Posts Tagged ‘suicide’

by Tori Rodriguez, MA, LPC

Although there was a consistent reduction in US suicide rates from 1986 through 1999, the trend appears to have reversed during the most recent investigation period. A new report from the Centers for Disease Control and Prevention (1) reveals that suicide rates increased by 24% from 1999 to 2014, with the greatest increase observed in the latter half of that period.

The increase occurred among males and females in all age groups from 10-74. While rates for males still exceed those for females, the gap began to narrow during the most recent period. Among females, the rate increase was almost triple that of males: 45% vs 16%.

While the highest suicide rate was observed among men aged 75 and older, there was a reduction of 8% in this group from the previous report. There was a 43% increase among males in the 45-64 age group, making it the group with the greatest rate increase and the second-highest suicide rate among males. The second highest increase (37%) occurred among males aged 10–14, although this group had the lowest rate among all of the age groups.

As with males, the suicide rate also decreased among females in the 75 and over group, by 11%. The steepest increase (200%) occurred among females aged 10-14, though the actual number of suicides in this age group was relatively small (150 in 2014). The females with the highest suicide rates comprised the 45-64 age group, which had the second greatest increase (63%) since the previous period. For females in the age groups of 15-24, 25-44, and 65-74, rate increases ranged from 31% to 53%.

The most common cause of suicide in females was poisoning, which accounted for 34.1% of cases, while the use of firearms accounted for more than half of male suicides (55.4%). Cases involving some form of suffocation–including hanging and strangulation–increased among both males and females.

Though the report does not provide possible explanations for these trends, other recent findings offer clues about a host of variables that could be influencing rates in the middle age brackets in particular, with especially strong support for economic issues as a potential influence. A study published in 2015 in the American Journal of Preventive Medicine, for example, found that economic and legal problems disproportionately affected adults aged 40-64 who had committed suicide (2). Research reported in 2014 showed a robust link between suicide rates and unemployment rates in adults in middle-aged adults but not other age groups, and according to a 2011 CDC study, suicide rates increased during periods of economic recession and declined during economic growth among people aged 25-64 years (3,4).

A co-author of the 2014 and 2015 studies, Julie A. Phillips, PhD, of the Institute for Health, Health Care Policy and Aging Research at Rutgers University, has received a grant from the American Foundation of Suicide to investigate the numerous variables that could be influencing the trend in middle-aged adults.

Additionally, a randomized controlled trial published in 2016 in PLoS Medicine found promising results with a brief, low-cost treatment designed to address the main risk factor for suicide: previous attempts (5).

An approach called the Attempted Suicide Short Intervention Program (ASSIP) was shown to reduce subsequent attempts by 80% among patients admitted to the emergency department after a suicide attempt.

If you or someone you know is experiencing suicidal thoughts, contact the National Suicide Prevention Line at 1-800-273-TALK (8255) and visit online at http://www.suicidepreventionlifeline.org.

References

1. Curtin SC, Warner M, Hedegaard H. Increase in suicide in the United States, 1999–2014. NCHS data brief, no 241. 2016; Hyattsville, MD: National Center for Health Statistics.

2. Hempstead KA, Phillips JA. Rising suicide among adults aged 40-64 years: the role of job and financial circumstances. Am J Prev Med. 2015; 48(5):491-500.

3. Phillips JA, Nugent CN. Suicide and the Great Recession of 2007-2009: the role of economic factors in the 50 U.S. states. Social Science & Medicine. 2014; 116:22-31.

4. Luo F, Florence CS, Quispe-Agnoli M, et al. Impact of business cycles on US suicide rates, 1928-2007. Am J Public Health. 2011; 101(6):1139-46.

5. Gysin-Maillart A, Schwab S, Soravia L, Megert M, Michel K. A novel brief therapy for patients who attempt suicide: A 24-months follow-up randomized controlled study of the Attempted Suicide Short Intervention Program (ASSIP). PLoS Medicine. 2016; 13(3): e1001968.

http://www.psychiatryadvisor.com/suicide-and-self-harm/increase-in-suicide-rates-in-united-states-cdc/article/492762/?DCMP=EMC-PA_Update_RD&cpn=psych_md,psych_all&hmSubId=&hmEmail=5JIkN8Id_eWz7RlW__D9F5p_RUD7HzdI0&NID=1710903786&dl=0&spMailingID=14943637&spUserID=MTQ4MTYyNjcyNzk2S0&spJobID=820858811&spReportId=ODIwODU4ODExS0

Advertisements

by Tori Rodriguez, MA, LPC

While the top risk factor for completed suicide is a history of previous attempts, childhood trauma and impulsivity have also been found to increase the risk of suicidality in adults (1,2). However, there have been few investigations into whether these 2 variables influence each other in their association with suicidal ideation and attempts.

Prior research has linked childhood trauma with increased frequency of a range of psychiatric disorders, such as depression, posttraumatic stress disorder, eating disorders, panic disorder, and substance abuse.1 Additionally, a correlation between impulsivity and risky behaviors — including suicidality — has been found, and research published in 2014 discovered higher levels of impulsivity among patients with a self-reported history of at least 1 suicide attempt, compared to those with no reported previous attempts (3).

“People with histories of childhood trauma often develop difficulties with managing negative emotion, coping with stress, and maintaining optimism in the face of life stressors,” Lisa Cohen, PhD, a professor of psychiatry at Icahn School of Medicine at Mount Sinai Beth Israel in New York, told Psychiatry Advisor. “Impulsivity is a risk factor for all types of reckless behavior, including suicidal behavior,” she added.

Dr Cohen and others, including lead author Laura DeRubeis, a doctoral student at Adelphi University in New York, recently sought to determine whether impulsivity mediates the relationship between childhood trauma and suicidality in a sample of 113 adult inpatients (4). They hypothesized that after impulsivity was controlled for, childhood trauma would no longer predict suicidality at a statistically significant level.

As part of a larger investigation, participants were administered several questionnaires: the Childhood Trauma Questionnaire (CTQ), a Likert-type scale that measures emotional, physical, and sexual abuse, as well as emotional and physical neglect; the Barratt Impulsiveness Scale (BIS-11) and the Behavioral Activation Scale (BAS) of the Behavioral Inhibition and Activation Scales (collectively known as BIS/BAS, not to be confused with the BIS-11); and select items from the Columbia Suicide Severity Rating Scale (C-SSRS) to assess ideation and attempts.

According to the results, which were presented at the 2016 Annual Meeting of the American Psychiatric (APA) in Atlanta, Georgia, both childhood trauma and impulsivity had independent effects on suicidal ideation. However, childhood trauma was found to have an independent association with suicide attempts, while impulsivity was not. “We expected childhood trauma to influence suicidal ideation and attempts through a pathway of impulsivity, so that trauma leads to impulsivity which then leads to suicidal ideation and attempts,” explains Dr Cohen. Instead, they found that impulsivity was only related to suicidal ideation, and when childhood trauma was controlled for, impulsivity no longer predicted attempts.

Though these findings are in line with previous data on the correlation between childhood trauma, impulsivity, and suicidal ideation, they contradict the hypothesis of the current study as well as results of other studies suggesting that impulsivity is a risk factor for suicide attempts. “Childhood trauma seems to have a potent independent effect on both suicidal ideation and suicidal attempts,” the authors concluded in their paper.

References

1. O’Brien BS, Sher L. Child sexual abuse and the pathophysiology of suicide in adolescents and adults. Int J Adolesc Med Health. 2013;25(3):201-205.

2. Wedig MM, Silverman MH, Frankenburg FR, Reich DB, Fitzmaurice G, Zanarini MC. Predictors of suicide attempts in patients with borderline personality disorder over 16 years of prospective follow-up. Psychol Med. 2012;42(11):2395-2404.

3. Mccullumsmith CB, Williamson DJ, May RS, A, Bruer EH, Sheehan DV, Alphs LD. Simple measures of hopelessness and impulsivity are associated with acute suicidal ideation and attempts in patients in psychiatric crisis. Innov Clin Neurosci. 2014;11(9-10): 47-53.

4. DeRubeis L, Kim KHS, Ardalan F, Tanis T, Galynker I, Cohen L. The relationship between childhood trauma, impulsivity, and suicidality in an inpatient sample. Poster presentation at: 2016 Annual Meeting of the American Psychiatric Association; May 14-18, 2016; Atlanta, GA. Young Investigators’ New Research 1–017.

http://www.psychiatryadvisor.com/apa-2016-coverage/apa-2016-research-found-impulsivity-without-childhood-trauma-did-not-predict-suicide-attempts/article/497331/

by Erin Zaleski

A young French woman broadcast her last moments in a haunting livestream video.

More than 1,000 people are believed to have watched the young woman kill herself.

They watched her calmly discuss her decision to die, just as they watched her slip on her sneakers before heading to a nearby station and throwing herself in front of an oncoming suburban RER C train.

No one watching was able to approach the platform, or yell for her to stop, or to do anything else that may have prevented her from carrying out her desperate act, because no one could. The hundreds of people who witnessed her last moments watched the drama unfold behind their phone screens.

At the Egly train station south of Paris on Tuesday, a French teenager broadcast her suicide on Periscope, a smartphone app that allows users to stream live videos. The video has reportedly been removed from Periscope, but footage of the minutes leading up to her death has been posted on YouTube.

While suicide, and even public suicide, is nothing new, the age of social media makes such acts of despair accessible in a way they have never been previously. Indeed, Tuesday’s tragedy near Paris is not the first time a young person has broadcast a suicide on social media. In 2010, a 21-year-old Swedish man hanged himself on a live webcam broadcast. And a young woman in Shanghai documented the events leading up to her suicide on Instagram in 2014, uploading a series of disturbing images, including one in which her legs are dangling out of the window of a high-rise apartment.

“I will haunt you day and night after I’m dead,” she reportedly posted on the photo-sharing app in a message to her ex-boyfriend before jumping to her death.

In its guidelines, Periscope, which is owned by Twitter, prohibits what it deems “explicitly graphic content or media that is intended to incite violent, illegal or dangerous activities.” However, with some 10 million active users, monitoring every account 24/7 would be daunting, if not impossible.

“Why do you say you love me, you don’t even know me?” asks the pretty young woman seated on a red couch in her apartment and facing the camera. She is pale with long brown hair and piercings, one in her left nostril and two just beneath her lower lip. A prospective suitor has messaged her, but she calmly and firmly rebuffs his advances.

“Yes, I am single, but I am not looking for that. Really.”

She rolls a cigarette before continuing.

“What is about to happen is very shocking, so those who are underage should leave.”

She takes a long drag and continues to field questions from users. She tells them that she is 19 and works at a retirement home. Her determined, unemotional demeanor is a bit unsettling to watch. As is the way she calmly answers questions, sometimes even cracking a smile or unleashing a soft giggle.

“Why are you asking me who I am?” she asks with a chuckle before taking another drag. “I am no one.”

At one point she stops speaking and continues to smoke while scrolling through messages other Periscope users are sending her—mostly lame pick-up lines and other typical online inanities. Footage of her final act has been replaced with a black screen, but the faint voices of emergency personnel can be heard on the audio track, and messages from fellow users shift from playful banter to disbelief to concern.

“Stop messing around,” one of them reads.

“Where did she go? Call the cops!” reads another.

Indeed, it was a fellow Periscope user who alerted emergency services, but by the time they arrived at the station yesterday afternoon it was too late. French police have reportedly launched an investigation into her death.

Before she died, the young French woman reportedly claimed to be a victim of a sexual assault and named her alleged attacker. Whether it was the trauma of rape or another reason that drove her to violently end her life is not known. More unnerving is her decision to broadcast her death to hundreds of strangers. It’s not clear whether it’s a cry for help, since in the video she refuses to divulge any personal details, including her name and location. Had she wanted to feel less alone? Was she seeking empathy? Or in today’s digital world, where we joke that an event never really happened unless it’s posted, tweeted, or streamed, was she merely seeking to document, and thus, validate, the last moments of her life?

“What I want to make clear is that I am not doing this for the hype, but to send a message, to open minds,” she explains in the video.

The precise nature of the message she was hoping to send may never be understood. Instead, we are left a troubling glimpse of a young woman in pain, whom no one could help in time.

http://www.thedailybeast.com/articles/2016/05/11/french-teen-periscopes-her-suicide.html

by Kristy Puchko

Northwest of the majestic Mount Fuji is the sprawling 13.5 square miles of Aokigahara, a forest so thick with foliage that it’s known as the Sea of Trees. But it’s the Japanese landmark’s horrific history that made the woods a fitting location for the spooky horror film The Forest. Untold visitors have chosen this place, notoriously called The Suicide Forest, as the setting for their final moments, walking in with no intention of ever walking back out. Here are a few of the terrible truths and scary stories that forged Aokigahara’s morbid reputation.

1. AOKIGAHARA IS ONE OF THE MOST POPULAR SUICIDE DESTINATIONS IN THE WORLD.

Statistics on Aokigahara’s suicide rates vary, in part because the forest is so lush that some corpses can go undiscovered for years or might be forever lost. However, some estimates claim as many as 100 people a year have successfully killed themselves there.


2. JAPAN HAS A LONG TRADITION OF SUICIDE.

Self-inflicted death doesn’t carry the same stigma in this nation as it does in others. Seppuku—a samurai’s ritual suicide thought to be honorable—dates back to Japan’s feudal era. And while the practice is no longer the norm, it has left a mark. “Vestiges of the seppuku culture can be seen today in the way suicide is viewed as a way of taking responsibility,” said Yoshinori Cho, author of Why do People Commit Suicide? and director of the psychiatry department at Teikyo University in Kawasaki, Kanagawa.

3. JAPAN HAS ONE OF THE HIGHEST SUICIDE RATES IN THE WORLD.

The global financial crisis of 2008 made matters worse, resulting in 2,645 recorded suicides in January 2009, a 15 percent increase from the previous year. The numbers reached their peak in March, the end of Japan’s financial year. In 2011, the executive director of a suicide prevention hotline told Japan Times, “Callers most frequently cite mental health and family problems as the reason for contemplating suicide. But behind that are other issues, such as financial problems or losing their job.”

4. SUICIDE PREVENTION ATTEMPTS INCLUDE SURVEILLANCE AND POSITIVE POSTS.

Because of the high suicide rate, Japan’s government enacted a plan of action that aims to reduce such rates by 20 percent within the next seven years. Part of these measures included posting security cameras at the entrance of the Suicide Forest and increasing patrols. Suicide counselors and police have also posted signs on various paths throughout the forest that offer messages like “Think carefully about your children, your family” and “Your life is a precious gift from your parents.”

5. IT’S NATURALLY EERIE.

Bad reputation aside, this is no place for a leisurely stroll. The forest’s trees organically twist and turn, their roots winding across the forest floor in treacherous threads. Because of its location at the base of a mountain, the ground is uneven, rocky, and perforated with hundreds of caves. But more jarring than its tricky terrain is the feeling of isolation created from the stillness; the trees are too tightly packed for winds to whip through and the wildlife is sparse. One visitor described the silence as “chasms of emptiness.” She added, “I cannot emphasize enough the absence of sound. My breath sounded like a roar.”

6. DEATH BY HANGING IS THE MOST POPULAR METHOD OF SUICIDE AMONG THE SEA OF TREES.

The second is said to be poisoning, often by drug overdose.

7. A NOVEL POPULARIZED THIS DARK TRADITION. . .

In 1960, Japanese writer Seichō Matsumoto released the tragic novel Kuroi Jukai, in which a heartbroken lover retreats to the Sea of Trees to end her life. This romantic imagery has proved a seminal and sinister influence on Japanese culture. Also, looped into this lore: The Complete Suicide Manual, which dubs Aokigahara “the perfect place to die.” The book has been found among the abandoned possessions of various Suicide Forest visitors.

8. BUT IT WAS NOT THE START OF THE FOREST’S DARK LEGACY.

Ubasute is a brutal form of euthanasia that translates roughly to “abandoning the old woman.” An uncommon practice—only resorted to in desperate times of famine—where a family would lessen the amount of mouths to feed by leading an elderly relative to a mountain or similarly remote and rough environment to die, not by means of suicide but by dehydration, starvation, or exposure. Some insist this was not a real occurrence, but rather grim folklore. Regardless, stories of the Sea of Trees being a site for such abandonment have long been a part of its mythos.

9. THE SUICIDE FOREST MAY BE HAUNTED.

Some believe the ghosts—or yurei—of those abandoned by ubasute and the mournful spirits of the suicidal linger in the woods. Folklore claims they are vengeful, dedicated to tormenting visitors and luring those that are sad and lost off the path.

10. ANNUAL SEARCHES HAVE BEEN HELD THERE SINCE 1970.

There are volunteers who do patrol the area, making interventional efforts. However, these annual endeavors are not intended to rescue people, but to recover their remains. Police and volunteers trek through the Sea of Trees to bring bodies back to civilization for a proper burial. In recent years, the Japanese government has declined to release the numbers of corpses recovered from these gruesome searches. But in the early 2000s, 70 to 100 were uncovered each year.

11. BRINGING A TENT INTO THE FOREST SUGGESTS DOUBT.

Camping is allowed in the area but visitors who bring a tent with them are believed to be undecided on their suicide attempt. Some will camp for days, debating their fates. People on prevention patrol will gently speak with such campers, entreating them to leave the forest.

12. THE SUICIDE FOREST IS SO THICK THAT SOME VISITORS USE TAPE TO AVOID GETTING LOST.

Volunteers who search the area for bodies and those considering suicide typically mark their way with plastic ribbon that they’ll loop around trees in this leafy labyrinth. Otherwise, one could easily lose their bearings after leaving the path and become fatally lost.

13. YOU MAY NOT BE ABLE TO CALL FOR HELP.

Rich with magnetic iron, the soil of the Suicide Forest plays havoc on cellphone service, GPS systems, and even compasses. This is why tape can be so crucial. But some believe this feature is proof of demons in the dark.

14. NOT EVERYONE WHO GOES THERE HAS DEATH ON THEIR AGENDA.

Locals lament that this natural wonder is known first and foremost for its lethal allure. Still, tourists can take in gorgeous views of Mount Fuji and visit highlights like the distinctive lava plateau, 300-year-old trees, and the enchanting Narusawa Ice Cave.

15. GOING OFF THE PATH CAN LEAD TO GHASTLY DISCOVERIES.

The Internet is littered with disturbing images from the Suicide Forest, from abandoned personal effects snared in the undergrowth to human bones and even more grisly remains strewn across the forest floor or dangling from branches. So if you dare to venture into this forbidding forest, do as the signs suggest and stay on the path.

http://mentalfloss.com/article/73288/15-eerie-things-about-japans-suicide-forest

New research published in the Canadian Medical Association Journal shows that even mild concussions sustained in ordinary community settings might be more detrimental than anyone anticipated; the long-term risk of suicide increases threefold in adults if they have experienced even one concussion. That risk increases by a third if the concussion is sustained on a weekend instead of a weekday—suggesting recreational concussions are riskier long-term than those sustained on the job.

“The typical patient I see is a middle-aged adult, not an elite athlete,” says Donald Redelmeier, a senior scientist at the University of Toronto and one of the study’s lead authors. “And the usual circumstances for acquiring a concussion are not while playing football; it is when driving in traffic and getting into a crash, when missing a step and falling down a staircase, when getting overly ambitious about home repairs—the everyday activities of life.”

Redelmeier and his team wanted to examine the risks of the concussions acquired under those circumstances. They identified nearly a quarter of a million adults in Ontario who were diagnosed with a mild concussion over a timespan of 20 years—severe cases that resulted in hospital admission were excluded from the study—and tracked them for subsequent mortality due to suicide. It turned out that more than 660 suicides occurred among these patients, equivalent to 31 deaths per 100,000 patients annually—three times the population norm. On average, suicide occurred almost six years after the concussion. This risk was found to be independent of demographics or previous psychiatric conditions, and it increased with additional concussions.

For weekend concussions, the later suicide risk increased to four times the norm. Redelmeier and his fellow researchers had wondered whether the risk would differ between occupational and recreational concussions. They did not have information about how the concussions happened, so they used day of the week as a proxy. Although they do not know why weekend risk is indeed higher, they suspect it may be because on weekends medical staff may not be as available or accessible or people may not seek immediate care.

Although the underlying causes of the connection between concussion and suicide are not yet known, Redelmeier says that there were at least three potential explanations. A concussion may be a marker but not necessarily a mechanism of subsequent troubles—or, in other words, people who sustain concussions may already have baseline life imbalances that increase their risks for depression and suicide. “But we also looked at the subgroup of patients who had no past psychiatric history, no past problems, and we still found a significant increase in risk. So I don’t think that’s the entire story,” he notes. One of the more likely explanations, he says, is that concussion causes brain injury such as inflammation (as has been found in some studies) from which the patient may never fully recover. Indeed, a study conducted in 2014 found that sustaining a head injury leads to a greater risk of mental illness later in life. The other possibility is that some patients may not give themselves enough time to get better before returning to an ordinary schedule, leading to strain, frustration and disappointment—which, in turn, may result in depression and ultimately even suicide.

Lea Alhilali, a physician and researcher at the Barrow Neurological Institute who did not participate in this study, uses diffusion tensor imaging (an MRI technique) to measure the integrity of white matter in the brain. Her team has found similarities between white matter degeneration patterns in patients with concussion-related depression and noninjured patients with major depressive disorder—particularly in the nucleus accumbens, or the “reward center” of the brain. “It can be difficult to tease out what’s related to an injury and what’s related to the circumstances surrounding the trauma,” Alhilali says. “There could be PTSD, loss of job, orthopedic injuries that can all influence depression. But I do believe there’s probably an organic brain injury.”

Alhilali points to recent studies on chronic traumatic encephalopathy (CTE), a progressive degenerative brain disease associated with repeated head traumas. Often linked to dementia, depression, loss of impulse control and suicide, CTE was recently diagnosed in 87 of 91 deceased NFL players. Why, then, she says, should we not suspect that concussion causes other brain damage as well?

This new study may only represent the tip of the iceberg. “We’re only looking at the most extreme outcomes, at taking your own life,” Redelmeier says. “But for every person who dies from suicide, there are many others who attempt suicide, and hundreds more who think about it and thousands more who suffer from depression.”

More research needs to be done; this study was unable to take into account the exact circumstances under which the concussions were sustained. Redelmeier’s research examined only the records of adults who sought medical attention, it did not include more severe head injuries that required hospitalization or extensive emergency care. To that extent, his findings may have underestimated the magnitude of the absolute risks at hand.

Yet many people are not aware of these risks.

Redelmeier is adamant that people should take concussions seriously. “We need to do more research about prevention and recovery,” he says. “But let me at least articulate three things to do: One, give yourself permission to get some rest. Two, when you start to feel better, don’t try to come back with a vengeance. And three, even after you’re feeling better, after you’ve rested properly, don’t forget about it entirely. If you had an allergic reaction to penicillin 15 years ago, you’d want to mention that to your doctor and have it as a permanent part of your medical record. So, too, if you’ve had a concussion 15 years ago.”

http://www.scientificamerican.com/article/a-single-concussion-may-triple-the-long-term-risk-of-suicide1/

Older men of European descent (white men) have significantly higher suicide rates than any other demographic group in the United States, including older women across ethnicities and older men of African, Latino, or Indigenous decent, according to research published in Men and Masculinities.

In her latest addition to suicide research, Silvia Sara Canetto, PhD, professor in the Department of Psychology at Colorado State University, has found that older white men have higher suicide rates yet fewer burdens associated with aging. They are less likely to experience widowhood, have better physical health and fewer disabilities than older women, and have more economic resources than older women across ethnicities and ethnic minority older men.

Rather than being due to physical aging adversities, therefore, increased suicide rates among older white men in the United States may be because they are less psychologically equipped to deal with the normal challenges of aging; likely because of their privilege until late adulthood, Dr Canetto asserted.
Another important factor in white men’s vulnerability to suicide once they reach late life may be dominant cultural scripts of masculinity, aging, and suicide, Dr Canetto said. A particularly damaging cultural script may be the belief that suicide is a masculine response to “the indignities of aging.” This idea implies that suicide is justified or even glorified among men.

To illustrate these cultural scripts, Dr Canetto examined two famous suicide cases and their accompanying media coverage. The founder of Kodak, George Eastman, died of suicide at age 77. His biographer said that Eastman was “unprepared and unwilling to face the indignities of old age.”

American journalist and author Hunter S. Thompson died of suicide in 2005 at age 67, and was described by friends as having triumphed over “the indignities of aging.” Both of these suicides were covered in the press through scripts of conventional “white” masculinity, Dr Canetto stated. “The dominant story was that their suicide was a rational, courageous, powerful choice,” she said in a statement.

Canetto’s research challenges the idea that high suicide rates are inevitable among older white men. Canetto notes that older men are not the most suicide-prone group everywhere in the world; in China, for example, women at reproductive age are the demographic with the highest rate of suicide. This is additional evidence that suicide in older white men is culturally determined and thus preventable.

Dr Canetto’s research shows that cultural scripts may offer a new way of understanding and preventing suicide. The “indignities of aging” suicide script and the belief that suicide is a masculine, powerful response to aging can and should be challenged, Dr Canetto said.

Canetto SS. Suicide: Why Are Older Men So Vulnerable? Men Masc. 2015; doi:10.1177/1097184X15613832.

South Korea has one of the highest suicide rates in the world, and workers often report feeling stressed. So in order to make people appreciate life, some companies are making employees take part in their own pretend funerals.

In a large room in a nondescript modern office block in Seoul, staff from a recruitment company are staging their own funerals. Dressed in white robes, they sit at desks and write final letters to their loved ones. Tearful sniffling becomes open weeping, barely stifled by the copious use of tissues.

And then, the climax: they rise and stand over the wooden coffins laid out beside them. They pause, get in and lie down. They each hug a picture of themselves, draped in black ribbon.

As they look up, the boxes are banged shut by a man dressed in black with a tall hat. He represents the Angel of Death. Enclosed in darkness, the employees reflect on the meaning of life.

The macabre ritual is a bonding exercise designed to teach them to value life. Before they get into the casket, they are shown videos of people in adversity – a cancer sufferer making the most of her final days, someone born without all her limbs who learned to swim.

All this is designed to help people come to terms with their own problems, which must be accepted as part of life, says Jeong Yong-mun who runs the Hyowon Healing Centre – his previous job was with a funeral company.

The participants at this session were sent by their employer, human resources firm Staffs. “Our company has always encouraged employees to change their old ways of thinking, but it was hard to bring about any real difference,” says its president, Park Chun-woong. “I thought going inside a coffin would be such a shocking experience it would completely reset their minds for a completely fresh start in their attitudes.”

“After the coffin experience, I realised I should try to live a new style of life,” says Cho Yong-tae as he emerges from the casket. “I’ve realised I’ve made lots of mistakes. I hope to be more passionate in all the work I do and spend more time with my family.”

As the company’s president, Park Chun-woong believes an employer’s responsibility extends beyond the office. For example, he sends flowers to the parents of his employees simply to thank them for bringing his workers up.

He also insists that his staff engage in another ritual every morning when they get to work – they must do stretching exercises together culminating in loud, joint outbursts of forced laughter. They bray uproariously, like laughing asses together. It is odd to see.

“At first, laughing together felt really awkward and I wondered what good it could do,” says one woman. “But once you start laughing, you can’t help but look at the faces of your colleagues around you and you end up laughing together.

“I think it really does have a positive influence. There’s so little to laugh about in a normal office atmosphere, I think this kind of laughter helps.”

Certainly, some laughter is needed in the South Korean workplace. The country has the highest rate of suicide in the industrialised world. There is a constant complaint of “presenteeism” – having to get to the office before the boss and stay until he – invariably he – has gone.

The Korean Neuropsychiatric Association found that a quarter of those it questioned suffered from high stress levels, with problems at work cited as a prime cause.

http://www.bbc.com/news/magazine-34797017