Napoleon, made a complete botch of suicide. When 3,000 French troops were slaughtered during the last engagement of the Peninsula War at Toulouse in 1814, the ill-fated emperor swallowed a vital of poison prepared two years before (he believed he had thought of everything). Unfortunately for him, it was stale and he was forced to retire, alive and shamefacedly to Elba.
The poet and writer Al Alvarez conceded in his frank testimony on suicide. Savage God, that, ‘I am a failed suicide.’ After recovering from swallowing tablets he had been hoarding for months, Alvarez, by contrast, retired only as for as Hampstead. Suicide was a criminal offence. The police put the event down to an ‘accident’.
Suicide attempts can also produce surprising benefits. A decade ago, one young man afflicted with compulsive and obsession symptoms tried to escape his enveloping depression by shooting himself through the mouth. Astonishingly, his misjudged aim conducted the most precise excision of his frontal lobes. As a result, his obsessive-compulsive complaint improved dramatically. The young school teacher who, have been caught with child pornography, recently threw himself off in the river, didn’t have such a fortuitous fate.
The paradox is that it seems almost impossible to know how to prevent a suicide from taking place. Suicides are rare and the warning signs are easy to miss. How can that be? We might know why some people drift towards this option. Mental illness, feeling trapped with no way out, but that doesn’t mean we can help them. Still, reducing our suicide rate is a bold and uncompromising government objective.
How can we possibly do it? There are clues. When you examine closely the weeks and months leading up to a suicide, you can often see fumbling attempts to make contact with a doctor. Spotting this sudden change in behavior is one key to prevention. In the week before death, for example, about 15 % of patients go to their GPs. Yet only a few doctors note the danger signals. And when people are discharged from hospital, the withdrawal of constant care can bring about a crisis: in one study, a third of suicides took place in the three months after leaving hospital.
Today, aggressive behavior is often the key. In a confidential inquiry into suicides among the mentally ill, completed by the Royal College of Psychiatrists, a third of people who took their own lives displayed past evidence of aggression.
An expert called suicide ‘contagious’. And so it is. Suicide is a social phenomenon. Its solution lies with society, not only medicine.