A friend recently asked to meet for coffee. "I've had some more bad news," his text said. A "fifty something" year old friend had taken his own life the day before. Jack had hanged himself from a tree in a public park on the outskirts of London; it was his fourth attempt. He had four children. This was the second, middle-aged, male friend to have committed suicide within six months.
Their stories are far from unique. Suicide occurs everywhere in the world to people of all age groups, from 15 to 70 years.The World Health Organisation (WHO) says that almost one million people commit suicide every year, with 20 times that number attempting it, and the numbers are rising. Methods vary from country to country: in the USA, where firearms litter the streets, 60% of people shoot themselves; in India and other Asian countries, as well as South Africa, taking poison, particularly drinking pesticides, is the most popular choice. In Hong Kong, China and urban Taiwan, WHO records that a new method, "charcoal-burning suicide" has been recorded. Drowning, jumping from a height, slashing wrists and hanging (the most popular form in Britain, the Balkans and Eastern European countries) are some of the other ways desperate human beings decide to end their lives.
Stigma and under-reporting of suicides
According to WHO, 1.5% of worldwide deaths were caused by suicide in 2012, making it the third highest cause of death in the world. And this is just those deaths confirmed as suicide. WHO admits that the availability and quality of data is poor, with only 60 Member States providing statistics "that can be used directly to estimate suicide rates."Many suicides, they say, "are hidden among other causes of death, such as single car, single driver road traffic accidents, un-witnessed drownings and other undetermined deaths." These are just some of the many factors that make accurately assessing the numbers who take their own lives problematic. In countries where social attitudes, or religious dogma, shroud suicide in a stigma of guilt (Sub-Saharan Africa, where suicide is rarely if ever discussed or admitted, for instance), suicide may be hidden and go un-reported; so too in countries where suicide is still regarded as a criminal act: Hungary for example, where attempted suicide carries a prison sentence of five years, or Japan where it is illegal to commit suicide. North Korea, where relatives of a person committing suicide are penalised; Ireland, where self-harm is not generally regarded as a form of attempted suicide; Singapore, where suicide remains illegal and attempted suicide can result in imprisonment; or Russia, where the rate of teenage suicides is three times the world average and where those attempting suicide can be committed to a psychiatric hospital. All of which are pretty strong reasons for hiding suicide attempts and concealing suicide as the cause of death, as well as deterring people from discussing suicidal thoughts.
Whatever the precise number of total deaths by suicide – and all the indications are that it is a good deal higher than WHO says – what is clear is that suicide is a major social issue. The figures of both attempted suicides and committed suicides are increasing; it needs to be openly discussed, the causes understood and more support provided.In the last 45 years, WHO states that suicide rates have increased by 60%, and unless something marvellous happens that drastically changes the environment in which we are living, they predict that by 2020 the rate of death will have doubled – from one suicide every 40 seconds, to someone, somewhere in the world taking his/her life every 20 seconds!
Rates of suicide and gender ratios vary from country to country and region to region, but overwhelmingly men are more at risk than women. WHO found that 75% of global suicides occurred in low- and middle-income countries, with 30% of all suicides occurring in China and India where suicide was only de-criminalised in 2014. Eastern European countries, such as Lithuania and the Russian Federation, recorded the highest numbers of suicides, the Eastern Mediterranean Region, Central and South America (Peru, Mexico, Brazil and Colombia) the lowest. And although suicide rates worldwide have traditionally been highest amongst elderly men, young people – that's 15-29 – year olds, are now the group at the greatest risk in a third of all countries. Suicide, WHO states, is the "leading cause of death in this age group after transport and other accidents and assault for males," with very little gender difference – "9.5% in males and 8.2% in females."
Throughout western societies, around three times the number of men die by suicide than women, and over 50s are particularly vulnerable. In Britain, men account for 80% of all suicide cases (with an average of 13 men a day killing themselves); 40-44 year olds are particularly at risk here. In "low- and middle-income countries", WHO records, "the male-to-female ratio is much lower [than more developed countries] at 1.5 men to each woman." Surprisingly, in the USA, where four times the number of men die from suicide than women, according to The Centre of Disease Control and Prevention, women are more likely to attempt it. The statistical gender gap in western societies may in small part be caused, The Samaritans think, by the different suicide methods used by men and women. Leading to the fact that in some cases "the intent cannot be determined (or assumed) as easily [with women] as in methods more common to males." This may result, they say, "in more under-reporting of suicidal deaths in females."
The causes of suicide
The specific reasons why people commit suicide are many and varied; 'mental health issues' is the umbrella term often cited as the cause. According to researchers at Glasgow University, 90% of suicide cases suffer from some form of mental illness. It is an ambiguous phrase though, that explains little, and comforts the bereaved less. It would seem obvious that if someone kills themselves, they are not feeling mentally or emotionally "intact," or "good." "I struggled for so long"; "I couldn't cope anymore"; "life seemed meaningless"; "I felt tremendous anxiety," and so on, are phrases common to many of us, including those people contemplating, attempting or committing suicide. Perhaps understandably, depression is usually mentioned as a cause, but this of course does not mean everyone suffering from depression is at risk of suicide!
The WHO makes clear that whilst suicide rates vary enormously from country to country, differences, "influenced bythe cultural, social, religious and economic environments in which people live and sometimes want to stop living..…the pressures of life, that cause extreme emotional distress" and sometimes lead to suicide, "are similar everywhere."
It is these "pressures of life," that need to be properly understood: what they are, where they come from, the impact they have and how we can change the structure of society to free humanity from them. Why do we have such damaging "pressures of life?" We should not be living in a world that produces such detrimental forces. Something in our world society is terribly wrong when a million or so people kill themselves every year, and where suicide is the second highest cause of death amongst under 20 year olds.
I am not a psychologist, but commonsense would suggest that the "sense of self" must be at the heart of the issue, the volatile central cause. If that "sense of self" is positive, if one feels connected to "life," has structure, purpose and self-belief, feels liked, loved even, then suicide would seem unlikely. If, however, the image of self is negative, of a "failure," unable to "fit in," feeling lost, lacking direction and experiencing social and emotional withdrawal, a fragile sense of self and increasing vulnerability are, it would seem, likely.
Then there are the practical problems we all face of earning a living and paying the rent/mortgage; the more subtle issues – pressures of "succeeding" – economically, socially, in a career, and in "love." The inability – real or perceived – to meet these "pressures of life" creating worry and anxiety – perhaps leading to alcohol or substance abuse – which strengthens social isolation, reinforces the image of failure, weakening self-belief/confidence and strengthening self-loathing. And all this in a world where weakness, particularly in men, is frowned upon; where sensitivity, uncertainty and fragility are to be overcome – "toughen up" is the message, spoken directly or indirectly.
We have little understanding of who and what we are, so we create images, cling to ideological constructs that move us further and further away from our true nature. The ideal image of what it means to be a human being, particularly a man, has become increasingly narrow. Men, especially under 40 year olds, must be decisive, strong and ambitious. Any flowery beliefs – philosophical or religious for example – should be eradicated, or at least hidden, certainly not mentioned in public. Any admission of self-doubt and signs of vulnerability should be completely avoided, and a macho, no-nonsense approach to life adopted and expressed.
Broadly speaking, this has become the stereotype of what it is to be a man in the 21st century, and conformity to the pattern is insisted on – via education, peer pressure and the corporate media. Women, particularly young women, are expected to meet a similarly, if slightly less constricting, formulated ideal. Both are extremely restrictive, unhealthy images that fit into a worldwide system of societal uniformity, built by, and in the interests of, multinationals (who own everything), facilitated by corporate governments (who lack principles), which is sucking the richness and diversity out of life. Everyone is expected to want the same things, to wear the same clothes, believe the same propaganda, aspire to the same ideals and behave the same. Every country, city, town and village is seen as a marketplace, every person a consumer to be exploited fully, sucked dry and discarded.
Competition and conformity have infiltrated every area of worldwide society, from education to health care. Everything and everyone is seen as a commodity, to be bought at the lowest price and sold at the highest, financial profit is the overwhelming motive that drives and distorts action. Materialistic values promoting individual success, greed and selfishness saturate the world; "values" that divide and separate humanity, leading to social tension, conflict and illness. Ideals, which are not values in any real sense of the word, which have both fashioned the divisive political-economic landscape in which we live (which has failed the masses and poisoned the planet), and been strengthened by it. Together with the economic system of market fundamentalism which so ardently promotes them, these "values" form, I believe, the basic ingredients in the interwoven set of social factors that cause a great deal of the "mental health issues," which lead those most vulnerable members of our society to commit suicide. Men, women and children who simply cannot cope with the "pressures of life" anymore, who feel the collective and individual pain of life acutely, are disposed towards introspection and find the world too noisy, its values too crude, its demands of "strength" not weakness, "success" not failure, "confidence" not doubt, impossible to meet. And why should they have to meet them, why do these "pressures of life" exist at all?
It is time to build an altogether different, healthier model, a new way of living in which true perennial values of goodness, shape the systems that govern the societies in which we live, and not the corrosive, ideologically reductive corporate weapons of ubiquitous living which are sucking the beauty, diversity and joy out of life. Values of compassion, selflessness, cooperation, tolerance and understanding; we need, as Arundhati Roy puts it, "to redefine the meaning of modernity, to redefine the meaning of happiness," for we have exchanged happiness for pleasure, replaced love with desire, unity with division, cooperation with competition, and have created a divided society, where conflict rages, internationally, regionally, communally and individually.