STEVE INSKEEP, host:
Because these suicides took place at a specific location over a short period of time, scientists call it a suicide cluster. Reporter Michelle Trudeau has more.
MICHELLE TRUDEAU: There are, on average, five suicide clusters a year in this country, according to psychiatric epidemiologist Madelyn Gould at Columbia University.
She says the most distinctive feature about suicide clusters is that they most frequently occur in teenagers.
Dr. MADELYN GOULD (Psychiatric Epidemiologist, Columbia University): Suicides following the exposure to someone's death by suicide was about two to four times higher among 15 to 19 year olds than other age groups.
TRUDEAU: So what is it about teenagers that makes them particularly vulnerable to being part of a suicide cluster? Gould and other scientists say one thing is social modeling.
Dr. GOULD: For adolescents, it's the peers that replace family members and other adults as the most influential group. And given that they are that influential, a suicide is another behavior that can be modeled, unfortunately.
TRUDEAU: Another feature about teens that puts them at suicide risk is their tendency to act impulsively. There brains are still developing, so they are not good yet at putting on the brakes or planning ahead or problem solving. Suicide might seem like a solution to problems, especially if a friend or acquaintance has taken that route. But Gould stresses that the most significant red flag for adolescent suicide is mental health problems. In teens, that's most commonly depression, anxiety, alcohol or drug abuse.
Dr. GOULD: That's absolutely the major risk factor. Even in the context of someone else's suicide, without that underlying vulnerability, they're not going to go on attempt suicide or die by suicide.
TRUDEAU: Gould is studying 50 suicide clusters that have occurred in the U. S. over the past decade, comparing them to young people who died by suicide but not in a cluster. She's doing what's called a psychological autopsy on each suicide, interviewing family, friends, teachers, checking school records, the teens' emails, phone calls, trying to identify what might initiate a suicide cluster.
Dr. GOULD: Why do you have the tragedy of a suicide in one town, but it doesn't lead to additional suicides. Yet in another town, it may lead to two, to three, or four more suicides.
TRUDEAU: Gould has identified a crucial characteristic that plays a role in most clusters.
Dr. GOULD: If the first suicide is a public suicide�
TRUDEAU: That is if the first suicide gets media attention.
Dr. GOULD: �it's more apt to trigger other deaths.
TRUDEAU: So, the way the media cover the first suicide is critical.
Dr. GOULD: There is something called the dose-response association. So that the size of the increase in suicides following a suicide story is proportional to the amount, and the duration, and the prominence of the coverage.
TRUDEAU: Psychiatrist Paula Clayton, medical director of the American Foundation for Suicide Prevention, regularly advises the media on how to report on a suicide. Reporting can actually help if, for example, the coverage includes the many factors that may have led up to the suicide and emphasizes that 90 percent of people who kill themselves have an underlying mental health problem. But there are also details of the suicide, Clayton cautions, that can increase the risk of suicide clusters that the media should avoid reporting on.
Ms. PAULA CLAYTON (Psychiatrist, American Foundation for Suicide Prevention): Don't talk about the method or show the place where the suicide occurred. And don't glorify it.
TRUDEAU: Clayton's group has also been consulting with the Palo Alto community about the recent suicide cluster there. Telling them about the research on physical barriers and how effectively they prevent suicides.
Ms. CLAYTON: So, if you build barriers for bridges or put nets up, the suicide rates go down at the bridge, and don't go up at the nearby bridges. If you build railroad barriers, the suicides go down.
TRUDEAU: In addition, in a new study by Madelyn Gould coming out in December, the value of school-wide suicide screening is confirmed. Identifying teens at risk for suicide and offering them help does result in teenagers getting treatment for their mental health problems.
For NPR News, I'm Michelle Trudeau.
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