Teen Suicide and the Limits of Sociology

REVIEW: ‘Life under Pressure: The Social Roots of Youth Suicide and What to Do About Them’

March 3, 2024

"No one, it appears, was free to just parent as they wanted to parent—free of the web of social ties that both gave their lives meaning and set firm constraints around expected behaviors." This observation from a new book about the town of Poplar Grove—the fictional name for a real, wealthy community where there have been an unusually high number of teen suicides in the past decade—seems like it could be made of almost any community.

In Life Under Pressure: The Social Roots of Youth Suicide and What to Do About Them, authors Anna Mueller and Seth Abrutyn are interested in understanding what makes the sites of suicide clusters unique, but they continue to offer observations that only make these communities seem, well, human. It’s true that parents cannot parent any way they want to in Poplar Grove without being judged by their neighbors, but where has this not been true?

Mueller and Abrutyn, sociologists at Indiana University Bloomington and the University of British Columbia, respectively, are addressing a topic of increasing importance. In the United States, they note, "the youth suicide rate has increased significantly since 1999, and particularly since 2007. Today suicide is the second leading cause of death for youth ages 15 to 24 and the third for ages 10 to 14." Everyone is talking about the youth mental health crisis these days—and there is certainly an argument to be made that we are overdiagnosing young people—but how do we figure out which kids are actually going to harm themselves?

Unfortunately, there does not seem to be a clear line from a little bit of anxiety and depression to suicidality. As the authors note, "suicide is not necessarily caused by mental illness. … In reality, psychological pain combined with hopelessness is what’s fundamental." Still, there are many people who experience that mixture without actually killing themselves or trying to. And this is where the suicide cluster comes in. Between 2007 and 2015, Poplar Grove experienced 19 youth/young adult suicides. They began with an attempt by a young woman the authors refer to as "Alice" jumping off a bridge, but surviving. After that, one of her teammates jumped off a bridge and then another boy killed himself with a gun.

What creates these suicide clusters? The authors perform what they call a "social autopsy" to understand the phenomenon. First, they paint a picture of Poplar Grove that will be familiar to any middle- or upper-class family in America today. It is a small suburb with very little crime and very good schools. The kids "appeared to be the heart of Poplar Grove, its raison d’être." As one mother explained, "We’re here because our kids are here or we’re friends with you because our kids are friends."

The authors zero in on Poplar Grove’s racial and ethnic homogeneity as something that sets it apart, with 90 percent of its population being white non-Hispanic, despite being in a state that is racially diverse. The authors say they are not accusing the town of being racist, but note that people in their focus groups told them it was not easy to be non-white in Poplar Grove. The authors write that "what living in a homogeneous community does is amplify the importance of being a member of that community to community members. … While being surrounded by people like us facilitates the creation of wonderful social connectedness, it also amplified the importance of conformity, of fitting in." These are no doubt true, if rather banal, statements. But what do they have to do with suicide clusters? Were kids who were not white more likely to commit suicide? They don’t say, so one presumes not. Were other suicide clusters more likely to happen in homogeneous communities? They don’t say.

The authors make a similar point of describing the socioeconomic status of Poplar Grove residents. The average income was high, and kids whose families didn’t have resources sometimes felt badly about that. But were these kids any more likely to take their own lives? Did communities with less economic diversity see more suicide clusters? Who knows?

Later in the book, the authors suggest that "narrow cultural beliefs are painful for those who do not fit in." And they suggest that "narrow beliefs about acceptable forms of masculinity … are associated with greater risk of suicidality among men who see themselves as failing to perform the ‘right’ kind of manhood." Again, none of what happened in Poplar Grove seems relevant here. If there were any kids struggling with sexual identity issues among the dead they are not mentioned.

The picture that begins to emerge from the book is a sort of Stepford Wives, where if you’re not rich or white or straight you’re ostracized and this, in turn, is somehow leading to more psychological pain among residents. Maybe this is true, but the evidence is thin. Many communities are racially and economically homogeneous. People gravitate to live toward other people who seem like them. Especially in smaller towns, it would be rare to find the kind of diversity that the authors seem to have as their basis of comparison.

They are on more solid ground, though, when they describe the academic pressures of Poplar Grove and the impact these can have on children. Madison was one of the teens who talked to the authors about how the "mental health problems plaguing their peers stemmed from the community’s high-pressure atmosphere." The need to take a lot of AP classes, excel in sports, participate in other extracurricular activities took center stage. Her own parents, she complained, wouldn’t let her stay home from school when she didn’t feel well because "School comes first. You’re not going to get into vet school with C’s."

Many of the victims the authors describe seem to have it all—they perform at high levels, both academically and otherwise. They have plenty of friends and supportive families. Is keeping up this veneer of perfection what is causing them to attempt suicide? One concern the authors note is that when we talk about suicide as simply the result of too much stress and pressure, kids who are not suicidal might start to think of that as a solution.

Or maybe it’s not the stress itself but rather that having mental health challenges does not fit in with the high achieving culture and the fact that community members say there is a stigma against seeking help for feelings of hopelessness. In other words, it is not the academic pressure itself so much as the fact that kids who are struggling don’t feel they can admit it and even if they tell their parents, some of the parents are ashamed. I suspect this has probably changed significantly since the authors conducted their interviews between 2013 and 2016. Particularly since the pandemic, the conversation about youth mental health has reached a fever pitch and it’s hard to imagine that a significant percentage of the kids in Poplar Grove are currently not in therapy or on medication or both.

The underlying problem of kids’ psychological pain and sense of hopelessness is still there—even, and perhaps especially, in these high performing towns. But kids, historically, have been raised in much more stressful circumstances—poverty, war, abandonment seem like they would make suicide more likely than AP Physics. The problem is not the pressure per se. Tim Carney’s forthcoming Family Unfriendly and Jennifer Breheny Wallace’s Never Enough both delve into how children have simply become vehicles for parents’ ambitions.

Mueller and Abrutyn write that kids are the "moral center" of Poplar Grove. "Having a strong shared moral center transforms mundane rituals like dropping kids off at school or attending soccer practice, and spectacular events, like rival matchups and homecoming games, into opportunities to intensify the collective identity, the sense that we’re in this together." The question is "In what?" Kids and parents are often not sure why they are doing all this. The fact that churches and faith communities are mentioned only in passing suggests that one major way of finding meaning has largely been lost.

The authors mention churches in their advice toward the end of the book on "postventions," i.e., what communities should do in the wake of a suicide. "Because faith communities are often involved in memorialization and mourning rituals, they must be prepared to respond to suicide losses in evidence-informed ways." Here are institutions that have been known on occasion to help people find hope and understand how to wrestle with psychological pain, and sociologists manage to reduce them to a vehicle for evidence-based practices. Ugh.

Where do the authors think that postventions will be most successful? Schools, and public schools specifically. The authors say the idea that talking about suicide creates more of it is a "myth." They conclude that "what is not safe is role-modeling, in which media stories or personal experiences with peers communicate motives and methods—meaning they communicate the when, why, where, and how of attempted or accomplished suicide." This, though, is an awfully delicate balance. And if you have sat in on any kind of high school assembly recently or health class or seen some of the cringeworthy public service messages geared toward teens, you would rightly have doubts about the ability of teachers or school counselors to get this right. Indeed, a recent paper found that students who were exposed to more therapeutic exercises in school (social emotional learning) were more depressed, more anxious, and had more difficulty regulating their emotions.

In addition to more money for schools to accomplish this education, the authors suggest more "infrastructure funding" on the list of solutions. In addition to bridge barriers to prevent jumpers they also advocate that libraries could provide gun locks and medicine lockboxes. The result is a frustrating jumble of a book—the causes of the suicide cluster seem no more clear, and the solutions seem random as well. Maybe this is the nature of the topic. We will never know exactly why and the questions we are left with may better be answered by philosophy or theology than sociology.

Life under Pressure: The Social Roots of Youth Suicide and What to Do About Them
by Anna S. Mueller and Seth Abrutyn
Oxford University Press, 264 pp., $29.99

Naomi Schaefer Riley, a senior fellow at the American Enterprise Institute and the Independent Women's Forum, is the author of No Way to Treat a Child: How the Foster Care System, Family Courts, and Racial Activists Are Wrecking Young Lives.