and suicide attempts were still increased among those who had reported a suicide in their school two years previously."
Friends closest to the suicide victim were no more likely to have an increased risk of suicidal thoughts than other acquaintances, according to the study.
"We suggest schools should be thinking about doing interventions after a suicide schoolwide, involving everybody in the school, rather than just the friends or immediate classmates of the person who died," Colman said. "Schools should consider longer-term interventions or programs where they're going to revisit the intervention because we saw this longer-term effect."
Psychiatrist Dr. Karen Johnson says she doesn't believe the study should be considered "cut-and-dried information."
"As they mentioned, there are many other risk factors for teenagers, girls and boys, to attempt or consider suicide," says Johnson, associate chair of psychiatry at MedStar Washington Hospital Center.
"There was no indication as to what were the youngsters' state prior to their classmate's attempt," she noted. "Did these kids already have risk factors themselves prior to their classmate's attempt? Did they have a history of depression anxiety or substance abuse? Did they have a family history of suicide attempts or completions? Did they have a history of traumatic events in their life? It would have been good to know if the kids in the study met any of these criteria prior to the classmate attempt."
Colman says schools "may want to consider paying attention to the younger students, where these effects seem to be felt the strongest." He says these children should not feel like they are alone and helpless. "It's important to create a culture where students or children feel comfortable seeking help if they're struggling with their mental health. It's important for parents to talk to their kids about mental health. Be open, be supportive and make sure that your child knows that help is available."