Book 3, Letter 18, part 3 of 3 To Tacitus, on Suicide

I don't want to make hard conclusions, however, I have two stories. The first is a rumour really, and it does not add to my happiness, but I will tell it anyway since it goes towards answering my question about modern popular suicide methods.. The local city train station currently has a high turnover of staff among their drivers. This is due, so the story goes, because one person a week is committing suicide by stepping onto the tracks in front of a moving train. This rumour comes via friends working in the mental health sector as therapists. These therapists are perhaps fighting on the front lines of our culture's darkest impulses, and have a unique, if somewhat bleak perspective.

The second story is more ambiguous, from the Japanese Zen tradition. A monk who, for decades had diligently performed all the rituals and meditations as instructed by his masters, finally became worn down by his inability to have a single moment of enlightenment. Considering himself a failure, he went to his master and announced his intention to commit suicide. The master did not try to dissuade him, but merely accompanied him to the high wall of the monastery, overlooking a a cliff. The student, knowing that now was the moment he must choose between enlightenment or death, put his foot upon the stone wall, ready to throw himself over.

In that moment, his mind cleared, and enlightenment burst from within him.

Enlightenment or death.

He made his choice.

*

So with the rumours, stories and philosophical discussions aside, I will share a few of the facts, derived from a variety of sources. I here quote directly from the web-pages I read, mostly government statistical studies.

In every state and territory of Australia, suicide is much more common among males than females, with the ratio standing at 3:1 in 2012.

According to hospital data, females are more likely to deliberately injure themselves than males. In the 2008–2009 financial year, 62% of those who were hospitalised due to self-harm were female.

Researchers have attributed the difference between attempted and completed suicides among the sexes to males using more lethal means to end their lives.

Suicide rates for both males and females have generally decreased since the mid-90s with the overall suicide rate decreasing by 23% between 1999 and 2009. Suicide rates for males peaked in 1997 at 23.6 per 100,000 but have steadily decreased since then and stood at 14.9 per 100,000 in 2009.

Female rates reached a high of 6.2 per 100 000 in 1997. Rates declined after that and was 4.5 per 100 000 in 2009. Comparing sex differences in suicide rates need to consider differences across the lifespan. Since 2003, for females, suicide rates range from 4 – 6 suicides per 100 000 with no apparent age association, whilst for men suicide rates range from 10 – 30 suicides per 100 000 with substantive differences across the lifespan; those males in middle and older age report substantially increased rates of suicide.

Methods of Suicide

In 2003 the most common method of suicide was hanging, which was used in almost half (45%) of all suicide deaths. The next most used methods were poisoning by 'other' (including motor vehicle exhaust) (19%), Other (15%), poisoning by drugs (13%), and methods using firearms (9%). This distribution was consistent with that of the previous few years. However, over the decade strong trends were apparent such as the increase in the use of hanging, and a decrease in methods using firearms. 

In 2016, suicide was the leading cause of death among all people 15-44 years of age

In 2016, suicide accounted for over one-third of deaths (35%) among people 15-24 years of age, and over a quarter of deaths (28%) among those 25-34 years of age.

According to the ABS, for those people 35-44 years of age, 16% of deaths were due to intentional self-harm.

Intentional self-harm top 10 multiple causes, proportion of total suicides , by age group, 2017

Cause of death and ICD code	5-24 years	25-44 years	45-64 years	65-84 years	85 years +	All ages
Mood disorders (F30-F39)	34.3	43.0	49.0	40.3	26.0	43.0
Mental and behavioural disorders due to psychoactive substance use (F10-F19)	25.9	41.6	26.7	10.1	2.6	29.5
Other symptoms and signs involving emotional state (R458) (c)	20.6	16.9	19.5	16.4	11.7	18.1
Anxiety and stress-related disorders (F40-49)	15.2	19.7	17.9	13.6	9.1	17.5
Findings of alcohol, drugs and other substances in blood (R78)	18.5	17.0	13.7	9.6	7.8	14.9
Schizophrenia, schizotypal and delusional disorders (F20-F29)	3.5	7.9	5.2	2.3	—	5.5
Unspecified mental disorder (F99)	7.2	5.0	4.3	1.8	—	4.5
Malignant neoplasms (C00-C97, D45-D46, D47.1, D47.3-D47.5)	0.5	0.9	1.9	16.1	24.7	3.7
Diseases of the musculoskeletal system (M00-M99)	0.2	1.7	3.3	11.1	15.6	3.6
Personality disorders (F60-F69)	5.4	5.0	2.0	1.3	—	3.5
Chronic pain (R522)	0.5	1.3	3.7	5.3	5.2	2.6
Ischaemic heart diseases (I20-I25)	0.2	0.7	1.8	7.8	16.9	2.3
Chronic lower respiratory diseases (J40-J47)	0.2	0.5	2.0	6.0	9.1	1.9
Diabetes (E10-E14)	0.5	0.6	2.0	5.0	9.1	1.8
Heart failure (I50-I51)	0.2	0.2	1.0	5.0	7.8	1.2
Behavioural disorders usually occurring in childhood and adolescence (F90-F98)	3.7	1.1	0.6	—	—	1.1
Disorders of psychological development (F80-F89)	2.1	0.5	0.1	—	—	0.5

Indigenous Suicide Rates

Indigenous suicide rates are between two and four times those of non-Indigenous Australians in the 15 and 44 age groups

For those of Aboriginal and Torres Strait Islander descent in NSW, QLD, SA, WA and NT there were 162 deaths due to suicide (119 male, 43 female), which was the fifth most common cause of death.

While suicide is a big problem across our entire society, for Australia’s Aboriginal peoples, it’s at epidemic proportions.

As the esteemed suicide prevention researcher Gerry Georgatos recently wrote in The Guardian Australia the figures below may not even represent the full extent of the issue.

“Suicide accounts for more than 5% of Aboriginal and Torres Strait Islander deaths… In fact in my estimations, because of under-reporting issues, suicide accounts for 10% of indigenous deaths.”

*

Discerning the reasons behind suicides is more difficult, but the sources suggest that long term unemployment among men, particularly in rural areas, is the greatest contributor. There is a feeling of chronic uselessness that, year after year builds up inside a man and dries up his sense of personal honour and respect. Of course, every suicide is unique, and individual personal reasons will involve many different factors.

So, Tacitus, while the high-profile suicides of ancient history make for fascinating reading, the modern daily facts make for grim study. We aren't killing ourselves because tyrants threaten us with torture and execution, but rather, every day existence and the struggle to make ends meet is torture enough.

I have said enough of the reasons for choosing to die, so I shall end my letter with a quote from Cicero, who, in his piece entitled Scipio's Dream, tells us that it is our duty to remain alive. In a conversation with the spirit of Scipio Africanus, the following advice is given to the younger, still living Scipio.

Unless that God whose temple is around you everywhere shall have liberated you from the chains of the body, you cannot come to us. Men are begotten subject to this law... Wherefore, my son, by you and by all just men that soul must be retained within its body's confines, nor can it be allowed to flit without command of him by whom it has been given to you. You may not escape the duty which God has entrusted to you.... It is your duty to your parents and to your relatives, but especially to you country. There lies the road to heaven.

So, right or wrong, suicide is happening every day. Whether we talk about it or not, it is happening. We are affected by it, our whole society is influenced by our attitudes towards suicide, and by the stories we tell ourselves about what it means. That is my purpose in writing this letter, to allow of an open discussion on a difficult topic. We Australians are killing ourselves in private, and in shame, loneliness and desperation, and keeping the truth of this epidemic hidden away, or only silently acknowledged, will not help anyone.

Thank you Tacitus, even when the lessons are hard, I am proud to know you, and grateful to have you as a teacher.

Morgan.

PS. As I finish writing this letter to you I have found more writing from both Cicero and Epictetus on the subject of suicide and suffering. I sense that I will write more on this subject in the future.  However, I will part with this quote from Albert Camus...

There is but one truly serious philosophical problem, and that is suicide. Judging whether life is or is not worth living amounts to answering the fundamental question of philosophy. All the rest — whether or not the world has three dimensions, whether the mind has nine or twelve categories — comes afterwards. These are games; one must first answer. And if it is true, as Nietzsche claims, that a philosopher, to deserve our respect, must preach by example, you can appreciate the importance of that reply, for it will precede the definitive act. These are facts the heart can feel; yet they call for careful study before they become clear to the intellect.