In March 2022, the Department of Social Work at Howest will organize a Blended International Program (BIP) in Belgium, where students from different European universities will explore the role of the social worker in prevention and treatment of suicidal behaviour. The organizer has been interested in collaborating with me as a suicide researcher and also explored Humak`s options to co-operate on next year`s symposium. In this context, I decided to discuss some of my research on suicide. The text is based on my academic doctoral thesis ”A story of tragedy” (Kiuru 2015) and on research I have carried out later on.
Suicide research has been characterised by an attempt to identify related risk factors. It includes strong medical merits; the depression framework dominates. The focus has also been on identifying psychological and social causalities. This is also the case in Finland, where suicide rates are high, even though there has been a decrease in recent years. According to research, suicide rates have at least reduced among young people. In 2020, 717 people died by suicide in Finland (Findikaattori 2021). It also remains to be seen how the COVID-19 pandemic and the restrictions will affect mental health and thereupon suicide rates as well.
More information is needed on the psycho-social factors that contribute to self-destruction. As people who have committed suicide can no longer tell us about their reasons for having done so, it is important to study the experiences of those who were left behind. This kind of research increases the understanding of the phenomenon and challenges the dominating perceptions and attitudes that are linked to suicide. To understand suicide as an act requires that factors related to the person and their environment be examined. This is the basis of my research and this text.
”This is how it begins. The letter that I would not like to write and that you would not like to read. I would not like to write this, because I will only be reproached. You would not like to read this, because it reduces your ability to deny what has happened. Still, I think that it is better to write than not to write.”
”I think that this is sad. I am not going with defiance, not blaming anyone or trying to escape, nor am I in a state of insanity. I am going because I am tired of this disease [depression] that they are unable to cure in Finland. I have received everything that I can out of life and do not wish to receive anything more. (A farewell to parents, Kalevi 25 yrs)”
Finnish suicides have certain key features in common. This can be called the cultural sphere of Finnish suicide. The Finnish suicide rate is high on an international level, and is somewhere between the rates of Western and Eastern Europe. The suicide rate is exceptionally high among young men under 35 years of age. However, the suicide rate of women is also at a high Western European level. A distinguishing feature is the suicide rate of young adults, which is higher than in any other European country.
Whilst statistics show that men are, by far, more likely to die by suicide, women are more likely to attempt to take their own life. Suicides are strongly linked to the violent tendencies of men. In Finland, school massacres and family murders are also common in relation to the population.
Social and cultural factors include relationships and the living environment with its special social characteristics. Suicides are often linked to relationships, most often to interactions between two people. Cultural factors affect the way we react to signs that precede suicide. In Western countries, self-destructive behaviour is often deemed to be one’s personal problem or a mental disorder, rather than being linked to society. On the other hand, it is known that social and societal factors affect the suicide rate. In Finland, a person who commits suicide is typically a man whose socioeconomic status is poor, who lives in a remote area, and consumes large amounts of alcohol.
Socioeconomic differences are significant especially among men who take their own life. It is a cultural question whether individuals blame themselves or their environment for their own failures. Cultural expectations can lead to feelings of failure and shame, which can trigger self-destructive behaviour. In Finland, success is idealised, and there is an ethos that emphasizes coping on one’s own. This is linked to hard values where failure is considered to be shameful. A Finnish man does not cry… It could even be asked whether the Finnish culture nurtures suicide.
Suicide can be seen as the end point of a process that leads to self-destruction. The following factors should be noted as regards the key characteristics of self-destruction in young people: recognizing depression can be difficult due to the emotional turmoil that is typical of the age group, in addition to which some level of impulsive behaviour is intrinsic to young people.
Most people who end up taking their own life have been propelled, from the beginning, onto a life path that is characterised by various deficiencies and an accumulation of problems. People often fall into the suicide-prone risk group already in early childhood. The suicide risk factors include life crises, social exclusion, the lack of social support, various other stress factors, depression, other mental health problems, and alcohol and drug abuse. Other risk factors include previous suicide attempts, an intention to commit suicide, and the suicide of a family member or a close friend.
The suicidal tendencies of young people have various key characteristics. For example, following someone else’s example and the impacts of social media are highlighted.
Most of the studies completed among young people in the field of suicide have focused on the suicide risk and on the preventive measures that aim at lowering the number of young people who die within these risk groups (Maple 2005). These studies are quantitative and strengthen the medical discourse on suicide. They inevitably ignore the meanings that storytellers attach to certain events and situations.
Previous studies also suggest that further research is needed to broaden our understanding of those bereaved by suicide, especially those most intimately involved in a young person’s death, namely their family and parents (Beautrais 1999; Maple 2005). My research work scrutinizes young people’s suicide from their parents’ viewpoint and provides a cultural example of what and how the parents narrate their child’s suicide. The study (Kiuru 2015) examines the act of suicide committed by young Finns from the perspective of human and social dimensions. The research attained subjective experiences of parents whose child had committed suicide. The aim was to determine:
(1) what kind of contents and meanings do the lives and suicides of the young people gain through the narratives made by the parents;
(2) in what way had the parents been aware of the signs concerning the upcoming suicide of their child and how had defensive factors been formed on the basis of these signs and
(3) what kind of meanings does assistance work gain as part of the narratives that relate to signs and defensive factors?
The study localised sensitive topics to be dealt with by the ranks of social work research. It also follows the research traditions of psychosocial social work. The study aims to contribute to the prevention of suicide. The starting point is the development of the service system of assistance work, aided by experience-based data.
The approach used in the study (Kiuru 2015) is narrative qualitative research. The main source of material is narrative interviews with the parents of 14 youngsters who had committed suicide. Supplementary materials consist of email discussions with the parents as well as additional written material provided by them. These include the parents’ own memoirs as well as diary entries and farewell letters written by the young people who had committed suicide.
The research (Kiuru 2015) involved 11 mothers and three fathers who represented middle-class families. The study describes the lives of five young women and nine young men as well as the end of their lives through suicide. The age of death of the young people varied between 15–31 years. The lenght of the time period since the parents had experienced their loss ranged from six months to 26 years.
The analysis is considered to be extensive as it is based on exploiting the opportunities provided by narrative and content analysis, whilst also drawing on a biographical perspective. Structuring was used to organise the parents’ narratives into three stories, which are the young person’s life story, the story of the tragedy and the parents’ own survival story.
“I’m scared, because I’m simply too tired to go on. Now I know what it feels like to be a glass that breaks. (Farewell letter to parents, Maarit 16 yrs)”
Based on the parents’ narratives, the vast majority of the young people had actually sought death, although not so much for its own sake, but because they believed that death would offer a way out of what seemed like an endless state of hopelessness.
One matter to be interpreted was that the young person had experienced some form of mental upset prior to the act of self-destruction. It had led to a blurring of reality and loss of the connection to one’s self and the environment, which was defined, in particular, as social relationships. It could be considered that in the experience of the young people, the loss of this connection would have symbolized insecurity, being the ultimate outsider, and being left alone.
Signs or clues that were present before the child committed suicide and were only realised later by the parents are associated with several simultaneously occurring processes, in which the general sub-areas of life are interconnected and mixed with one another.
Defensive factors are constructed as the opposite of the signs, meaning as contents from the perspective of a parent; what should have happened in the youngster’s life, or what the parent has subsequently thought that someone should have understood or done differently.
Parents widely criticised the assistance work. The criticism focused on the service system and the actions of the parties involved in the assistance work.
The narratives of the parents indicate that the mental symptoms of the young people had been encountered and then primarily treated medically. Potential therapeutic work had remained subordinate to this. In professional encounters, an exhausted, panicked, or distraught young person may be lost behind a diagnosis of depression.
The actions of the young persons had, in part, complicated the encounters in the service system as well as the directing of the assistance. Often professional helpers only saw one selected side of the young person, so that concerns were voiced to them individually in various different contexts. As a result, the entity formed by these concerns was not identified. Consequently, the seriousness of the situation may have been misunderstood.
The parents’ critical agency increases the visibility of the complex relationship between individuals and society. The service system must be developed from the perspective of empirical data. The importance of psychosocial work is emphasized in professional practice.
In terms of suicide prevention work, an important element is to speak and handle matters within the family. This is important both during a young person’s life as well as after their death. A large portion of the young people had confessed their suicidal thoughts to a friend or a sibling. However, the information had remained private. Many of the young people had also spoken of death with their parents around. The suicide of a young person may, in turn, lead to a difficult atmosphere in the family. In some families, ”silence” had become a permanent state.
The research shows that studies on sensitive issues are important. Additionally, there is a significant need for studies on suicide in a qualitative and cultural context.
Beautrais, Annette. 1999. Risk factors for suicide and attempted suicide among young people. In National youth suicide prevention strategy: Setting the evidence-based research agenda for Australia (a literature review). Canberra: Department of Health and Aged Care, Commonwealth of Australia, 113–278.
Findikaattori. 2021. Itsemurhat. Accessed 7.2.2022. https://findikaattori.fi/fi/10 (in Finnish)
Kiuru, Hanna. 2015. A story of tragedy. The life of young people – ended through suicide. As told by the parents. Academic dissertation thesis. Finland, Turku: University of Turku.
Maple, Myfanwy. 2005. Parental bereavement and youth suicide: An assessment of the literature. Australian Social Work, 58, 179–187.
Text: Hanna Kiuru, Senior Lecturer, Doctor of Social Sciences. Humak University of Applied Sciences.