Ideation Gone Wrong: The Suicide Phenomenon

By Don C. Johnson CLI

Suicide is in the news lately, and it is more likely to make the national news when the decedent is a famous person or noted celebrity. As I write this, in the past week we have seen two such stories; the death of fashion designer Kate Spade and the celebrity chef Anthony Bourdain. Suicide should be part of our national dialogue at all times, and beyond the mental health circles and their trade publications, or the occasional newspaper or magazine article that focuses on the phenomenon and not the victim. Awareness breeds alertness. If we are more familiar with a subject, we are more likely to be prepared to address it when we witness its looming presence.

My firsthand exposure to suicide was in my role as a legal investigator, when in the early 1990s I was tasked with investigating a suspicious suicide determination made by an Indiana coroner in a nearby county. An insurance company had denied death benefits to the parents of the decedent, based on a suicide exemption clause in the life insurance policy the parents held on their son, who at the time of his death was in his early 20s. The parents had alleged foul play involving their son’s estranged wife. The couple had a volatile relationship. My preliminary research was focused on determining the elements of law required to support a determination of suicide made at a death scene or subsequently by an investigating authority, because a death certificate is not prima facie evidence of suicide, or any other determination of the manner of death.

My investigation was successful, in that I uncovered sufficient evidence to cast doubt on a suicide. I was unable to rule out an accidental death or a death by foul play. In the end, because of what the investigation uncovered, the insurance company withdrew its denial of benefits. However, the family was unable to get the local sheriff’s department or prosecutor to pursue the case to another conclusion, and our investigation came to an end. I featured this case in a white paper I wrote in 1997, “Suicide Investigations,” for the quarterly journal, The Legal Investigator, published by the National Association of Legal Investigators. I expanded my research in a subsequent article I wrote for a reference book, “Suicide Determination in an Equivocal Death Investigation,” published by Lawyers and Judges Publishing Company in 2000. In that article, I go into detail on the four elements under law necessary to support a determination of suicide, as my research revealed at the time, and I quote here:

1. Intent. The two most important indicators of intent to commit suicide are a statement made by the defendant and a suicide note. The presence of either of these is a clear indication that suicidal ideation was present. Of course, the fact that someone mentioned a desire to commit suicide is not proof that he or she did, just as a suicide note may have been written by someone other than the deceased. Further investigation is warranted. Clinical psychologists have suggested that suicidal behaviors can be conceptualized as falling along a continuum of suicide potential from ideation, contemplations, and threats, to attempts, and finally to completion. But these same specialists are unable to predict who will progress from one level of suicidal behavior to another.26 Many people who kill themselves never express any intent to do so, although other indicators of suicide potential may have been present. Less than five percent of those who talk about killing themselves actually do so, yet 90 percent of those who commit suicide will have talked about it.27

The investigator should search for other written expressions of intent, such as in a diary, letters to a friend or family member. Such documents should not be accepted as prima facie evidence of intent, just as a suicide note should be treated with an investigator’s skepticism. They must be subjected to verification. A handwriting analysis by a qualified document examiner is warranted, as is the dusting for fingerprints, if it is subsequently suspected that someone other than the decedent may have written the suicide note, or forged a letter from the decedent expressing an intent.29  E-mail suicide notes are appearing, especially among teenagers who have grown up using computers. A careful examination of an equivocal death scene will include a search of any computers the victim used regularly, or had access to. The E-mail files, notepads and other word processing programs should be checked for suicide notes, even in the deleted files.

Understanding suicide ideation is important in conducting a thorough equivocal death investigation. As in other areas of human behavior, there are varied and changing influences which may play a significant role in an individual’s ideation of suicide. Later in this chapter, suicide ideation phenomena are detailed.

2. Knowledge of the Fatal Instrument. The victim of a suicide will demonstrate some knowledge or familiarity of the agency of death, a weapon or other instrument. At some point, the victim will have learned of the deadly character of the mode of suicide which he or she selected. The deadly nature of a firearm is obvious, of course, but the knowledge of how to use it needs to be established.

The most common method of committing suicide is cutting the throat or wrists, except in the young. Recent data from the Centers for Disease Control and Prevention show that firearms, followed by hanging and poisoning, are the most common means of committing suicide among victims 15-25 years of age.28 Handguns are the preferred choice to shotguns or rifles, for the obvious reason that the victim would have trouble firing a long gun.29 In a death by a long gun, the victim’s arm reach should be measured and compared with the shotgun or rifle’s trigger to barrel end length. The investigator should look for a ruler or pencil, or similar object, used to fire the trigger. The victim would have most likely been seated, and would have braced the stock of the gun against a stable object. Victims rarely fire through their clothing to kill themselves. The most common manner in using a handgun is to fire into the right temple, the mouth, or, thirdly, the heart.30

Suicide by carbon monoxide or pharmacological poisoning is the result of a desire for a painless death, but, once again, is not a prima facie indicator of suicide. In carbon monoxide suicides in garages, the victims have often locked all doors leading into the garage, to prevent interruption of the suicide attempt. Knowledge of the danger of prescription drug abuse should be looked for. Poisoning will be found more often in female suicides, just as suicide by firearms and hanging is more common in males.31 Also, more women commit suicide by jumping than men.32

3. History of Previous Attempts. The investigator should look for evidence of previous suicide attempts. Signs are not always present on the body or at the death scene, but may be discovered through subsequent interviews of family or friends. A gross examination of the corpse would have revealed hesitation marks in incised wounds of the throat or arms, indicating previous suicide attempts. In a firearm death, misfired cartridges may be found. In the suspicious suicide by barbiturate poisoning, the investigator should look for a history of doses exceeding the prescription amounts. Further investigation into the decedent’s medical history may reveal an unknown suicide attempt aborted by the subject’s sudden change of heart, and a voluntary admission into a medical emergency facility. Most states do not have laws requiring the reporting of suicide attempts.

4. Physical and Mental Status, or the Psychological Autopsy. Perhaps the most important element to establish suicide ideation, or motive, is the victim’s mental state at the time of death. Analysis into suicide victims’ medical and psychological histories has shown that virtually all of them suffered from some form of emotional depression. In fact, mental disturbance is the chief cause of suicide, and most of these suicides also abused alcohol or drugs.33 The combination of mental distress and alcohol is a determining factor in establishing death by suicide. Intoxication at the time of death is not statistically inclusive of suicide. Likewise, the location of a wound and the type of weapon do not discriminate between homicide, suicide and accident.34

Some medical and psychiatric investigators have established a connection between suicide victims and visits to a medical doctor shortly before their attempted or completed suicide. In a majority of those cases, the patient’s risk of suicide was not diagnosed, and there was no increased use of medical services. However, a majority of suicide victims had seen a physician within a year of death.35 As noted earlier in this chapter, some these physicians unfortunately provide the final instrument of death in a prescribed medication, having failed do diagnose the suicide ideation in their patient.

The investigator should look for significant problems in the victim’s personal or professional life which would have contributed to mental distress. Financial upheavals and business failures are more contributory factors than marital discord, or other matters of the heart. Certain occupations exhibit higher incidents of suicides, such as the legal and medical professions. In some major cities, police officers are at high risk of suicide ideation.36 The investigator should search for factual evidence in these situations, and not rely on opinion and heresay derived from interviews.37

Since my original research in the early 1990s, the suicide rate in the U.S. continues to rise, by nearly 30% since 1999 according to recent news stories. Demographic statistics in suicide deaths are easier to come by than establishing suicide ideation in an individual before he or she actually acts on the impulse. As noted in my article on equivocal death investigations, the most important element in determining suicide is to establish the victim’s intent, which is the culmination of their ideation. Counselors to a suicide victim’s loved ones will emphasize that the family is not at fault for the drastic action taken by the victim. Yet the truth is that many such deaths could have been averted had the family and friends been more alert for obvious signs of suicide ideation. The same holds true for the victim’s physician, psychiatrist, or mental health worker. Often, an equivocal death investigation will establish that the victim had indeed displayed signs of suicide ideation, especially in the last few weeks and days before the final act.

Much has been written about the death of Kate Spade and her struggles with depression over the years. To date, nothing has emerged about Anthony Bourdain suffering from any mental illness or displaying any signs of suicide ideation. Authorities thus far have discounted any signs of violence at the death scene, but a final determination will depend on a thorough investigation.

No matter the outcome of an investigation into a suspected suicide, the decedent’s family and friends will still feel the loss of their loved one, but, in the search for the truth, perhaps further wrongs will be undone and lessons learned by all involved.

When you need a legal investigation to eliminate doubt in a suspicious suicide, contact the professionals at Trace Investigations at 800-310-8857.

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Endnotes from “The Four Elements …” in the article “Suicide Determination …” referenced above:

26 Lisa Cooper-Patrick, Rosa Crum and Daniel E. Ford, Identifying Suicidal Ideation in General Medical Patients, The Journal of the American Medical Association, Dec. 14, 1994, Vol. 272, No. 22, p. 1757.

27 Elizabeth Royte, They Seemed So Normal, Health, Nov-Dec 1994, Vol. 8, No. 7, p. 76.

28 Centers for Disease Control and Prevention, Suicide Among Children, Adolescents, and Young Adults, The Journal of the American Medical Association, August 9, 1995, Vol. 274, No.6, p. 451.

29 Anthony M. Golec, CLI, Techniques of Legal Investigation, Third Edition, Illinois, Charles C. Thomas Publisher, 1995.

30 Golec, op. cit.

31 Charles R. O’Hara and Gregory L. O’Hara, Fundamentals of Criminal Investigation, Sixth Edition, Illinois, Charles C. Thomas Publisher, 1994, p. 557.

32 Royte, op. cit.

33 O’Hara, op. cit.

34 R.E. Litman, Five Hundred Psychological Autopsies, The Journal of Forensic Science, May 1989, Vol. 34, pp. 638-646; Mark L. Rosenburg, M.D., Operational Criteria for the Determination of Suicide, The Journal of Forensic Science, November 1988, Vol. 33, pp. 1445-1456.

35 Cooper-Patrick, op. cit.

36 Nancy Gibbs, Officers on the Edge, Time, September 26, 1994, Vol. 144, No. 13, p. 62.

37 O’Hara, op. cit.