Monday, 24 November 2008

Tragic death on camera in Miami

The death by overdose of a 19 year old Abraham Bigg on camera watched by thousands of people on the internet is tragic. Commentary about this has focused either that it was online and people actually encouraged him to carry through with his act (sic) or that "internet causes suicide". Just to put this in context there are over 30,000 suicides in the USA every year - so what was different about this death? People have very different views about people who want to die. Historically the view that people who want to "self murder" are bad people who should be condemned has been prominent. This is clearly what a lot of people watching this thought. More recently thinking of suicide as a medical probleem has generated several useful ways of thinking about suicide prevention including effectively treating mental illness. What hasn't been emphasised is that Mr. Bigg had a bipolar disorder the adequate treatment of which represents an important opportunity for suicide prevention. This however is not a sexy headline - especially when compared with internet causes suicide. The other thing to note here is that clearly Mr. Bigg was ambivalent about death - otherwise he wouldn't have killed himself in a way which also offered the chance of someone saving him. Mr. Bigg's exposure by web cam to a potentially vast audience was both an expression of anger and hope. It is a truism that if someone is talking to you about suicide they are ambiivalent and at least part of them wants to live.


Anonymous said...

It is truly shocking to me that a suicide was on the internet, and that people particpated.

But I'm also concerned at calling suicide'self murder' For one thing, The stigma people with mental illness encounter is perpetuated by medical people using this kind of terminology, and as mentioned, many people who attempt suicide have a mental illness.

At present, it is simply not possible for many people who feel suicidal to get assistance, they are refused help. The public or even medical or psychiatry may be unaware that a phone call to a crisis team frequently results in a person who is having suicidal thoughts or feelings being blamed for it, told they are responsible for keeping safe and that nobody will see them. More stigma, more blame.

A trip to a hospital emergency room can end in crisis team being called and them refusing to see the person.

My extended family has had 3 people who have attempted suicide - one almost succeeded. We have had a friend of my parent's who suicided, while in a psychiatric unit.

And another who died because he chose to. He had been diagnosed with terminal cancer. He had just nursed a close friend through the exact same cancer and watched him die. None of us called it 'self murder' and we all felt compassion for his plight, and I personally supported his decision to chose when to die.

So for me, there are so many reasons that people take their own lives, putting them all together and labelling it 'self murder' and using a 'medical model'could be said to be black and white thinking.

I guess that's what I'm wondering about. Where is compassion? When I've been very down and asked for help, I've experienced what I described above. I wonder how many people go on to harm themselves because the nasty critical attitued and behaviour of mental health crisis teams towards them add to their despair?

My challenge, to people is to actually experiment. Try pretending you are desperate, and phone the people who are ment to help, look for resources, people to contact. I've found...nobody. Even Lifeline now cuts off phone calls if they are already talking to people, so that you call, get an answer machine, told to call back later , then a dial tone. They are so busy that I've found that it is no longer possible to reach them. SPINZ isn't set up to support desperate people, it's an information service, and the same for depression line - they say they are not there to help people, they refer whom? It all comes back to crisis teams, and plenty has been publicised about their responses, or lack of it.

So I reckon, Service Providers, get back in touch with your humanity, don't make suicidal people 'other' don't label them or stimatise them don't tell them how bad they are for having these feelings, or that they are mad, - how about an organistaion being set up to actually offer real help? It's the missing link.

Simon Hatcher MD said...

Suicide is a recent word in the English language only coming into use round about the middle of the 17th century. Prior to that people who killed themselves were called self murders and were treated in the same way as murderers - this was also reflected in the law with many severe punishments for attempting to kill yourself (including death bizarrely). Many languages do not have an equivalent word to suicide and still call it self murder.

Interesting point about ringing up services pretending to be "desperate". This has been done in the 1960's and 1970's but not sure it would get past an ethics committee now. However it's a study I've always wanted to do - maybe in the near future. Watch this space...