Editor's note: This writing contains references to suicide, suicide attempts and completion, suicidal ideation, and suicide coercion. Please use discretion while reading.
It was a Friday. I remember it was January, but I don’t remember it being cold. I had seven decks of cards in a black canvas bag I got in middle school. I don’t know why I had so many, but I know there were seven. We counted them when I gave my belongings to the nurses, right after they took my shoelaces.
You think you know when it’s going to happen: when you’re going to hit rock bottom, when they tell you that you can’t turn down help this time. But you don’t. My boyfriend escorted me into the taxi and held my hand as we rode across town. I didn’t cry. I walked through the sliding doors to the emergency room’s front desk. “My name is Madison,” I said, “and I want to kill myself.”
That emergency room visit saved my life. I was connected to resources to treat my mental illness and increase my resilience. While I had mental health support before my hospital stay, I was terrified to admit the extent of my struggles and feared that asking for help would be too much of a burden on my loved ones.
I went to the hospital in hopes of getting help without bothering my family or friends, but was surprised to find that they weren’t bothered at all. I am here today not just because I asked for help, but because of the incredible humanity and kindness I experienced from others in my time of crisis.
I went to the hospital in hopes of getting help without bothering my family or friends, but was surprised to find that they weren’t bothered at all.
Not everyone is so lucky. In Massachusetts, two alarming cases have occurred in the past decade in which young people died by suicide after being aggressively coerced by their partners to do so: Conrad Roy in 2014 and Alexander Urtula in 2019. Roy and Urtula’s deaths are horrifying, not just because of their loss of life or their partners’ encouragement of self-harm, but because their partners’ behavior was incongruent with the humanity I have seen in others during suicidal crises.
In my experience, people don’t become antagonistic or coercive when they encounter a suicidal person. They become frightened, caring and protective. They shapeshift into crisis managers, triage conductors and phone tree coordinators. They brave the storm and try to reason with someone experiencing unreasonable thoughts and feelings. They may feel ill-equipped, but overwhelmingly, kindness and compassion rule. That’s why stories of people who seize such moments to cause harm seem so abhorrent and inhuman.
Legal prosecution seems like a just consequence for these vicious few. While Roy and Urtula’s partners were each convicted of involuntary manslaughter, they were unable to be specifically charged with suicide coercion (most states have explicit laws against suicide coercion, but Massachusetts is not one of them). This is something that pending bill H.1548, nicknamed “Conrad’s Law,” aims to change.
Prosecuting suicide coercion is hard. It’s hard because suicide is not illegal, and thus coercing someone to engage in suicidal behaviors is not synonymous with coercing someone to engage in homicidal ones. It’s hard because many believe that suicide requires personal agency, and by that logic, the suicidal person can back out at any time. It’s hard because medical aid in dying could be inadvertently and unjustly criminalized. It’s hard because criminalizing the use of words to suggest that another person should harm themselves could violate First Amendment rights. And it’s hard because mental illness is hard, death is hard, suicide is hard, and wanting justice for such challenging, complicated things is a human instinct.
I was lost and desperate for a road map.
I have spent hours considering how best to address this issue. I have pored over court documents, media coverage and case law. No matter which way I land, someone loses. If Massachusetts bill H.1548, written with input from Conrad Roy’s family, is not passed, future cases like Roy’s may not be prosecuted. If the bill passes, there is potential for legal consequences that conflict with First Amendment rights. Perhaps the best choice is to adjust the language of Conrad’s Law to specify that only coercive actions persistent in both repetition and intensity over a sustained period of time are punishable by law.
This legislation should not exist in a vacuum. Crisis intervention services and behavioral health care in Massachusetts must be bolstered. It is not enough for a person experiencing intensive suicidal ideation to know that help exists. In the months prior to going to the emergency room, I saw a therapist regularly, took antidepressants and even called the suicide hotline (and was immediately put on hold).
It was not that I didn’t know help was available, but rather that I didn’t know what would happen, or how people would react, if I asked for it. If someone had encouraged me to engage in self-injurious behaviors rather than help-seeking ones, I might have listened to them: I was lost and desperate for a road map. Massachusetts needs to make one.
If you or someone you know is experiencing suicidal ideation, please call the Suicide & Crisis Lifeline at 988 or text HOME to 741741.