Suicide Contagion and Suicide Clusters in Teens: How to Talk to Your Teen When a Friend or One of their Idols Commits Suicide

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Risk of Escalation from Self-Harm to Suicide Attempts in Adolescents[/seriesbox]We’ll answer the question “Is suicide contagious?” right away.

The answer:

“Yes – but not in the way we typically think of the word contagious.”

The contagion effect in suicide does not happen through the transmission of a bacterial or viral pathogen, which many of us associate with the word contagious. Suicide contagion is not like the flu, which is caused by a virus and transferred between humans through direct contact, such as breathing in droplets exhaled by an infected individual, or indirect contact, such as touching fomites, which is the scientific term for high touch/high traffic inanimate objects like door handles or ATM machines where viral particles linger.

Suicide contagion – according to the U.S. Department of Health and Human Services –  occurs when the idea of committing suicide reaches people that would likely not have considered attempting suicide before exposure to the information about the specific suicide.

Research shows teens and adolescents are particularly vulnerable to the suicide contagion effect. When the contagion effect occurs, imitation suicides can occur in suicide clusters. Let’s take a closer look at these two terms, suicide contagion and suicide cluster.

What is Suicide Contagion?

We offered a simplified definition above, but there’s more. Experts cite the suicide contagion effect as responsible for imitation suicides, wherein one suicide triggers other suicides, and evidence shows those who completed imitation suicides learned suicide-related behaviors from information about the initial suicide.

Here’s a simpler way to define suicide contagion. We retrieved this from the National Association of School Psychologists (NASP) report Suicide Contagion and Clusters—Part 1: What School Psychologists Should Know.

• Suicide Contagion:
  • A phenomenon that occurs when a single completed suicide – or sometimes an attempted suicide – increases the suicidal behavior of others.

What that definition clarifies is not only that the idea of suicide reaches additional individuals, but that information results in the increase in the measurable suicidal behavior of others. That confirms the idea that the suicide contagion effect is real, and has real-world consequences, up to and including death by suicide.

Now let’s look at the term suicide cluster.

What are Suicide Clusters?

Here’s how the Centers for Disease Control (CDC) define the term:

• Suicide Cluster:
  • A suicide cluster is “a group of suicides or suicide attempts, or both, that occur closer together in time and space than would normally be expected in a given community.”

The CDC indicates that the suicide contagion effect can lead to suicide clusters. Suicide clusters are an aggregate measure of the dangerous, real-world consequences of the suicide contagion effect.

Now that we know exactly what we’re talking about, let’s add more knowledge to the concept of suicide clusters.

Suicide Clusters: Types, Prevalence, and Effects

There are two main types of suicide clusters that can impact affect teens in the community or school environment.  We’ll define the two types of suicide clusters, offer examples of each, then offer expert advice on how to help teens process the suicide of a celebrity, friend, or peer that touches or has touched their life in a way that makes the suicide more painful than that of someone completely unknown to them.

First, the definitions.

• Mass clusters:
  • Mass clusters are not location specific, but they are time specific. They involve a temporary increase in suicidal behavior during a discrete time period. They occur most often in response to the suicide of a well-known person or persons, such as an entertainment celebrity, a professional athlete, or other famous person. Suicide experts connect mass clusters with media coverage of suicide.
• Point cluster:s
  • Point clusters are location and time specific. They involve an increase in suicidal behavior that’s close in time or space and may occur in communities such as schools. They most often occur in response to the suicide of a student or students in a school, or the member or members of a relatively small community.

Mass Clusters: How Often do They Happen?

Experts on suicide and suicide contagion conclude that it’s difficult to assess the impact or direct effect of a celebrity suicide on teenagers. Therefore, it’s difficult to assign a cause-and-effect relationship between the suicide of a teen hero and subsequent teen suicides that occur close in time to the celebrity suicide. Experts do believe, however, that media reports on celebrity suicide in ways that are unsafe and, in some cases, irresponsible.

Here are two examples from the past few years.

Mass Cluster One: Chris Cornell and Chester Bennington

Cornell was the lead singer of the influential Seattle grunge band Soundgarden. He died by suicide in 2017. Media reports including “vivid details from the police report of the moments leading up to his suicide were published.” Details included:

• The general method(s) he used
• Conversations he had with his wife while he was in the process of committing suicide, including direct quotes.
• A graphic description of exactly what he looked like when discovered
  • With photographs
• A specific description of the physical objects involved in the method he used
  • With photographs

Experts on the suicide contagion effect observed and documented the effect of the media coverage of Chris Cornell’s suicide, which we’ll describe now.

The Effect of Cornell’s Suicide

Chester Bennington, the lead singer of another well-known band, Linkin Park, and close friend of Cornell, committed suicide on Cornell’s birthday in the same manner as described in the police reports published by media sites about the specifics of Cornell’s death.

Here’s how experts arrived at the conclusion that these two celebrity deaths resulted in a mass cluster influenced by media reporting:

• After Bennington’s death, several adolescent fans of both singers committed suicide.
• The methods they used mirrored those published about the methods used by Cornell and Bennington.
• The National Suicide Prevention Lifeline reported an increase of 14% in suicide-related calls the day after Bennington’s death

Mass Cluster Two: The TV Show 13 Reasons Why

The first season of the popular Netflix series 13 Reasons Why garnered national attention for all the wrong reasons. While the impact of the series – negative or positive – is a matter of debate, we’ll offer select publicly available statistics related to teen suicide collected in the time immediately following the premier of Season 1. These statistics are in the “13 Reasons had a negative impact” camp.

For an alternate point of view on the show, please read this article we published recently:

Can TV Shows Help Teens Struggling with Depression and Other Mental Health Issues?

The Effect of 13 Reasons Why

Let’s have a look at the statistics associated with this show. After the first season aired, researchers noted:

• An increase of 19% increase in online searches related to suicide.
• Of these searches, specific search terms and phrases included:
  • How to commit suicide: 26%
  • Commit suicide: 18%
  • How to kill yourself: 9%
• At the peak of public interest in 13 Reasons:
  • Adolescent suicides increased in the U.S. by 22.5%.
  • In raw numbers, that equals about 100 more completed adolescent suicides than the same time period in previous years

That’s the evidence on mass suicide clusters. It’s alarming and persuasive. We’ll now discuss the second type of suicide cluster, point clusters.

Point Clusters: How Often do They Happen?

The CDC identifies the phenomenon of point clusters in several locations in the U.S. over the past twenty years. Locations include:

• Palo Alto, California: 2002, 2009, 2014
• Fairfax County, Virginia: 2014
• Colorado Springs, Colorado: 2017
• Salt Lake City, Utah: 2018

We’ll focus our attention on the point cluster in Palo Alto, CA, since the CDC published extensive data on this point cluster. They also issued reports that identified the root causes and include information designed to help prevent a recurrence of similar clusters in other communities.

The Palo Alto Cluster

In 2016, the CDC received reports of an atypical increase in suicides in the Palo Alto area of Santa Clara County, California. They dispatched an emergency team – called an Epi-Aid Team – to investigate the situation. The goal of the team was to understand why suicide rates in Palo Alto and neighboring areas were unusually high.

Here’s what they found out about the teens who committed suicide:

• A high percentage had mental health disorders.
• A high percentage recently experienced a personal crisis.
• Other risk factors included:
  • Alcohol and drug use
  • Bullying
  • LGBTQI+ identification
  • Risky sexual behavior
  • Academic problems
  • Pervasive sense of hopelessness

The Epi-Aid team also reported that media reports of the initial suicides could have triggered the imitation suicides. The team analyzed media coverage of the initial suicides and concluded that many of the media reports:

• Had titles with sensational headlines
• Provided details of the methods of suicide
• Showed photos of students grieving over the suicides

In response to their findings, the Epi-Team made the following recommendations:

• Local officials should increase school-based programs that focus on strengthening peer connections and fostering coping/ emotion-regulation skills among students.
• Local officials should encourage more family-based programming, including parenting classes and family therapy.
• School officials should provide better access to evidence-based mental health treatment programs.
• School officials should provide teens with additional support to help manage stress, crises, and other mental health issues
• Media outlets should not:
  • Publish sensational headlines about suicide
  • Include details about methods
  • Include details about personal communications around the suicide
  • Publish pictures directly related to the suicide event

All those recommendations make sense to us, and we support the efforts of any school district or community anywhere in the country – regardless of whether they’ve had a suicide cluster – in their communities.

How Parents Can Help Prevent the Contagion Effect

It’s important for communities to take steps like those above. And when we consider the fact suicide is now the second leading cause of death among teens and young adults in the U.S., we realize supporting our teens is an essential step to take as we move forward.

It’s important on a national level, and it’s also important on a local level, which starts at home.

If your teen knows someone who recently committed suicide, or one of their idols from the sports or entertainment industry recently committee suicide, there are some things that are important for them to hear.

Four Things Teens Need to Hear When They’re Exposed to a Suicide

1. Tell them it’s not their fault.

This point is not about celebrity suicide. It’s about suicide that hits close to home. Teens may feel guilt and shame over a friend’s suicide. They may think they were somehow responsible. They need to know this is not true. Teens who commit suicide often have a severe, untreated mental health disorder. These are the result of various biopsychosocial factors – not because of something their friends did or did not do. Your teen needs to get the message in no uncertain terms that they are not responsible for their friend’s death.

2. Help them find people to talk to.

They can talk to you, their friends, their friend’s family, or close family members. When you talk to your teen about the suicide, don’t hide from the emotions. Let them cry. Cry together. They might not want to talk about it but taking helps – especially with people who knew and loved the friend or were also fans of the celebrity who committed suicide.

3. Find professional support.

Even in cases where you think your teen may not need it, they may learn that talking to a trained, licensed therapist will help them work through unresolved emotions about the suicide. Seeking help from a mental health professional is imperative if they show the following symptoms of grief and loss:

• Have persistent feelings of distress
• Have phantom aches and pains
• Feel disconnected, spaced-out, or in denial
• Feel anxious and exhausted all the time

4. If they’re in crisis, tell them you know how to help.

If your teen engages in suicidal ideation, they can call a Suicide Prevention Hotline. We provide resources below. You can tell your teen that close exposure to suicide can cause them to consider suicide – that’s the subject of this entire article. If your teen is in crisis, tell them you’re there for them and you can help right now.

Teens In Crisis: Parents Should Act Now

If you think your teen is in imminent danger, call 911 or take them to the emergency room immediately. Do not wait. Take any talk of suicide seriously.

You or your teen can also us to the following resources:

• The Suicide Prevention Hotline number: 1-800-273-TALK (800-273-8255).
• The Crisis Text Line at 741741. Text “HOME” to this number and a trained crisis support counselor will give you free assistance 24/7.

Finding Help: Resources

If you’re seeking treatment for your teen, please navigate to our page How to Find the Best Treatment Programs for Teens and download our helpful handbook, A Parent’s Guide to Mental Health Treatment for Teens.

In addition, the American Academy of Child and Adolescent Psychiatry (AACAP) is an excellent resource for locating licensed and qualified psychiatrists, therapists, and counselors in your area. Both the National Institute of Mental Health (NIMH) and the National Alliance on Mental Illness also provide and high-quality online resources, ready and waiting for you right now.