Patricia Farrell's COLUMN

Suicide and Self-Harm Enablers Are Out There Now

Websites and individuals are ready and willing to provide methods to commit suicide or self-harm and advise others.

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I have friends who’ve tried suicide many times and haven’t succeeded. I myself made an attempt, so I had a connection with that sort of group of people who have tried suicide at one time in their lives. — Judy Collins

The morning had a slight wind, and it was cold. Everyone was wearing a winter jacket, but as he passed the open office door, I could see his jacket was wide open, as though the cold made no difference to him.

As always, his face showed no display of emotion with that flat affect that we know is characteristic of people who have a diagnosis of schizophrenia. Eyes were fixed straight ahead. There was no greeting or notice. He was going to work in the local shop as he did every day, day after day, in an exacting fashion.

A skilled artist, all of his exquisite drawings were in his room hidden behind a closet. They would never be displayed, he would never sell them, but he would enjoy making them in his spare time when no one was in the area. One of the few who was permitted sharpened pencils, he used them to great effect.

An hour or two after he had passed the door, someone came running up to the entrance, banging in distress on the outside. “He’s hanging there! He’s hanging there from the tree behind the building!” There he swung slowly, jacket open, occasionally twirling until they cut him down.

Yes, he had no fear of being cold that morning because he had decided this would be the last day he would ever feel cold again. Within a week of his death, several other young men would attempt to kill themselves in various ways that the staff had come to know were common methods among the patients.

Sheets were a favorite, and if placed just right, the staff wouldn’t be able to open the door to rescue you because rescue was the last thing on your mind that day. After they cut him down, they discovered a second sheet under his jacket. There was no doubt he was fully prepared that day.

Photo by Altin Ferreira

The Facilitators

As in other psychiatric hospitals, there are always those patients who are willing to share any number of ways to commit self-harm (as the woman who dismantled small desks and inserted screws in her arm) or suicide. The methods are simple, require almost nothing, and the individual is quickly gone.

Attempts at resuscitation are useless, especially in hospitals that have no equipment to assist staff in saving a life. The oxygen bottle on one unit was empty. On another, the antidote for pine-needle poisoning was unavailable. That young man died, too.

Staff, in an earnest effort to remove the means of suicide on units, ensured that no doors had knobs or handles, no showers had rods for shower curtains, and all eating utensils were collected after meals. But one hospital did not have the luxury of removing everything. There were slender pipes suspended from the ceiling throughout the buildings, a perfect means of escape from life.

As too often is the case, one young woman reveled in the information she exchanged with other patients. She was an exquisite example of someone who self-harms. Doors were to be used to break your arm; shower curtains, if you could find one, had small hooks which could be inserted into a vein. She was always on the lookout for another choice weapon, freely sharing the information on the unit.

In time, however, she would change and become involved in work on grounds, and, ultimately, she was discharged to a group home where she apparently did well.

Why did she self-harm? One look at her diabolical home life was sufficient to supply enough for a textbook on how to raise a self-harming child. Brutality was the order of the day, and she had been beaten, burned, and bruised throughout her young life. Bouncing from foster home to foster home, she became a source of sex, income, and an unpaid maid.

Photo by Rob Hampson

Technology Brings Self-Harm to the Masses

Technology has not only brought the Internet into our homes; it has brought it into our hands wherever we may be. Proving to be an irresistible source of, primarily, entertainment and mindless communication with others, cell phones can also be deadly. No, not the cell phone itself, but what it can display to vulnerable people.

Although there are many sites available to help people suffering from depression, loneliness, or feelings of alienation, there are also sites run by people with dubious reasons for providing deadly information regarding suicide and self-harm. Usually, these sites, in the past, may have remained on the fringes of the Internet.

We knew there were sites, and probably still are, that enable people to continue with their own anorexia nervosa or bulimia. In effect, they are helping people kill themselves because these eating disorders can result in death.

After the body loses a sufficient amount of fat, it begins to cannibalize itself in terms of muscle, and the primary muscle it may go after is the heart. Therefore, individuals with anorexia may have sudden, deadly cardiac arrests. We can only hope that monitoring the many platforms where these sites may be found will do the right thing and pull them down.

Of course, that would violate free speech, and here we tread on a very serious and sacred issue. Who is to determine what should be on the Internet? Of course, this is a current dialogue between various governmental bodies in the United States and abroad that involves Facebook, Google, and Twitter.

But the suicide enablers are feeling the noose tighten around their activities. In Massachusetts, there’s now a law specifically directed toward enablers.

The bill is called Conrad’s Law, named after local teen Conrad Roy, who was encouraged to commit suicide in 2014 by his girlfriend, Michelle Carter. Carter was later convicted of involuntary manslaughter and sentenced to 15 months in prison.

This law would make convincing or manipulating someone into committing suicide a crime punishable by jail time, with a maximum sentence of five years.

Photo by Thomas Lefebvre

Online Forums

One site that provides a place for suicide survivors to talk about their issues freely is still up and running. The media refuses to provide its name for fear that there are enablers on it after one young man took his life; he was a site member. They found it open on his phone after he killed himself.

Suicide Solution (not its real name) is a self-described “pro-choice” community of people who feel suicidal or are having suicidal thoughts and ideation. From reading the posts on the website… hundreds of people were writing about ending their lives, the ways they might do it, and receiving well wishes and sympathy from other members. The site has about 500 members.

The enablers are seen as predators looking for vulnerable people. Why do they do it? Undoubtedly, researchers need to investigate what would cause someone to wish to help others end their lives. On the other hand, those who are thinking of suicide need to have the means to express their feelings in a safe environment.

One reason many suicide survivors or those who are thinking of suicide don’t discuss their thoughts is that they are afraid they will be locked up in a mental institution and their liberty taken away from them. The fear is so strong that they hesitate to go anywhere for help, thinking that they will be hospitalized against their will.

It should be noted that anyone who expresses suicidal ideation to a licensed healthcare professional must be evaluated, and it is an ethical consideration that cannot be dismissed as a joke or a passing remark. Any expression of suicide must be taken at face value.

Living through this experience and talking to others about how they managed to push through it can be a helpful experience, and places on the Internet are offering this. But, again, some of the members of these online groups are skeptical of individual members’ motives.

They have expressed concerns that some are enablers come into the group with that goal in mind. Perhaps it makes enablers feel important or powerful. We don’t know at this point. But safety is relative and how does anyone protect the group from enablers who may be able to conceal their intentions well?

If you or someone you know is in crisis, call the National Suicide Prevention Lifeline at 800–273–8255, text TALK to 741741, or visit http://suicidepreventionlifeline.org for more information.

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Pat Farrell PhDhttps://medium.com/@drpatfarrell
I'm a licensed psychologist in NJ/FL and have been in the field for over 30 years serving in most areas of mental health, psychiatry research, consulting, teaching (post-grad), private practice, consultant to WebMD and writing self-help books. Currently, I am concentrating on writing articles and books.

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DR PATRICIA FARRELL

Medika Editor: Mental Health

I'm a licensed psychologist in NJ/FL and have been in the field for over 30 years serving in most areas of mental health, psychiatry research, consulting, teaching (post-grad), private practice, consultant to WebMD and writing self-help books. Currently, I am concentrating on writing articles and books.

Patricia also acts in an editorial capacity for Medika's mental health articles, providing invaluable input on a wide range of mental health issues.

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