Language is important, essential to everyday living. For instance, if I tell you that I worked today, would you know what I meant? It could mean that I worked by deep cleaning my refrigerator, or maybe that I worked on detangling my little girl’s extra curly hair (which is hard labor if you ask me), or that I worked 8 hours on my job writing this blog and working on an upcoming presentation. Our word choices matter as we communicate to others. In the context of suicide prevention, language can mean life or death. With the potential for such dire consequences, how we speak about suicide is critical. Even as a trained subject matter expert in suicide prevention, I catch myself sometimes using outdated, and often times stigmatizing language. We all make these errors. Common examples include: “my friend committed suicide,” “it was a successful suicide,” or “it was a failed suicide attempt.” What I want to suggest today is that as a society we be more intentional and mindful in shifting our language when talking about suicide. By using national recommended language, we can work towards destigmatizing suicide.
So, let’s start by recommending language to discontinue…
Committed Suicide: This suicide-related phrase is probably the most frequently used that is not recommended. When looking at the origins of the phrase, the word “committed” is used in a legal context and implies criminal intent. For example, a person commits murder, burglary, or another crime. To say a person committed suicide suggests suicide is a crime and stigmatizes those who struggle with suicidal thoughts or attempt suicide. Since this stigma contributes to deterring people from seeking help for suicidal thoughts and behaviors, it has a negative impact on suicide prevention work.
Successful suicide: Both of these terms suggest a desired outcome was achieved, which goes against the suicide prevention aim to keep people alive. This language reflects a positive impression of dying. This can have negative implications for a person with suicidal thoughts and behaviors, so we avoid using this language.
Failed Attempt: The problem with this language is that it sounds like failure to achieve a desired outcome. People with suicidal thoughts and behaviors often may also struggle with self-esteem issues and view themselves as failures. A suicide attempt not resulting in death could be internalized as another “failure” adding more fuel to this fire. Further, for mental health providers, it is important not to use such language in documentation too, as patients readily gain access to their medical record and may perceive that the provider shares the patient’s own belief of being a failure.
Additionally, there are a few additional terms to avoid because they are either confusing or too ambiguous.
Suicidality: When used as to talk about the topic of suicide broadly, the term suicidality is appropriate. However, frequently it is used clinically to refer to both suicidal thoughts and behavior, this term is too ambiguous. I think we can all agree that suicidal thoughts and behaviors are vastly different, so to use the term suicidality interchangeably for thoughts and behaviors is confusing and unclear.
Parasuicidal: A term that was introduced by Dr. Marsha Linehan as part of Dialectical Behavior Therapy, this term is often used in both research and clinical applications. It was used to describe all non-fatal suicide behaviors regardless of intent to die. As such, the use of the term was confusing, which led the World Health Organization to now recommend against using it.
Suicide gesture: When using the phrase suicide gesture, there is often a sense that the behavior was a threat or manipulative act. Embedded within this is a value judgment with a pejorative or negative impression of the person’s intent. Typically, the phrase is used to describe an episode of nonfatal, self-directed violence. A more objective description of this would be non-suicidal self-directed violence or suicidal self-directed violence.
So, if we move away from these common terms when talking about suicide, what language should we use? Generally, using specific, descriptive, non-judgmental language to describe suicidal thoughts and behaviors is preferred. Commonly recommended words or phrases include:
As I mentioned earlier, we all slip and use language that I’ve suggested we discontinue when talking about suicide. Many of these terms were used in our training experiences or are so ingrained in our culture that it’s challenging to catch and correct it. However, with attention and focus, we can shift our language away from outdated language and begin utilizing the new recommended ways of communicating about suicide. I want to leave you with recommended resources from the Rocky Mountain MIRECC for Suicide Prevention, which can be an invaluable tool as you continue to refine your suicide prevention language, https://www.mirecc.va.gov/visn19/education/nomenclature.asp.
The opinions in CDP Staff Perspective blogs are solely those of the author and do not necessarily reflect the opinion of the Uniformed Services University of the Health Science or the Department of Defense.
Erin Frick, Psy.D., is a clinical psychologist and Military Behavioral Health Psychogist with the Center for Deployment Psychology (CDP) at the Uniformed Services University of the Health Sciences in Bethesda, Maryland.