Tyler Clementi killed himself in 2010 after his roommate at Rutgers University filmed him kissing another man. Phoebe Prince, a 15-year-old girl who moved to the U.S. from Ireland, killed herself the same year after being bullied by high school classmates in Massachusetts. Fifteen-year-old Amanda Cummings from Staten Island made headlines early this January when her family said that relentless bullying was to blame for her suicide.
Each of these tragedies mobilized a cultural army of anti-bullying advocates, celebrities, the media and policymakers who have said -- or at least strongly implied -- that bullying can lead to suicide.
But mental health professionals and those who work in suicide prevention say bullying-related suicides that reach the spotlight are painted far too simplistically. Bullying and suicide can indeed be connected, though the relationship between the two is much more complicated than a tabloid headline might suggest. To imply clear-cut lines of cause and effect, many experts maintain, is misleading and potentially damaging as it ignores key underlying mental health issues, such as depression and anxiety.
"Bullying is so at the top of our consciousness that we're bending over backwards to get it into the story," said Ann Haas, a senior project specialist with the American Foundation for Suicide Prevention. "Years and years of research has taught us that the overwhelming number of people who die by suicide had a diagnosable mental disorder at the time of their death."
Haas argues that failing to look at the other contributing factors, from depression to family life to the ending of a relationship, is problematic and even perilous from a suicide prevention standpoint. "I am very concerned about the narrative that these stories collectively are writing, which is that suicide is a normal, understandable response to this terrible [bullying] behavior," said Haas. "In suicide prevention, we tend to favor the explanation that there are multiple causes."
Lidia Bernik, an associate project director with National Suicide Prevention Lifeline, said that people often seek a simple explanation when something as difficult to understand as suicide occurs. "I speak from personal experience," she said. "I lost my sister to suicide. You're left with, 'Why did this happen?'"
Bullying can offer an answer, she said: "It's almost easier to understand -- someone was victimized, and then they killed themselves."
Nicole Cardarelli, 27, who works in state advocacy outreach for the American Foundation for Suicide Prevention, admits that for years after her brother Greg's suicide in 2004, she also blamed bullying. While in high school, Greg began what he thought was a relationship with a girl he met online in a Ford Thunderbird car club. It turned out that two of his friends were behind the fake account. After several months, the boys exposed the prank to Greg. Hours later, he killed himself. His family opted not to press charges but they couldn't help placing blame when Greg had named what the boys did in his suicide note as the reason he could no longer go on living.
"If you had asked me after Greg died what I wanted to have happen, I probably would have said I want to kill those boys," said Cardarelli. "It's so much harder to look at the person you loved so much and ask, what was going on inside him?"
At the time, Cardarelli didn't see the signs that Greg was troubled, she recalled. But in the subsequent years, she has thought about his behavior a few months before he died. He had lost interest in baseball and Boy Scouts -- two activities he'd been involved with for years. He was sleeping more than usual, pulling away from his family and spending a lot of time on his computer. Cardarelli even remembers a conversation where her mother told her she thought there might be something really wrong with Greg.
"I believe that he was depressed," she said recently.
Just as that suicide may have been more complicated than Cardarelli initially thought, several high-profile cases have exhibited similar, deeper patterns upon further investigation.
Emily Bazelon's 2010 article for Slate exploring the suicide of Phoebe Prince, the teen from Ireland, serves as a powerful example of what can be learned when a suicide is examined more closely. There's no doubt that Prince endured cruel treatment from a group of classmates, but Bazelon reported that Prince had attempted suicide in the past, that she'd gone off antidepressants, and that she frequently cut herself. (In December, Bazelon followed up on the Prince case by reporting that Prince's family members had reached a settlement with the town of South Hadley, Mass., for $225,000.)
The death of Staten Island teen Amanda Cummings, whose family primarily blamed bullying for her death, is proving to be less straight-forward as well. The NYPD has yet to find any evidence of bullying, and she was reportedly devastated over the end of a relationship with an older boy.
Last week, the New Yorker revisited the Clementi case at Rutgers from 2010 and offered a more nuanced view of the tragedy. News stories initially reported that Clementi was outed by his roommate, and that the video of him with another man was posted to the Internet, neither of which is true.
According to the New Yorker, Clementi came out to family members three days before he started at Rutgers -- he told a friend his mother didn't respond well -- and he attended a meeting of the school's Bisexual, Gay, and Lesbian Alliance. Documents found on Clementi's computer, the piece reported, were titled "sorry" and "Why is everything so painful." He had told a friend, "I would consider myself out if only there was someone for me to come out to." His roommate's actions were reprehensible, and they may have contributed to Clementi's death, but these new details suggest the possibility of a far more complex situation.
Even though suicides often prove to involve multiple factors, most experts are still quick to add that bullying can aggravate depression and increase suicide risk, and its seriousness shouldn't be minimized.
Clayton Cook, a professor of educational psychology at the University of Washington, argues that because mental health issues are often a common thread running through bullying and suicide, schools should not have a narrowly-focused solution.
"The idea is that if you adopt a broad spectrum approach to preventing mental health problems, that you're also going to reduce the bullying," said Cook. "If you look at the scientific literature, bullying prevention programs haven't shown to be effective. It's addressing the symptom and not the cause." Cook suggests teachers adopt a social emotional learning curriculum as they would a reading curriculum. "We'd teach kids how to exhibit care and concern for others, how to manage their emotions before they get the best of them," Cook explained.
The good news, according to Cook, is that the prevalence of bullying has likely been overstated. Catherine Bradshaw, deputy director of the Center for the Prevention of Youth Violence at Johns Hopkins, agrees. "We don't have data to show that bullying is an epidemic or that it's increasing," she said.
The Centers for Disease Control's bullying task force, of which Cook and Bradshaw are members, is working to establish a uniform definition of bullying for research purposes, but results may not be available until this summer. The task force is treating bullying as a public health concern and developing policy-based solutions.
As far as the prevalence of youth suicide goes, the most recent numbers from the CDC show that, among 15 to 19 year-olds, suicides fell marginally from 8.02 per 100,000 in 2000 to 7.79 per 100,00 in 2009. Those numbers have fluctuated in the years between though, and the 10-year low was in 2007.
"We don't know about 2009 to 2011," said Madelyn Gould, a professor of clinical epidemiology in psychiatry at Columbia who studies youth suicide and prevention efforts. "But probably, the accessibility of the Internet has made it such that there are many more stories about suicide, not necessarily more suicides." Since January of 2010, the words bullying and suicide have appeared together in 592 articles -- and that's only print newspapers.
"I would just hope that these stories also talk about the other risks involved with suicidal behavior," said Gould. "If someone is being bullied, they should not jump to the conclusion that one of [their] options is suicide. What they should jump to is, one of the options I have is to get help."
Megan Meier killed herself in 2006 after a cruel MySpace prank orchestrated by an adult neighbor. Her mother, Tina Meier, argues that the pros of linking bullying and suicide still outweigh the cons. "I think since Megan's story there has been a lot more awareness," she explained. "Before, everybody was kind of like, 'Okay, well kids get bullied and we'll deal with it.' We didn't realize the impact that it truly has."
Young people may not be able to avoid exposure to bullying or suicide, but David Litts, an associate director with the Suicide Prevention Resource Center, said parents should take these tragic stories as an opportunity to talk to their children, especially if already concerned.
"You really need to open up the dialogue in a way that he or she can risk being honest," said Litts. "To look someone in the eye and say, 'Yes, I want to kill myself,' is a hard thing to do. So it's important that whoever asks the question asks it in a way that conveys they're ready to hear an honest answer."