Suicide Investigation

Here I will try to discuss Suicide Investigation Using the Psychological Autopsy Method which is a scientific method used to understand the cause of death by suspected suicide. Psychological autopsy is performed by a forensic behaviorist or psychiatrist by collecting retrospective information about victims who are thought to have died from suicide.

Historical data is taken from family, relatives or close people, as well as from doctors or medical experts who provide care in the last period of a person's life. The purpose of a psychological autopsy is to obtain an overview of the life situation, personality, mental health conditions and health services that the victim has accessed before the end of his life.

Psychological autopsy has been used as a standard examination of sudden death cases suspected to be caused by suicide in various countries.

The hope, with a psychological autopsy examination, can be known what and how so that someone decides to end his own life.

In the legal process, psychological autopsy is included in the investigation process. The investigation process aims to find out whether a criminal act has occurred (whether there is a violation of legal norms).

Psychological autopsy began to be included in the process of systematic investigation for the first time in 1956-1957, in order to understand the causes of One Hundred Thirty Four suicides in St. Petersburg. Louis, United States.

Since that time, psychological autopsy procedures have been used to determine whether the victim died by suicide or from other causes (for example: a murder that looks like suicide, or an accident).

In general, the results of a psychological autopsy are thought to be helpful in understanding why someone commits suicide.

About psychological autopsy procedures

In general, psychological autopsy has two main procedures:

• In depth interviews with the victim's family or relatives and closest people.

• Gather medical, psychological, psychiatric information or history and all information deemed important to explain the victim's life history.

Interviews with family and loved ones will usually be conducted after obtaining family approval.

The interview process will be guided by clinical interview standards which aim to:

• Understand the behavior patterns and daily life of the victim.

• The situation of the victim's relationship with his family or closest people.

• Whether there is use of addictive substances or alcohol

• Whether there have been previous suicide attempts and seeking help, or have communicated the idea of ​​ending life.

• Whether there were important events or stress before his death.

It is important to understand that this interview should be conducted with someone who really understands the victim, such as a boy or girlfriend or partner or close friend. Not always the nuclear family understands the victim deeply.

For example: sometimes the victim cannot open up to her parents, but is more open to her boy or girlfriend. Then the investigator needs to understand well, to whom he should conduct a psychological autopsy interview.

Interviews are conducted with due regard to ethics, that is, do not interfere with the family mourning period (interviews can be started about three to four months after death). Why is it necessary to appreciate the moment of grief? This is done with the assumption that families going through the grieving process will be better prepared to participate in the interview process. So, as a result, they will be more open and cooperative in providing information about the victims who died.

If you do not appreciate the grieving period, it is possible that the closest people will limit information more because they are unable to tell about the victim. Especially when it comes to information that seems negative about the deceased.

In some cultures, even relatives will refuse to speak ill of a deceased victim. This of course will affect the quality of the information to be collected.

Interviews with health workers (for example: doctors who have worked with them) also need to be conducted to determine whether there are problems or health and care needs that the victim has accessed at the end of his life.

From interviews with doctors, psychiatrists, psychologists or other health professionals, it will also get a picture of what pressure or stress he is facing, and how the stress impacts on the functioning of his daily life at the end of the victim's life.

Psychological autopsy is performed by a professional in the forensic field by exploring scientific behavior. The psychiatric or clinical psychology interview protocol will consist of comprehensive objective questions and in depth extracting of qualitative information.

The number of informants must be doubled to obtain complete information about the victim's history until the end of his life. In addition, psychological autopsy investigations should also be carried out by several experts (ideally more than two people), to carry out an inter-investigator assessment analysis.

This is done to minimize subjective judgment bias. Psychological autopsies were considered stable or consistent when the investigator reached a sufficiently high level of agreement.

This means that the psychological autopsy process to understand what and how death occurs will take time. However, to reach an understanding and a bright spot of events, this is appropriate and important.

Maybe You Have Ever Asked Your Heart, Why Do People Commit Suicide?

From various research studies on the causes of suicide, it is known that there are two main causes of suicide.

• Mood disorders

• Substance abuse related disorders

Both are psychological disorders syndromes that reduce the ability of humans to try to solve the problems they face in a solution so that they can finally give up and decide to end their lives.

The main cause of suicide was found to be due to depressive symptoms. About Ninety Percent of suicides are known to develop symptoms of depression late in life.

Apart from depression, it was found that a number of suicide victims also exhibited symptoms of other psychological disorders, such as: bipolar disorder, schizophrenia, alcohol or substance abuse and personality disorders.

Psychological research has also found that if a person is found to have a depressive condition that is comorbid with substance use disorders, or a mood disorder with personality disorders (especially Borderline personality disorder), the risk of suicide is higher.

About suicide and depression messages

One of the information that will be explored in a psychological autopsy is whether or not a message indicating the intention to end his life has been conveyed by the victim to his closest people. This is known as a suicide message. Suicide messages can be in the form of writing, spoken words, or other notes and symbols.

In some cases, it was found that the victim was preparing to leave. Some write messages, and others set up a series of detachment processes (dress well, go to a certain place, and prepare equipment).

However, some did not seem prepared to leave. There are even cases where the family does not have symptoms of depression, or the impression that they are about to commit suicide. This could happen because the victim still doubted his intention to end his life and finally decided to commit suicide.

It found that although the majority of suicides were found to be associated with depression, there were also suicides in which it was not clear whether the victim had depression or symptoms of a mental disorder (no psychiatric condition was found). It needs to be understood, in the psychological autopsy process, efforts will be made to diagnose mental disorders post mortem through reports from people closest to the victim.

Suicide without psychiatric symptoms is more common in Western non-cultural communities, for example in China or India. This is because the conception of depressive conditions or psychiatric symptoms can vary between cultures.

The way non-Western societies name and term depression differently, so that they report "depressive" symptoms (strong emotional nuances of sadness) is also different, even the way they seek help if they are "depressed" will also be different.

Consequently, understanding and reporting of psychiatric symptoms of depression in non-Western communities will not be the same as in Western communities. This means that psychological autopsy investigators must be sensitive. In exploring information about depressive symptoms or other psychiatric symptoms, it is best to use idioms or terms that are contextual to local culture and language.

This is to help families express the phenomena they see with their language and understanding. Not just using the term clinical diagnosis.

Suicide prevention

An understanding of the factors that cause suicide can actually be used to do prevention.

If someone has talked about suicidal ideation and, or has attempted suicide but failed. This needs to be anticipated if he will commit suicide again in the near future. At this stage, they will appear to be at high risk of committing suicide.

As a result, people who have attempted suicide have up to three hundred and seventy times the risk of being successful. Therefore, monitoring and supporting people who have committed suicide attempts is very important.

Women were found to be more likely to commit failed suicide attempts, while men were found to be more successful at committing suicide. Attempted suicide by women is actually a way to ask for help and attention, so women often choose methods that are less lethal ( Non lethal, such as cutting the arteries in their hands).

But when a man thinks of committing suicide, he will choose more lethal methods, so that his success is higher (lethal, for example stabbing the heart or other vital organs).

The causes of suicide over time are also contextual. In the adolescent population, suicide is often associated with risky personality patterns (closed attitudes and difficulty solving problems) and substance-alcohol abuse behavior.

In adults, it was found that the causes of stress that trigger suicide are associated with problems causing major depression, loss or unemployment, problems with marriage or intimate relationships or divorce, alcohol dependence, and the inability to solve life problems.

In several cases of adult male suicide it was found that the ability to commit suicide was triggered by violent behavior leading to the ability to tolerate pain and no longer fear death.

In the elderly, health problems, retirement and feelings of helplessness, as well as major depression will increase the risk of death from suicide.

Therefore, if we know that there is a risk of suicide in someone, then we need to provide intensive and supportive help to that person. Prevention occurs from the onset of depressive symptoms, before a suicide attempt or act is committed.

Increased risk of suicide due to drug interactions and psychological disorders

Various studies have found that the risk of suicide increases in people who experience psychological depression accompanied by substance abuse.

Alcohol use has long been known to be strongly linked to suicide. The nature of alcohol is a depressant, or it decreases brain activity, decreases awareness and judgment as a result of which a person affected by alcohol can make wrong decisions. The long-term impact of alcohol use is depression, which can also increase the risk of suicide.

Stimulant drug abuse can also be linked to suicide. Stimulants (for example: amphetamines, cocaine) will increase activity in the brain, and as a result people will become more excited, easily aroused, and overflow with excitement.

However, the negative effects of using stimulants will be felt when the effects of the drugs begin to wear off. Moods that are elevated due to substance use will drop to an extreme which can lead to pronounced mood swings and even the individual can feel like he is losing self-control and helpless.

And if the stimulant drug is used incorrectly or not under the supervision of a psychiatrist and is administered by a person who is clinically depressed, the effect can be devastating because it will worsen the state of depression. This can lead to death by suicide.

Conclusion

From various studies conducted in the world, it is known that the main risk of death from suicide is depression as a mood disorder. So, in a psychological autopsy a history will be extracted whether the victim committed suicide or experienced depression at the end of his life.

In addition, various psychological and social factors will be explored to explain why at that time in his life a person decides to end his life.

However, if no definitive explanation for the death due to suicide cannot be found, it is necessary to seek explanations for other causes of death.

The explanation of death is important to understand. Not only to fulfill the legal process, but also because it becomes a need for understanding and acceptance for the family left behind.

Sorry if my writing is too long, because when writing sometimes forgets everything. Hopefully useful and add knowledge for readers.