Some time ago, my Twitter timeline brought me references to an article about an NHS Trust chief executive who had shared a deceased colleague’s suicide with the trust staff. The reaction both of the staff and on Twitter was strongly negative. In this post, I would like to comment on it.

I must admit that my first reaction to the news was as negative as others’. Why would you share someone’s suicide note with people at large? All the stereotypes of notes as private messages kicked in and it took me a while to stop and think. I needed to reflect on the immediacy of the negative reaction. But before I get there, however, let me make a couple of comments on the ‘nature’ of suicide notes.

First, suicide notes are not personal, let alone, as Antoon Leenaars, a great scholar studying them, proposes, ultrapersonal. They are nothing of the sort. Though, suicide notes vary significantly, if anything, they should be understood as semi-public texts and for two reasons. First, quite a lot of farewell letters I read (I did read many) are explicitly addressed to people who are unlikely to find them. People write to their bosses, priests, to prosecutors, doctors, distant family, family friends and so on, and the like. Moreover, second, suicide notes are more than likely to be read in institutional contexts by people they are not addressed to. Ambulance crew, police, investigators, lawyers, all of them are likely to have access to suicide notes as part of the evidence in investigations into suicidal deaths. Significantly, people writing suicide notes often make it explicitly clear that they realise this will happen.

This means, basically, that suicide notes do not only have the ‘front stage’ (Goffman’s term) or the direct addressees, but they also have other recipients, some of them explicitly licensed (as in notes addressed to, say, a father but left for the mother to be found), and some not (e.g. police, prosecutors). This, in turn, changes the nature of communication. Commonsensically, if I know that someone is eavesdropping or can overhear me, I need either to change the medium/channel of communication (e.g. start whispering) or the message. The medium of the suicide note cannot be changed, so I must adjust the message in a way that will reflect the likelihood that it will be read by third parties (there is much evidence to suggest that this happens).

Furthermore, suicide notes must be seen as acts of strategic communication, negotiating what must be said with what can be said. Some, in fact, are also likely to be deceptive or manipulative. After all, the suicide note might (and I stress ‘might’) be the last opportunity to take revenge, to get your own back, to score one. To hurt, to harm, to cause pain and leave the addressee/s with bucketfuls of guilt (there are many notes which cannot be read in any other way as attempting to hurt the addressee). There is no reason to assume that just because a person wants to take their life, all ulterior motives disappear. And given the number of notes confessing eternal love and stressing inability to live without it, it seems that at least there is a (often) socially justified context for it. I do want to emphasise, however, that I do not claim that this is the case in all suicide notes, only that it is unlikely that suicide notes are all embodiments of transparency.

This is very much in contrast to continuing assumptions in suicidology. Research on suicide notes has (tacitly) assumed that suicide notes are simply honest and sincere acts of communication. The most common assumption here (see work of such major scholars as Shneidman and Leenaars) is that suicide notes somehow give easy and clear insight into the suicidal mind of the person about to kill themselves. You read the note and you understand what the person was thinking, feeling and whatever else. This is highly implausible.

And so, when I started thinking and reminded myself all that, I started wondering where my immediate and very negative reaction to making a suicide note (semi-)public had come from and though I haven’t got clear answers, I have some ideas, which, alas, are not particularly novel.

So, first I thought about suicide as covered by social taboo. One does not commit*) suicide and one does not talk about it, and there is much research on it. One study showed that suicide of a family member is hidden for as many as three generations. It’s also worth reminding ourselves that suicide is still illegal in some countries (including Cyprus in Europe). Sending a suicide note to people way outside the group of expected readers breaks the taboo and brings what is not spoken about into the public domain.

The flip side of the suicide taboo is the stigma attached to it. Suicide continues to bring shame on those who commit it and those around. Although attitudes towards suicide are changing (I wrote about it here), suicide continues to be highly stigmatising.

This is, indeed, I think, why suicide is thought to be personal. If suicide is something to be hidden, it also should remain with the family and sharing a suicide note seems unacceptable. The note offers insight into something that we are somehow not allowed to know. Is this why the staff of the NHS trust objected to sending the suicide note around? The above-quoted article suggests that people had never seen a farewell letter and didn’t want to.

This is quite remarkable as, the article tells us, the suicide note was expressly written to be read and, possibly, shared. Moreover, permission was obtained from a family member for making the note public. And yet, people who had received it objected to having received it; as did people commenting of Twitter, at least as far as I was able to see. Suicide must remain under the veil of silence.

So, what do I now think about making a suicide letter public? Was it OK? I haven’t got an easy answer. As an academic, after giving the matter some thought, I would say, probably yes, it was. The sending of the letter makes suicide less shameful, less stigmatising.  This, as I said in my blogpost I quoted above, is likely to have to some unwanted consequences, but nonetheless, it does work to remove the stigma.

So, what of my (and others’) initial reaction? Can it (and should it) be simply ignored as pandering to negative stereotypes of suicide? I am not so certain. Here we come back to the ‘unwanted consequences’ of legitimising suicide. If suicide is fully acceptable, more people will kill themselves (there is research on stigma as a protective factor for men). So perhaps, it’s better not to work on removing the stigma? This a hugely complex and difficult issue and, I must admit, I am often quite irritated by how easy it is made out to be. It’s not.

We arrive at a paradox, as propositions about the usefulness of stigma go right against quite a significant push in today’s suicide prevention activities to reduce the stigma of suicide. In fact, engaging in conversations on suicide is encouraged and promoted. In contrast, I continue to think that such campaigns are not fully thought out. For example, I continue to think that asking members of the public to ‘help’ with conversations on suicide is particularly problematic. And yet, no one, it seems, considers potentially very harmful and destructive consequences of such engagement (here my post about it).  I am also worried about the significant increase in the number of people who think that solving life problems with killing yourself is OK. Is it? Is suicide simply OK?  (I am not going to answer such questions lest the post become too controversial, but questions like this should be debated in order to escape simple and simplistic answers.)

And so, as often happens in the case of suicide, I end with ambivalence. In my view, there are no easy and simple answers to questions about making a suicide note public in a company letter.  But as much as I am ambivalent about whether it was good (or acceptable) to send it, I also reject the idea that it was definitely bad and harmful to do so.

Suicide is way too complex for one-sentence answers.

*) I consciously and deliberately use the word ‘commit’, which I explained in a number of posts on this blog. I find its replacements such as ‘die by suicide’ counteruseful and too euphemistic.