CLUSTERING

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CLUSTERING CONTAGION OF SUICIDE

• Bridgend Samaritans

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(No Transcript)
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Northern Ireland Clusters

• 2006 291 young people took their own
• lives. A 37 rise on
  previous
• year.
• Suicide rates in young men have risen by one
  third since end of The troubles
• 2005 Teenage suicides 213 deaths
• 2000-2004 approx 150 teenage deaths by suicide

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OTHER CLUSTERS

• Ardoyne Belfast 2004 13 teenagers
• took their own lives
• Cromarty
• Scottish Highlands 2004 /2005 4 young
• footballers died
• Gnosall Staffordshire 2007 5 young males
• 1
  female teenager

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DEFINITIONS OF SUICIDE CLUSTERS

• Are highly complex phenomena to understand
• Difficulty in finding a consensus among
  researchers /academics
• A group of suicides or suicide attempts, or
  both, that occur closer together in time and
  space ( OCarroll , 1990)

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Definitions

• It is not necessary for the decadents in a
  cluster to have had direct contact with each
  other. Sometimes a knowledge of the first
  suicide was obtained through the news media (
  Gould 1992)

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Media Role

• Clusters are glorified by unethical media
  reporting Bold headings front page.
• Not helpful to the current trauma of a small
  community
• Media frequently lack any objective scientific
  evidence of clusters

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Suicidal Contagion

• Suicide clusters recorded in Biblical times.
• Contagion is a highly complex process to unravel.
• Still have little scientific evidence to show
  how contagion can adequately explain suicide
  clusters.

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Suicidal Contagion

• Suicide clusters thought to occur by
• contagion and social influence
• Tendency for one individuals suicidal behaviour
  to influence all others in the cluster.
• All others in the cluster have vulnerable
  identities, ie depression, hopelessness etc
• triggered off by an environmental stressor

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TYPES OF CLUSTERS

• Joiner ( 1999) found evidence for two types
  MASS Clusters POINT Clusters
• Mass clusters are media related, evidence is
  unclear
• Point clusters are local and these do appear to
  occur. Bridgend and Laurelvale (N Ireland )

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PSYCHACHE

• Young peoples personal identities are under
  threat from psychological pain.
• Sense of helplessness /hopelessness
• Clusters comprise of young people vulnerable to
  suicide /impulsivity
• They cluster together well before the stressor ie
  boredom, disconnectedness becomes the motivator
  for suicide.

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Who gets involved in Clusters?

• Psychiatric patients, college /school students,
  prisoners, marines ( Gould 1990) USA
• College students, schoolchildren, underachievers,
  sportspeople, Psychiatric patients, (UK)

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How do we explain clusters?

• Research evidence ( Joiner 2005, Gould 2006)
  shows young males are completers
• females are attempters, now becoming
  completers.
• Assortative relating is involved.
• Young adults may form relationships based in part
  on shared suicidal risk factors ( drug abuse,
  depression, lack of belonging, hopelessness)

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Clusters

• They relate assortatively, not randomly , in a
  town or village.
• The potential for a suicide cluster is
  prearranged in advance of the stressor which
  activates the cluster.
• If one in the cluster commits suicide, this is
  the trigger.
• Internet is another pernicious way vulnerable
  teenagers assortatively relate.

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What factors provoke clusters?

• Early research evidence ( Davidson 1989)
• found emotional illness, previous suicide
  attempts, loss, family instability as factors.
• Gould( 1990) while clusters include school
  friends, church friends, its not necessary for
  them to engage in direct contact. They may simply
  have heard of each other.

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Main psychological factors in teenage suicides

• Impulsivity ( personality traits)
• Burdensomeness
• Lack of belonging
• Hopelessness.

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Constellation Effect

• All three Impulsivity, Burdensomeness
• Lack of belonging constitute
• Psychache.
• Impulsivity, acting without thinking,
  underlines and explains the relation between
  psychological pain release and suicide.

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Constellation Effect

• Risk taking personalities are at high risk
• Burdensomeness and failed belongingness
• work together to produce psycheache.
• Potential suicide victims feel a burden to their
  family and peers, evident in constricted
  thinking, and a lack of belonging.

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The desire for death

• Schneidmans typology for suicide is that
  Suicide falls into one of five clusters of
  psychological needs
• Thwarted love
• Ruptured relationships
• Assaulted self image
• Fractured control
• Frustrated needs for dominance

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Joiners Critique

• Joiner collapsed Schneidmans failings
• into two categories
• Thwarted belongingness ( Thwarted love, ruptured
  relationships)
• Perceived burdensomeness ( Assaulted self image,
  fractured control, anger related to frustrated
  dominance)

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Want is belongingness?

• Frequent interaction and persistent caring
• There is an innate need to belong, a conscious
  awareness that someone cares
• Young teenagers must engage in frequent and
  positive social interactions.
• Need for a secure attachment integrated with self
  reliance.

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CONNECTEDNESS

• An unmet need to belong has potential for
  suicidal desire
• Suicidal individuals experience interactions that
  do not satisfy their need to belong or may not
  feel connected.
• Self perceived competence is based on being
  effective as a young person.

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On Being a Burden

• Features of clusters are that many young people
  think how effective or ineffective they are in a
  group.
• Letting the group down - intense negativity sets
  in and its permanent.
• Perceived burdensomeness motivates suicide, the
  young person sees death as a solution to the
  problem
• Important to understand that perceptions are
  mistaken.

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EFFECTIVE INTERVENTIONS

• High profile presence increased exposure to
  youth
• Focused listening for signs of burdensomeness and
  lack of belonging
• Listening releases psychological pain
• Establish Crisis Cards for teenagers