The Stigma Of Suicide

Robin Williams ended his own life. As the news filtered out across the world, the widespread reaction was to treat it as a tragic mistake – and to imagine that any other outcome would have been preferable.

Hearing people speaking on the radio, and observing what was being said on social media, the immediate assumption was that – as someone who had experienced difficulties with alcohol and drugs – the great actor and comedian must have been the victim of a bad episode; and that, if only he had been able to talk to someone, he might have been saved.
Gradually, however, a different picture started to emerge. Robin Williams’ family issued a statement stating that he was sober at the time of his death. This was not a drunken man doing the unthinkable. His wife Susan Schneider also revealed that Williams had been diagnosed with Parkinson’s Disease. And so it may well be that, faced with an awareness of the inevitable deterioration which Parkinson’s would have inflicted, Robin Williams decided simply that he’d had enough.
I can understand why. My own father died as a result of complications associated with Parkinson’s. He couldn’t take the drugs that were prescribed because they caused hallucinations – and so his deterioration was relatively rapid. He was just 70 years of age when the life finally drained out of him. While it was horribly distressing for the family, in our hearts we knew that it was a release for him. We had seen how the disease afflicted others in his greater family, and were aware that he had been spared the terrible indignity of coming gradually undone, mentally and physically, over a much longer and more painful period.
Equally, I know people who live with Parkinson’s and do it brilliantly. The songwriter Shay Healy went public about the illness, and his fortitude in holding back its progress has been exemplary. The thing is, we are all different; and we are all entitled to make our own decisions about the battles we want to fight. Where my father was concerned, fate took over; Robin Williams took that same fate into his own hands.
I think it is important to be truthful about suicide. Not every incident is a “cry for help” that goes wrong. We have to recognise that there are times when people make what they consider to be an informed decision that they really do want out. Wishful thinking aside, all the evidence suggests that this is exactly what Robin Williams did. And rather than engaging in a process of denial, I believe it is incumbent on us to respect the fact that this was a choice that he was perfectly entitled to make.
There has been a lot of talk about getting rid of the stigma associated with suicide. Well, if we want to do that, as a starting point we must acknowledge that it is a human right. That may not be what people want to hear – at least in part because the aftermath of suicide can be very hard on the family and friends of the person who has taken his or her own life.
But how could it be otherwise? We do not, in any meaningful sense, choose to be born. Life, you might say, is imposed on us. It can, of course, be seen as a gift. But for some people, on occasion at least, it feels more like a curse. The only control we can exercise in relation to all of this is to know that we have the right to opt out.
In practice this is irrefutable. This is what Marie Fleming, who was battling against multiple sclerosis, campaigned for: in her case, she wanted the right to assisted suicide. But underlying this is a belief that the decision about when to go rests with the individual concerned. The only basis for denying this right has to do with religion. If life is defined as a gift from God, then the argument is that it is not ours to take away. And that, in essence, is the basis for the stigma that traditionally surrounded suicide. But does anyone in their right mind think that people who take their own lives are consigned to hell or some other form of damnation? And if not, then what is supposed to be wrong with in religious terms, and why?
In truth, far from being something to fear, it is an empowering realisation; that any of us can decide whether to live or to leave. When you look at it in those clear and unambiguous terms, then the onus is on us all to take responsibility for what we are and for what we do. It is a good thing to decide: I want to live and here’s why. And most of us choose, for very good reasons, to stay.
Once we have agreed that there is a right to die – people exercise it all the time and there is no practical way in which they can be punished – then we can start to help people, especially young people, to understand that, while it may be a right, it is not a necessity.
I was very close to two people who died by suicide. In both cases, they were dealing with the long-term effects of paranoid schizophrenia. The first never accepted that he was sick. He refused all efforts to medicalise the condition with which he was burdened. Despite the deep love and support of his family, and numerous interventions that were aimed at helping him, but which didn't, for over a decade he lived a horribly tormented life in which all of his extraordinary potential as a young adult was absolutely and devastatingly crushed. Terrible things happened along the way. The condition beat him up remorselessly, again and again, and finally broke him completely. He did not want to live with it any more and he decided to take his own life.
In so many ways, the second was harder to accept. He was much more of a social character, full of humour and fun when he was at his best. He had a girlfriend who loved him enormously. And he had achieved enough in his life to suggest that he could have gone on to fulfil his potential in a way that would, with time, have made him both proud and happy. But to say all of that is to underestimate the brutal reality of what it is like, living with severe paranoid schizophrenia. He hated the effect the drugs he was prescribed had on him. There was a pattern of accepting and then rejecting medical support. He tried to combat the disease for stretches without the help of drugs, but the herculean effort required always ended in a psychotic episode, some worse than others. For him, too, it was a form of torture. He hated the affliction. And in the end, he chose to bring the appalling wear and tear of it to an end.
Where both of these young men were concerned – they were 29 and 33 respectively when they died – it was extremely difficult for their family and friends to come to terms with what had happened. But I came to the conclusion, in the longer run, that it was important to fully and unconditionally respect the decision that they had both taken as individuals.
Who am I to try to say that either one of them should have been happy to go on living with what is a desperately debilitating – and at its worst a profoundly distressing – condition? For me, or anyone else, to insist on that would be presumptuous in the extreme.
To acknowledge suicide as a right is not to say that every suicide is inevitable. On the contrary, more often than not, there are ways in which we can deal with the experience of loneliness, isolation, panic, fear and depression through which many people go – and which are often the trigger for suicidal incidents.
Where young people are concerned, it is vital to understand that often what is needed most is for the person at risk of suicide to know that there are people out there to whom they can speak, and in whom they can confide, people who will help them back from the edge of the abyss.
Our mental heath is precious. Some of us are lucky, and live stable, balanced lives without ever having to think very much about it. Most people experience some level of turbulence along the way. And there are others who are faced with a daily battle just to find a way of surviving.
Make no mistake: in relation to mental health, there is a crisis in Ireland now. The savage cuts to budgets for mental health services have exacerbated what was already a difficult situation. The increased rate of suicide in recent years is just one measure of how difficult people are finding things.
It was against this backdrop that we decided to devote much of this issue to Mental Health. In the pages that follow, a number of brave people have stepped forward to talk about their own experiences. And there are some acute reflections from our columnists. Hopefully, the powers-that-be in the Department of Health and the HSE will take note.
In the end, come budget time, their job requires them to fight effectively to secure the resources necessary, so that Irish people can be given the very best chance of living balanced, productive lives, free to the greatest extent possible of the burden of mental illness. As you will see, as you read on, there is no time to waste. The future starts here.