Dilemmas in suicide’s aftermath: To disclose or not to disclose?

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In the days and weeks after my son Josh took his life, I was faced with several painful predicaments. How do I break the news, to family, friends, coworkers, neighbors? How deeply do I dig for the irrational why, in cellphone, laptop, autopsy report? How do I handle religious aggression and other boundary violations? How do I navigate a world newly full of triggers?

Over the next few weeks, I’ll address these dilemmas one at a time. With some hindsight, I’ll explore how I screwed up, as well as my actions meriting an internal attaboy. I’m no suicide answer man, but I hope that writing out my thought processes will help others facing their own tragedies. For others, perhaps these columns will facilitate your understanding of the quandaries unique to traumatic loss.

As I write about the first dilemma, whether to disclose how Josh ended his life, keep an eye out for the themes that guided my decision-making: secrecy, privacy, shame, stigma. They’ll pop up repeatedly.

On the morning of my son’s death, the police sergeant who came to our door left no doubt Josh had taken his life. A reliable witness, the poor man, made it clear that Josh was deliberate and intentional in his final, awful choice. Thus, from the standpoint of factual certainty, there was no reason to sidestep the cause of death in the first round of phone calls to immediate family. As I informed Josh’s mother, brother, sister, my father, my brother, and a grandmotherly aunt, I was unambiguous about the fact of Josh’s suicide. With these select unhappy few, I shared as much or as little about the method of his suicide as each person requested.

Grief after suicide is sufficiently intense and relentless. There’s no need to add to my burden by piling on 100 pounds of secrecy.

Over the next few days, I notified close friends about Josh’s suicide. For extended family and other friends, I relied on social media to state vaguely that Josh had died suddenly. It’s hardly optimal to use Facebook this way, but I couldn’t handle more phone calls.

After a couple of weeks and much consideration, I felt ready to craft a Facebook post in which I reported that Josh had taken his life. (My “friends” group on social media has been carefully pruned and curated over the years, into a group I trust and truly love.) I wrote in a socially responsible manner, opening with a content warning, attributing Josh’s act to mental illness, and closing with a plea to seek help if the reader themselves is contemplating suicide. I made no mention of the means of suicide, as I don’t want to insert this image into people’s psyches, as a source of morbid rumination or, even worse, imitation.

This is where those four concepts I mentioned above came into play. I am fully convinced that secrecy around suicide allows harmful ideation to fester. Josh’s inability to open up about his desperation is living and dying proof of this. The more we talk about suicide responsibly—not as an acceptable reaction to stress, but as a tragic offshoot of mental illness—the more we can prevent it.

Openness lessens the stigma of mental illness, in turn allowing shame to diminish, so more people will seek help. I also want to root out any seeds of shame inside myself over Josh’s choice. I’m not answerable for it.

In addition, grief after suicide is sufficiently intense and relentless. There’s no need to add to my burden by piling on 100 pounds of secrecy. I’m sure this is why reputable mental health websites, info sheets, and books encourage openness after suicide.

With so much spinning out of control, it’s empowering to assert some agency over the narrative of your loved one’s death. Bad news travels fast, so it’s best to be proactive as soon as you’re able.

It’s similarly recommended to be open with children, commensurate with their level of comprehension. Would you rather they hear a ghoulish tale from a half-informed kid cousin, or from a conscientious grownup? A good starter: “Sometimes people are so sad and so sick that they lose all hope they’re ever going to feel better. This is why Josh took his own life. If you ever feel that sad, please tell me or another grownup, because you really will feel better again.”

Once the social circle expanded past family and trusted friends, privacy took precedence over openness. After the first couple of neighbors learned of Josh’s death from my wife Jessica and me, near-strangers knew of our tragedy. This was entirely predictable: an early, wise mentor told me that once two people in a system have a piece of information, it’s only a matter of time before everyone knows. Nothing in the ensuing 25 years has contradicted this axiom.

Thus, I harbor no ill will for this course of events, but this is where I wish I had a do-over. A couple of neighbors pressed me for details I felt uneasy disclosing, and I caved.

Were I able to hit rewind, I would stick to the script I’ve since created: “I’m not comfortable sharing more details right now. I hope you’ll respect my family’s need for privacy.” Repeat, broken record style, as necessary.

With few exceptions, I’ve stayed silent about Josh’s death in professional settings. Medical workplaces are ridiculously porous: once the staff know a juicy tidbit, word soon leaks to patients. I’ve been able to compartmentalize my personal tragedy for the most part, and I want to keep it that way. I would hate to be known as “the doctor whose kid killed himself.” Besides, patients come to see me for their own needs and problems, not to hear about mine.

(The one time a tech-savvy patient stalked me on social media and learned of Josh’s suicide, it made for an uncomfortable encounter. When she told me she was sorry to read of my son’s death, I responded with a concise, nearly flat “thank you,” making it clear this was not a topic for further discussion.)

Overall, however, I feel a social responsibility to be open about how my family has been ravaged by suicide. Secrecy and shame can kill, so I’ve chosen the opposite path.