Review: Religion and Suicide

Detail of The Death of Socrates. A disciple is handing Socrates a goblet of hemlock (Photo credit: Wikipedia)

This is a review of the research paper “Religion and Suicide: An exploratory study of the role of the Church in deaths by suicide in Highland, Scotland” by Harriet Mowat, Cameron Stark, John Swinton and Donald Mowat (2006). I haven’t been able to locate a copy online, although the University of Aberdeen has a summary here (pdf) and there is a shorter version of the report in the Scottish Journal of Healthcare Chaplaincy. To read the full report you may wish to contact Mowat Research via their website and ask where to find the report.

I received a free copy of this report at the Headroom conference in Edinburgh recently and it is certainly interesting, and not just to people in the Highlands. It starts by acknowledging that suicide rates in Scotland increased in the 1980s and 90s although they were decreasing in England and Wales, and that areas such as Highland and the Western Isles have a consistently high rate of male suicide.

A theme from the beginning is expressed in a quote from Professor Norman Sartorius who said that “suicide is a fundamental breakdown of trust between individual and social environment” (quoted on p5) and the report authors’ write:

“Suicide is a challenge to normative values. It confronts exclusive behaviour which shuts out some members of the community. It lays bare social deprivation, poverty, mental illness and attitudes to mental illness. Suicide and deliberate self harm affects individuals, families, communities and society. This most tragic of deaths confronts us all with questions of meaning, hope and social cohesion and challenges us to acknowledge the possibility of suicide for each of us in particular circumstances.” (p5)

The study goes on to discuss what we already know about the Church and suicide, and summarises others’ research into this. They quote a number of studies that suggest that people who engage in religious practises are less likely to die by suicide, or have thoughts of suicide, although they note that these studies may be flawed in that, due to sanctions against suicide people may be less likely to report suicidal feelings. They note that the relationship between a lack of suicide and Church membership is complex, and that some studies have shown that contextual levels of religious belief are also important (that is, that it is relevant whether the wider society engages in religious belief as well as whether the individual themselves has faith.) One study noted that mental illness may be more of a factor in those who die by suicide who are members of religious groups rather than those who die who are not members of groups. It may be that whereas someone outside religion may suicide for a variety of reasons, not all of them due to mental illness, a religious person is more likely to die while the balance of the mind is disturbed, as the old phrase has it.

I have felt suicidal many times, in my case when I am ill, and while I think that my belief in God has to a certain extent stopped me from completing the act, I also think that the added benefits of religion – such as being in a community of people who (hopefully) look out for and support one another has a big impact. The study notes that:

• Most mainstream religious groups are likely to provide some protection against suicide. This protection is probably greatest when congregations have the greatest interaction with one another, can respond in a crisis, and counsel against suicide.
• Internal religious beliefs as well as public expression of religion, are important in their own right.
• Mental illness is one of the mechanisms for over-riding these protective factors in people with religious affiliations.
• Overall levels of religious belief in a community appear to provide some protection against suicide in men in Western countries, perhaps both by regulation in advice against suicide, and by integration, with routes by which support can be accessed. (p10)

One point that the authors’ make which I found interesting is that, although most people probably think that mental illness is the reason why people commit suicide, and indeed it is indicated in many cases, but not all suicides are mentally ill, and social fragmentation and disconnection from the community are also factors.

The question the study asked was what is the role of the minister and the church in suicide events? The authors’ interviewed 17 ministers, mostly Church of Scotland although there were Baptists, Episcopalians, Free Church and Catholic ministers included. They used case studies to trigger a discussion, although the case studies are not reproduced, nor are quotes used as the ministers were concerned about confidentiality. They also had a focus group made up of interested lay people from a variety of denominations.

The first section is on theories of suicide – where the participants thought that there was a sense of disconnection or disillusion from others, the opportunity could present itself to those who engaged in alcohol abuse, which produced a cycle of aggression and guilt which could lead to suicide. They thought that having no faith, no belief in a future after death, misinterpretation of church views and the loss of taboos against suicide could also have an affect. They also identified that some of the causes of suicide are to protect the family, to search for peace and to stop hurting others, and included mental illness, particularly unspotted mental illness as a factor.

They discussed whether Highland is particularly vulnerable to suicide, as rates are higher there. They discussed that the area is moving to a tourist/retirement economy, that the communities are “almost incestuous” in their closeness, and a fear of new or different things. They did think though that the small communities of the Highlands could be very supportive, that there is genuine care for one another and that the area is physically very beautiful. However the area has the potential to damage people in that there is a pervasive drinking culture, sexuality can be a problem for some, that privacy is highly valued, that there is a myth about a past golden age which can hold back change and that people can be strangers to each other in reality. They also spoke of the long dark winters and a “dark druid” culture. Lack of transport and employment were also identified as possible factors. Finally there were some who stated that people are people and behave much the same anywhere, and that Highland is not that different from elsewhere.

Strategies for helping were discussed, and included helping families post-suicide by listening, being there, expressing unconditional love, helping with questions and “holding” unanswered ones, and doing funerals. For those feeling suicidal love was again important, as was showing what the individual has to give and live for, and they mentioned the story of Paul and the gaoler. They mentioned that setting up an awareness group could help prevent suicides, as could praying for the congregation, spiritual support and education, suicide education for senior schoolchildren and being a light in the darkness. They also mentioned parish nursing.

For help after a suicide they mentioned visiting families, letting it be known that suicide is not a sin, praying with people, using the funeral as a healing ritual, fielding anger and being a repository for others’ feelings.

The ministers also indicated that they would like to be included with the multi-disciplinary healthcare team and felt they could help in their communities were they to be included. They suggested that hospital chaplains could help in training them to deal with issues such as suicide.

A number of times in this report the story of Paul and the gaoler came up. This is the tale in Acts 16 of some of the believers in prison when a violent earthquake shook all the chains off the prisoners, and opened the door. The gaoler was about to kill himself when Paul said “Don’t harm yourself! We are all here.” (Acts 16:28) Several of the ministers used this story as an example of what the church should be to those who are suicidal, that “we are all here”.

Ministers requested greater education and training on mental health and suicide, and the ability to work closely with healthcare in the community. The concept of a parish nurse was mentioned, this is someone who is based in a religious community and “seeks to develop specific health promoting practices in response to the unique needs and priorities of a particular area(s) across the life span.” (p29) This person would see the patient as a whole person and not seek to duplicate services that are already present. I found this interesting and would like to know more about this role. I’m afraid there was not much information on it in this report.

This has already gone on longer than I intended but let me say that this is an interesting report on suicide and how the Church reacts to it. It also highlights what ministers and congregants would like to happen to help them react to issues of mental health and suicide. It would be particularly interesting for those working in suicide prevention, healthcare or pastoral care.