February 23, 2024

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World Mental Health Day: When talking about suicide, avoid using these words

5 min read

Editor’s note: If you or someone you know is struggling with suicidal thoughts or mental health matters, please call the 988 Suicide & Crisis Lifeline by dialing 988 to connect with a trained counselor, or visit the 988 Lifeline website.



CNN
 — 

When it comes to reducing stigma around suicide, not treating it as the elephant in the room is helpful, say mental health experts.

But it’s not just talking about it that matters, it’s also about what you say and how you say it — which is why some have moved away from saying “committed suicide” and other phrases that can have harmful consequences.

Social stigma around suicide can amplify shame for people experiencing suicidality — which includes suicidal thoughts, plans and attempts — making seeking help or talking about it more difficult, said Urszula Klich, a clinical psychologist in Atlanta.

“When we’re stigmatizing those aspects of mental health, and then those individuals don’t get help,” Klich added, “very often, that’s the slippery slope into some of the key factors that wind up increasing risk for death by suicide.”

READ MORE: Debunking myths about suicide helps encourage compassion and understanding

Stigmatizing language about suicide can also cement ideas that people who attempted or died by suicide, when compared with everyone else, are broken, disabled, less than or different in some way, experts said.

This “us and them” mindset can detract people from feeling empathy or being compassionate, fragmenting our ability to connect with others’ struggles and developing strategies that might help prevent suicides, Klich said — which is why experts have suggestions for ways you can discuss suicide without potentially worsening the problem.

Some of the earliest calls for changing how we talk about suicide began in the mid-2000s, with authors whose own lives had been affected by the suicides of loved ones. P. Bonny Ball’s 2005 book “The Power of Words: The Language of Suicide” identified words in need of replacing due to problematic connotations. Thomas Joiner’s 2007 book “Why People Die by Suicide” also helped facilitate understanding about the issue, Klich said.

READ MORE: People who attempt suicide might show signs early on. Here’s what to watch for

It was around then that the Alberta Mental Health Board, as part of its provincial suicide prevention strategy, addressed harmful standard terms and suggested alternatives, according to Canada’s Centre for Suicide Prevention. The center publicly supported this in 2011, saying educating those in power — such as the media, academia and educators — would be key in efforts to change the language overall.

Since then, studies have shown that academic publication of the word “commit” has decreased by about 20% since 2000 — but “it has not translated, really, to the general population,” Klich said.

Use of the word “committed” stems back to when suicide attempts were illegal in many countries, before Germany was the first country to decriminalize the act in 1751 and other European countries and North America did so after the French Revolution, according to a 2015 study. Suicide remains a crime in at least 23 countries, including the Bahamas, Nigeria and Bangladesh, according to the World Health Organization.

In addition to the phrase “committed suicide” implying criminality, it also “clearly has a moral judgment, and it might not reflect the situation,” said Dr. Jacek Debiec, an assistant professor of psychiatry at the University of Michigan.

Some other problematic words people use are “successful,” “failed” or completed, experts said.

The first two are particularly harmful. “Successful” has connotations of a positive achievement, which taking one’s life is not. Additionally, “to the person struggling with (suicidality), that success to them might be very different than the provider assessing the risk,” said Justin Baker, clinical psychologist and clinical director of The Suicide and Trauma Reduction Initiative for Veterans at Ohio State University’s Wexner Medical Center.

And since “failed” typically has negative undertones, using it to describe someone who attempted, but didn’t die from, suicide can imply a lack of strength of character or that surviving isn’t the best outcome. “It’s not unheard of to have a patient go, ‘I can’t even die correctly,’ and use that to further shame and blame themselves,” he added. “We want to not do that — we want to help work towards improved outcomes and quality of life.”

Given these factors, to eliminate stigma and judgment, the preferred language “is ‘died by suicide,’ (like) ‘someone died of a heart attack or stroke,’” Baker said.

“Fatal suicide attempt,” “killed herself” or “took his own life” are other alternatives, experts said. And when referring to someone who didn’t die from a suicide attempt, acceptable shorthand ways to say that include “nonfatal suicide attempt” or simply “suicide attempt.”

Another commonly used, but misguided, phrase is that suicide is a “selfish act.”

Characterizing suicide as “selfish” has derogatory connotations because it implies the person did it for a pleasurable reason, when in reality, people who attempt or die by suicide more often want to end their pain or see themselves as burdensome, clinical psychologist Michael Roeske told CNN in 2021.

“It’s a decision based on the idea that ‘I don’t know how to get out of this moment. I feel so overwhelmed. I feel so stressed. I feel so sad that this opportunity to escape is what I need, and I don’t feel I have any other choice,’” Roeske, senior director of the Newport Healthcare Center for Research & Innovation, said.

Therefore, “nearsighted” may be a better term, he added, since “their focus becomes really limited down to what’s immediately in front of them and they’re not able to see the larger context of the history of their life, the relationships and the dimensionality of things.”

Overall, sticking to factual, nonjudgmental terms is best, Baker said.

If we use more inclusive language and become “aware that people die by suicide, they die from their mental health problems, then we might be a little bit more apt to feel that we also can,” Klich said. “This consciousness of other people’s distress and a desire to alleviate it — we open the pathway to compassion more than when we say ‘committed suicide.’”

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