Monday Morning Crisis Quarterback

In the last month, three students at Cornell University in Ithaca, New York have killed themselves by jumping off bridges into the gorges that mark the campus.  Two died on consecutive days last week.  The total number of suicides at Cornell this year now stands at six, with four additional deaths from other causes, on a campus of roughly 20,000 students.  If that sounds high to you, it is.  The suicide rate nationally for college students is roughly 7.5 per 100,000 per year, which would give a school the size of Cornell a predicted rate of 1.5 suicides per year.  They're at six, and it's still March.

So, what is going on at Cornell?  First of all, as the college points out, their average number of suicides per year is still about 1.4, so if whatever is going on is Cornell-specific, it is specific to this year.  One might posit reasons why Cornell students might be at higher risk than other students.  Cornell is a relatively high pressure school.  Ithaca is way off the beaten path, which may isolate some students from natural support systems.  And the system of gorges and bridges represent a particularly convenient and lethal way to attempt suicide, so those who attempt it might be more likely to complete it.  On the other hand, none of those things is new, and before this year Cornell hadn't had a suicide in four or five years.  So what is going on?

Those who study suicide will tell you that suicide is, in some sense, contagious.  People whose relatives complete a suicide are more likely to attempt one themselves, and people who have friends, or even just close peers, who complete a suicide are also more likely to try.  The reasons for this are complex.  It's not as simple as someone learning that someone close to them has killed themselves and "getting the idea."  In some cases, people who have already contemplated suicide think "if they can do it I can too."  They identify with the person who died and how they were feeling, and the example they set by killing themselves tilts others decision making in that direction.  In other cases, the reaction to the suicide of a loved one is so complex and severe that it promotes suicidal actions from others.  There is also some component of this phenomenon caused by the fact that someone who completes a suicide makes others aware that that particular method works, so people who might otherwise have tried something less lethal are more likely to complete their suicide.

There are absolutely things that institutions can do in an effort to be caring that can make things worse.  The most common is to over-honor and over-memorialized the person who died.  Particularly in adolescence and young adults, whose brains are not fully developed and hence don't think things through very well, watching a peer get the full attention of the school or community in death may encourage them to kill themselves in a misguided attempt to get that attention for themselves.

Given the complexity of the problem, the response of Cornell this week has been pretty impressive.  They have put in place two initiatives that have grabbed headlines, perhaps even more than the suicides themselves.  The first is that they have placed staff at the bridges over the various gorges on campus, and placed suicide hotline information on the bridges.  This is a relatively small and short-term fix, but in a community that has demonstrated that it is at increased risk, taking away the method of choice for suicide is not a bad idea.

If that were all Cornell were doing, it would be inadequate.  However, they are also having staff members knock on the door of every single student in the residence halls, check on their welfare and engage them in conversation.  This may seem like a small thing, but it is a really good idea.  It prevents anyone on campus from being completely isolated, and it breaks the silence that often surrounds suicide and depression in our society.  It invites every single student, individually, to talk about how they are doing.

I once heard a fellow CISM person describe people contemplating suicide as fish drowning in a bowl of water.  Everything they need is right there, but they can't make use of it.  If that is true, Cornell is doing two things:  making it hard for the fish to jump out of the water, and providing individual assistance in figuring out how to use the water they're in.  I sure hope it works.