Suicide on the Internet
| Leonard Holmes, Ph.D. http://mentalhealth.about.com |
Suicidal thoughts are present in many mental disorders. Many people without mental disorders also have these thoughts at some point in their life. In a another article I discussed issues surrounding physician-assisted suicide. Terminally ill patients in severe pain sometime kill themselves and even ask their doctor for help. If there is no depression present many physicians seem to be sympathetic with their plight.
Depressed patients can also have intense suicidal thoughts, but these thoughts are usually a part of their illness and often involve a loss of perspective. Severe depression involves a loss of awareness of what one's options are. Suicide seems like a viable option because the person has lost the ability to see other options. Their perspective has narrowed and they are often unable to look at real legitimate choices which they have in their life.
Suicidal persons can use the Internet for help, but face-to-face help is probably also needed. An excellent resource is if you are thinking about suicide read this first. Few online counselors are comfortable working with suicidal clients by email.
An exception to this rule is the Samaritans. This British group was formed to provide telephone assistance to persons in crisis and persons considering suicide. They quickly developed email as a delivery modality as the Internet developed. All correspondence with the Samaritans is completely confidential. They go as far as to say that they will maintain confidentiality "to the grave." The Samaritans are a part of a larger group known as Befrienders International.
This promise is quite different than what U.S. mental health professionals can offer. In the United States clinicians have a duty to protect someone from themselves. The details vary from state-to-state, further complicating the picture. If an online counselor believes that you are a serious imminent suicidal threat they must make some effort to insure your safety. The reason for this is straightforward. If you are depressed and get treatment you may decide that you do want to live. If you have already killed yourself you will never live to know this. Your counselor has a duty to help you have the chance to change your mind.
What should you do? Start by reviewing the resources on this page. If you are seriously suicidal then you should seek face-to-face help in your community. All communities in the United States have low-cost services available at "community mental health centers." These facilities generally provide help on a sliding scale based on income. Your family doctor is also a good place to start. He or she can prescribe a medication which may help the depression, but may also refer you to a therapist. Medication alone is probably not the best treatment for suicidal thinking, and there is good evidence that therapy and medications work well together.
Suicidal thoughts and actions create some special problems in the online world. Storm King has written an essay on Suicidal Ideation in Virtual Support Groups. He describes the impact of a threatened suicide on a tight-knit online support group of recovering substance abusers. His essay speaks to the value of these support groups as well as to the dilemma which we find ourselves in responding to a suicidal person miles away.
The American Association of Suicidology is a clearinghouse for information on suicide. They do not offer crisis support services. The Canadian Association for Suicide Prevention has a focus on preventing suicide. The Light for Life Foundation sponsors the Yellow Ribbon Campaign for the prevention of youth suicide.
| Leonard Holmes, Ph.D. http://mentalhealth.about.com |