Cluster suicide refers to the occurrence of two or more suicides or suicide attempts, or both, that occur closer together in time and geographic space. Of all the different age groups, teenagers are more susceptible to cluster suicide than others, accounting for about 100 to 200 deaths every year in the United States. It has been estimated that about 1% to 5% of all completed suicides among teenagers and young adults occur in clusters. The extent of clustering in suicide attempts however, is difficult to estimate due to the underreporting and misreporting of attempts.
Cluster suicide is more commonly seen among religious cults, prison inmates, marine troops, high school students, college students, and psychiatric inpatients. There are two types of suicide clusters: mass clusters and point clusters. In mass clusters, suicides and suicide attempts follow media portrayal of an actual or fictional suicide or suicide attempt.
Glamorization of death by suicide results in a chain reaction among those who are psychologically vulnerable. Point clusters, on the other hand, occur locally; for example, a suicide of a teenager in the neighborhood triggers a series of attempts or completed suicides by peers. Geographical area is a common denominator in point clusters.
The existence of mass suicide clusters has been documented worldwide following fictional depiction of suicide. There is a general consensus among suicidologists that newspaper and television coverage of suicide has a detrimental effect on suicidal behaviors. There is also evidence of outbreaks of suicidal behavior that occurs in high schools, often reaching epidemic proportions. These point clusters typically occur in institutional settings like schools and psychiatric hospitals, although proximity is not a prerequisite.
Vulnerability to suicide or suicidal behavior increases in the presence of negative life events like the death of a loved one or a traumatic loss. Similarly, having a psychiatric diagnosis, being unemployed, experiencing health crises, and lack of family support are potential risk factors for suicide. A possible explanation for suicide clusters is that humans tend to group together because of similar personal traits and temperamental characteristics. When one member of the cluster becomes suicidal and attempts or commits suicide, it consequently puts the others in the cluster at a higher risk.
Increased risk for cluster suicide among adolescents can be attributed to unintentional glamorization and glorification of suicide by the school system, which makes suicide attractive to vulnerable teenagers. A common environmental stressor sometimes influences clustering of suicide among those who are exposed to it.
It is important to differentiate between imitation suicide or copycat suicide and cluster suicide. In imitation suicide, the phenomenon of contagion impacts those who are in close proximity to the person who commits suicide. For example, studies have documented an increase in both suicide and suicide attempts among adolescents following the suicidal death of a parent. A somewhat rare form of clustering is known as a suicide pact, in which two or more individuals simultaneously plan and commit suicide. Suicide pacts are common among close friends or life partners.
In order to prevent cluster suicides from occurring, it is important to educate parents and teachers in schools and avoid the glorification and media coverage when a suicide occurs in an institution.
Conducting school-based postvention efforts in terms of offering counseling services to students is of vital importance following a campus suicide or suicide attempt. The Centers for Disease Control (CDC) recommends delivering a public response that minimizes glamorization of suicide and glorification of the victims of suicide and conducting timely evaluation and intervention with close friends of the deceased who may be at high risk. Educating family members is also crucial because family support and presence of family strengths mediate the impact of stressors.
References:
- American Association of Suicidology, http://www.suicidology.org
- American Foundation for Suicide Prevention, http://www.afsp.org
- Centers for Disease Control and Prev (n.d.). CDC recommends [database]. Available from http://www.phppo.cdc.gov/CDCRecommends/AdvSearchV.asp
- Coleman, (1987). Suicide clusters. Boston: Faber & Faber.
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- Gould, S., Wallenstein, S., & Kleinman, M. (1990). Timespace clustering of teenage suicide. American Journal of Epidemiology, 131, 71–78.
- Joiner, T. , Jr. (1999). The clustering and contagion of suicide. Current Direction in Psychological Science, 8(3),89–92.
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- Velting, D. M., & Gould, M. S. (1997). Suicide contagion. In R. Maris, S. Canetto, & M. Silverman (Eds.), Review of suicidology. New York