Signs of suicide

I was reminded by the article written about Finn Casperson’s death, of the signs often present when a person is contemplating suicide (http://www.nytimes.com/2009/09/16/business/16suicide.html?_r=1&th&emc=th). A prominent businessman, Casperson resigned from several boards he worked on as well as put his property up for sale prior to ending his life. While the ‘news’ side of the story relates to speculation that he had hidden his money away to avoid taxes and might soon be caught, this potential which obviously might be very stressful, is second to the fact that he also had kidney cancer. It is unfortunate that this angle was chosen for the story. It appears this businessman and philanthropist will now be dragged down in the desire for a story.

There were some cues to suicide in this story that are good reminders for us: his resignation from several boards, stepping down from civic and private positions that it appears he found quite meaningful and important; and placing his estate up for sale. Those seem to be signals of a person withdrawing from his life. We know that often prior to ending their lives, individuals do try to put things in order and take care of things important to them. Of course in the context of treatment for kidney cancer, it might be perceived that these were a way to limit activity and focus on getting well.

It is always important that clinicians consider stressors as well as actions taken by individuals in trying to determine their safety. Mr. Casperson’s story shows us a good example of this often overlooked sign, which we do try to recognize in those we assess who are depressed or overwhelmed by many stressful events.

We often discuss how difficult it is to really be certain that your assessment of someone’s mental state is accurate. Newer students feel their lack of experience contributes to having a less definitive knowledge of whether someone ‘is safe’. The article does not indicate whether Mr. Casperson’s family, friends, or caregivers had any awareness of the potential for suicide.

Unfortunately Mr. Casperson’s story (at least as told here) is a reminder that there are times we will not know how deeply a person is suffering, and that if intent on ending their life, individuals are quite capable of keeping this hidden from those who know them best. My heart goes out to his family and friends who suffer now with his loss.