In the Marine Corps, I believe we talk too much about suicide. Over the past year I’ve had to take no less than seven suicide-prevention classes. Is the idea to teach us how to do it? In one recent class, statistics were given showing that white males aged 18 to 24 in the infantry are the mostly likely candidates, and they usually use violent means such as a handgun. Also, they almost always succeed. But this is a skewed depiction of the data. An overwhelming majority of infantryman are white males in this age group. So this class taught me that as a white male infantryman aged 18 to 24, I am susceptible to suicide. And if I try, I must succeed via violent means.
The Committee on Public Education found suicide to be the third leading cause of death, behind accidents and homicide, among people aged 15 to 24.1 With most military members in this age group, an additional complication is what researcher M.S. Gould calls “suicide contagion or clusters.”2 It is not a new phenomenon. Evidence of suicide clusters and imitative deaths has been reported from ancient times through the 20th century.
Concern about suicide contagion has increased in recent years because of a number of highly publicized outbreaks among teenagers and young adults, as well as new evidence pointing to an association with stories of suicide in the press. Clusters have been reported among psychiatric inpatients, high-school and college students, Native Americans, military troops, prison inmates, and religious sects.
Just as with sporadic suicides, behavioral and psychiatric problems make cluster members more susceptible. Every year in the United States, 100 to 200 youngsters die in such groups, and there are signs that the rate is rising. These estimates do not include attempted suicide clusters, as there is no registry of attempts. Groups have included friends or acquaintances in the same school or church, but the decedents have not necessarily had direct contact. Sometimes knowledge of the initial suicides was gained through the news or, in the case of Marines, our leadership.
One major issue in the self-inflicted death of any young person is the bereavement of those left behind. Researchers M. Parrish and J. Tunkle found that given the increasing prevalence of youthful deaths by suicide, social workers are more likely to be called on to respond to traumatized families, peers, and professional colleagues.3
The Centre for Suicide Prevention in Calgary, Alberta, emphasizes the difficulty and stress of losing a peer in this way. Such a death can personally and professionally affect caregivers, who may reexamine the relationship, asking what they missed and how they might have prevented the death.4 Other reactions may include disbelief, shock, feelings of failure, loss of self-esteem, a sense of inadequacy, fear of professional consequences, anger, and guilt. Peers experience a range of reactions including guilt, denial, acting out, anger, anxiety, withdrawal, relief, fear, helplessness, blame, confusion, and shock.
To help youths, many caregivers have contact with bereaved young people. Even peers not directly connected with the deceased may be affected. This could be their first experience with death or major loss. They may have difficulty in expressing their thoughts and feelings to adults, as this is the time in their lives when they are also trying to become more independent.
Counselors, or in our case leaders, who cannot help a bereaved young person without judging or blaming (either the victim or the bereaved) should make referrals to other leaders or therapists. They should always keep in mind that the youth may not be asking them to fix anything. All they may want is someone to listen in an accepting, nonjudgmental way.
Suicide is a complicated issue, but it is hardly confined to military service members. This brief survey shows that it is widespread in this age group, regardless of environment or affiliation. I am not recommending that we stop talking about suicide altogether. But I think that in the Marines, we may not need to talk about it as much as we do. Instead, we could talk more about multiple combat tours and coping mechanisms.
1. Committee on Public Education, Pediatrics, July 2001.
2. M.S. Gould, “Impact of Modeling on Adolescent Suicidal Behavior: Suicide Contagion (Clusters),” Psychiatric Clinics of North America 31, no. 2 (2008): pp. 293-316.
3. M. Parrish and J. Tunkle, “Clinical Challenges Following an Adolescent’s Death by Suicide: Bereavement Issues Faced by Family, Friends, Schools, and Clinicians,” Clinical Social Work Journal 33, 1 (July 2005).
4. Youth at Risk of Suicide, Calgary, Alberta: Centre for Suicide Prevention, 2007.