A child's suicide note weighs heavy in mother's handbag

Suicides among the under-20s have halved in the last 15 years

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By Päivi Punkka-Hänninen
     
      Arja, a woman from Helsinki, carries around a handbag that weighs more than most. For the past seven years, everywhere she goes, she has carried around a copy of the note left by her 17-year-old son in which he said goodbye and tried to explain why he had chosen to take his own life.
      That same year, in 1999, 51 other young Finns under the age of 20 reached the same decision and committed suicide.
     
Arja shares her feelings with others who have experienced this kind of loss. She runs two peer-group counselling sessions at Surunauha, a Helsinki support group organisation for the relatives of those who have committed suicide.
      Arja says that the passer-by might see a laughing bunch of women sitting at a corner table in a restaurant. Few would know to look at them that this was a support group of mothers who had lost their children in this way. Grief and mourning are not constant topics of discussion. It helps just to know that the person sitting next to you can understand what it feels like.
      The number who share Arja's experences has declined, since the incidence of suicide among juveniles and young adults has fallen by more than half in the past fifteen years, from 74 in 1990 to 31 in 2005.
      The annual toll in the Greater Helsinki area declined from ten to seven. The variations in these smaller numbers are not statistically significant.
     
Last year's figures will not be released until the autumn, but it is believed that the positive trend is continuing.
      According to Prof. Jouko Lönnqvist of the National Public Health Institute, one reason for the declining numbers of people who finally decide to end it all is that more attention has been paid to depression, both during a decade-long drive against suicide from 1986-1996 and thereafter.
      There is often discussion of the inadequate funding for child psychiatric services in this country, but in Lönnqvist's view the situation is not impossible. "Although there are obvious shortcomings, the volume of psychiatric services offered to children and young people has roughly doubled since the beginning of the 1990s", he says.
     
Depression is often a cause of suicides among the young, but in the majority of cases there is actually no recognition of mental health problems before it is too late, according to Kuopio University's Prof. Mauri Marttunen, who has researched the subject in depth.
      In every third case there is substance abuse of some kind as a factor, and half of the boys were drunk at the time that they took their lives.
      Arja says that her son did not exhibit any obvious symptoms of discomfort, and did not use alcohol, so no help was sought. His school and free-time activities were going OK, and he had a good bunch of friends around him.
      However, the death of the boy triggered off a latent bipolar tendency in the father. It is possible that the son may have had a similar inherited manic-depressive disorder that increased the risk of suicide.
     
There are no pretty stories to tell about suicide. Arja's son stabbed himself in his bed after having wished his mother goodnight.
      Talking with members of the peer-group has reduced Arja's own personal feelings of guilt about what happened: for many other parents, too, the child's drastic solution to his or her problems came as a complete bolt from the blue, with no prior warning.
      "My son was a good kid, never getting into fights or any trouble. And the same has been said about many of the children of other members of the group."
      Sometimes the young person's silence is a greater problem than rebellion. According to Lönnqvist, revolt acts as a means of discharging bad feelings, but the problems of the quiet introverted child may slide a long way towards crisis levels before they are ever picked up.
     
"I have thought many times about suicide, and I have even planned it, but then I have dropped the idea when the day has brightened things up. Still, even that bright spell is only fleeting", writes a 15-year-old girl on an online youth discussion forum. Her parents do not know of her thoughts.
      According to questionnaire studies carried out on Finnish schoolchildren, roughly one in ten have harboured serious thoughts of suicide at one time or another. Half of the young people admitted into psychiatric care have considered the fatal deed, and one in five have actually tried.
      Prof. Lönnqvist also observes that every third person under the age of 20 who commits suicide has tried and failed earlier.
     
For Arja, the peer-group experience has been a great help. Discussions with others who have shared the same fate and the same self-recriminations have helped her to understand that bitterness, grief, and indulging in "If only I..." thinking are all typical reactions for the relatives of those who have committed suicide.
      On the other hand, Arja has little good to say about the official response to her situation. She reports that initially she and the boy's father were suspected of having killed their son, until the boy's suicide note was discovered under the mattress.
      "No doctors or other helpers came to visit us. We were just told not to argue."
      Later she has received help through Surunauha and from the Finnish Association for Mental Health and from doctors at her workplace.
      "I am gradually letting go. Naturally you never do get over it as such, but I have learned to live with what happened."
     
Helsingin Sanomat / First published in print 16.1.2007


Previously in HS International Edition:
  Study finds use of antidepressants reduces suicides, but increases attempts (7.12.2006)
  Finnish male suicides and alcohol-related deaths decline (21.10.2003)
  Suicides on the rise again; more women killing themselves (19.5.2003)

Links:
  The Finnish Association for Mental Health
  Surunauha (in Finnish)

PÄIVI PUNKKA-HÄNNINEN / Helsingin Sanomat
paivi.punkka-hanninen@hs.fi