Making sense of suicide

John McGowan

“I've danced with a man, who's danced with a girl, who's danced with the Prince of Wales” went the 20s song, written before Edward VIII became King and took a dip in popularity. The case of Jacintha Saldanha, who put through a call to someone who gave out information about the Duchess of Cambridge, ended far more tragically than for the flapper chanteuse. Our hunger for remote royal associations however, seems undimmed.

Speculation about Ms Saldanha (who did not appear to have courted any sort of publicity in her life) has been rampant on a global scale. Her suicide led to a huge array of responses: compassionate neutrality on the part of the royals, self-flagellating guilt from the pranksters, outrage about the lack of support for the family, and consideration of the limits of free speech. 

How are we to understand such an act? Not just in this case but whenever it happens? The possible risk factors for suicide are multiple. Also, as I have argued elsewhere, the potential motivations behind suicide and self-harm are manifold and complex. The act may be about escape, release, anger, revenge or a host of other feelings. It may be accidental, perhaps the seeking of care or an expression of desperation that has gone wrong. People’s motives can be shifting and not always evident, even to themselves. At this stage we don’t actually know if Ms Saldanha’s death was linked to the prank call.
Even if one of the three notes she apparently left suggested an association, it would be  unlikely to be the whole story. And if she hadn’t drawn such a link? Well then there would be no royal connection to add a frisson. Move on folks. Nothing to see here.

Respect for an individual’s motivations and state of mind are central in understanding a suicidal act, and in helping people who are at risk. A lack of consideration for individual motivations is not unique to speculation about deaths in the public eye, but also a gap in the Government's current Suicide Prevention Strategy. This is an estimable document in many ways, targeting higher risk groups and stressing the value of psychological help. However, it contains little about how we understand people. Without knowing what people mean by a suicidal act it is difficult to know the best way to help them. Should we prevent the act at all costs? We can detain people and take away their means of hurting themselves. Or perhaps our help should be focused on helping people to understand and start to bear difficult feelings more independently? I’d argue this is the core business of all psychological therapies. However, helping people get in touch with the difficult stuff can feel risky, especially when someone’s life is at stake.

The Government’s strategy is also based on the assumption that prevention is ultimately our goal in all circumstances. Of course someone ending their own life is a tragedy. But is the tragedy the act, or the pain that led them to it, with suicide as a release?  Might there be occasions when we might actually wish to respect a person’s right to end their life? The issue of assisted suicide and how we can tolerate it suggests that some people beleive that the act can be construed as a rational response rather than a sick one.

There is a palpable need to read meaning into Ms Saldanha’s death or to have something good come out of it. However, our lack of knowledge allows people project their issues of concern (outrage at breaches of privacy, the failure of hospital management, discomfort with pranks or excessive fascination with royalty) onto this act in a way which takes us no closer to understanding it. To be fair, some of the causes seem worth highlighting (e.g. appropriate support for families). It’s worth remembering, though, that the Royal Family, and others who choose to be in the public eye, are the willing recipients of our hopes, fantasies and discontents. They earn their living by it. Jacintha Saldanha had struck no such bargain and lived a private life. Perhaps one thing we can do as an appropriate response to her actions is to extended the courtesy of not assuming we knew who she was, or that we understand the meaning of her death.




Here is an embedded version to the slideshow linked above. It offers an overview of some of the areas which might be important in a considering suicidal risks.