News Archive: October, November, December 2018

December 2018

In Screening for Suicide Risk, Facebook Takes On Tricky Public Health Role

A police officer on the late shift in an Ohio town recently received an unusual call from Facebook.

Earlier that day, a local woman wrote a Facebook post saying she was walking home and intended to kill herself when she got there, according to a police report on the case. Facebook called to warn the Police Department about the suicide threat.

The officer who took the call quickly located the woman, but she denied having suicidal thoughts, the police report said. Even so, the officer believed she might harm herself and told the woman that she must go to a hospital — either voluntarily or in police custody. He ultimately drove her to a hospital for a mental health work-up, an evaluation prompted by Facebook’s intervention. (The New York Times withheld some details of the case for privacy reasons.)

Police stations from Massachusetts to Mumbai have received similar alerts from Facebook over the last 18 months as part of what is most likely the world’s largest suicide threat screening and alert program. The social network ramped up the effort after several people live-streamed their suicides on Facebook Live in early 2017. It now utilizes both algorithms and user reports to flag possible suicide threat

The New York Times, December 31, 2018

Gun suicides rise to highest level in 40 years

While mass-shootings are the most visible and spectacular consequence of America’s love affair with guns, the person most likely to shoot you is you (either accidentally or deliberately), with a loved one or a friend (again, either accidentally or deliberately) close behind.

Suicide is an impulsive act. Half of suicide survivors report planning their deaths for less than ten minutes. States like Connecticut that have passed background check laws for handguns have seen precipitous drops in firearm suicides, and states with more lax gun laws experience higher gun mortality of all types. States that have repealed background checks for handguns saw increases in firearm suicides.

The most gun-suicidal populations are older white men and veterans. Guns are only used in a small minority of suicide attempts, but half of all successful suicides are firearm suicides.

BoingBoing, December 28, 2018

Child and Adolescent Suicide and Self Harm: Treatment and Prevention

I received a message from the parent of a patient that read, “He finally did it.” Tragically, the boy was found dead in his college dorm room after hanging himself. I had treated the boy when he was 15 years old following a suicide attempt. At that time, the boy was suffering from depression and suicidal thoughts. These problems remitted with treatment, and there were no other suicide attempts during high school. He went to college, and saw a psychiatrist near the college for follow-up care.

Suicide prevention is perhaps our greatest challenge. Among youth ages 10 to 24 years, suicide is the second leading cause of death. Over 6000 individuals in the 10- to 24-year age group lost their lives to suicide in 2016.1 Although still a rare event statistically (nearly 15,000 individuals in the same age range died by unintentional injuries in 2016), many of us providing psychiatric care will lose patients to suicide. Despite the recognition that as much as we try it is not possible to prevent all suicides, there have been substantial advances in knowledge regarding treatment. This article reviews some of these advances, which have been selected to inform clinical care.

Psychiatric Times, December 26, 2018

Introduction: Turning Suicide Prevention Science Into Action: A National Imperative

We are living in a pressing time of transition in our nation. Even while attitudes are opening up about mental health and suicide prevention, the rate of suicide continues to rise in the United States, in fact by nearly 30% over the past two decades.

After a century of progress as a nation, overall mortality particularly in the middle years is increasing as a result of the so-called deaths of despair due to suicide, alcohol, opioids, and liver disease.

In an era with greater technologic advances and potential connectivity, the science of suicide demonstrates that many forces are still active, including human experiences of isolation, struggle, loss, and unmet expectations, and concurrently, low mental health literacy. Although 94% of US adults believe mental health is equally important to physical health, most do not know how to identify changes in mental health that signal serious risk, or what to do in response, let alone have feasible access and mental health coverage anywhere near parity.

Additionally, over reliance on a sense of self-sufficiency and fear of judgment are barriers to achieving deeper connections in our relationships and fully integrating suicide prevention into actionable steps in our homes and communities. The truth is that interpersonal connectivity is a basic need for humans.

When we lose that experience of connection, whether due to changes in culture and modern frenetic living or shame that drives people to hide their true internal experiences, then the prevalent experience of unaddressed mental health conditions and other types of suffering can lead to the problems we are seeing in the rising suicide rate.

Psychiatric Times, December 26, 2018

Remove content on suicide and self-harm, government minister tells tech giants including Google and Facebook

• The government’s minister for suicide prevention said internet giants must act 
• Thurrock MP Jackie Doyle-Price, 49, hit out at sites that publish suicide methods
• She said firms should treat the content the same way they would terror material 

Technology giants including Google and Facebook should be forced to remove content about suicide and self-harm, the government’s minister for suicide prevention has demanded.

Jackie Doyle-Price, 49, said internet giants need to take action against self-harm methods in the same way they tackle online extremist content.

The MP for Thurrock, Essex, was appointed as Britain’s first suicide prevention minister in October.

In an interview with the Daily Telegraph, the minister said that sites Wikipedia, Google, Facebook and Twitter were behaving like ‘unruly teenagers’ who had to be ‘dragged, kicking and screaming’ into taking action.

Daily Mail, December 23, 2018

The Language of Suicide

By the time my father died, it wasn’t a surprise. It was scary and sad, but it was also a terrible sort of relief. It was an unglamorous death in the Canal Street apartment he had chosen for its expansive, unfinished rooftop on which he tended his clivia and miniature lemon trees. Empty bottles of antidepressants and antihypertensives stood next to his computer, on which the browser history revealed a final Google search that read: “how to commit suicide with Paxil.”

No one talked much about how he had died. As is often the case with suicide, it was mostly an open secret, though some suggested that perhaps I was wrong, that it was not intentional after all. As a society we’ve come a long way with respect to suicide, mental illness, and addiction, but we have a long way yet to go. When the topic of his death comes up, I often hesitate, pulled between the desire to share openly that my life, like so many others, has been impacted by suicide and that the topic remains heavily stigmatized, emotionally burdensome, and susceptible to all manner of unsolicited—and frequently erroneous—opinions and narratives.

I can never settle on what language to use—“he killed himself” sounds too violent; “committed suicide” too clinical; “died by suicide” too affected; “took his own life” too romantic. There is no easy way to accept condolences while also honoring the reality that while he was in pain, he also caused great pain. Although he hurt, he also caused lasting hurt. There is no casual way to remark that his death was a tragedy, but his life was too.

JAMA Network, December 22, 2018

New pathways for implementing universal suicide risk screening in healthcare settings, model could help hospitals better identify and aid youth at risk for suicide.

A new report, authored in part by researchers at the National Institute of Mental Health (NIMH), part of the National Institutes of Health, provides guidance on how to implement universal suicide risk screening of youth in medical settings. The report describes a way for hospitals to address the rising suicide rate in a way that is flexible and mindful of limited resources.

In 2016 alone, more than 6,000 youth in the United States under the age of 25 died by suicide, according to the Centers for Disease Control and Prevention. Studies have found that a majority of youth who died by suicide visited a health care provider or medical setting in the month prior to killing themselves. The interactions of these youth with the health care system make medical settings an ideal place for positioning suicide intervention efforts.

“Suicide is a major public health concern and early detection is a critical prevention strategy,” said NIMH Director Joshua A. Gordon, M.D., Ph.D. “Part of NIMH’s suicide prevention research portfolio focuses primarily on testing and implementing effective strategies for identifying individuals at risk of suicide. Results from these research efforts are poised to make a real difference and help save lives.

National Institute of Health, December 20, 2018

Suicide prediction technology is revolutionary. It badly needs oversight. Should we trust Facebook to dispatch police to the homes of distraught users?

Last year, more than 1 million Americans attempted suicide, and 47,000 succeeded. While some people display warning signs, many others do not, which makes suicide difficult to predict and leaves family members shocked — and anguished that they couldn’t do something.

Medical providers and tech companies, including the Department of Veterans Affairs and Facebook, are increasingly applying artificial intelligence to the problem of suicide prediction. Machine learning software, which excels at pattern recognition, can mine health records and online posts for words and behaviors linked to suicide and alert physicians or others to impending attempts. The potential upside of this effort is huge, because even small increases in predictive accuracy could save thousands of lives each year.

The Washington Post, December 20, 2018

Fighting against teen suicide: ASU psychology seniors launch initiative to support students, parents and educators

Just two years ago, 31 teenagers died by suicide in the East Valley. Teen suicide is not just localized to large cities like Phoenix; it is a problem throughout Arizona and nationally. In 2017 alone, 1.3 million people attempted suicide and almost 50,000 died by suicide. For people of all ages, suicide is the 10th leading cause of death, but for teenagers, it is the second.

Arizona State University students Sonia Sabrowsky and Madison Sutton, both seniors in the Department of Psychology and Barrett, The Honors College decided they had to do something to try to prevent teen suicide. Madison Sutton and Sonia Sabrowsky decided they had to do something to try to prevent teen suicide. Their motivation is personal. When Sabrowsky and Sutton were in high school, a friend died by suicide.

Both women are members of ASU’s Courage Lab and the ASU Tillman Scholars Program. The Tillman Scholars Program is a community of high achieving students, alumni and mentors who espouse the values and actions of Pat Tillman. They were encouraged to come up with a social venture designed to make a difference.

Arizona State University, December 18, 2018

Stigma of suicide makes it hard to fight growing public health epidemic

There’s an “out of darkness” bracelet on William Fallen’s right wrist. On his left forearm is a tattoo with angel wings and the date 7/7/17. And around Fallen’s neck is a cross containing some of the ashes of his older brother, Loren Hunley.

After Hunley died by suicide in the summer of 2017, Fallen looked for ways to talk about what happened, to let others know it was OK to talk about how their loved one had died. The tattoo, which he got a few weeks after his brother’s death, has led to many people confiding in Fallen.

“I wanted that reminder to be with me, I wanted to always honor him, and I wanted to have a conversation piece.”

Fallen has been surprised by how many people he knows have lost someone to suicide, which kills more people each year than homicide or motor vehicle accidents. In 2016, more than 1,400 people died by suicide in Illinois, and 45,000 died nationwide. Suicide that year was the second-leading cause of death for ages 10-34 and the fourth-leading cause for ages 35-54.

Chicago Sun-Times, December 17, 2018

What To Do If You See Someone Posting Suicidal Thoughts On Social Media, According To Experts

When someone speaks out about their mental health struggles, you might not know if you’re the right person to offer support. But even if it’s someone you’re not close with anymore or even an acquaintance, you may be able to make a difference. Especially because some people turn to social media when they’re in crisis — even posting on social media about suicidal thoughts.

“Social media has given us a portal into the most personal thoughts and feelings of everyone and anyone,” Joshua Klapow, PhD, clinical psychologist and host of The Kurre and Klapow Show, tells Bustle. “Likewise, it has given us a way to share our own most personal thoughts and feelings with literally the world. What that means is that we are going to be exposed to the distress that comes into people’s lives.” If you see someone posting about suicidal thoughts on social media, it can be difficult to know what to do next.

Bustle, December 17, 2018

Boys need better access to mental health care. Why aren’t they getting it?

“If you can’t turn to someone in your life and say how you are really feeling, then you’re only going to end up hurting yourself somehow down the road.”

Throughout high school, Alexander Sanchez was severely depressed. He thought about suicide, and he didn’t know how to explain what was wrong or ask for help. Instead, Sanchez said that whenever he wasn’t in school, he would lie in bed all day, “not eating, not being happy, being almost not there.”

It wasn’t until Sanchez, who grew up in College Station, Texas, got to college that a friend convinced him to see a psychologist, who diagnosed him with depression. In hindsight, Sanchez said he did not reach out for help sooner because he believed that men should be self-reliant— an idea he believes he picked up from Tom Cruise and other macho characters on TV and in movies.

“I think I had really internalized this emotional stoicism that I know I was supposed to have,” said Sanchez, 21, who is now a senior studying psychology at New York University.

NBC News, December 15, 2018

Girl, 9, commits suicide after classmates bully her for having white friend, family says

A 9-year-old girl committed suicide last week after she was allegedly bullied by students at her Alabama elementary school.

The past week has been “an emotional roller-coaster” following the Dec. 3 death of McKenzie Adams, her aunt Edwinna Harris told The Columbus Dispatch.

Adams’ grandmother reportedly found the fourth-grader after she hung herself in their Linden residence.

The 9-year-old’s decision to take her own life came months after the alleged harassment by her classmates at U.S. Jones Elementary School in Demopolis began, her relatives told the outlet. Some of the tauntings stemmed from her being friends with a white boy, her aunt said.

Fox News, December 13, 2018

Child suicides can be linked to bullying, but it’s never the sole cause, mental health professionals say

The death by suicide of a 9-year-old Alabama girl this month has drawn attention back to the alarming increase in suicide by youth, and to the question of whether bullying is playing a role.
It was at least the third death by suicide this year of a child younger than 12 who had been harassed by peers. Mental health professionals say bullying can be a factor in a child’s decision to attempt suicide but is typically one of several.

“There is not a causal link between bullying – either being victimized or being a perpetrator – and suicidal ideation and attempts,” says University of Florida psychology professor Dorothy Espelage, lead author of a 2013 study on bullying and suicide. “It is one potent predictor of suicidal ideation and attempts, (but) it’s one of many.”

USA Today, December 13, 2018

‘I’ve watched this happen for four years’: Northwestern University grapples with string of suicides

Alarmed by the suicides of four students this year, including a sophomore found dead in his dormitory in late November, Northwestern University is boosting staff at the campus’ main counseling center.

Two new employees will join its mental health center, Counseling and Psychological Services, to perform suicide screenings and clinical support services, Vice President for Student Affairs Patricia Telles-Irvin announced in a message to students last week.

“I share your concerns about the need for the university to respond to the fullest extent possible to issues surrounding students who may be struggling, and we have worked diligently and deliberately to do so,” Telles-Irvin wrote Dec. 5.

Daniel Jessell, a sophomore, was found dead the night of Nov. 28 at his dorm on the north side of the Evanston campus, according to university and Cook County medical examiner’s office officials. The coroner ruled Jessell died in a suicide. Reached through email, his mother declined comment.

Chicago Tribune, December 11, 2018

University of Utah researchers identify 4 gene variants linked to heightened suicide risk

University of Utah Health researchers have identified some genetic factors that may increase a person’s risk of dying by suicide, according to the results of a newly published study.
Variants in four genes — known as APH1B, AGBL2, SP110 and SUCLA2 — were identified as being noticeably associated with suicide risk, according to the study published in late October in the peer-reviewed scientific journal Molecular Psychiatry.

The findings strengthen existing research linking genetics and suicide, and could have implications leading to “new treatments for those who suffer,” said Dr. Douglas Gray, the senior author of the study and a professor of psychiatry at the U.

Deseret News Utah, December 8, 2018

Holiday depression? Suicides actually lowest in December

It’s a common thought that during the holidays, suicides go up. But, according to the Centers for Disease Control as well as Psychology Today, that just isn’t the case.

In fact, national suicide rates are at their lowest in December.

“The Annenberg Public Policy Center has been tracking media reports on suicide since 2000,” the CDC says on its website. “A recent analysis found that 50% of articles written during the 2009–2010 holiday season perpetuated the myth.”

The CDC says suicide rates peak during the spring and autumn months and that pattern has not changed recently.

The CDC goes on to say that the myth surrounding an increase in suicides may actually harm suicide prevention efforts. Suicide, the CDC says, is preventable.

Channel 2, KUTV, December 8, 2018

Infections in kids tied to subsequent mental illness risk in new study

Serious infections during childhood have been tied to a subsequent increased risk of mental disorders in a new study.

The study, published in the journal JAMA Psychiatry on Wednesday, found that infections requiring hospitalizations were associated with an about 84% increased risk of being diagnosed with any mental disorder and an about 42% increased risk of using psychotropic drugs to treat a mental disorder.

Less severe infections treated with anti-infective medications, like antibiotics, were associated with increased risks of 40% and 22%, respectively, the study found.

“The surprising finding was that the infections in general – and in particular, the less severe infections, those that were treated with anti-infective agents – increased the risk for the majority of mental disorders,” said Dr. Ole Köhler-Forsberg, a neuroscientist and doctoral fellow at Aarhus University in Denmark, who led the study.

CNN, December 6, 2018

10 common questions about depression, answered

There are a lot of misconceptions surrounding depression.

Depression is a common mood disorder that can make even daily activities difficult.

Although 40 million people in the US suffer from depression, many don’t know much about the disorder.

Depression can happen to anyone at any age, regardless of their gender.

Medications are not the only treatments for depression — others include therapy and lifestyle changes.

According to the National Institute of Health, depression is a common but serious mood disorder that causes severe symptoms. These symptoms — feelings of hopelessness, sadness, irritability, and decreased energy, among others — affect how you feel, think, and handle daily activities, such as sleeping, eating, or working.

For those who are not familiar with what depression, chances are they have a lot of questions.

To help you get a better understanding, here are 10 commonly asked questions – and their answers – about depression.

Insider, December 5, 2018

November 2018

Want to help prevent teen suicide? Get rid of the gun in your house

According to the American Academy of Pediatrics, the safest home for a kid is one without guns.

That won’t sit well with a lot of folks, especially those who maintain that guns don’t kill people—people do—but here’s what all of us need to keep in mind. Every day in this country, 78 children, teens and young adults are injured or killed by guns.

Last year alone, 285 children got hold of a gun and inadvertently shot themselves or someone else. Add to that, adolescents, in particular, are at a higher risk for suicide when there is a gun in the home. And contrary to popular belief, a gun in the home is more likely to be used to kill a friend or family member than a burglar or other criminal.

The Atlanta Journal-Constitution, November 30, 2018

Can We Stop Suicides?

It’s been way too long since there was a new class of drugs to treat depression. Ketamine might be the solution.

The suicide rate has been rising in the United States since the beginning of the century, and is now the 10th leading cause of death, according to the Centers for Disease Control and Prevention. It’s often called a public health crisis. And yet no new classes of drugs have been developed to treat depression (and by extension suicidality) in about 30 years, since the advent of selective serotonin re-uptake inhibitors like Prozac.

The trend most likely has social causes — lack of access to mental health care, economic stress, loneliness and despair, the opioid epidemic, and the unique difficulties facing small-town America. These are serious problems that need long-term solutions. But in the meantime, the field of psychiatry desperately needs new treatment options for patients who show up with a stomach full of pills.

Now, scientists think that they may have found one — an old anesthetic called ketamine that, at low doses, can halt suicidal thoughts almost immediately.

The New York Times, November 30, 2018

CDC Director’s Media Statement on U.S. Life Expectancy

“The latest CDC data show that the U.S. life expectancy has declined over the past few years. Tragically, this troubling trend is largely driven by deaths from drug overdose and suicide. Life expectancy gives us a snapshot of the Nation’s overall health and these sobering statistics are a wakeup call that we are losing too many Americans, too early and too often, to conditions that are preventable. CDC is committed to putting science into action to protect U.S. health, but we must all work together to reverse this trend and help ensure that all Americans live longer and healthier lives.” — Robert R. Redfield, M.D., CDC Director

Centers for Disease Control and Prevention, November 29, 2018

Suicide kills 47,000 men, women and children a year. Society shrugs.

If a killer roaming America left 47,000 men, women and children dead each year, you can bet society would be demanding something be done to end the scourge.

Well, such a killer exists. It’s called suicide, and the rate of it has steadily risen.

Yet the national response has been little more than a shrug, apart from raised awareness whenever celebrities — fashion designer Kate Spade and renowned chef Anthony Bourdain, to name two this year — are tragically found dead by their own hand.

USA TODAY’s comprehensive look at this public health crisis and its ripple effect, published Wednesday, includes a daughter’s heart-wrenching narrative of losing a mother to suicide, as told by former Cincinnati Enquirer Managing Editor Laura Trujillo.

Although suicide is the 10th eading cause of death in America, efforts to understand and prevent it fall dismally short. The National Institutes of Health, by far the world’s largest underwriter of biomedical study, spent $68 million last year on suicide — a relatively small amount compared with NIH funds devoted to other leading killers.

USA Today, November 28, 2018

Suicide at the holidays: Suicide is the second leading cause of death among college students

According to the American College Health Association (ACHA), the suicide rate among young adults, ages 15-24, has tripled over the last two generations.

If we want that to change, DBSA needs your support.

The Depression and Bipolar Support Alliance recognizes the transition to adulthood can be one of the most trying times in a person’s life. The uncertainty of the future, the fear of not fitting in, the stark reality of student loan debt, and the pressures of succeeding academically, can all contribute to mental health crises and substance use.

Corsicana Daily Sun, November 25, 2018

Guest commentary: School psychologists help prevent suicide

In 2017, the suicide rate for Utah children ages 10-17 was 42 per 100,000 people. The causes of suicide are complex, but there are some things community members and schools can do to prevent suicide.

Language plays an important role, said Lacey McFarland, the suicide prevention coordinator at Weber-Morgan Health Department.

“If we report suicide within safe messaging guidelines, that can open the doors to communication,” McFarland said. “If we sensationalize it or we glamorize it, then we can contribute to that spread.”

School counselors, school social workers and school psychologists all work together to prevent suicide by actively supporting student health and safety. While the role of each provider varies depending on school district and age of the students, each holds a common goal to create a supportive and healthy environment.

The Herald Journal News, November 23, 2018

Fifth of 17 to 19-year-old girls self-harm or attempt suicide

Biggest research into young people’s mental health for 13 years shows one in 10 boys also affected

A fifth of girls aged 17-19 and one in 10 boys the same age have self-harmed or tried to kill themselves, the biggest research into young people’s mental health for 13 years has found.

Experts said the figures were “deeply worrying” and raised serious questions about the damage that social media, pressures to look good, and sexual violence were doing to the mental welfare of young women in England.

The government-funded study has also prompted concern by revealing that 5.5% of children aged between two and four have a mental health disorder – the first time official figures have captured such data on young children.

The Guardian, November 22, 2018

Suicide: Study finds 4 genes that may raise risk

New research finds four genetic variants that may raise the risk of dying by suicide, regardless of environmental factors. The study also identifies hundreds of other genes that require further analysis and that may also raise the likelihood that a person dies by suicide.

According to the World Health Organization (WHO), almost 800,000 people die by suicide every year.

Among people aged 15–29, suicide is the second leading cause of death worldwide.

In the United States, almost 45,000 people die as a result of suicide every year, making suicide the 10th leading cause of death among individuals of all ages.

Medical News Today, November 20, 2018

Netflix’s ’13 Reasons Why’ Linked to Raised Suicide Risk in Study

Suicidal teenagers have claimed the controversial Netflix series 13 Reasons Why raised their risk of taking their lives, according to a study.

Just over half of teenagers at risk of suicide (51 percent) who took part in a study published in the journal Psychiatric Services said the series increased their suicide risk. Teens who “strongly identified” with the main character were “significantly” more likely to hold this belief, the researchers found.

13 Reasons Why tells the story of high school student Hannah Baker, who leaves a box of cassette tapes detailing her motivations for taking her life. The hugely popular program was Googled more than any other show in the U.S. in 2017, the authors of the study highlighted.

The show sparked a debate about on-screen depictions of suicide, and prompted the American Foundation for Suicide Prevention to publish guidance on the series amid fears it could encourage copycat cases and impact vulnerable youths.

Newsweek, November 20, 2018

Here’s how to better support people who are suicidal

I remember whispers, silence, and shame. When I was growing up in the 1960s and 70s, an older cousin violently ended his life. It was never openly discussed, leaving questions and grief surrounding his death to reverberate for years.

Decades later, suicide continues to create quiet circles of despair, a circle that grows ever wider in this country: The latest Centers for Disease Control and Prevention numbers show a 25.4 percent jump in the national suicide rate from 1999 to 2016, when nearly 45,000 people ages 10 or older completed suicide. For every life lost, there are even more stories – from family, friends, and colleagues – that must be heard to eradicate the deep-seated stigma and the silence that contribute to this crisis.

Mashable, November 17, 2018

The Best Way To Save People From Suicide

It seemed so ridiculous: letters that could pull a person out of an abyss that deep. Not personal messages, but form letters typed out on one of the office’s IBM Selectrics. Motto wanted them to be simple and direct, with no clinical jargon or ass-covering fine print. Most importantly, they had to demand nothing. “No expressions like ‘you really should try to resume therapy’ or ‘would you fill out this depressive scale so we can determine what your status is?’” he said. It ought to convey a genuine sense of kinship—“simply what one might say to a friend.”

Motto didn’t take long to write the first letter a patient would receive. He knew what he wanted to say, hitting upon two sentences—37 words—that felt just right: “It has been some time since you were here at the hospital, and we hope things are going well for you. If you wish to drop us a note we would be glad to hear from you.”

With each letter they sent out, the research team’s secretaries enclosed a self-addressed envelope. Motto insisted that it not include a stamp. “That’s important,” he later explained, “because some of these persons were so sensitive that putting the stamp on the envelope would be pressure, that they’d feel obligated that we wouldn’t waste our stamp.”

Huffington Post, November 15, 2018

Nearly 1 in 5 teens seriously considers suicide. Can schools offer relief?

The statistics are sobering: according to the Centers for Disease Control and Prevention, suicide is now the second-leading cause of death for ages 10 to 18, and the number of teens reporting feeling sad, hopeless or suicidal has risen. But experts say suicide is preventable. Special correspondent Lisa Stark of Education Week reports on how one Virginia high school is confronting the problem.

PBS News Hour, November 13, 2018

Concussion Tied to Suicide Risk

People who have experienced either a concussion or a mild traumatic brain injury are twice as likely to commit suicide than others, a new review suggests.

The analysis also indicates that men and women who have had a concussion are also more likely to consider or attempt suicide.

The investigators stressed that the absolute risk of suicide for any one concussion patient remains very low.

Still, study lead author Dr. Michael Fralick said he was somewhat surprised that many of the 17 studies reviewed noted “that concussion was a clear risk factor for suicide, suicide attempt and suicidal thoughts.”

U.S. News & World Report, November 12, 2018

Two Georgia Siblings Create an App to Help Prevent Teen Suicide

What if, when you’re feeling vulnerable and alone and scared, you could push one button and the people who care about you most instantly came to help? That’s the idea behind notOK, an app developed by the Lucas siblings, Hannah, 16, and Charlie, 13, of Cumming, Georgia, that launched in January. The app sends a text message and current GPS location to up to five pre-selected contacts.

The idea for the app came to Hannah during a “really, really dark time” when she was dealing with severe depression and anxiety after being diagnosed with Postural Orthostatic Tachycardia Syndrome (POTS), a chronic illness that causes frequent fainting. Mental health stats reinforce the need for help for teens: Depression rates in teens jumped by 63 percent from 2013 to 2016. More than 1.7 million youth with major depressive disorders received no treatment.

Parade, November 9, 2018

Mental health is a large concern across the country, and a recent study shows just how dire the situation is with college students

According to new research published in the Depression and Anxiety journal, more than 20 percent of college students experienced stressful events in the past year that were associated with mental health problems, including harming themselves and suicidal thoughts or attempts.

Study leaders analyzed data from a 2015 college health assessment survey that included more than 67,000 students.

Health Enews, November 9, 2018

Every 30 seconds, someone in the world commits suicide. Blue lights at railway stations can help tackle this.

Three thousand people commit suicide every day – 60% more than 50 years ago, according to the WorldHealth Organization. Yasuyuki Sawada, Chief Economist of the Asian Development Bank, discusses the use of blue lights on platforms and crossings to reduce suicides.

An assessment of this approach in Japan found that it led to a 84% reduction in suicide at railway stations. Blue lights are also cheap to and easy to install. This evidence resulted in the adoption of blue lights for suicide prevention by railway companies in Europe.

VoxDev, July 11, 2018 (published here on Nov. 9, 2018)

Dellie Champagne: To address youth suicide, support mobile crisis services

In the recent Finding Hope series, the Monitor highlighted youth suicide as a surging crisis in New Hampshire. New Hampshire’s youth suicide rates are 50 percent higher than the national average, and they’re spiking. To the mother of a son with a serious and persistent mental illness, this is devastating. I applaud the Monitor for highlighting what is an avoidable situation in New Hampshire.

Suicide prevention must be addressed, and our lawmakers have a duty to ensure youth have access to critical care in New Hampshire. Together we are obligated to invest in our children and youth. We can all make a difference by coordinating care and increasing supports, building on the strengths of children and their families.

Concord Monitor, November 9, 2018

This Life with Gracie: Another suicide, another parent’s drive to prevent more

Things were starting to look up. Ivey Mustaki seemed more like herself. Happy. Hopeful again.

Her mom, Lauralyn Mustaki, could hear the cheer in her voice as they talked on the phone, making plans for the weekend. It was the same way the next day when Ivey talked with her grandmother from the kitchen and the two of them agreed on poached eggs for breakfast.

Ivey seemed to be in a good place. Then just moments later, her grandmother heard a noise in the bathroom. She found Ivey inside with a gunshot wound to the head.

Atlanta Journal-Constitution, November 8, 2018

How to Talk to a Suicide Loss Survivor: What to Say, What to Avoid

Commonly referred to as Survivor Day, International Survivors of Suicide Loss Day is devoted to remembering loved ones and offering comfort for suicide loss survivors. On this day, large and small events are held in communities all around the world, and there may be programs happening in your area.

Suicide is a hard topic to talk about, especially when it involves someone you know. It can be difficult to understand how to address a suicide in a compassionate manner, and you might refrain from talking to a suicide loss survivor out of fear that you will say something hurtful unintentionally. However, even if you aren’t a close friend of the person who’s grieving, it’s better to show you care than to avoid them entirely. To someone who recently lost a loved one, your support, even if it’s nonverbal, can make a difference.

The Recovery Village, November 7, 2018

Japan’s youth suicide rate highest in 30 years

Bullying, family issues, stress main factorsMore Japanese children and teenagers killed themselves between 2016 and 2017 than in any year since 1986, according to a new government report.

The latest survey shows 250 elementary and high school age children took their own lives in that year for a variety of reasons including bullying, family issues and stress, the country’s Ministry of Education said Monday, according to local media.

“The long break from school enables you to stay at home, so it’s heaven for those who are bullied,” Nanae Munemasa, then 17, told CNN in 2015. “When summer ends, you have to go back. And once you start worrying about getting bullied, committing suicide might be possible.”

ABC News 10, November 5, 2018

Suicide jokes’ normalization not harmful, brings important issues to light

There is a pretty good chance that you or one of your friends has said something along the lines of “just kill me” this week. Dark humor, particularly in the form of suicide jokes, has been rapidly gaining popularity among this generation’s youth and on social media since around 2011. Understandably, concerns have arisen about the effects of such a morbid collective mindset. People may worry that suicide jokes cause or romanticize suicide, but this is hardly ever the case.

Humor as a coping mechanism is not a new phenomenon. In late 1840s Germany, the term “gallows humor” was coined in reference to cynical humor arising from stressful or traumatic situations. Gallows humor is even commonplace in certain professional settings. Hospital workers and ER personnel frequently crack jokes that may seem insensitive to an outsider in order to cope with emotionally painful operations and patient deaths.

Journalists who have to report on disaster events and appalling crimes also employ gallows humor to stay sane. As for teens and young adults on the internet — well, with the circus that is the current American political landscape and the bleak nature of breaking news, it really isn’t surprising that gallows humor has become a social norm.

Collegiate Times, November 4, 2018

Suicide jokes’ normalization trivializes mental health issues, negatively impacts youth

We’ve all been there. The stress builds up, you’re under pressure, and you feel like a little humor might lighten your mood — so you make a joke. Maybe you ask if you can drink from your roommate’s container of bleach. Maybe, when you get a notification that your essay has been graded on Canvas, you tell your friend, “If I don’t get an A on this, I’m going to throw myself off a cliff.”

Our generation is defined by its morbid sense of humor. Open up Twitter, and you’re likely to see a slew of jokes suggesting that students escape the horrors of college and academic stress by walking into traffic or jumping off a bridge. Go on Facebook, and it’s all too easy to find any of a hundred different pages revolving around gallows humor. Venture onto Tumblr, and it should take only a few scrolls before you’re inundated with the bleakest of wisecracks about any number of challenges our generation faces, ranging from the wage gap to the #MeToo movement.

Collegiate Times, November 4, 2018

Guns End More Lives by Suicide Than Murder

Shootings make the headlines, yet the American public doesn’t know that guns take more lives by suicide than by homicide, a new study reveals.

In the United States, suicide is twice as common as murder, and suicide by firearm is more common than homicide by firearm, the researchers reported.

However, the new “research indicates that in the scope of violent death, the majority of U.S. adults don’t know how people are dying,” said study author Erin Morgan. She’s a doctoral student with the University of Washington School of Public Health’s department of epidemiology, in Seattle.

More Americans kill themselves with guns than kill others, Morgan said. This fact should give people who have guns second thoughts about how guns are stored and if they should keep firearms at all, she added.

Health Day, November 2, 2018

Bradley Hospital doctors addressing teenage suicide in new study

A new report from the Centers for Disease Control (CDC) revealed that suicide is the second leading cause of death in people ages 10-34. This statistic has doctors at Bradley Hospital in East Providence acting quickly to address the issue through a research study being conducted by the hospital’s PediMIND Program.

The study aims to better understand why some children engage in self-harm and whether there’s a link to suicide. 12 Eyewitness News, November 2, 2018

Mental health diagnoses rising among U.S. college students

A range of common mental health conditions are being diagnosed more often in U.S. university students, according to a study that also finds students are more willing to seek help than in the past.

Based on surveys of more than 450,000 college students at 452 institutions, researchers found that from 2009 to 2015, the proportion who report having a diagnosis or being treated has gone up for anxiety, attention deficit hyperactivity disorder (ADHD), depression, insomnia, obsessive-compulsive disorder (OCD) and panic attacks.

Anxiety and depression continue to be the most common self-reported conditions. Diagnosis or treatment of anxiety increased from about 9 percent of survey participants in 2009 to 15 percent in 2015, and depression diagnosis or treatment rose from 9 percent to 12 percent.

Reuters, November 1, 2018

October 2018

Generation Z reported the most mental health problems, and gun violence is the biggest stressor

Many members of Generation Z–young people between 15 and 21–have taken more active roles in political activism this year, and a new survey indicates that the state of the nation is to blame for this generation’s stress levels.

As gun violence, sexual assault claims and immigration dominate the 2018 news cycle, the American Psychological Association’s annual Stress in America survey says that such issues are the main cause of stress among young adults.

The survey, released Tuesday, was conducted among 3,459 people 18 and older, and it included interviews with 300 teenagers ages 15 to 17. It measures attitudes and perception of stress to identify the leading sources of stress among the general public.

CNN, October 30, 2018

Film offers remarkably candid look at Palo Alto teen suicides

One of Palo Alto’s darkest chapters is explored on the big screen in a remarkably personal documentary on suicides among students at the highly rated public schools in one of Silicon Valley’s toniest enclaves.

“The Edge of Success” features interviews with former students and teachers, parents and school officials reflecting on two tragic suicide clusters from 2009 to 2015 that claimed nine students’ lives. It premiered last week at the DTLA Film Festival in Los Angeles and is being shown at the Portland Film Festival this week.

The Mercury News, October 28, 2018

Study Plumbs Sources of Students’ Pain

New study explores the causes of mental health problems in college students, finding that many are not taking advantage of campus services.

Many research studies have been devoted to college students’ mental health and a lack of campus resources to help them. Now researchers, curious about what contributed to these issues, have decided to analyze numerous studies. They found that common contributing factors to students’ mental-health challenges were race, violence and sexual assault.

Professors at North Carolina State University and Pennsylvania State University studied 165 academic and news articles from 2010 to 2015 – including some from Inside Higher Ed – on college mental health. The authors of the study, which was published recently in the journal JMIR Mental Health, mined these pieces, identified certain terms and themes, then grouped them together into six general categories: age-related factors in mental health, race, crime, services that institutions offer, the “aftermath” of negative experiences in mental health, and violence and sexual assault.

Inside Higher Ed, October 25, 2018

How One Colorado Town Is Tackling Suicide Prevention — Starting With The Kids

At the confluence of the Gunnison and Colorado rivers, the town of Grand Junction, Colo., sits in a bowl of a valley ringed by tall mountains, desert mesas and red rock cliffs. For local residents like Victoria Mendoza, sometimes the setting makes her and others feel isolated.
“I know we can’t really fix this because it’s nature,” says Mendoza. “I feel like people in our valley feel like there’s only life inside of Grand Junction.”

Mendoza, 17, has battled with depression. It runs in her family. The first funeral she ever went to as a little girl was for an uncle who died by suicide. Things got even worse during the 2016-2017 school year. There were seven teen suicides, including a student Mendoza knew from being in band together. At another high school, a student killed himself in the parking lot in front of a crowd.

“It felt like there was this cloud around our whole valley,” Mendoza says. “It got to a point where we were just waiting for the next one.”

NPR, SHOTS–Health News from NPR, October 23, 2018

The Centers for Disease Control and Prevention (CDC) has published a “technical package” of suicide-prevention strategies that can be used at the state and community levels as well as by psychiatrists and mental health professionals.

The 67-page document, titled “Preventing Suicide: A Technical Package of Policies, Programs and Practices,” describes a select group of strategies based on the best available evidence. These strategies are described in seven chapters that cover the topics of strengthening economic supports, strengthening access and delivery of suicide prevention care, creating protective environments, promoting connectedness, teaching coping and problem-solving skills, identifying and supporting people at risk, and lessening harms and preventing future risk.

“States and communities already engaged in suicide prevention can use this technical package to assess their activities and see if there are areas in which to expand their efforts,” said Deb Stone, Sc.D., M.S.W., M.P.H., in comments to Psychiatric News. She is a behavioral scientist in the Division of Violence Prevention at the CDC’s National Center for Injury Prevention and Control. “For states and communities who have not begun work in the area of suicide prevention, this technical package can help guide decision making and prevention planning.”

Psychiatric News, American Psychiatric Association, October 12, 2018

Study: 1 in 5 College Students has Considered Suicide

College is a busy time for many young adults and it can also be a very stressful time.

A recent survey shows that as many as one in every five college students has considered suicide.

Scott Bea, PsyD, of Cleveland Clinic did not take part in the study, but said young adulthood is often a perfect storm for stressors to get the best of us, but too often, we don’t talk about it.

“We do know that that developmental stage of college-age kids – late adolescence, early adulthood–is a really challenging time where people are struggling with their identity, with becoming independent, with managing–maybe for the first time-problems with their moods, anxiety, and suicide can have a place in their thoughts at times and unless we’re actively asking about it, we’re not going to know about it,” he said.

Dr. Bea said during young adulthood, our brains are still developing and we aren’t always equipped with the ability to handle stressors effectively when they begin to pile up.

Cleveland Clinic Newsroom, October 17, 2018

Lethality of first suicide attempt in youth higher than previously thought

An analysis of data from a study published in 2016 demonstrated that 71.4% of completed youth suicides occurred at the index attempt. Findings were published in the Journal of the American Academy of Child & Adolescent Psychiatry.

In addition, firearms were implicated in 85% of lethal first suicide attempts among youth, according to the results.

“To date, most studies examining suicide risk after suicide attempt have relied on convenience samples limited to a particular attempt method, a specific treatment setting, or a specific type of care received after an attempt,” Alastair J.S. McKean, MD, from Mayo Clinic, and colleagues wrote. “As a result, these approaches have systematically overlooked those dying at the index attempt.”

Helio Psychiatric Annals, October 11, 2018

Lady Gaga Pens Powerful Op-Ed on Suicide and Mental Health Awareness

“We can no longer afford to be silenced by stigma.”

In honor of Mental Illness Awareness Week, Lady Gaga is doing her part to eradicate the stigma surrounding mental health issues and suicide. The A Star Is Born actress, along with World Health Organization’s director-general Dr. Tedros Adhanom Ghebreyesus, have penned a powerful new op-ed for The Guardian—and what they have to say is truly important.

“By the time you finish reading this, at least six people will have killed themselves around the world,” the duo begin the powerful letter aptly titled “800,00 people kill themselves every year. What can we do?”

Prevention, October 10, 2018

Massive survey finds 1 in 3 college freshmen struggle with mental health—here are 4 things you can do

Mental health is a major concern on college campuses around the world. According to new research published by the American Psychological Association, over one-third of first-year college students are impacted.

Researchers from the World Health Organization, led by Columbia University Psychology Professor Randy P. Auerbach, surveyed nearly 14,000 first-year college students from eight countries (Australia, Belgium, Germany, Mexico, Northern Ireland, South Africa, Spain and the U.S.) and found that 35 percent struggled with a mental illness. Auerbach says this finding “represents a key global mental health issue.”

CNBC, Make It, October 4, 2018

Nonprofit says someone commits suicide every 4.5 days in our area; they’re working to change that

Suicide is the second leading cause of death for people younger than 34. Prior to 2013, the death rate among people ages 10-19 declined, but rose by 12% from 2013 to 2016. An increase in the number of suicides was a contributing factor.
NewsChannel 6’s Ashley Osborne talked to one of the leaders of the local organization, Natalie’s Light. Their members are fighting hard to reverse suicide trends.
Natalie’s Light was started after an Augusta Prep senior, Natalie Wood, took her own life in 2015. Hundreds showed up to her candle light vigil and that is when her mom, Dr. Leslie Lesoon realized how many people her daughter had touched. Dr. Lesoon gathered friends like Dr. Laura Hughes and created the non-profit, Natalie’s Light, to continue impacting young lives. “In our area, someone dies of suicide every four and a half days,” says Dr. Laura Hughes.

WJBF, ABC News Channel, October 3, 2018

AFSP Has Over 40 Videos to Answer Your Questions about Suicide


The American Foundation for Suicide Prevention has a series of short videos –over 40 of them!–on the topic of Learning More About Suicide. Covering topics like Opiods and Suicide, Social Media and Suicide, How Parents Can Talk to Kids about Suicide, Suicide Contagion and many more.

American Foundation for Suicide Prevention, October 2, 2018

Suicide rates are rising across the US and the numbers are not subtle

Suicide is contagious; in fact a recent British study revealed that experiencing the suicide of a close friend or family member increases your risk of attempting suicide yourself. Of course such a painful event can also make you more sensitive to another’s suffering and put you more in a position to help prevent a suicide.

I vividly recall many years ago when one of my closest friends, a fellow physician, came to see me for lunch and when he said goodbye I had the uncomfortable feeling that he was saying goodbye for good. I talked myself out of the feeling and two weeks later he drove his car into a wall at high speed, devastating his family and friends. Ever since I have been more on the lookout for the signs of desperation and a suicidal plan in others. The next time someone tried to say goodbye to me for good I called 911 just in time.

The Hill, October 1, 2018


TO OUR READERS: In December 2017 we published a link to a New York Times op-ed piece that was critical of the American Foundation for Suicide Prevention’s position on the role of guns in suicide (see below). In the interests of fairness we feel it is important to offer the AFSP’s own words on Firearms and Suicide Prevention.

As we begin 2018, the American Foundation for Suicide Prevention embarks on the next phase of Project 2025, the first, large-scale initiative focused on reducing the suicide rate in the U.S. Suicide is a major public health issue with a 25 percent increase over the past two decades; suicide remains the 10th leading cause of death with the rate continuing to increase. As the nation’s largest suicide prevention organization, AFSP has set an imperative to use new evidence-based approaches to save as many lives as possible through Project 2025.

Project 2025 identifies a set of critical areas, based on in-depth analysis, where the most lives can be saved in the shortest amount of time. In the critical area of suicide by firearm, we learned that educating firearms owners about suicide prevention has the potential to save more than 9,000 lives by 2025 if implemented nationwide.

We know the facts well:

•Half of all suicides in the U.S. are by firearm
•Suicide risk increases when lethal means are readily accessible
•Research shows that having a firearm in the home increases the risk of suicide

To date, efforts to reduce suicide by gun have largely failed – with 23,000 lives lost each year – we must try a new approach. There is promising evidence that providing suicide prevention training for those who influence a specific community can reduce the suicide risk for that community. Research also tells us that by educating the firearms-owning community about suicide risk, safe storage and removing access to lethal means, including firearms, when someone is at risk, we can reduce suicide. In fact, this approach is called for in our country’s 2012 National Strategy for Suicide Prevention.

This is why AFSP made a strategic decision to work with the firearms-owning community on suicide prevention education. By working with the National Shooting Sports Foundation, we are systematically disseminating suicide prevention education to thousands of gun retail stores, shooting ranges and gun owners nationwide. This education focuses on risk factors and warning signs, and actions that must be taken: temporary removal of firearms from the home during periods of risk, safe storage (locked and unloaded) at all times; and denying sale when appropriate.

Importantly, AFSP receives no funding from NSSF, firearms manufacturers or gun lobbying organizations, nor is AFSP providing funds to NSSF or similar groups. As an organization that welcomes all people with diverse views, we do not currently engage in any political action related to gun policy.

We are taking an unprecedented, large-scale step to reduce suicide by firearm and save as many lives as possible. In 2018, we look forward to working with additional partners to help extend the reach of this critical Project 2025 area.


The original post from December, 2017:

The Gun Lobby Is Hindering Suicide Prevention

In August 2006, my father fatally shot himself with a gun he pilfered from a friend’s bedroom. I wanted to do something positive in my mourning, so I went on a suicide-prevention walk organized by a nonprofit organization called the American Foundation for Suicide Prevention in Santa Monica, Calif.

After conversations with the A.F.S.P. staff area director in Los Angeles about my passion for suicide prevention and gun control — issues she told me she cared about, too — I joined the group’s Greater Los Angeles Chapter board, which required me to donate or raise $1,000 a year. I also helped organize an “Out of the Darkness” walk in Pasadena, Calif.; the organization raises more than $22 million a year at such walks around the country.

The New York Times, December 26, 2017



Deaths From Suicide: A Look at 18 States
A Special Report with Data from the National Violent Death Reporting System, 2013-2014

Established in 1993, the Safe States Alliance is a national non-profit organization and professional association whose mission is to strengthen the practice of injury and violence prevention. Safe States is the only national non-profit or-ganization and professional association that represents the diverse and ever-expanding group of professionals who comprise the field of injury and violence prevention.

Safe States • • February 2017




The Boston Globe’s Spotlight Team – whose investigative work was the subject of the acclaimed 2015 film Spotlight – has produced a report on the current state of mental health care in Massachusetts, The Desperate and the Dead: Families in Fear. Closing psychiatric hospitals seemed humane, but the state failed to build a system to replace them, June 23, 2016.  




Children’s Hospitals Admissions for Suicidal Thoughts or Actions Double During Past Decade – Report from the Pediatric Academic Societies.



Suicide Rates After Discharge From Psychiatric Facilities

IMPORTANCE: High rates of suicide after psychiatric hospitalization are reported in many studies, yet the magnitude of the increases and the factors underlying them remain unclear.

OBJECTIVES: To quantify the rates of suicide after discharge from psychiatric facilities and examine what moderates those rates.

JAMA Psychiatry, June 01, 2017


The World Health Organization and the International Association for Suicide Prevention have released an updated version of their guide for media professionals, Preventing Suicide. It’s a 21 page resource for responsible reporting about suicide and includes a section on the scientific evidence of the impact media has on suicidal behavior.

Highly recommended reading for anyone who cares about this issue. If you come across insensitive or inappropriate reporting on suicide, consider sending this guide to the editors and reporters.

“13 Reasons Why” – Waiting for the Light,
Cursing the Bread 

The Netflix adaptation of the young adult novel 13 Reasons Why has stirred up debate about how this topic is covered across media – especially in popular fiction. 

Here on the Tommy Fuss News page we’ve covered this topic several times:

City teen’s suicide prevention video goes viral – 13 Reasons Why Not
– The Journal Gazette, June 3, 2017

Is Suicide Contagion Real?
Psych Central, May 19, 2017

How To React When Your Friend Is Talking About Suicide
Refinery29, May 5, 2017

Educators and school psychologists raise alarms about 13 Reasons Why
The Washington Post, May 2, 2017 

Netflix’s 13 Reasons Why and the trouble with dramatising suicide
The Guardian, April 26, 2017

How 13 Reasons Why gets suicide wrong: Voices
USA Today, April 18, 2017

To these we’d like to add this publication from the American Foundation for Suicide Prevention: Tips for Parents to talk with their Children about 13 Reasons Why and Suicide.



Critics have pointed out that the framing device – the central character Hannah sends 13 cassette tapes to friends and others detailing how they contributed to her decision to end her life – is not the typical course of the mental illness and stressors that result in suicide.

[May I be forgiven for suggesting that a contemporary teenager using a cassette tape recorder instead of a smartphone to make and distribute their post-suicide diatribes seems a wild anachronism. Akin to having Hannah send the info via telegram. The teens I know today would be hard pressed to identify a cassette tape much less use one.]

13 Reasons Why has been accused of  romanticizing suicide, a claim that also could be made against the most famous teen suicides in all of literature: 15 year old Romeo Montague and 13 year old Juliet Capulet. 

The arch of the 13 Reasons Why story also defines suicide as a means of revenge against those who Hannah felt betrayed and ostracized her. This, researchers and professionals tell us, is almost never the case in real life. Depression and anxiety are mental illnesses that, left untreated (or improperly treated), can result in suicide. 

It is not the actions of others that is the primary cause of suicidal ideation. It is a self-generated condition. Externally many suicides can appear successful in all the ways we measure success.

Whenever Richard Cory went down town,
We people on the pavement looked at him:
He was a gentleman from sole to crown,
Clean favored, and imperially slim.

And he was always quietly arrayed,
And he was always human when he talked; 
But still he fluttered pulses when he said,
‘Good-morning,’ and he glittered when he walked.

And he was rich – yes, richer than a king –
And admirably schooled in every grace:
In fine, we thought that he was everything
To make us wish that we were in his place.

So on we worked, and waited for the light,
And went without the meat, and cursed the bread; 
And Richard Cory, one calm summer night,
Went home and put a bullet through his head. 

– Edwin Arlington Robinson