Many media have reported the news that the Quebec Ministry of Health is asking teachers and librarians not to recommend or even tell students about the novel by François Blais, The Boy with Upside-Down Feet: The Chronicles of Saint-Severe. This recommendation is based on the belief that reading this novel may lead to suicidal behavior in students.
However, it is important to note that many classic works of world literature feature suicide, for example Madame Bovary, Romeo and Juliet and Anna Karenina, to only cite a few. Exposure to suicide among students who consult literary works is not a new phenomenon.
In fact, several scientific studies have examined copycat suicides after exposure to a fictitious suicide. A recent review article concluded that “the findings suggest that current evidence does not support the fictional media suicide contagion theory.”1. Another review article found a slightly higher rate of copycat suicides after a fictional suicide2.
These two articles note that the existing studies have many methodological weaknesses and that they almost all focus on fictional suicides in film or television, rather than in literature. Regarding the literature, a seminal article concluded “there is virtually no systematic analysis of the effects of suicide imitation in the suicide literature”3.
As such, there appears to be insufficient evidence to make conclusive statements about exposure to suicide in the literature and suicide by copycat.
Indeed, Ministry of Health guidance may be based on a well-intentioned, but mistaken belief that the mere act of talking about suicide encourages suicidal behavior in others.
In fact, several studies have refuted this outdated belief, with recent research indicating that open discussion can actually reduce suicides.4. This is especially the case if that discussion focuses on messages of hope, resilience in the face of adversity, recovery from mental illness, coping with crises, and information about prevention resources.
This raises a larger question that needs to be discussed. Society and its institutions must talk more about suicide and, above all, about its prevention.
No public health issue is resolved by silence, but many stakeholders still prefer to ignore the issue of suicide.
Perhaps Mr. Blais’ book opens a window of opportunity for the Ministry of Health and school service centers to re-evaluate their overall approach to the issue of suicide, and in particular to think about suicide prevention and mental health promotion programs. One thing we do know is that young people will likely discuss Mr. Blais’ book intensely among their peers on social media and in person. We saw this phenomenon after 13 Reasons Why.
Thus, it is of vital importance that experienced and responsible teachers and experts discuss suicide and suicide prevention in educational institutions in a supportive and caring manner, focusing the discussion on hopeful and recovery-oriented, which has been linked to a reduction in suicides.
Instead of being a threat to public health, Mr. Blais’ book can open much-needed discussions on a subject long considered taboo by teachers, educators and society as a whole.