Suicide is too complex to be reduced to ‘clickbait’ | Gail Debono

A video that went viral last week - in which onlookers could be heard encouraging a potential suicide victim to ‘jump’ – provoked a lot of discussion locally. Many interpreted it along the lines that ‘we have hit rock bottom’… but how representative are such incidents, really, of society as a whole?

From a psychologist’s point of view, I wouldn’t take a standalone incident to mean anything about society at all. Certainly, that video was not representative of ‘society as a whole’. In fact, I daresay many people on my timeline were emphatic, and upset by what they saw. There were some who couldn’t even bring themselves to watch it....

So I’m very wary of generalisations about society. Only a couple of days before, there was another video [of an attempt to rescue lives at sea], and the reactions were the opposite: comments such as, “Look how ‘good’, or ‘benevolent’, we are as a nation…”

But neither reaction, really, tells us much about who we are. At the end of the day, we are neither a ‘saintly’ nation; nor are we a nation which urges people to commit suicide. If you’re going to generalise, you would need a sample that is representative of the society you are trying to study. One isolated case is certainly not enough…

In this case, the video was uploaded onto social media before being reported in the press. This illustrates a reality concerning modern media: newspapers are no longer the ‘custodians’, so to speak, of the public domain. Anyone can now upload a video or a photo onto the Internet. How can one be ‘responsible’ in reporting such cases? Should they even be reported at all?

I think it should have been reported, yes. But I don’t think the video should have been shared. For one thing, out of respect for the [potentially suicidal] person in question; but also, for the sake of the persons conducting the misdemeanour. In the video, we saw only a few seconds of what someone was saying. I completely condemn what was said, of course; but the fact is, that video also gave us a snapshot of the person saying it.

Now: we don’t know anything at all about that person. For all we know, she might have thought she was being ‘funny’. And even if there was nothing remotely funny about it… we do have to make a distinction between a ‘bad judgment’, and an active intention to make someone else commit suicide.

Either way, she faced a lot of backlash. We ended up abusing her, too… so, how much better are we, than her?

I do, however, understand that people would not have believed this really happened, had they not seen it with their own eyes. Had it just been a description, with no footage…  most people would probably assume that the situation had somehow been misinterpreted’. So I do understand that people would feel the need to share the video.

However, there is a difference between ‘the media’, and ‘the common person’. The common person is not the media. Social media exists – unfortunately, I would venture to add – but it is the media that have a responsibility, in cases such as this…

But whether a video is uploaded onto social media, or carried as a mainstream news article… the effect is ultimately the same. So should social media be regulated in the same way, when it comes to reporting suicide?

I see what you’re driving at; and it’s a tough one. From a psychologist’s point of view… yes.  Ideally, people should not be sharing videos of someone contemplating suicide. But it’s a very different question from, ‘should the media be regulated’.

Let me put it this way: I am not in favour of censorship. But there is fine line between ‘freedom of speech’, and ‘destroying the dignity of others’. From a psychological perspective, all I can say is that it would be better if people did not share such videos. And I would even add that, ideally, they should not be allowed to share them, either. Because they are only damaging others in the process.

But that’s a psychological perspective; I do not come from a legal background, so I can’t really say what should be regulated, or not.

The Chamber of Psychologists warned that “it is a dangerous myth that people who are public about their suicidal intentions are less likely to commit suicide” (a view that was expressed by onlookers). Do you think that – possibly because of media, including television – some people may feel they know more about psychology, than psychologists?

People definitely think they know more about psychology, than they really do. And from our perspective: we wish that was the case… and that people really do know as much as they think they know.

But you made a valid point there, about television. It might not be coming directly from TV, in itself: but as human beings, we do have a tendency to immerse ourselves in what we are familiar with.

Take period dramas, for instance: why do we love period dramas? Because they make us feel like we’re ‘living in that era’. But are we really living in that era? No, of course not. We are only experiencing what the director wants us to experience…

Psychology is no exception. It is not surprising that people misinterpret psychology, when so much of what they think they know comes from… not just TV, but even reading up on the subject online.

A very common misconception, for instance, is that if somebody openly says they are contemplating suicide - or if they are making a show of their suicidality – then it’s all just ‘for attention’; and therefore, the danger isn’t real.

For starters, I can assure you that it is just not true. But there is also the fact that: if someone is faking suicidal tendencies, merely to attract attention… that is in itself an indication that something is seriously wrong. It would certainly set off alarm bells in my mind… so the attention would be warranted anyway.

Another concern is that: while the comments were directed only at that one person… others, who might also be experiencing suicidal tendencies, would get to hear them. How much truth is there, in the belief that this can encourage others to take their own lives?

It is definitely a concern, yes. One of the symptoms of suicidality is, in fact, the feeling that people around you would be ‘better off if you were dead’. And that is exactly what those people were saying, in the video: which is why the Chamber of Psychologists condemned it, in fact.

Once again, however, that it is simply not true at all. In all such cases, there will be people you don’t even know you, who will not want you to commit suicide… let alone the people who do know you.

The problem with videos like this, and actions like this, is precisely that they make others in that situation think: ‘Maybe they’re right. Maybe I should jump…’ And yes: that could result in ‘copycat suicides’…

So I think the most responsible way to handle cases like this, would be to talk about suicide itself; research suicide; ask questions about suicide… rather than to take one single, isolated incident, and use it as clickbait.

This was not the only suicide to have been reported. A series of unexplained deaths in prison – 14, in just over two years: several of them suicides – also caused widespread discussion. Apart from your role in the Chamber, you are also a prison psychologist. Do you share the view that such a high number of fatalities indicate that something is clearly wrong in the administration of prison?

In your question, you were careful to distinguish that not all the 14 deaths were, in fact, suicides. Unfortunately, however, that is not how it was reported in the media. Most media reported ‘14 suicides’… which was not the case.

Just to clarify: the number 14 refers to the total deaths that occurred under the tenure of our last Prison Director: that is, from mid-June 2018, to date...

Would you consider that a high number, though?

[Shrugs] One death is a ‘high number’, in my opinion. Realistically speaking, however… the fact remains that a prison environment is not conducive to good health. In our own prison, we have an ageing population as it is; and even the simple fact that inmates spend so much time indoors… none of it, at the end of the day, is conducive to good health.

But whether those 14 deaths represent an increase, or not… I can’t really answer that: even because the prison population has never been as high, as it is today. Five years ago – when I joined the prison staff myself – the population was only half of what it is now…

Limiting ourselves only to the suicide cases: there has been a lot of talk about the conditions of prison, and the militaristic approach of Alexander Dalli. Would you say that these factors may be conducive to a higher rate of suicide among inmates?

Are you serious? No! Otherwise, it would imply that people committed suicide ‘because their cell had been painted black’: to mention just one of the claims made in the press…

I was thinking more along the lines of: because their lives were made Hell…

I would say that has more to do with how it was reported, than with reality. As a psychologist, it was never my place to comment publicly about those reports: but what I can say is this. With every article that came out, I did my own research into the claims – because it is in my own interest to do so: as a psychologist, it is important to reassure myself that I am not working in a place that promotes this behaviour…

… and this, by the way, was even suggested: that psychologists were ‘doing nothing about their clients being tortured’, and so on…

So it was a very difficult time for us; and, well, to be honest I stopped reading articles after a certain point: because I thought that it was all just fiction.

Nonetheless, I genuinely believe that the people who should know what we are doing, do know. Because in spite of all the negative reporting, there have been huge developments, over the past five years, in terms of the care and reintegration of inmates. There is even a ‘Care and Reintegration Team’, comprising 30 professionals: psychologists, psychiatrists, doctors, social workers…

When I joined five years ago, none of this even existed. I was one of only three, very green, prison psychologists…

Do you not see any contradiction, however, between the improved levels of psychological care, and at the high rate of suicide?

Why would you see a contradiction? One thing to consider is that the prison population, for the past two years, has been between 700 and 900 – that’s around double the capacity it was designed for; although there have been new extensions. Another is that there is a high risk of suicide associated with prison to begin with.

To be more accurate, however: there are certain times, or moments, which may entail a higher risk of suicide than others. Generally speaking, prison inmates are most at risk of suicide in four specific circumstances: for the first six weeks after they are arrested (while they are still awaiting trial); when they do get sentenced – and especially, when the sentence is either very long, or very short (I’ll explain why shortly); when they get bad news from home, or when there is a breakdown in relationships; and lastly, in the final four weeks prior to release.

There are also certain factors that are specific to Malta. Our small size, for example, means that inmates are inevitably going to be released back into the same environment they had come from. In other countries, you could always try to start afresh in another state or county, where nobody knows you; here, that is simply impossible.

So it is very intimidating, for someone to leave prison and integrate back into a society, as a different person. It is easier to go back to who they were before. Either way, the person’s anxiety-levels will shoot sky-high, at these moments. This is also why both very long, and very short, prison sentences tend to have the same effect: they induce a lot of anxiety.

As a prison psychologist, then, I look out for those moments when my clients will be most anxious or alarmed. I watch out for when they come in – because of course, some of them are repeat clients – and when they are due to be released; I watch out for whenever they have court: because even seemingly small things can have a serious effect – like a case being deferred for the umpteenth time; or a bail decision that wasn’t even heard…

These are all high-risk situations which we already recognise: and while I won’t go into details about any particular case – mostly out of respect for my clients: which include all prison inmates – they were also issues that played a role in a lot of the suicide cases we had.

Now: I’m not specifically blaming overcrowding… or family issues… or problems with the legal system. etc. All I’m saying is that suicide is a very, very complex issue. And it can never be brought down to only one, simplified factor.

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