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Key points
- To improve prevention efforts we identify three social roots of suicide.
- Rigid cultural expectations, mental health stigma, and lack of privacy amplify the usual adolescent stressors.
- Intense psychological pain and barriers to healthy help-seeking make youth vulnerable to suicidality.
- Exposure to suicide introduces the idea that one way to deal with the pressure of expectations is suicide.
As September is Suicide Prevention Awareness Month, we are keen to share our research on youth suicide and youth suicide clusters. Though our work on youth suicide spans a decade and a diverse array of data, this post and others to come focus on what we found in Poplar Grove, a community we spent several years observing in an effort to understand why this idyllic locale has an enduring youth suicide problem. This is especially puzzling as it seems, from a first glance, to be a place that wouldn’t such a problem. The town is safe, invests in social infrastructure like parks and community centers, is well-known for its quality of education, and has parents who are overconcerned with their children. There are plenty of places like this and plenty more that strive to become like it.
One thing the case of Poplar Grove invites is an examination of why some places seem disproportionately vulnerable to suicide, while other seemingly similar places are not. It also invites us to shift our focus away from the individual, psychological risk factors for suicide to consider how we can build worlds worth living in for kids. Instead, we are compelled to look more closely at the social roots of suicide if we are to do the work of building better, sustainable safety nets. We detail answers to these questions in our recent book, Life Under Pressure: The Social Roots of Youth Suicide and What to Do About Them, which identifies three social factors that contributed to young people’s psychological pain and despair and that, if not addressed, would undermine even the most evidence-based local suicide prevention efforts. We call these social factors suicide’s social roots.
So, what did we find?
The Social Roots
First, the community had clear, widely-shared, narrow expectations about what it meant to be a “good” Poplar Grove kid and a “good” Poplar Grove family. In short, youth were expected to be high achieving in academics and athletics and to be aiming for a prestigious college, preferably on a merit or athletic scholarship. Regardless of their skill, desire, interest, or capabilities, kids felt they had to be “perfect” and to do it with ease, no matter how hard they had to work. This message came from the school, which felt pressure to maintain its elite reputation, which was part of the community’s central understanding of its own identity. It also came from parents and even peers. You can imagine why this may have been challenging for local youth.
Second, adults and youth alike perpetuated a pervasive mental health stigma in the community. The high premium placed on achievement and excellence came to mean that psychological struggles were a sign of imperfection. Mental health professionals told us about parents who wanted quick, quiet fixes instead of therapy that other parents might find out about and judge them for. Kids also didn’t want to be diagnosed or given medication, lest a classmate discover their struggles. As a result, kids worked hard to hide the stress and anxiety of growing up in Poplar Grove instead of asking for support.
The third social root, a high level of connectedness, exacerbated the rigid cultural expectations and existing mental health stigma. This may seem surprising because we usually think of connectedness as a positive, protective factor. But in Poplar Grove, as in many small towns, the connectedness stripped everyone of a sense of privacy. Everyone knew just about everything about everybody. Keeping secrets was hard. Community members young and old felt constantly watched, which in turn made them pay extra-close attention to how they presented themselves in public places. This in turn intensified the importance of fitting in, meeting expectations, and not being caught needing mental health help. In this way, the connectedness made it even more difficult to hide what some might reasonably want to keep private and built up barriers to getting help.
The Consequences for Kids
Together, these social roots had consequences. Most palpably, kids reported feeling unbelievable emotional and psychological pain. The highest-achieving kids felt like nothing was ever enough, while the average kids and those struggling in school felt they could never meet expectations. The ordinary pressures that come with adolescence were magnified. Seeing a hopeful future, so many local youth expressed, was difficult to do, as the threat of failure was ever-present.
This perspective also distorted their ability to judge when they were failing, which left many kids feeling ashamed of themselves. Shame is an emotional signal that a person is “bad” or in some way “deficient” and which, when not dealt with, can add dramatically to the psychological pain of even perceived failures. Some youth felt like suicide might be the only solution to the inescapable pain they felt but could not share with adults. Thus, the combination of psychological pain, shame, and steep barriers to help-seeking made young people vulnerable to self-harm.
And once a suicide occurred, the tight-knit nature of the community made exposure to suicidality inevitable. That all youth felt that their friends and classmates were under the same pressure made it “easy” to understand why a kid might contemplate or attempt to take their life: to escape the pressure and pain. These social roots, then, became self-reinforcing. Just as pressure to achieve became a normative thing, with each new suicide the idea that some kids under pressure die by suicide had become understandable, and applicable to the lives of many. The stories that we tell about why kids die by suicide become just as important to think deliberately about as the unintended consequences of making routine a high-achieving culture that is inescapable, but unhealthy for its most vulnerable members.
To be clear, these social roots represent collective beliefs in one place, rather than objective facts. What’s more, these beliefs are malleable and can be shaped by interventions—for example, steps that diminish academic pressure, address mental health stigma, encourage help-seeking, and normalize talking about psychological pain and mental illness. We do not have to accept living in social worlds that make life feel like it is not worth living for young people, but we have to acknowledge that these social factors matter to the changing the story of suicide in Poplar Grove.
Your community may look different from Poplar Grove, but there are some generalizable insights from this case that are worth considering. What are the sources of psychological pain that exacerbate youth struggles in your community? What thwarts young people’s ability to feel like they belong, like they matter, and like they have a meaningful future? Addressing these factors will strengthen our ability to support youth in the 21st century.
If you or someone you love is contemplating suicide, seek help immediately. For help 24/7 dial 988 for the National Suicide Prevention Lifeline, or reach out to the Crisis Text Line by texting TALK to 741741. To find a therapist near you, visit the Psychology Today Therapy Directory.
