Kathy Book wrote goodbye notes to her husband, son and daughter last December 14, then walked behind her New Jersey home, into the woods, intending to kill herself. She survived, thanks to quick thinking by her husband and local police.
(This story and accompanying podcast include extensive discussion of suicide. If you or someone you love is in crisis, call 9-8-8, a free hotline staffed by professionals who can provide immediate help.)
It’s never about the money. It’s about the violation, the emotional distress, the real-life financial consequences, the disorientation. Often, it’s also about lost love or friendship or dreams or trust — in others and in yourself. I’ve been writing about computer crime for decades, always stressing that we don’t do nearly enough to protect consumers and care for victims. I’ve pleaded with companies to take more responsibility for the damage done with the tools they’ve created; I’ve asked that society take more time to understand the real pain victims endure.
Now, this plea comes with much greater urgency.
Recently, I’ve heard from several credible places that the stakes are higher than ever. Internet crime is far more organized than ever; the cover stories and methods are much more sophisticated. More important, the consequences for victims are far more devastating. Many are left penniless and with few options. That’s why Kathy Book thought her best option was unburdening her family after she was manipulated into sending much of her family’s life savings to a criminal she met on Words with Friends.
It might sound like an exaggeration that desperate scam victims are increasingly attempting suicide; I’m not the only one to come to this conclusion. We don’t have solid data on scam-driven suicide attempts, but by the time we get that data, it will be too late for many families. There are enough anecdotes to sound the alarm. I’m grateful AARP has let us take on this very sensitive subject in a two-part series for The Perfect Scam podcast.
Kathy Book is a survivor. I think you’ll be inspired by her journey back from the darkest of places. The podcast ends with a family celebration, a party to mark her 50th wedding anniversary — a party she almost missed. I think it’s worth listening to this episode just to hear Kathy read the daily affirmations she uses to overcome her feelings of doubt and dread. But the episode also includes extensive, specific suggestions from experts for loved ones who might find themselves near a person contemplating self-harm. Most of that advice I’ve included in the excerpt below, but I’d like to highlight a few things.
First off, financial distress is one potential risk factor for suicide. So anyone who is the victim of a scam, particularly one that throws their financial future into doubt, is at risk.
Second, it’s ok to ask someone you love if they have considered suicide. Decades of research shows that question won’t give someone an idea they hadn’t already contemplated. On the other hand, the question can open the door to getting a person the right help at just the right time. It’s a scary question to ask, but it can also be heroic.
Also, while much (worthy) attention is devoted to suicide among youths, older adults are actually at a higher risk of committing suicide. The most at-risk group is men over 85 years old. So what you think you know about suicide might not be accurate.
You can listen to both episodes of this podcast by clicking play below, or by visiting the episode website, or by subscribing to The Perfect Scam in your favorite podcast tool. Also below, I’ve pasted most of the advice I heard from Jonathan Singer, a professor at Loyola University-Chicago and past president of the American Association of Suicidology.
[00:07:56] Jonathan Singer: Okay, so some of the classic warning signs for suicide risk, include disconnecting from people socially, and that might mean these days deactivating social media accounts. It could mean not hanging out with people that you would normally hang out with. Other warning signs include difficulty sleeping, either sleeping more than usual or less than usual, and again I realize that, you know, people at different stages of their life can have difficulty sleeping, so that in and of itself is not necessarily a standalone warning sign. But if you hear people saying things like, you know I, I’ve really screwed up, and I think that, you know, people would be better off if, if I weren’t alive, or if I weren’t here.
[00:08:43] Bob: Context matters and careful listening can help. But most of us aren’t suicide experts, so it’s important not to leap to conclusions either way.
[00:08:52] Jonathan Singer: I think kind of a knee-jerk reaction for most people is to not take that seriously and to say, no, what are you talking about? We, like we love you. Like of course we, of course you belong, right? And not, and not hear it as a suicidal statement. And then if you have signs of depression, you know, again the, the sense of hopelessness, the sadness, the blunted affect, right, it’s a, it should be a really happy experience and it doesn’t seem like the person is able to enjoy it. When, when you start to have all of these things happening together, right, somebody saying, “I feel like nobody would care if I lived or died,” or somebody, or people would be better off if I were dead, and I haven’t been sleeping well, and you know, I know that I’ve been going bowling with these folks for years, but I’ve stopped going, and it’s really hard for me to find joy even in the little things, right. When you have all of those things together, those are signals that something is going on that is likely part of this person’s thoughts about wanting to kill themselves. So another risk factor, particularly for adults, is either starting to drink or use drugs that they ordinarily wouldn’t use in quantities they wouldn’t use, or to start up for the first time. What we know is that people are more likely to report thoughts of suicide and attempt suicide when under the influence, and that they are more likely to make a more lethal attempt when they are under the influence than, than when they’re not.
[00:10:36] Bob: And so it’s important that all of us learn how to pick up on signs that something is really wrong.
[00:10:43] Jonathan Singer: So it can be hard to see the signs, but we do know that a, a fair number of people indicate this sense of hopelessness or this sense of burdensomeness, that they will share things and if you know what to listen for, it’s easier to recognize it. Again, any one of the things that I mentioned, it could just be a Wednesday, right? You know it’s like, oh, so and so had too much to drink tonight. Fair enough. Somebody isn’t getting a lot of sleep. Okay, fine. But when you start pulling these things together, especially when people are giving away possessions, when they’re shoring up their will, when they are disconnecting from others, you know, and they’re doing those sorts of things then that’s when you stop and you say, wait a minute. I wonder if this person is having thoughts of ending their life.
[00:11:36] Bob: Perhaps one day you’ll arrive at a moment when you worry someone you care about is at risk. But you don’t know what to do. That’s natural. You might even be afraid to bring up the subject that you might do more harm than good. That’s only natural too.
[00:11:50] Jonathan Singer: And that’s the point where folks get really scared to ask the question, because they’re worried that by asking the question, they’re going to put the idea into someone’s head. And what we know from research, and what we know from clinical experience, is that that’s not true. You can’t make somebody suicidal by asking them the question, having you been having thoughts of killing yourself?
[00:12:14] Bob: That seems like a really important piece of information. So I’m going to ask you to talk a little bit more about that. So there’s actually research that shows just asking a simple question, are you having suicidal thoughts, can’t do any harm.
[00:12:30] Jonathan Singer: That’s right. That’s right. So there’s been a lot of research over almost the last 20 years that demonstrates that asking the question, are you thinking of killing yourself, are you having thoughts of suicide, not only does it not increase suicide risk for those who are currently suicidal, it actually results in, in people feeling less distress, right. There, there’s actually a therapeutic value in someone asking the question, and for folks that aren’t suicidal, there is no evidence to suggest that someone asking that question actually increases suicide risk.
[00:13:14] Bob: So for example, say someone you love has been the victim of a scam and you know they’re taking it very hard. You can have a heart-to-heart with the victim about how they’re feeling, and you can feel free to ask about suicidal thoughts if you are worried about that.
[00:13:29] Jonathan Singer: If somebody, if you say, hey, so, I, I just found out about what happened with you and your life savings, and it sounds awful, and I understand how upset you are, and, and I’m just wondering if with all that’s going on, have you been having thoughts of ending your life? And they say to me, uh, no. No. I have my grandkids, and I have this, and I’m miserable but I, I, I wouldn’t do that. The worst-case scenario is that they will know that you care enough to ask the question that most people are terrified to ask. They say, well, you know, nobody’s actually asked me that, but and I’m embarrassed to say this, but yeah, I have been having these thoughts and it scares me, because it’ll be three in the morning and I’m laying in bed, and I just can’t help but think that I’ve so screwed this up that people would probably be better off if I were dead. And then you have the conversation.
[00:14:32] Bob: It strikes me that very well-intentioned people might think to themselves, I don’t want to offend someone, or my, my brother is going to hate me if I ask this question, right? That’s not, that’s not going to happen, right?
[00:14:43] Jonathan Singer: Well, I, I can’t say that nobody will be offended by that question. But what I would say is that it’s better to have someone that you care about mad at you for a short period of time, than for that person to be dead.
[00:15:01] Bob: It’s only natural to be afraid of where a conversation like this might take you. Most of us aren’t trained social workers, and so it can be scary to talk with someone about deep feelings or suicide, but there are some pretty specific steps you can take, and Dr. Singer is happy to walk us through those.
[00:15:20] Jonathan Singer: And at the end of the day, when a loved one asks somebody they care about if they are thinking of suicide, and they get an affirmative answer, right, then that is the time when. if you don’t have training in this, right, if this is, if you don’t happen to be volunteering on a crisis line or you’re, you’re not already a healthcare professional or a counselor in your, in your personal life, that’s when you start to reach out to others who can have this conversation and, and, and dive in in a way that it might be really difficult for you as the grandson or the, the husband or the, the daughter to do this.
[00:16:09] Bob: Okay, so let’s say the answer is what you described, I just can’t seem to get these thoughts out of my head. Well what is the next step someone should take?
[00:16:18] Jonathan Singer: So if you find out that somebody you love is suicidal, there are a couple of things you can do. Number one, you can ask a couple more questions like, “Have you thought about how you’re going to do it?” Right, which is kind of the generic way of saying, do you have a plan? And if they say yes, then you, then you can, you can ask the question, do you know when you’re going to do it? And if they’re, and if they say, you know, I’m going to do it pretty soon, then you can make a decision about kind of how urgent it is. And so for, for all of these scenarios, one option is always to call 988. 988 is the suicide and crisis lifeline. It used to be a longer number, and it used to be an 800-number, but it’s now 988. And 24/7 all across the country in Spanish and in English, you have people that are trained to talk to folks about suicidal thoughts. So that would be an immediate thing to do, right, is to say, hey, I would love it if you spoke with somebody at the crisis line. Now the crisis line is not 911, right, the crisis line is not a dispatch service that’s going to send out the police or EMS. In very rare cases where somebody is actively attempting suicide, there might be a dispatch to go intervene, what’s called an active rescue. But 98% of the time it’s a phone call to somebody who is trained to be able to talk about that. Now another option is if the person has a primary care provider, may–, maybe they’re already seeing a therapist, right, maybe they’ve got a psychiatrist, would be to make a call immediately to that person, day or night, and try and speak with that person, or at least set up an appointment for the next day so that they could get in and talk with a professional. Now if they don’t have one, or if they, for, and there are lots of reasons why people don’t want to talk to medical professionals or mental health professionals, if they’re part of a faith community, and you know that their faith leader would be open to talking about that and not sort of engage in some sort of like theologically-based shaming, then I would encourage them to speak with that person, right.
[00:18:41] Bob: Getting that person into a conversation with a professional as soon as possible is key and should be your top priority.
[00:18:49] Jonathan Singer: One of the things that we know about the sense of being in a dark tunnel with no way out, is that that in and of itself can become a self-fulfilling prophesy, but the minute you, you talk about it, you start to open up the light, right. You start to have possibility come into the conversation to where something that seemed overwhelming half an hour ago, now doesn’t seem overwhelming, and maybe in an hour from now there’s actually some hope. And so that’s what you’re going for.
[00:19:24] Bob: Are there a couple of mechanical tips like it, let’s say the person says, “I have thought about how. I do think I might do it soon,” I mean do you like grab your cellphone and dial 988 and hand it to the person?
[00:19:36] Jonathan Singer: So if you’re sitting next to somebody and they’re saying, yeah, I’ve actually been thinking about how I might end my life, and you know, I know how to do it, and I was actually thinking about doing it sometime this weekend. I mean what I would, what I would say in that moment is, “It sounds like you are, you’re thinking that, that you and everybody else will be better off if you are dead. And I just, you know, I don’t say this to guilt you or shame you, but I would be devastated if you weren’t here. And I know lots of people that it would change their life for the worse. And I would love for you to be able to talk to somebody about what’s going on. Would it be okay if I called the crisis line right now? And we can be on the phone together, you can be on the phone by yourself, I just feel like we really need to have some support here.”
[00:20:29] Bob: If you feel like the person is in immediate physical danger, and that person refuses to talk to someone to get help, say they won’t call 988, then calling 911 is an option.
[00:20:41] Jonathan Singer: Now, and if they say no, and you feel like they are actively going to do something to end their life, nobody, nobody can make you, at this point, intervene, but a last case scenario would be to contact 911 and to let them know, I’m worried that my grandmother is going to end her life. She told me that she knows how to end her life. That she’s been looking up ways on the internet to do it. And, and then when we were on the phone, she hung up. She lives at this address. Can you go do a welfare check? Right, and so that is, that is a way to activate our emergency services to go out and intervene. Again, this is something that is a very last case scenario, right, and one of the reasons is because when emergency services intervenes, they’re either looking typically for a medical emergency, and if the police are involved, then behavioral crises turn into legal crises, and that can be problematic on multiple levels.
[00:21:46] Bob: In some limited cases, 988 operators have the ability to conduct welfare checks now.
[00:21:53] Jonathan Singer: They’re still building out capacity, but there are many crisis centers that have mobile outreach, so for example Behavioral Health Response in St. Louis has a, a crisis call center and they have masters’ level trained social workers, counselors, who are part of mobile crisis response, and they go out and they are the ones to do the, the home visits. And again, only in the most rare circumstances is there the need for law enforcement.
[00:22:27] Bob: It’s quite possible that you might get a more nuanced or vague answer to the suicide question, however. Here’s what to do in that case.
[00:22:36] Jonathan Singer: So if somebody says, “Yeah, I’ve been having thoughts of suicide, but I don’t have a plan,” then at that point, you know, there’s a little bit more time and one of the things that’s helpful is to, if possible, you can get them into therapy, which I know can be challenging, because therapy costs money, and if part of the issues is finances, then you’ve got to figure out how to pay for that, but one of the things that you would do in therapy would be to help support the person in some problem-solving, if there are distorted thoughts about how they’ve ruined lives, if there are ways in which they feel like they have broken people’s trust, relationships, then therapists are trained to address that. And so what they’re doing is they’re addressing the things that surround the suicidal thoughts with the idea being that if you’re able to say, yes, I, I did something that hurt others, and at the same time, I matter to others, right, being able to hold those two ideas in your mind at the same time can be really difficult to do on your own, and so having a therapist who can help, help get to that point can be really invaluable and life affirming.
[00:23:49] Bob: Life affirming like Kathy’s affirmation cards.
[00:23:53] Jonathan Singer: Affirmations, the idea behind them is that over time you, you, you start to say something that directly challenges a core belief that you might have. Like let’s say your core belief is I’m a failure. Or nobody loves me. Or I’m unlovable. Or I’m, I, I can’t trust myself. Nobody should trust me, right? So let’s say those are some core beliefs. If you have very specific affirmations that are things like even though I’m not perfect, I matter to people. Or every day I can make choices that will benefit me and others. Right, so you, so you do things that sort of directly counter these, what some people would call negative core beliefs. And in doing so, over time it might seem silly, but for some people they actually start to change these core beliefs that they have about themselves, and, and start to replace them with core beliefs that would not lend themselves to suicide, or suicidal thoughts.
[00:25:07] Bob: There’s been a lot of research about suicide over the past several decades which has filled out our understanding of who is most at risk. We mentioned last episode that men over 85 are at the highest risk, which might be a surprise to many of you, it surprised me. But some other risk factors might also be a surprise.
[00:25:27] Jonathan Singer: So youth suicide, when we talk about youth suicide in the news, we’re usually talking about 15 to 24. And so suicide for that age group, in general, it’s the second leading cause of death for adolescents. And so we hear a lot about how suicide is one of the biggest killers in adolescents. But that’s because adolescents don’t die by other things, right? Adults tend to attempt suicide and die by suicide more often than adolescents, in part, because physically it’s much easier for them to die. Suicide is also lower on the list of leading causes of death for adults, because they die by other things; cancer, heart disease, strokes, etc., etc. So this is why when I talk about deaths by suicide, yes, suicide is the second leading cause of death for adolescents, but the suicide rate, right, the number of people who died by suicide per 100,000, is about three times as high for older adults as it is for adolescents.
[00:26:37] Bob: Also it might be surprising to learn about the role of gender in suicide risk.
[00:26:42] Jonathan Singer: So I think one of the things that’s important is when we think about suicide and adults, oftentimes we have this sort of stereotypical image of the white man. And what’s true is that numerically white men are more likely to die by suicide than any other group. So for example, in 2021, almost 70% of suicide deaths were white males. It’s much less common for women to die by suicide, even though women are more likely to attempt suicide. And you know without getting into some of the ways that race and uh ethnicity and gender identity and, and rural or urban play into this, if we’re just talking about kind of the, these basic stats, I think it’s important to recognize that oftentimes we don’t think about suicide risk in women. And that is problematic, because we can see women engaging in what are sort of, sort of gender stereotypes of being emotional about being maybe depressed, or maybe being sad, or getting angry, right, so that, sort of the emotionality and not think about is this connected to suicidal thoughts? And if, if we don’t remember that suicide is an equal opportunity killer, and that there is no group that is immune to suicide that, you know, we should always have in the back of our mind when we see somebody who’s really struggling, the option of asking them if they’re having thoughts of suicide. As scary as that can be.
[00:28:36] Bob: For someone who has been in crisis but survived it, like Kathy, the experience lives on. And there is plenty of help for that group too.
[00:28:46] Jonathan Singer: So you have folks like Kevin Hines and, and Dese’Rae and Craig and Kevin, they’ve all talked about how, you know, speaking about their struggles with suicidal thoughts and their suicide attempts, this is something that they live with, they live with every day, right? And it’s like somebody who has been diagnosed with diabetes, right? They have to do things to keep themselves healthy. They have to do some things every day to manage these suicidal thoughts and so if, if you’re somebody who’s never had thoughts of suicide and you, you, you have a crisis, it’s possible that you might find that you don’t have thoughts of suicide anymore once the crisis goes away. But it’s possible that you might continue to have those thoughts, and you’re not alone. And it doesn’t mean that you’re somehow damaged or deficient, or that it’s going to be bad for the rest of your life. It just means this now something that needs to be part of your self-care, right, it’s part of your partnerships with others. Who, who do you talk to? How do you, how do you let folks know that you’re moving into a space where you’re thinking about suicide more than you were a couple of weeks ago, and what do they do, right? So this is the part where having that as part of your narrative and setting up supports is really important, and it’s what people do.