"Coupled"

Suicide. Most of us assume that all that is relevant is the state of mind of the person who takes that extreme step. But, asks Malcolm Gladwell in Talking to Strangers, is the availability of the means to suicide a key factor? Are the two (state of mind + availability of means) “coupled”, he asks.

 

Psychiatrists and social workers did not believe in the coupling theory. Ronald Clarke puts it perfectly:

“(Most people feel) it was sort of insulting to think you could deal with it (suicide) by simply making it harder to commit suicide.”

 

In England, writes Gladwell, in the decades when town gas was delivered at homes for cooking etc, one of its constituents was carbon monoxide. Guess what was a popular way to commit suicide? Stick your head in the oven, seal it to the best you could with clothes etc, and inhale away. Later, when town gas was replaced with a different gas with no carbon monoxide, did suicides drop? If there’s no coupling, it shouldn’t matter: people would just find other ways to commit suicide, right? Guess what, adjusting for other events (like economic downturns that lead to job losses and increased suicides), suicides rates did drop on the switch away from town gas.

 

Means do matter. If the means are not guaranteed (e.g. overdose of sleeping pills), or can lead to a failed attempt and disfigurement/handicap (e.g. getting in front of a bus), or not accessible at that very instant when a person feels suicidal (e.g. jumping off a bridge), statistics show that suicide rates fall.

 

But this is not at all how we think of suicides, do we? Which explains why the authorities refused to install a suicide barrier at one of the world’s most popular suicide bridges, the Golden Gate Bridge, for decades. As Gladwell writes, Golden Gate authorities spent millions to protect cyclists on the bridge, to build dividers against oncoming traffic, and installed nets while construction was in progress:

“But for suicides? Nothing for more than eighty years.”

 

Don’t blame the authorities for this. Turns out authorities periodically asked the public if money should be spent on suicide barriers. Why on earth, was the most common response. If you put them on the Golden Bridge, suicidal folks will just find a different bridge (or a different means). Instead, why not spend that money on mental health clinics etc, people responded.

 

We just can’t imagine that context matters, writes Gladwell, even though:

“Suicide is coupled.”

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