Jane was fortunate: her parents successfully sued for guardianship, and a court ordered the medication to be destroyed. Jane “went on to recover from all of it, including her anorexia”, according to Matt Vallière, the executive director of the Institute for Patients’ Rights. Jane found work as an occupational therapist, went on vacation, and even purchased a home. Although she ultimately died two years later of complications from her history of eating disorders, she’d had an opportunity to “live her best life”, Vallière says. That any medical professional decided that Jane qualified for assisted suicide, he claims, was “absurd”. 

Jane’s case isn’t unusual. It’s a symptom of unprecedented behind-the-scenes chaos in the assisted-suicide bureaucracy. Violations of assisted-suicide laws are rampant in the states with the largest and oldest programs. Yet I have found no suspensions or revocations of clinician licenses, even when patients were endangered.  

Much of the issue is oversight. In each of the 11 states that have implemented suicide-by-doctor, regulations require clinicians to submit compliance forms, typically within days of a patient’s death. These forms document that the patient expressly consented to die through assisted suicide, and that the clinicians followed all necessary legal safeguards and eligibility criteria, including affirming that the patient is terminally ill and of sound mind.

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Failure to submit this documentation isn’t just a statutory offense. Medical providers and pharmacists who fail to “make a good-faith effort to file required documentation in a complete and timely manner”, as Washington state law instructs, risk losing “immunity protection” for the criminal act of assisting someone’s suicide. Yet a Department of Health report found that physicians improperly reported compliance for a third of all assisted suicide deaths in the Evergreen State. Indeed, Washington is missing 515 compliance forms entirely for the period between 2009 to 2023, according to my calculations based on annual reports, and is also short of 293 “written request” documents that patients are required to sign attesting that they wish to die by suicide. In Colorado, my calculations find that almost 1,800 compliance forms have remained missing since 2017. 

States can’t answer the most basic question: how many physician-assisted suicides have been facilitated by clinicians in America? Across Colorado and California, state authorities have no record of the type of “aid-in-dying drugs” that were prescribed to more than 1,000 patients, according to my analysis of state reports, including the California End of Life Option Act 2024 Data Report. In Oregon, the health authority has records on 376 assisted suicides completed in 2024, but for another 178 cases in which medications were prescribed, authorities don’t know if the patient died by ingesting the drugs, or even died at all. 

Assisted-suicide physicians aren’t the only ones to blame. The proverbial smoke detector keeps going off, but state overseers are choosing instead to remove the batteries. In 2022, Washington state announced that its Department of Health is diverting “all available funding” for its assisted-suicide compliance-review program to “data entry of submitted forms”, due to lack of funding from the state. Data entry is commendable. But by law, the state is also required to “review” reporting compliance and issue an annual report. Instead, this summer, a pop-up appeared on the department’s website: “Important Note: Due to funding cuts, the Death with Dignity Program at the Department of Health is suspended. … A 2024 annual statistical report will not be released.” 

Washington state’s decision surprised even assisted-suicide clinicians. Jessica Kaan, the medical director for End of Life Washington, an institution which facilitates assisted suicides in the state, warned on a forum for providers that “no one will even be monitoring or responding to emails or phone calls that come into the DOH [Department of Health] about the DWD [Dying With Dignity] program”. Kaan called it “a grim situation”. After this pushback, the state announced that it will release the 2024 report after all — but it will be the last one ever to be released. 

Washington isn’t alone. When New Mexico legalized assisted suicide in 2021, state legislators mandated annual compliance reporting, which has never happened. Instead, the state Department of Health’s website described these reports as “coming soon” — until this summer, when, according to internet archives, the promise was quietly taken down. 

This systematic disregard of safeguards is happening as the process is being fast-tracked: states are removing requirements that applicants reside in state; allowing less-credentialed providers, such as social workers, nurses, and physician associates, to perform assessments instead of psychiatrists and psychologists; and reducing minimum waiting periods. In Oregon, which waived waiting periods in 2020, clinicians have reported in Oregon’s annual Death with Dignity Act report that assisted suicides routinely occur on the same or next day the patient makes the request. Since in some cases it takes up to five days for a patient to die from ingesting the death cocktail, it is possible that it will take a patient longer to die than to receive lethal prescriptions.

The proportion of deaths of vulnerable patients has also increased by magnitudes. In the first year of Washington state’s program, 16% of patients mentioned “the physical or emotional burden on family, friends, or caregivers” as a reason for their decision to die, and 2% were concerned about “the financial cost of treating or prolonging the patient’s terminal condition”. By 2023, according to the state’s reporting, the number concerned with “feeling like a burden” jumped to half of all assisted-suicide deaths, and a 10th were concerned about “financial implications of treatment”. 

A similar trend is unfolding in Oregon. In 2009, the first year that the program was available, no patients told their assisted-suicide clinician that they were choosing to die because of financial concerns, and only 12% felt like a burden. By 2024, the state’s reporting revealed that it was 9% and 42% of all assisted suicide deaths, respectively. No other states even report this data. The “attending physician follow-up form” in California, which records patient concerns that contribute to the choice of “aid-in-dying”, doesn’t have “financial concerns” or “feeling like a burden” on its otherwise identical menu of options. 

The lack of both governmental and physician compliance with legally mandated oversight is resulting in a dangerous situation for patients. Craig New, who told me on the telephone that he’s the sole employee of the Oregon Health Authority responsible for monitoring compliance reporting, says that “ultimately the things usually get resolved because we bug them until they finally send in the paperwork”, but even so, his office has reported around a dozen physicians to the Oregon Medical Board for violations of compliance reporting. Thanks to privacy laws regarding medical licensing, it is impossible to know whether the reported physicians faced repercussions, but my review of the Oregon Medical Board’s investigations reveals that few offenses are prosecuted. 

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One example is Rose Jeannine Kenny, a family doctor, who in 2016 was sentenced to five years probation by the Oregon Medical Board for dozens of alleged prescription violations. Later the board received “credible information” that Kenny may have again violated the same provisions she was previously reprimanded for, and may possibly have committed “violations of the Oregon Death with Dignity Act”, such as failure to ensure consent, follow the rules of written and oral assisted-suicide requests, abide by the minimum waiting period, and file compliance records. Kenny once again kept her license, this time by agreeing to “participate in all physician steps” for 10 more assisted suicides, supervised by a mentoring physician from Compassion & Choices — the largest lobbying group for assisted suicide in the United States. (UnHerd was unable to reach Dr. Kenny at any of the medical practices with which she is associated online.)

The states are the only entities able to keep records on assisted suicides and the only entities available to monitor them. Neither researchers nor law enforcement are allowed to systematically access records due to confidentiality laws regarding physicians and patients. In some states, such as Oregon, records are routinely destroyed after a year, and in most states, death certificates by law can’t mention assisted suicide.

Recent court proceedings in Maryland eerily echo the lawsuit regarding Jane. Angela Guarda, the director of the Eating Disorders Program at Johns Hopkins Hospital, testified that she was contacted by an ex-patient of Jennifer Gaudiani, the physician who coined the term “terminal anorexia”, and who has prescribed assisted-suicide medication to at least one patient. The concept of terminal anorexia was meant to apply only to patients over age 30; for younger patients, Gaudiani stressed in a paper for the Journal of Eating Disorders that “every effort should be made to promote full recovery and continuation of life”.

The ex-patient reported that her assisted-suicide assessor told her “she would ‘make an exception’ for me and ‘allow’ me to die”. The patient reported feeling coerced. She eventually weaned herself off morphine and hospice drugs and, 18 months later, reports that she’s doing well, with a job, a group of friends and a new puppy.

Patients like these, who need hope the most, are facing much more than their illnesses. They also confront an assisted-suicide regime that blatantly and routinely violates the legal safeguards that were meant to ensure their protection from a death they might not want.

Correction: An earlier version of this essay misstated the entity that lodged the Jane lawsuit.

BBC reports don’t name the site for fear of directing people there, but I found it anyway. And it is roughly as you might expect: namely, every loving parent’s nightmare. Instead of swapping relationship anecdotes or cookery tips, members pour out their pain, discuss the pros and cons of various approaches to death in great depth, and affirm each other in the desire to die. Many users are obviously young. Biographies under made-up names say things like “Autistic and heartbroken”, “Trapped in the suffering”, and “Eating disordered junkie”, but there are a lot of people who just write “Student”.

Like other chat sites with which we are more familiar, it forms its own cultural ecosystem. Here, too, there are unspoken club rules, recurrent personalities, and dramatic story arcs. Despite — or perhaps because of — posters’ grim intentions and feelings of mental isolation, most are friendly and solicitous towards one another, apparently searching for a welcoming tribe. This juxtaposition of gregarious form and nihilistic content feels surreal, though I expect regulars get used to it.

On the top of every page, there is now an official response to the Ofcom announcement, talking about “a clear and unprecedented overreach by a foreign regulator against a US-based platform”. Owners say they “reject this interference and will be defending the site’s existence and mission”. There are also new threads from concerned users. Reads one: “I live in the UK and we’re very anti suicide and I don’t want… this website to be connected to my death in any way in case the authorities do some investigation.”

Such forums test the limits of many stalwarts about free expression, mine included. Like the BBC, I choose not to mention the site in question’s name here, and to be vague about other details. Indeed, its existence is a difficult thing to write about at all. It is not that suicidal ideation can be conjured out of the blue in a casual passer-by; the worry is about what finding the site might do to someone already in the throes. I can see how prolonged contact with the enveloping atmosphere of helpful, judgment-free camaraderie — part-cosy and part-bleak — could easily speed up a person’s desire to die, as well as giving them new information about available means. Even Mumsnet users worry about what their favorite site does to their mental health. Quite frankly, this one seems a lot worse.

The Samaritans stresses that “Suicidal behavior is extremely complex and can rarely, if ever, be attributed to a single cause”. This is obviously true; human suffering tends to sprawl messily over several issues at once, and depression often can’t tell the difference between a boulder and pebble. This fact gives the lie to attempts to politically weaponize particular suicides by depicting them in simplistic terms, whether they be by trans-identified children or teachers inspected by Ofsted.

But it is also true that in a complex causal chain leading up to an event, we can identify significant precipitating factors. During the Reformation, the suicide rate rose in both England and Germany, arguably due to the increased emphasis on personal moral responsibility. In 1860s St Petersburg, there was a vogue for suicide due to “civic grief” at deplorable societal conditions. Explanations of why some particular person takes his own life can cite large-scale events and trends like these; but also include small-scale events like a fateful meeting with a particular person, or even with a text. After publication of Goethe’s The Sorrows of Young Werther, depicting the hero’s suicide as a merciful release from the tragedies of life, there was a spate of copycat deaths among romantic-minded student readers. Why not then a chance meeting with a website; or even with an article that writes about a website?

In fact, society has long been reticent to talk a lot about suicide for fear that it sets a spark going in already parched psychic tinder. Medieval chroniclers and coroners would write in euphemisms, describing people dying “of an excess of grief”, or drowning “by the temptation of the Devil”. The 13th-century prior Caesarius of Heisterbach skirts around the matter of attempted suicides in his writings on miracles: “I would tell you many recent examples of this sort of depression, but I fear it would endanger weaker souls to hear or read such things.” Even on forums dedicated to suicide, such as the one Ofcom is presently looking at, some users can’t quite bring themselves to mention the word. They write of their longing to “CTB” or “catch the bus” instead.

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But reticence to name suicide, as such, is not just due to worries about inadvertent participation in other people’s tragedies. Historically, it was also a response to feelings of shame associated with the deed — and therefore the word — made vivid by the perception that deliberate self-destruction was a grave offense against God. For failed attempts, there could be draconian retribution from Christian authorities. Almost unbelievably, jailing people for attempts continued in England until the end of the Fifties. And even in today’s secular society, feelings of shame are reported among survivors, not just for having failed but also for having tried at all. Ostensibly worried about stigma, in recent months pro-assisted dying MPs such as Kim Leadbeater have strongly objected to the word “suicide” for the deliberate self-killing of people “already dying”, apparently unaware that it would follow you couldn’t murder a terminally ill person either.

In a sense, then, pro-suicide sites can be seen as a deformed but intelligible response to residual religious associations of shame: a kind of proud and unabashed reclaiming of the right to self-annihilation. Viewed in that light, they are of a piece with the 18th-century Romantic view that suicide could be a positive grasping of one’s autonomy, demonstrating independence from religion and even from nature itself. German has a literary word for it: a Freitod (“free death”), as opposed to Selbstmord (“self-murder”) or Selbsttötung (“self-killing”). Dostoevsky satirizes this idea in Demons with the engineer Kirillov, a character enslaved by his obsessive desire to kill himself as a means of asserting self-government: “If God exists, then all will is his, and I can’t escape his will. If he does not exist, then all will is mine… I am killing myself in order to show my independence and my new terrible freedom.”

Modern day Kirillov-types, monomaniacally focused upon freedom, will presumably leap to the defense of pro-suicide sites in order to protect both the word and the deed from outside interference. They will deny there is ever such a thing as having the better part of your mind taken over by hostile forces. It is always you who is ultimately in charge, for better or worse; even in the throes of depression and loneliness, enticed by the warm words of fake friends, on an apparently welcoming website. At the other end of the scale we find people like Leadbeater, trying to get the word banned for what are technically still suicides, on the spurious grounds that death is not deliberately chosen at all in such cases, but is already happening anyway.

Both stances involve self-serving fictions: one of total responsibility, the other of none. Somewhere in the middle is the truth: that the common good requires the use of clear, unambiguous language about the nature of suicide; but also to avoid glamorizing and validating it, for fear of who might get caught up. Indeed, these are two sides of the same coin. There’s neither shame nor glory in any suicide; but making pro-suicide websites is nothing to be proud of.

www.samaritans.org

Overwhelmed, Bradshaw loaded his few remaining possessions into a clapped-out Jag, and boarded a ferry from Cork to Santander. He had planned to travel on to Portugal, the site of so many holidays with his wife and kids. But they no longer saw him. And where the open sea once promised escape, staring into the ship’s wake now pushed Bradshaw, 36 to despair. 

“Look at the wake of mess I’ve left behind me — look at the lies I’ve told,” Bradshaw remembers thinking. “I don’t know where the fuck I’m going. I haven’t got a house to go anymore, nor a home and I’ve fucked my kids’ lives. That’s when it really hit me. The world would look a lot better without me in it.” In the end, it was the thought of his two sons that stopped Bradshaw from jumping overboard that March night. But not everyone is so lucky. 

In the United Kingdom, this week’s front pages — dominated by reports of an election mired in a betting scandal — threaten to distract from a wider malaise: the fact that there are around 400 gambling-related suicides each year. Just like Bradshaw, young people seem particularly susceptible. Between an underdeveloped brain on the one hand, and frantic advertising from gambling companies on the other, some 55,000 British youngsters (age 11-16) are addicted to gambling. A further 85,000 also believed to be at risk of addiction. 

No wonder activists are pushing hard for change. But without more fundamental reforms — and with the gambling industry as rich and influential as ever — desperate cases like Bradshaw’s are unlikely to disappear.  

Mark thinks he knows why. The neuroscience of gambling addiction closely resembles that of drink or drug dependency. Gambling rewires the brain, flooding it with so much dopamine that the body soon learns to protect itself. That, in turn, reduces the sensitivity of so-called “bliss hormones” — which become less responsive to the high gained from that first successful flutter. As dopamine tolerance builds, punters need to raise the stakes to recreate those early peaks. “Even if it’s a 1,000-to-1 shot,” Mark says, “right down to that very last bet, you convince yourself this is the one that could change my life.” Enter fully-fledged gambling disorders: the neurological state when the brain experiences withdrawal symptoms, and demands higher bets, just to get back to its altered new normal. 

“When you’re betting, the capacity for rational thought goes out the window,” Ryan Cowley explains. “But after heavy losses you get this crushing feeling of guilt.” At his lowest point, the 30-year-old was losing almost £4,000 a day, even as he grew skilled at hiding his problem from family: “I’d start with South American football, switch to the NFL and then of course there’s always horse racing and online slots.’’ Once, he blew his wages on payday — then cancelled and destroyed his bank cards, pretending his wallet had been stolen. He needed an excuse to not pay his mum the room and board she was expecting. 

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Beyond the raw brain chemistry, there’s evidence that young people, like Cowley, are particularly vulnerable to gambling disorders. As Dr Marc Potenza, director of Yale University’s Center of Excellence in Gambling Research explains, the prefrontal cortex doesn’t fully mature until around the age of 24. He suggests that, especially for young men, this makes them less able to postpone gratification and control impulsivity — and ultimately leaves them open to the highly addictive products developed by gambling companies. 

Those products, for their part, are made vastly more dangerous by their digital nature. Consider Cowley, whose gambling problem started around 12 years ago, and coincided with the arrival of smartphones and betting apps in his late teens. Suddenly, he not only had a casino in his pocket, but also the power to bet on anything, anywhere. He’s not alone. As a survey published by the Young Gamers and Gamblers Education Trust (YGAM) in March 2024 revealed, nearly 46% of students are gambling more than they can afford, lured by promises of free bets and quick cash. 

Now 23, Robert* has been battling a gambling addiction for five years. His problems began while still a student, when betting became intertwined with watching sport with friends. Watching them celebrate occasional windfalls on their phone drew him in — and soon Robert was losing more and more. When Robert’s parents entrusted a significant amount of his grandfather’s inheritance to him, they were unaware of his problem. But Robert gambled away £15,000 over just a couple of days. “Pretty much all of it is gone,” he says. “I still haven’t been able to pluck up the courage to tell my parents.”

It deepens the problem when gambling companies use the immense power of online systems to their advantage. If you have a gambling platform on your phone, you may have noticed just how regularly you’re required to re-download the latest version of the app. For Bradshaw, that’s some indication of just how rapidly betting operators are evolving their “getting-to-know-you” data-harvesting techniques.

“Within three months of signing up with a betting app,” he explains, “they will have collected 90 key data points, which will go far beyond what your favourite team is, or the time of the day you like to bet. They’ll know exactly which offers to push at you, all tailored to make you feel really smart — too smart to miss out on this great opportunity. And all the time they’re demanding your attention with products that are incredibly addictive.”

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In theory, racking up huge losses in betting binges, like Mark, Ryan and Robert’s, was about to become more difficult, with affordability checks set to be introduced as part of the government white paper on gambling reform published a year ago. It proposed that players who lose £1,000 within 24 hours, or £2,000 over 90 days, should face financial checks. Those who have a net loss beyond £125 each month, or £500 per year, will have to go through “frictionless” checks. Alongside affordability checks, the white paper also included significant proposals for a mandatory levy on gambling operators to fund addiction treatment, education and research.

Now, of course, we have an election on our hands, which will likely delay the implementation of some of the reforms. At the same time, however, many do not require primary legislation and are due to come into force later in the year anyway. But will they make any real difference?

Many anti-gambling campaigners argue that by the time customers demonstrate problematic betting behaviours, it is already too late: they will already have a gambling disorder, and though their betting may temporarily be stopped, the underlying condition doesn’t disappear. Gambling With Lives, for example, is a charity set up in 2018 by families bereaved by gambling related suicide. While they applaud the £100 million earmarked to fund research, education and treatment around gambling addiction, activists are otherwise sceptical about the planned legislation’s overall worth. 

Bradshaw, meanwhile, believes that the law isn’t keeping pace with the technology. Just as the UK’s 2005 Gambling Act couldn’t foresee the harms of the coming smartphone era, he suggests that today’s policymakers don’t understand how AI has already transformed the industry. ‘’It doesn’t refer to algorithms or artificial intelligence at all,” he says of the Gambling Reform Bill. “It is an analogue piece of legislation in an era [when] the gambling operators are already in an AI generation. Using the power of artificial intelligence, hundreds of markets are being formed within each game using all the data they’ve got on the sport, plus all the data on you as an individual. The products are incredibly addictive and the markets are formed so fast that the smartest human being couldn’t work out if it’s a fair bet or not, which of course is precisely the point.” 

For others, the white paper’s most serious omission concerns advertising, which many attribute to the influence of the immensely powerful Betting and Gaming Council, the industry body that represents the interests of UK gambling operators. Since it was effectively deregulated in 2005, the UK gambling industry has swollen into a behemoth, one raking in revenues of £15 billion a year. As a whole, it’s estimated that the sector redirects £1.5 billion of those profits into advertising. That can have a direct impact on gamblers: research suggests that 35% of people with gambling disorders receive daily incentives to gamble, compared to just 4% of those not suffering gambling harm.

The personal impact here is just as stark. Cowley says he’s forced to go on holiday during big events like the Cheltenham Festival, just to avoid being carpet-bombed by betting ads. In April, betting giant 888.com even planted its flag in London’s underground system, with signs provocatively proclaiming that “This Carriage is now a Casino”.

In the end, an online petition forced 888.com to partly withdraw the campaign, but such brazenness can plausibly be linked to the sector’s vast wealth. 888 Holdings also owns William Hill, which was fined £19.2 million in 2023 for — among other failings — allowing customers to lose tens of thousands of pounds within minutes of opening their accounts during the pandemic. That’s still the largest fine ever meted out by the Gambling Commission, but is unlikely to deter 888 Holdings, which last year saw revenues soar by 38% to £1.7 billion.

And therein lies the problem: gambling is an industry that has grown so rich so fast that it can afford to casually treat multi-million-pound fines as simply part of doing business.

Quite apart from the individual suffering, meanwhile, there is rising evidence that gambling addiction is impacting society as a whole. The government’s own research estimates that 0.5% of the population are already problem gamblers. And while the NHS recently opened its 15th regional treatment centre in Sheffield and now has the capacity to treat 3,000 across the UK, many believe it’s unlikely to be enough. With legislation still so weak, Mark Bradshaw thinks we’re in the early days of a public health disaster: he compares it to an “avalanche” that could yet overwhelm the authorities.

But at least he got out. Five years on from his near-death experience at sea, the Yorkshireman seems happier. At 41, he’s living in Dublin with a new family, and spends his time campaigning to protect the next generation of young people from gambling disorders. Regardless, Bradshaw is under no illusions about how dangerous the modern industry can be. “If I’d come of age in an era when sports-mad young men spend half their lives on their phones,” he says, “I would be dead by now.” 

Many there will have paid little attention to the confirmation last week of a new leader of the Senedd. Vaughan Gething has often pinned his allegiances to the trade union movement. But will his attention, like so many before him, shift away from these industrial regions? On a joint visit to North Wales yesterday, Gething and Keir Starmer vowed to “turbocharge jobs and growth”, but how many in Port Talbot were listening? The steelworks’ fate represents more than just the closure of another foreign-owned company, the latest in a long line to vacate these towns. It signifies the final nail in the coffin of South Wales Industry.

This story reads all too familiar to people from this part of the Isles. Since the birth of industrialisation, the Valleys have been continuously weathered by a collective system of manufactured depression, which has shaped and damaged the psychological condition of the Nation. Indeed, the very first signs of what is now commonly referred to as the Great Depression can be traced back to the economic collapse witnessed in the Valleys of South Wales in the spring-to-summer period of 1924. While only 2% of the population was unemployed at the start of that year, the impact was so profound that, by August 1925, it had risen to a staggering 28.5%. While numerous factors contributed to this, two stood out, both products of the raw realities of global economic and political conflict.

The first was the Treaty of Versailles, whose terms required a defeated Germany to supply cheap coal to Europe as part of its reparations. As the British representative on the Council of Four, the Welshman David Lloyd George was thus a signatory to a settlement that effectively pulled the rug of profitability from under the South Wales coalfields: the price of Welsh coal fell by nearly 50%. The second was a turn in the United States to more exploitable markets for energy in the Southern Hemisphere. By the time the Wall Street Crash had bankers and investors jumping from buildings in 1929, the Valleys of South Wales already had 45% of its workforce conscripted into the army of the unemployed.

The use of the military metaphor is not unintentional. As some 241 pits closed by 1936, resulting in the now familiar pattern of outward migration form the region of the fit and able, the only moment of reprieve would be the outbreak of the Second World War, resulting in the need once again for the region’s coal to help motor to machineries of warfare. What must it do to the psychology of a people knowing the survival of their own communities was tied to the continuation of a war as local boys and men continued to fight and dig for yards back home?

If the Valleys were subject to abandonment and social neglect in the decades that followed, by the end of the Eighties and the defeat of the miners, it was clear the industrious way of life which once sustained these communities had been largely destroyed. Port Talbot was in many ways an exception to this, though it should be added that many of its workers were descendants of miners from nearby collieries and still tried to carry the socialist spirit of defiance, which was somewhat captured in Michael Sheen’s The Way.

Abjection would soon become a defining term, which could be routinely applied across the entire coal-face region. The figure of the hardened miner was replaced by the steroid-using gym worker, a grim contrast to the emaciated bodies seeking quiet refuge as they administered heroin into their dejected veins. Stories started to become more commonplace about adults and even teenagers taking their own lives. Soon we all knew of somebody who could no longer face the reality of an abandoned world. Like most things in the Valleys, the more time passes, the greater the problem becomes. And the realisation these towns were facing a suicide epidemic captured international media attention in 2008, as the tragic loss of so many young teens in quick succession within a 10-mile radius of Bridgend led many to question the causes and possible solutions.

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Government statistics continue to document rising numbers of suicide, with Wales home to the highest percentage of any region in the United Kingdom. While the most convenient explanation for this often focuses upon the mental health of the afflicted, and invariably advocates more therapy and intervention at an individual level, less attention has been given to the idea that depression should first and foremost be seen as a social phenomenon — that is also inseparable from the lived conditions, the ecologies and atmospheres, into which a community is thrown.

Having said this, what is also peculiar about the Valleys is how the exponential rise in suicide corresponds to the regreening of the landscape, posing a direct challenge to those who primarily correlate wellbeing with environmental recovery. Recovery means nothing if people feel like they have no value or purpose to their existence, regardless of how many daffodils are growing.

While suicides among young girls (as in Bridgend) have become a growing problem — indeed I have lost two cousins this way — it is the vast rise in young male suicides that registers as the most pressing of concerns. Again, while there are many explanations offered for this, given how the figures compare to other social groups (notably black and Asian), surely such a phenomenon can only be properly explained by attending to the crisis of white male subjectivity.

Today, what we look upon are social systems in which young white men are struggling to find any meaning let alone political agency. As other groups are being encouraged to find a sense of purpose and belonging through a shared sense of historical outrage, such an identity has been denied them. The same men have also been thrown into a cultural milieu in which they are being asked to embrace their vulnerabilities, while stripping them of the very qualities of passion and fight that might allow them to deal with difficult times. Should they have the gall to question the status quo, often they are accused of exhibiting white male fragility, which is a rather peculiar way of defaulting back to a desired framing of brokenness.

Because people are not born vulnerable. Systems produce them that way. And if there is a violence to speak of today in places like the Valleys, it’s not one of masculine hardness — it’s a violence of the vulnerable.

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Young white men are continually being told they should aspire to whatever the new digital world has to offer, knowing full well to be born in the Valleys means the chances of escape are less with each rotation of the clock. This reminds of how static the empty time of social depression can truly be. Yet still some have the temerity to call them privileged. If such a word has any meaning, it should be linked to the luxury of time — or to properly separate those who inhabit a dead time that has no prospect versus those with the luxury of time to fire off social-media missives, day after day, without it having any impact on their material welfare.

Back in Port Talbot, meanwhile, as the spring rains fall and the furnaces that give life to the town are slowly doused, it’s hard not to be pessimistic. If a century of mass industrial closure has seen very little to replace it, the speeding up of automation and artificial intelligence promises to leave farther behind those who weren’t even at the starting line to begin with. Faced with these conditions of social depression, should we be surprised when desperate young men try to find a lasting way out? I know personally what it’s like to live through seasons marked by the weight of absence. It’s suffocating. It’s debilitating. And it’s soul-destroying.

***

Armstrong started mining the rest of her life. Dooce pivoted to offering carefully-scripted “unvarnished realities” on parenthood, marriage, and Armstrong’s struggles with depression. The market in the early 2000s was far less crowded than it was even a decade later, allowing a cornball line like this to land in a way it probably wouldn’t today: “I am here to tell you that there is no possible way to have an 8-pound creature GUMMING your tender nipple without the slightest bit of discomfort……the only way to describe it to a man is to suggest that he lay out his naked penis on a chopping block, place a manual stapler on the sacred helmet head, and bang in a couple hundred staples.” Off the back of insights such as these, Armstrong gained a monthly readership of 8.5 million fans, raking in anywhere from $30,000 to $50,000 a month at her peak. In 2011, Forbes ranked her 26th on its list of most the influential women in all media. Federated Media, the entity responsible for managing advertisements on her blog, celebrated Armstrong as one of their most prosperous bloggers, a top performer who generated over $1 million a year in ad revenue.

The same year, Armstrong contributed a foreword to Mom Blogging for Dummies, writing: “Some women who do what I do reject this label altogether because they consider the term mommy to be belittling. I understand this complaint, but I’m quite proud to be a member of this movement, this revolution of women determining their own destinies.” Hers is a cautionary tale, however, for those of us who write and consume content for a living.

Armstrong’s fame and online presence had greatly receded by the time she committed suicide at home earlier this year. In The Valedictorian of Being Dead, published in 2019, she details a life spent battling depression — on ten occasions, she went into a medically-induced coma, simulating brain death, in an attempt to alleviate her symptoms. Somewhere between introducing a guide to making money from nonstop mommy blogging and declaring mommy blogging dead, Armstrong came to recognise — or decided to admit — the negative impact her work was having on her mental health. In the foreword, she writes with a sense of pride, “I don’t get to go on vacation.” In The Valedictorian of Being Dead, she expressed her longing for an escape “the hamster wheel of my day-to-day existence”:

“I knew I just couldn’t do it anymore when I was trying to get my kids into the car to play a word game while driving to a ranch in the mountains. This would be the third of three posts I was to write for an automotive brand about quality time with my kids in the car … Marlo did not want to participate in yet another ruse, and I had to bribe and threaten and cajole to get her in that car. Right as she opened her door, she looked up at me through tears and begged, ‘Please, Mom, don’t make me do this.’”

Armstrong’s transition from viewing her work as a fulfilling occupation to a trap reflects the paradoxical reality of life as a content creator: the same facts, framed differently as market conditions changed, transformed from a testament of her dedication to a cry for relief. But it also speaks to a universal experience of life lived in the digital age. Her journey — from a person who wrote about her life on the internet for fun to an entrepreneur supporting not only her family but also employees with her blog revenues — illustrates the tremendous opportunity of the dotcom boom. But it also reveals the precarity inherent in what was then a burgeoning marketplace of intimate stories that would, as one critic observed later, gradually evolve into a “personal-essay industrial complex”.

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Armstrong was praised for offering humour, heart, and what some perceived as unflinching honesty. Long-time editor of The Rumpus, Lyz Lenz, likened her to the Hunter S. Thompson of domestic life — “a wild, weird gonzo journalist of domesticity and dog poop”. She had a knack for transforming ordinary experiences into amusing anecdotes, comparing her sick toddler to a “drunken blues singer whose wife done kicked him out of the house” — an utterance that would be described as “problematic” today — or injecting making a trip to the gynaecologist sound less horrific with a quip: “Somewhere there has to be a Garfield comic that talks about how Mondays aren’t bad enough already, and here you have to go and throw an enlarged ovary into his soup?”

Armstrong describes her blog as a “therapeutic outlet”, initially to process her postpartum depression. The carefully-composed, yet candid-sounding revelations of her struggles — often leavened with a bit of circa-2000s gross-out comedy — fostered a sense of virtual community among readers, who developed a strong attachment to, and a sense of entitlement over, Armstrong, their “queen mother”. This was a world where people were becoming ever more isolated — “bowling alone”, as Harvard professor Robert Putnam put it. These sad folk, existing at the murky “IRL/URL border”, turned to screens to soothe existential hurt and validate what were gradually becoming identities.

But the challenges of sustaining a profitable blogging business in an ever-evolving digital economy started to fracture the authentic voice that had once resonated with readers. Ad revenue declined. The need to shoehorn sponsored content into her blog posts became more pressing. Instead of writing about experiences, Armstrong had to manufacture them, experiences to fit the expectations of brand partnerships. The connection between the real Armstrong and the commercialised version of herself that the audience saw became increasingly flimsy.

So when Armstrong announced she was getting a divorce, her loyal readership felt betrayed. Here was an unwelcome reminder that her carefully-told story of a perfect family life was nothing more than fiction. Parasocial followers commented, “If you’ve read a blogger for years, you feel like you know them…the saddest thing I’ve read today“, “they’ve always seemed like a good couple”, and even the ironic “I wish you could have privacy“. Such intimate reactions echo those experienced by uber-public figures such as J.K. Rowling, whose stance on gender ideology has alienated fans who were clearly identifying far too strongly with her books, and now by Taylor Swift, whose fans are obsessively calling for her to dump her supposedly “problematic” new boyfriend. In any case, the story Armstrong was telling no longer fit what the marketplace desired; it had been corrupted by the complexities of a real life. And that led to the difficult realisation that she was, as she told Vox in 2019, an outdated product.

As many in the sales and marketing world can attest, the process of constantly reinventing yourself to meet external expectations can be a maddening endeavour — there is no escape, only yourself and your content, and if people aren’t buying, it’s hell on Earth. The hardest thing about her obsolescence, Armstrong writes in The Valedictorian of Being Dead, is that “writing was therapeutic”. And yet, no one forced her to stop writing; it’s just that fewer people wanted to read her. She could have kept writing without monetising it — many of us keep private journals, even in 2023 — yet she seemed to conflate writing with being read. So, what was it that she feels was therapeutic: writing, or creating a fictionalised version of her life that other people bought into?

I have argued before that blogging — indeed, many forms of social media — allows people to unhealthily distort themselves for profit. This isn’t therapeutic, despite Armstrong’s repeated claims to the contrary; in fact, as my own therapist has pointed out, reminding everyone around you that your creative work is “therapeutic” is a sure-fire sign that it probably isn’t. When personal reinvention for commercial success becomes the norm, it’s easy to lose sight of your own needs, while focused on catering to an audience’s demands. There is a vast difference between performing wellness for an audience and actually achieving it.

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The relentless cycle of selling and repackaging the self not only creates a dizzying array of personas to uphold but also lays the foundation for an existential crisis when the demand for one’s curated identity dwindles. In the final years of her life, Armstrong was already posthumously known; writing on Instagram to a fraction of her former audience, her past was better-known than her present. Many of today’s top posters, podcasters, and pundits will have the same experience. Countless people have invested themselves in the game of personal content creation — making moves that will invariably lead to diminishing returns, until they have no moves left to make.

Intriguingly, those most drawn to this lifestyle — and to social media in general — seem to be those seeking an escape from their present realities. Consider Armstrong’s aforementioned quip about her gynaecologist visit — the lame Garfield joke about her enlarged ovary. Clearly, this is a heavily filtered version of her experience in the doctor’s room, designed for the consumption of her audience. While the joke may have elicited a polite laugh, it detracts from the genuine fear anyone would feel at a medical diagnosis.

Armstrong saw herself as being in the business of making herself better. But did she write about it for herself, or for her audience? Even her final autobiographical work, The Valedictorian of Being Dead, was ultimately designed for consumption. So the question remains: who was she really trying to influence?

Nick Cave: I do have certain memories of the night Arthur died. Yet when I try to recall what happened after that night, it’s almost like there is a rupture that time and memory poured itself into. Everything disappears.

Seán O’Hagan: People tend not to want to revisit the moment of the actual trauma itself — and probably for good reason. Are you sure you even want to talk about this stuff?

NC: Fuck, I don’t know, Seán. I’m just kind of mystified by how little I remember, just how much I have forgotten.

I remember I was watching TV, and Arthur rings me, and I answer, but it’s not Arthur; it’s a stranger who had found his phone and his rucksack and shoes in a field near the black windmill outside Brighton. The stranger also says that there is police activity at the cliff near the windmill. Then there is this sudden roaring panic, and we are calling 999. Asking the operator what is happening at the cliffs! The police won’t tell us anything.

Then the police come to the house. My wife Susie and I standing on the doorstep, seeing the police car pull up, and the detectives stepping out and walking towards us with their composed faces, and us just knowing. The cops standing in the kitchen and telling us the news — our boy has fallen off the cliff, his body is in the hospital, he is dead, and my head starts roaring the loudest noise in the world…

SOH: I don’t know what to say, Nick. I just can’t imagine . . .

NC: I don’t remember much after that, for quite a while. Mostly, I just recall sitting on the back step of the house away from everyone and smoking and feeling the roaring body shock of it, like this alien force was going to burst out the ends of my fucking fingers. I remember feeling like I was physically detonating, like if I made any sudden moves I’d literally explode, so stuffed was my body with despair. And then sitting next to the bed, with Susie lying completely still in the dark, like a stone, her eyes closed, and saying, “I am here, babe, I’m here,” but really I’m not, I’m not there at all, I’m in a million fucking pieces, everywhere else, all over the place.

SOH: Were you angry at the world after Arthur died?

NC: No, I was in despair. I don’t think anger was part of it. Not for me, although who knows what boils away inside us. Susie, of course, entered a circle of hell that is reserved solely for mothers who lose their children. It’s a whole other level of loss and suffering, a terrible, terrible thing to happen to anyone. There are all sorts of feelings tied up in it, guilt and shame and self-loathing so primal, yet so complex, they are near impossible to unravel. We don’t have the language for it. Or maybe language itself is not up to the task. Perhaps the cultures that encourage people to dress in black and just wail, maybe that is the most articulate response.

I remember, in desperation, reaching across and taking Susie’s hand and feeling the shock of that same violent electricity in her hand. It was so physical. That physical affliction is not often talked about, as far as I can see. We tend to see grief as an emotional state, but it is also an atrocious destabilising assault upon the body. So much so that it can feel terminal.

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***

SOH: Nothing prepares you for it. It’s tidal and it can be capsizing.

NC: That’s a good word for it — “capsizing”. But it is important to say that these feelings I am describing, this point of absolute annihilation, is not exceptional. In fact it is ordinary. We are all, at some point in our lives, obliterated by loss. If you haven’t been by now, you will be in time — that’s for sure. And, of course, if you have been fortunate enough to have been truly loved, in this world, you will also cause extraordinary pain to others when you leave it. That’s the covenant of life and death, and the terrible beauty of grief.

It may not necessarily be a death, but there will be some kind of devastation. We see it happen to people all the time: a marriage breakdown, or a transgression that has a devastating effect on a person’s life, or health issues, or a betrayal, or a public shaming, or a separation where someone loses their kids, or whatever it is. And it shatters them completely, into a million pieces, and it seems like there is no coming back. It’s over. But in time they put themselves together piece by piece. And the thing is, when they do that, they often find that they are a different person, a changed, more complete, more realised, more clearly drawn person. I think that’s what it is to live, really — to die in a way and to be reborn. And sometimes it can happen many times over, that complex reordering of ourselves.

SOH: When you are deep in grief, there’s no real comfort to be had in people constantly telling you that time will make things better. But I distinctly remember waking up one morning, having finally had a decent night’s sleep, and thinking, it’s going to be okay. There was a sense that something had shifted imperceptibility. Did that happen to you?

NC: At first there was nothing but darkness, but, over time, Susie and I started to experience something like small fragments of light. These points of light were essentially thoughtful gestures from the people we encountered. We began to see, in a profound way, that people were kind. People cared. I know that sounds simplistic, maybe even naïve, but I came to the conclusion that the world wasn’t bad, at all — in fact, what we think of as bad, or as sin, is actually suffering. And that the world is not animated by evil, as we are so often told, but by love, and that, despite the suffering of the world, or maybe in defiance of it, people mostly just cared.

Grief can be seen as a kind of exalted state where the person who is grieving is the closest they will ever be to the fundamental essence of things. You either go under, or it changes you, or, worse, you become a small, hard thing that has contracted around an absence. Sometimes you find a grieving person constricted around the thing they have lost; they’ve become ossified and impossible to penetrate, and, well, other people go the other way, and grow open and expansive.

Arthur’s death literally changed everything for me. Absolutely everything. It made me a religious person. I am not talking about being a traditional Christian. I am not even talking about a belief in God, necessarily. It made me a religious person in the sense that I felt, on a profound level, a deep inclusion in the human predicament, and an understanding of our vulnerability and the sense that, as individuals, we are, each of us, imperilled. Each life is precarious, and some of us understand it and some don’t. I became a person after my son died.

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***

SOH: Back in your younger, wilder days, when you drew on biblical imagery as a source for your songwriting, was that also a reflection of a deeper interest in the divine?

NC: Even in the most chaotic times, when I was struggling with addiction, I always had a kind of spiritual envy, a longing for belief in the face of the impossibility of belief that addressed a fundamental emptiness inside me. I might wake in my hotel room surrounded by the detritus of a heavy night on the road — empty bottles, drug paraphernalia, maybe a stranger in my bed, all that kind of shit, but also an opened copy of the Gideon’s Bible with passages underlined.

After Arthur died, the world seemed to vibrate with a peculiar, spiritual energy. I was genuinely surprised by how susceptible I became to a kind of magical thinking. How readily I dispensed with that wholly rational part of my mind and how comforting it was to do so. Now, that may well be a strategy for survival and, as such, a part of the ordinary mechanics of grief, but it is something that persists to this day. Perhaps it is a kind of delusion, I don’t know, but if it is, it is a necessary and benevolent one.

SOH: If so, that kind of magical thinking is a strategy for survival that a lot of people use. Some sceptics might say it is the very basis of religious belief.

NC: Yes. Some see it as the lie at the heart of religion, but I tend to think it is the much-needed utility of religion. And the lie — if the existence of God is, in fact, a falsehood — is, in some way, irrelevant. Sometimes it feels to me as if the existence of God is a detail, or a technicality, so unbelievably rich are the benefits of a devotional life. Stepping into a church, listening to religious thinkers, reading scripture, sitting in silence, meditating, praying — all these religious activities eased the way back into the world for me. Those who discount them as falsities or superstitious nonsense, or worse, a collective mental feebleness, are made of sterner stuff than me. I grabbed at anything I could get my hands on and, since doing so, I’ve never let them go.

SOH: I have to say that I am slightly in awe of other people’s devotion. When I go into an empty church, it always feels meaningful somehow — and vulnerable — to just linger there for a moment or so. Do you know Larkin’s poem, “Church Going”, which touches on that very thing?

NC: Yes! “A serious house on serious earth it is.” And yes, there’s something about being open and vulnerable that is conversely very powerful, maybe even transformative.

For me, vulnerability is essential to spiritual and creative growth, whereas being invulnerable means being shut down, rigid, small. My experience of creating music and writing songs is finding enormous strength through vulnerability. You’re being open to whatever happens, including failure and shame. There’s certainly a vulnerability to that, and an incredible freedom.

SOH: The two are connected, maybe — vulnerability and freedom.

NC: I think to be truly vulnerable is to exist adjacent to collapse or obliteration. In that place we can feel extraordinarily alive and receptive to all sorts of things. It is the place where the big shifts can happen. The more time you spend there, the less worried you become of how you will be perceived or judged, and that is ultimately where the freedom is.

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****

SOH: It may be that the most meaningful things are the most difficult to explain.

NC: I do think the rational aspect of ourselves is a beautiful and necessary thing, of course, but often its inflexible nature can render these small gestures of hope merely fanciful. There is a kind of gentle scepticism that makes belief stronger rather than weaker. In fact, it can be the forge on which a more robust belief can be hammered out.

SOH: It’s intrinsically human to doubt, though, don’t you think?

NC: The rigid and self-righteous certainty of some religious people — and some atheists, for that matter — is something I find disagreeable. The hubris of it. The sanctimoniousness. It leaves me cold. The more overtly unshakeable someone’s beliefs are, the more diminished they seem to become, because they have stopped questioning, and the not-questioning can sometimes be accompanied by an attitude of moral superiority. The belligerent dogmatism of the current cultural moment is a case in point. A bit of humility wouldn’t go astray.

SOH: So, just to make sure I’ve got this right: you would like to get past your doubt and just believe wholeheartedly in God, but your rational self is telling you otherwise.

NC: Things happen in your life, terrible things, great obliterating events, where the need for spiritual consolation can be immense, and your sense of what is rational is less coherent and can suddenly find itself on very shaky ground. I think of late I’ve grown increasingly impatient with my own scepticism; it feels obtuse and counter-productive, something that’s simply standing in the way of a better-lived life. I feel it would be good for me to get beyond it. I think I would be happier if I stopped window-shopping and just stepped through the door.

When it comes down to it, maybe faith is just a decision like any other. And perhaps God is the search itself.

I think the only way I can fully give myself over to the idea of God is to have the room to question. To me, the great gift of God is that He provides us with the space to doubt. For me at least, doubt becomes the energy of belief.

SOH: That’s fair enough, I guess, but it’s starting from the premise that God exists and allows us to doubt, which an atheist would argue is essentially flawed logic.What would you say to that?

NC: Well, Seán, since when has belief in God had anything to do with logic? For me, it is the unreasonableness of the notion, its counterfactual aspect, that makes the experience of belief compelling. I find that leaning into these intimations of the divine, that for me do exist, as subtle, softly spoken and momentary as they may be, expands my relationship with the world — especially creatively. Why would I deny myself something that is clearly beneficial because it doesn’t make sense? That in itself would be illogical.

There seems to be a growing current of thought that tends towards a sort of cynicism and distrust of our very selves, a hatred of who we are, or, more accurately, a rejection of the innate wonder of our presence. I see this as a sort of affliction that is, in part, to do with the increasingly secular nature of our society. There’s an attempt to find meaning in places where it is ultimately unsustainable — in politics, identity and so on.

SOH: But, hang on, are you saying atheism — or secularism — is an affliction? And that you equate it with cynicism? I mean, come on, non-believers can have a sense of wonder at the world — with nature, the universe, with the wonders of science, philosophy and even the everyday.

NC: I am not saying secularism is an affliction in itself. I just don’t think it has done a very good job of addressing the questions that religion is well practised at answering.

SOH: What kinds of questions, in particular, would you say religion is more adept at answering?

NC: Religion deals with the necessity for forgiveness, for example, and mercy, whereas I don’t think secularism has found the language to address these matters. The upshot of that is a kind of callousness towards humanity in general, or so it seems to me. And I think callousness comes out of a feeling of aloneness, people feeling adrift or separated from the world. In a way, they look for religion — and meaning — elsewhere. And increasingly they are finding it in tribalism and the politics of division.

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SOH: The decline of organised religion may be one reason for that, but there are others, of course, social and political.

Whatever you think about the decline of organised religion — and I do accept that religion has a lot to answer for — it took with it a regard for the sacredness of things, for the value of humanity, in and of itself. This regard is rooted in a humility towards one’s place within the world — an understanding of our flawed nature. We are losing that understanding, as far as I can see, and it’s often being replaced by self-righteousness and hostility. There seems to be a growing current of thought that tends towards a sort of cynicism and distrust of our very selves, a hatred of who we are, or, more accurately, a rejection of the innate wonder of our presence.

Well, I love this world — with all its joys and its vast goodness, its civility and complete and utter lack of it, its brilliance and its absurdity. I love it all, and the people in it, all of them. I feel nothing but deep gratitude to be a part of this whole cosmic mess. I have no time for negativity, cynicism or blame. In that regard, Seán, I feel as if I am completely and hopelessly out of time.

I don’t know how to exactly say this, and please don’t misunderstand it, but since Arthur died I have been able to step beyond the full force of the grief and experience a kind of joy that is entirely new to me. It was as if grief enlarged my heart in some way. I have experienced periods of happiness more than I have ever felt before, even though it was the most devastating thing ever to happen to me. This is Arthur’s gift to me, one of the many. It is his munificence that’s made me a different person. I say all this with huge caution and a million caveats, but I also say it because there are those who think there is no way back from the catastrophic event. That they will never laugh again. But there is, and they will.

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Last year, assisted suicide accounted for 3.3% of all deaths in Canada, a third more than the previous year. At the same time, deaths officially recorded as suicides fell to the lowest rate in two decades. The Medical Assistance in Dying, or MAiD, Act was passed in 2016, requiring that a patient’s condition has to be “grievous and irremediable”, and death “reasonably foreseeable”, for them to qualify for euthanasia. But the law appears to allow loose interpretations of these conditions.

As a child, Alan Nichols had suffered complications from surgery which affected his mobility on one side and left him with hearing loss. Still, he was living independently before his death. Physically, Gary says, his brother had been doing much better: “He was being treated for absolutely nothing, no illness.” But Alan’s mental health was volatile. “He would go through stages where life was good and then he’d hit a stage for a while, for a month or two, where he didn’t feel like living.” He was prone to paranoia and reacted badly to change: if Gary was getting ready to leave, Alan might say: “Are you going to leave me home with all these knives?” And Gary would have to say: “Alan, I trust you. If that’s what you want to do, I can’t guard you 24/7.”

He did guard Alan, as well as he could. After their parents died, Gary and his other brother Wayne took turns in helping Alan to do tasks that overwhelmed him, such as banking. But they both had their own lives, and Alan struggled to accept help from friends. In the months before his death, he had begun to feel increasingly isolated. His local network was coming apart: Wayne had decided to take a trip across Canada; a trusted neighbour was planning to relocate; his favourite shop had closed. His story isn’t unusual: of the 31,664 assisted deaths in Canada, 17% of the patients cited “isolation or loneliness” as a reason for wanting to end their lives.

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The week before Wayne was due to leave, Alan was found by paramedics on the floor of his apartment. The neighbour he trusted had raised the alarm after not seeing him for days. He was malnourished and clearly suffering a major depressive episode. He was taken to Chilliwack General Hospital.

Alan did try to resist being sectioned. Gary was told that his brother “was fighting not to go into the ambulance”. Gary rushed to the hospital to see his brother, who said to him: “If you’re not here to bust me out, you might as well leave.” Gary didn’t bust him out, a decision he now says he regrets. He trusted the hospital to look after Alan. When he called to get updates on Alan’s condition, the staff were optimistic: “The hospital would say, ‘Oh, he’s doing fine. He’s okay. Yeah, he’s eating.’” It made Gary think Alan was “getting back on track.” What the hospital didn’t tell Gary was that his brother had actually signed his own death warrant.

For some Canadians, assisted suicide is a peaceful alternative to an unpleasant death. Patients with terminal illnesses often point out that end-of-life care can be highly undignified, and appreciate the power to choose something else. Don Kent was assisted to die in Ottawa after being diagnosed with terminal cancer. In a blog post written before his death, he declared: “We euthanise our pets humanely, but it is only recently that we have started applying humane dying to our own species. I want medical assistance to ease my way out of this life — nay, I demand it!” His family describe the process as cathartic: “As he requested, Deep Purple’s ‘Child in Time’ was cranked up in the background. His death was completely on his own terms, just as he wished.”

But what happens when there is no terminal diagnosis? What if your family don’t support your wish to die? In the days and weeks following his hospitalisation, Alan refused to take visits from his brothers. Gary tells me that patient confidentiality meant that the doctors didn’t have to inform them about Alan’s application for assisted dying. The people who loved him didn’t find out about it until a couple of days before the procedure was scheduled. Gary sees the hospital as partly responsible for keeping Alan from his family. “The last two weeks, they were treating him for nothing. They were giving him room and board.” He could have gone home. When, later, Gary asked the hospital, “Why did you keep him there?”, they said: “Alan didn’t think he should go home because you guys would try to convince him otherwise.”

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Gary did, indeed, spend the last day of his brother’s life trying to change Alan’s mind. He winces at the memory: “I think we came really, really close to convincing him not to do this.” Aware that his brother felt isolated, Gary told him: “Alan, I’m contemplating retiring this year, and possibly coming back to Chilliwack. To give you a little more support and a little more family close by”: “He just looks at me and says, ‘Geez, I wish I’d known that.’” In Alan’s view, it was already too late to alter his decision.

Now, Gary wonders if his brother would have regretted his attempt to end his life, had it not succeeded. It’s common knowledge in psychiatry that most previously suicidal people do. One Harvard study shows that “nine out of ten people who attempt suicide and survive will not go on to die by suicide at a later date”. Gary says he feels utterly betrayed by the hospital, the Canadian government, the whole system that undid all his family’s hard work to keep Alan alive.

Other countries are taking tentative steps towards a debate on legalised euthanasia. Last year, Spain passed legislation stating that a person can qualify for euthanasia if both incurable illness and “unbearable suffering” are proven. In the UK, both euthanasia and assisted suicide are currently illegal. But in 2021 an Assisted Dying Bill was proposed to the House of Lords and in the same year YouGov polls showed 73% of citizens supported legalising euthanasia for terminal patients. Only 35% of MPs agreed at the time, but since then the violent suicide of a grandfather with debilitating prostate cancer revived the debate, which remains preliminary and cautious.

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Justin Trudeau, meanwhile, is barreling at breakneck speed towards near total liberalisation. The Canadian system is set to become similar to Belgium’s or Switzerland’s. In March 2021, adults with “incurable diseases” but no foreseeable death were made eligible. Now, the “Special Joint Committee on MAiD” is considering whether to expand the law to “mature minors” (no further clarification given) and offering assisted dying to those with solely mental health conditions. Both tweaks to the law could come into effect in Canada as early as 2023.

Evidence suggests that there is demand for these services. Rupa Subramanya recently reported, for Bari Weiss’s Common Sense, on an epileptic woman called Victoria, who was only 21 when she considered applying for MAiD to alleviate her family’s dire financial situation. Subramanya also told the story of 23-year-old Kiano Vafaeian, who is seeking MAiD for depression, and his distraught family. Alan’s MAiD form, which I have seen, only listed “Hearing Loss” as his reason for requesting to die.

The conflicts of interest here are troubling. A 2020 preparatory analysis of MAiD predicted that it could save $66 million in healthcare costs. And facilities that carry out assisted suicides are given government support. In Alan Nichols’s case, the nurse who approved his application was also the “practitioner” giving him the fatal injection. “It’s like you’re writing your own paycheck,” Gary says.

Gary suspects Trudeau will allow the laws to go even further. “Why don’t you just set up a walk-in clinic for it? Because that’s what’s going to happen: once the government opens the door, these physicians and medical teams are just going to open it wider.”

As we say our goodbyes, Gary remembers something:

“In 2008, my mum called me and said: ‘Alan didn’t show up for dinner last night.’ So I said: ‘Okay, I’ll go check on him.’

So, I went over to see him, and his door was locked and wasn’t opening. I called a locksmith who came and opened up the door, and we went in there and he was laying in his bed.

And he says: ‘I knew eventually somebody would come to see me.’”

You can call Samaritans for free on 116 123, email them at jo@samaritans.org, or visit www.samaritans.org to find your nearest branch.

As the mother of a son who identifies as part of the transgender community,[1. My son uses the pronouns associated with his sex. I have chosen to remain anonymous to protect his identity.] the prospect of there being an epidemic of trans murders holds an added weight: is my son’s life in danger? Should I be beside myself with worry when he travels to work, let alone when goes out to a gig at a weekend? Suffice it to say that this is not an issue that I can afford to take lightly.

Facts always matter — but they take on a particular importance when they’re being used to claim that your child could be murdered. So I decided to delve into the research used to inform these claims. For me, it was personal.

The Government doesn’t publish data on the number of transgender people in the UK, though in 2018 it “tentatively” estimated that the figure stood between “approximately 200,000-500,000”. What proportion of that number must have been killed to warrant today’s warnings of trans murder epidemic? 10? 100? 1,000?

To find out, I analysed data collected by the trans-led organisation Transgender Europe, which has received more than a million dollars from the Arcus Foundation, who are based in the US and take a keen interest in transgender issues. As well as donating almost $150,000 to Stonewall, in 2015 the Arcus Foundation handed $312,000 to Transgender Europe specifically to supply reliable global data on transgender murders. The website it created provides an interactive map and links to documents naming the transgender victims.

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Looking at Transgender Europe’s list of cases, it became clear — to my relief — that  the total murders reported for the United Kingdom since 2008 amounted to 11. This translates as a murder rate of around 0.165%.

Now, that is still significantly higher than the murder rate for the UK as a whole: the ONS reports that the homicide rate in the UK for the year ending March 2020 was 11.7 per million people, rising to 17 per million among men. But look a bit closer at the list of trans murder victims, and that figure of 11 becomes increasingly suspect.

For instance, two of the listed victims, Vikki Thompson and Jacqueline Cowdry, appear to have been erroneously included. Thompson died by suicide while incarcerated in HMP Leeds, while Cowdry’s death was ultimately ruled as non-suspicious. This reduces the total to nine unlawful deaths, all of whom were born male. (By contrast, the number of homicides committed by transgender people between 2008 and 2017 was 12.) For context, the number of women killed by men during the same period was 1800. So much for our alleged “cis-privilege”.

Searching for more information led me to the work of Karen Ingala-Smith, who founded the Counting Dead Women project in 2012 after she realised that there was no central record of the extent of femicide here in the UK; thanks to her, a list of murdered women is read out in the House of Commons each year to imprint the rate of femicide on the minds our political class. Ingala-Smith’s tireless work focusses on female victims of, predominantly, male violence, though she made an exception to highlight the discrepancy between the mass hysteria about transgender victims of homicide compared to the treatment of woman-killing as mere background noise. (There is still no equivalent to the Trans Day of Remembrance for the much greater number of women killed by male violence.)

Crucially, her research sheds a vital spotlight on the nine remaining victims identified by the Trans Murder Monitoring report. Reading it, two things become clear. The first is that it is not entirely certain that all the victims themselves identified with the label “transgender”. The second is that the motives behind these crimes are more complex than straightforward “transphobia”.

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Three of the nine victims were murdered by a violent punter while working as prostitutes; another was killed by their husband, who lived on her earnings from prostitution. Another of the victims died at the hands of someone who was also trans-identifying. Another was a gay man who cross-dressed occasionally, and the motive for the murder has been ascribed to both transphobia and homophobia. Two of the murders were linked to drug use.

In other words, despite the way their deaths are often framed in the media and by activists, the large majority of these trans victims were not killed simply for being trans. Almost half appear to involve prostitution — a fact that has been quietly brushed under the carpet.

Nor is this wilful misunderstanding confined to the UK: according to global statistics, 58% of transgender murder victims were born male and work in prostitution. It seems remarkable, then, that “Trans women are women” and “Sex work is work” remain two of the most heavily promoted mantras in trans-activist circles. Indeed, a number of role models in the trans community go as far to claim that it was only because of prostitution that they were able to afford their treatment and surgeries.

Take, for example, trans activist Janet Mock, who has described how the “sex trade becomes a road well-travelled, helping trans women alleviate financial woes while also making many of us feel desired as women”. To be fair to Mock, she has also spoken publicly about the dangers of engaging in prostitution, emphasising the impacts of economic coercion, sexual abuse and trafficking on the trans community. She has also highlighted how prostitution is heavily racialised, with black and Latino communities making up a disproportionate number of transgender “sex workers”.

For reasons of sexual politics, I do not use the phrase “sex work” on the basis that the inside of our bodies, be they male or female, is not a legitimate place of work. That isn’t to say that I believe we should reprimand former prostitutes, or those still engaged in prostitution, for using this phrase. I know of former prostituted women who say this description was a survival strategy and allowed them to distance themselves from their experience.

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But that doesn’t make the phrase helpful — especially when used to describe transgender people. In recent years, the fetishisation of the transgender body has come increasingly into focus: PornHub’s annual report for 2021 — yes, they do an annual report! — showed there had been a 126% increase for porn searches using “trans”. There is clearly a “market” for trans-identified sex acts; and paired with the vulnerability of trans people to violence and murder while engaged in prostitution, the association of trans activism with “sex work” becomes even more dangerous.

Presented in this light, it seems obvious to me that we need to rethink the accepted narrative around transgender murder rates, regurgitated with monotonous regularity by both politicians and the media. For example, rather than holding vigils, those concerned with the tragic deaths of transgender people would do better to watch The Sex Map of Britain, a BBC documentary that follows two young men who were both homosexual and rejected by their family. In one of the most heart-breaking scenes, Mia, now a transgender escort, is brought to tears when talking about maternal rejection for the crime of being gay. Later Mia seeks reassurance from a client that they enjoy each other’s company. The punter answers that he does not want to cause offence, but he is only there because of the sex on offer. In another scene, Mia talks about hoping to find love in sex filmed for pornography.

It pains me to say it, but I see my son in Mia, and of one thing I am certain: looking for love, validation and self-worth in porn and prostitution won’t help him. Likewise, pretending that there’s a trans murder epidemic, when incidents are isolated and largely confined to prostitution, is equally unhelpful and even dangerous — not just to people like my son, but to the women whose murders are quietly forgotten in favour of performative headlines about an ‘epidemic’ that doesn’t exist.

Like so much of Woolf’s diaries, that last description has an echo in her fiction. In Mrs Dalloway, Clarissa, the eponymous wife, thinks about how much she dislikes her own appearance, her “ridiculous little face, beaked like a birds’”.

In her new, annotated edition of Mrs Dalloway, Merve Emre doesn’t footnote the parakeets. But she is frank about Woolf’s less sympathetic side — and the ghastly personal beliefs she subsumed into her fiction:

“The fact is that the working classes are detestable”, Woolf would write in her diary in 1920 — a prejudice she harboured and took great care to ironise in Mrs Dalloway.

Indeed, the point of Mrs Dalloway is to show the thoughtless distance that existed between the comfortable world of the rich and the unquiet world of the poor. Woolf “took great care” to transform the rudeness of her diaries: what appears as shockingly nasty and unprovoked becomes artful and observant — empathetic, even — in her fiction.

Because we do think about other people like that. We can’t control our thoughts. And Mrs Dalloway is concerned with the inner life (“one’s life,” Woolf wrote, “is not confined to one’s body and what one says and does”). Clarissa is so polite, so well mannered, so poised; Woolf drew on her own nastiness to show Clarissa’s interior: frustrated, suppressed, annoyed — about even the smallest things. “For Heaven’s sake, leave your knife alone! she cried to herself in irrepressible irritation.”

To use the language of Twitter, Clarissa Dalloway is trying to control her inner troll — just as Woolf was disguising, ironising and converting hers. In the online age, we are constantly confronted with the dilemma of appropriately expressing our thoughts, of not feeling free to express what ought to be acceptable, of feeling obliged to disguise or edit ourselves, or simply of disliking our own personality. The Annotated Mrs Dalloway is timely.

Woolf wrote in her diary that she detested “egoistical: personal” writing — of the kind that proliferates, now, in autofiction. She worked to be formal, objective. But Emre finds Woolf’s life surfacing everywhere. Woolf’s thoughts, and her self, are irrepressible. Her half-brother used to fondle her in bed, and Emre suggests we can see him “peeping out” from behind Hugh Whitbread, a “sexually abusive” character. Woolf’s early suicide attempt is drawn on. Like Septimus, the soldier suffering from PTSD, Woolf once hallucinated birds talking to her in ancient Greek.

The form of the footnotes mirrors their eclectic contents. They are laid out in thick margins, but sometimes they don’t run in sync with the text, so you have to scout around for the relevant note. There is at least one pile up, where a page of images is put in to allow the notes to catch up with the novel. Emre has created a kaleidoscope of revealing and illuminating images: contemporary photos of London; Duncan Grant’s painting of Regents Park; an etching of Oxford Street by Joseph Purnell; the Tatler cover for May 1922; an X-Ray of a hand. There are also frequent maps showing the characters’ routes through London.

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Just as Woolf’s fragmentary syntax reflects the irrepressible flux of a busy mind, the images and footnotes give a sense of the emergent bustle of London — one of the novel’s essential metaphors — and the disjoined way in which we piece our thoughts together. We are used to this of course — or we should be. Modern culture is chaotic. Social channels and comment threads enable everyone to footnote everything. But still, the annotations show what a marvel it is that Woolf managed to hold together this strange and vivid story — in her head and on the page.

It wasn’t easy. Emre shows how Woolf worked and worked and worked at this book. She was weary with the effort. She resented distractions — she often did. Throughout the letters and diaries, Woolf complains about the demands of other people. “We have seen an endless number of people”. Clarissa’s inventor was, like her, a reluctant hostess. Without people, she relaxed. She wrote to Vita Sackville-West from Sussex in 1928, “I am in soaring health and spirits after one day here and have sat looking at cows for 3 hours instead of chasing round London buying scraps of meat and coming home to find Clive, Miss Jenkins, Sybil, etc.”

Her diary, when she is home, crashes around from notes of where she has been, what she did, who was there, into convoluted psychological, ethical, and philosophical considerations. Just when the discussion becomes intractably deep, she flips into personal admin, grumbles, plans for work, gossip. Woolf seems calmer — nicer — when she is relieved of her anxieties, ambitions, and activities. Unquiet minds, we might speculate, produce unpleasant remarks. They also produce good art. Mrs Dalloway crashes around, too.

Woolf examined her own mind for material, but the novel wasn’t simply a re-working of her diary. Remember: Woolf took great care. She had almost impossibly high standards: she once told E.M. Forster that he wasn’t really a novelist. The poor man had nothing to say other than “Ah!” She criticised him for being unable to marry “satire and sympathy; fantasy and fact.” To meet Woolf’s high standards, then, one must transform the biographical. We must look for the way her rudeness is recreated — not merely expressed — in her art. What we dislike in her private voice, we most likely, unsuspectingly, admire in her public art. If only the same were true of our own vicious internet selves.

It would be easy to cancel Woolf today — parts of her, at least. Emre’s notes introduce critical debates about Woolf’s racism: the diaries are full of unacceptable remarks about Indian people. Mrs Dalloway, however, is not so straightforward. Woolf unflinchingly portrays how the English upper classes saw Indian women as mere objects of desire; as Emre (summarising Supriya Chaudhuri) says: “she represents prejudice from the intimate position of who feels it… Woolf is critiquing what she knows best: her failure to transcend her own racism.” By reading Woolf, we might critique our own rudeness. We might learn, like her, to use our lesser thoughts to encourage ourselves into empathy.

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Because some of the rudeness Woolf buried in her novels has become more, not less, acceptable: Emre shows many lines that were cut from the original draft of Mrs Dalloway, a lot of them about same-sex attraction. Clarissa’s memory of her first kiss with Sally was rewritten so that it described something spiritual and nostalgic, rather than a physical pleasure: “she became instantly soothed and yet stimulated as if myriads of bells chimed.” As with her racism, when writing about concealed desires, Woolf wrote about unacceptable things from the intimate vantage point of one who has experienced them.

Today’s literature looks for the personal everywhere — memoirs proliferate, especially from the unmemorable. But today’s culture is often intolerant of imperfection. We are too close to ourselves, perhaps, to see ourselves clearly, and accept what we find. The distance of fiction can help us see our irrepressible thoughts — to understand we are not obliged to be what we think or say or write.

There are various reasons, not least that spouses physically look after each other and once alone, a widow or widower might not care much any more. But there is also the psychological impact of grief, the broken heart and the feeling of not wanting to go on. Death is, in this sense, contagious — but, then, almost everything is. Perhaps after a tortuous year and a half in which everyone has learned about infection and “R values”, we should start to appreciate this more.

Today we exit lockdown after 16 difficult and strange months, a period that began and ended with two of the most watched television programmes in British history: the Prime Minister’s television broadcast to the nation, and the 2020 European Championship final.

In between those two events, the British public were forcibly locked into their homes, pubs were closed, casual sex was made illegal and parties were banned — it was the most popular policy in living memory, and a huge swathe of the population seemed to actually enjoy it. Indeed, a large section of the public wants lockdown to last forever, with almost one in five favouring a permanent 10pm curfew.

What some people liked about lockdown was the feeling that everyone was was in it together, all in the same boat: no one had a social life, everyone was isolated and scared, and that felt somehow more communal. And while the fetishisation of the NHS can feel strange, the Clap for Carers and the weird cult of Captain Tom was the closest thing we’ve had to common rituals for a long time — and people need common rituals.

The British obsession with the Second World War is often misinterpreted as being about triumph, but it’s actually related to the sense of common purpose people felt, especially during the Blitz; humans are much happier when they’re part of something, which is why suicide rates fall during periods of intense group feeling, a trend first noted by Durkheim.

When the virus first hit, Boris Johnson was slow and reluctant to act because he is, by nature, a classical liberal, a philosophy that holds individual liberty as the central good. It is deeply inadequate in such a crisis, because we have no individual choice during an epidemic — our risk of getting sick depends not just on our behaviour, but on the behaviour of those around us.

That is partly why the poor suffered higher death rates (that feeling that we were all in it together during lockdown was largely false). It was not only that most manual workers continued to go into sometimes dangerous workplaces, or that the poor have higher risk of ill-health and live in denser areas — it’s also because the people in their social networks were more likely to be infected to start with.

Yet the same is true of everything. Almost every aspect of life depends on contagion in some way, fixing the odds against those in the wrong networks. We are ultra-sociable as a species, unusually so for mammals, to the extent that E.O. Wilson even described humans as “eusocial apes”. Compared with our relatives, we like to live in very large groups, socialise with strangers, and imitate them. It is for that reason that plenty found lockdown unbearable.

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Because humans live in such large groups, and are also so unusually influenced by culture as well as genes, it’s not just viruses that are contagious within human populations, but ideas and behaviour. One of the first recognised “contagions” was suicide, a problem called the Werther effect, after the Goethe novel The Sorrows of Young Werther published in 1774. A story of unrequited love, the book was blamed for a string of suicides, with copies found beside the body in some cases.

In the Fifties it was first noticed that, whenever a prominent celebrity suicide was reported, there followed a spike in road fatalities. It turned out, as insurers soon cottoned onto, that a great deal of car accidents are disguised suicides. Copycat suicide has been found repeatedly in various studies across countries, the most prominent recent British case being the Bridgend epidemic. Multiple studies show that people are more likely to commit suicide after a friend or acquaintance does, mostly using the same methods. It is why the media has very strict rules about reporting suicides, probably the only rule that British newspapers have assiduously stuck to down the years.

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Suicide is not unique, though. Marriage is contagious, as is non-marital cohabitation, divorce and pregnancy. If a woman becomes pregnant, the likelihood of her friends becoming pregnant rises over the next two years.

Yet the contagion effect is largely ignored in political debates. One of the big issues of the Nineties and Noughties was whether out-of-wedlock births and fatherlessness had a negative impact on life chances, and what the state’s role was in this trend.

It’s hard to disentangle cause and effect, nature and nurture, but it now appears that what affects a child’s life outcomes is not just whether he has a father at home, it’s whether the other kids in the neighbourhood have a father at home. One US study found that “Black father presence at the neighborhood level strongly predicts black boys’ outcomes irrespective of whether their own father is present or not”; another that “Children of single parents have higher rates of upward mobility if they grow up in a neighbourhood with fewer single parent households”.

Boys from more comfortable backgrounds, whose own fathers were absent, were much more likely to have other male role models in their social network, where family break-up had not reached epidemic levels. It takes a village, as the saying goes, but you need men in the village.

The debate has largely disappeared with the sharp decline in teen pregnancies across a number of countries, and while much of this is down to greater contraception uptake, another is that girls are just much less likely to get pregnant if none of their friends do. The huge increase in teen pregnancies in the late 20th century was in part a contagion, and it’s burned out.

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Similarly, corruption, according to a meta-analysis of 137 experiments into unethical behaviour, is contagious, as are bad ethics. When a prominent steroid user joined baseball team, his teammates started cheating too. Drug taking, the biggest scourge in American life, is certainly contagious, and gun violence maybe, although people disagree about how much.

Likewise, happiness is contagious, as is sadness, so that “each person in your network who became happy increases your chance of becoming happy by 9%, an unhappy person drops it by 7%.” One of the reasons social media is depressing is because it’s just full of unhappy people writing about how miserable they are.

During the height of last June’s protests, leading health experts in America were justifying support for Black Lives Matters rallies by saying that racism was actually a deadly contagion, so this was actually a health matter. Obviously, it’s more sophisticated sounding than saying “I’m an abject moral coward and don’t want to go against the prevailing ideology, however obviously stupid it is”, but it is true that ideas have certain epidemiological traits.

That is, political beliefs are contagious, which is why students often adopt their roommate’s ideology.  University attendance makes people more Left-wing, not because students are being indoctrinated by academics, but because they’re copying their peers, just as they would if their peers smoked, drank or declared themselves non-binary.

Better technology means that ideas can spread through human populations more rapidly, so that the arrival of the iPhone caused the Great Awokening just as printing led to the Reformation. If the last year has often been odd, it’s partly because we’ve been both cut off from our regular networks, and at the same time subjected to the most contagious medium of viral spread.

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The internet, as at least one paper has suggested, is to our minds what the transition to cities was to our bodies. When people moved to the first urban settlement, novel diseases like measles, TB and later plague were able to spread rapidly among these eusocial apes; the same is arguably true with ideas and lifestyles in the 21st century, with technology imposed on a species uniquely vulnerable to contagion and imitation.

Many people have no more resistance to the insanity spreading out of US academia than our ancestors had to viruses carried by cattle or pigs. Humans are viral creatures, and if the Covid era has taught us anything, it’s that our life outcomes really depend on those closest to us and that everything, from the misery of illness to the mind-melting memes of June 2020, is contagious.

Humankind’s eusocial nature was almost perfectly summed up 400 years ago by another victim of infectious disease; John Donne, reflecting on life and death after a bout of typhus, afterwards wrote the immortal words that still bear true today: “No man is an Iland, intire of it selfe; every man is a peece of the Continent, a part of the maine.”

So happy “freedom day”, but remember: we are not as free as we suppose.

I once saw a television debate between the philosophers Ernest Gellner and Charles Taylor in which they suggested that humankind could be divided into the Tough and the Tender; I think I probably score high on the Tough side of the spectrum. I know that mental illness is real; it killed my son and has blighted the life of my best friend. But I do believe that many people could make themselves better. Resilience is like a muscle which grows weak with lack of use; human beings are born tough, but the fussing of an over-cautious society weakens them.

Mental illness has gone from being an ailment that we dare not speak of to one that we cannot escape; whenever I turn on Radio 4, I guarantee that the words “mental health” will be spoken within ten minutes.

But it’s not just a media problem; Ulrika Jonsson recently stripped off “to highlight the importance of men’s mental health” and to urge fans to donate to the charity StrongMen. What did her naked body have to do with it? I suppose 30 years ago it might have cheered some sad men up. But as it was, it was hard to define exactly who benefited.

Meanwhile, criminals are being spared jail for the sake of their mental health, the most recent example being when a cocaine-crazed driver left a nursery nurse with a fractured skull after running her over while talking on the phone and doing 63mph in a 30mph zone. Yasmin Jenkins was left in a coma and she is unable to return to work. But when sentencing her attacker, Clare Cassidy, earlier this month, Recorder Robert Lazarus noted: “You have a history of long-term mental health problems and I accept you are genuinely remorseful. I also note your mental health problems may deteriorate if sent to prison.” So that’s alright then!

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F. Scott Fitzgerald once wrote that he “avoided writers very carefully because they can perpetuate trouble as no one else can”. I thought of him as I picked up the latest book by Matt Haig, who has perpetuated his own troubles very successfully indeed. The Comfort Book is the latest in Haig’s canon of woe, preceded by Reasons To Stay Alive (2015) and Notes From A Nervous Planet (2018). It is, we’re told, “a collection of consolations learned in hard times and suggestions for making the bad days better”.

One of the signs of serious depression is the inability to be creative, but Mr Haig, who attempted to commit suicide aged 24, has been a veritable one-man library-stuffer, writing eleven children’s books and seven novels since he started out in 2004. He has, since then, also been signed up to something called The Mental Health Speakers Agency, along with Love Island’s Dr Alex and Blair Island’s Alastair Campbell. According to his profile, “Matt’s refreshingly honest and composed approach to a heavy topic makes him a hit time and time again” — which made me laugh as it sounds like an escort agency. Still, I’m sure it’s a lovely little earner; singing the blues will soon have you rolling in the greens.

Which brings us back to The Comfort Book. It’s very much what I think of as an UnBook, the sort of thing people who don’t like reading give to fellow illiterates at Christmas. If it were a garment, it would be a onesie. If it were food, it would be mashed potato. If it could speak, it would say “I’m here for you”. Keen not to startle us, Haig soothes us with an almost tangible hush: “You can place it beside your bed or keep it next to the toilet. You can throw it out of the window.” Option three, please!

He also reassures us that “You can tear out the pages”. But where to start? There’s so much to loathe: “We are all things. And we connect to all things. Human to human. Moment to moment. Pain to pleasure. Despair to hope.” “You were born worthy of love and you remain worthy of love. Be kind to yourself.” “Walking one foot in front of the other, in the same direction, will always get you further than running around in circles.” “It’s okay to be the teacup with a chip in it. That’s the one with a story.” It’s like that all the way through.

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But do we really need encouragement to be any soppier than we are? We are already a society in which dealing with one’s emotions privately is equated with “bottling it up”, which must surely lead to mayhem in the future. Indeed, this is the central argument of the current war between the Windsors and Sussexes; that processing and mastering one’s feelings alone is some sort of sham. But seeing the photographs of the Queen having a laugh at Royal Ascot last week, and comparing her resilience to the Sussexes’ ceaseless whining, this seems a spectacular own goal. All we see in the wars of the Windsors is an attempt by the Sussexes to “strength-shame” anyone who won’t put their personal problems in the shop window for all the world to pick over.

Of course, the mentally ill have always been with us, and always will be. But surely every other person didn’t have issues until they realised that it would get them attention? Rather like what one does in bed, a person’s neuroses are generally the least interesting thing about them, unless they are profoundly dull. Look at Churchill; a lifelong sufferer from severe manic depression, frequently suicidal — “I don’t like standing near the edge of a platform when an express train is passing through… I don’t like to stand by the side of a ship and look down into the water” — but he never let it get in the way of leading a tiny nation into battle against the might of the Nazi war machine.

When I was a girl, I couldn’t wait to be a grown-up. I imagined that adult life was dangerous and exciting, and I was eager to get out into the fray. But now the craze for over-protecting children (as I write, doctors have just begged parents to stop bringing record levels of children suffering from colds to A&E!) has spread to the adult world with its endless waffle about pampering, self-care and me-time — and “journaling”, of course, so we can all have a chance of producing our very own Comfort Book.

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Talking of which, I must admit that I suffered a touch of “low mood” myself — quickly mutating to high dudgeon — on seeing my adored Stoics quoted in this quivering blancmange of a book. Far from feeling the need to cosset and baby ourselves, Marcus Aurelius said that the strong — which most of us are and which just a few, like my poor son, are not — should positively give thanks for misfortunes: “It’s unfortunate that this has happened? No. It’s fortunate that this has happened and I’ve remained unharmed by it — not shattered by the present or frightened of the future. It could have happened to anyone. But not everyone could have remained unharmed by it.”

Indeed, if you must seek advice on how to live life, have a look at The Daily Stoic website; just ten minutes of study a day will turn your attitude around, as it did mine. There are even a few good self-help books — The Power Of Now, Feel The Fear And Do it Anyway — which see the world clearly as the big bad beautiful thing it is, and advise extreme boldness in engagement with it.

If you want to live your one and only life in a self-soothing fashion, go ahead. But don’t be surprised when you’re on your deathbed with only half a life to look back on. Because fortune favours the tough — and has a habit of swerving the tender.

Foolishly, I had allowed myself too much mental permission to fantasise about the where and the how. And, for a while, even this felt like a strange form of hope — a way of doing something about the darkness. At the end of a rope, everything would be forgotten.

Over the past year, suicide has become part of the public discourse about the lockdown. I do not want to conscript the pain of others, in all its harrowing specificity, into some general argument about whether the lockdown has caused a spike in suicide. But we have all heard so many examples of heart-breaking human misery that have been linked with the disruption. And, for some, there will surely have been a connection: jobs lost, crushing loneliness, more drinking, disrupted care, and worst of all domestic abuse. Indeed, in my pastoral role as a parish priest, I have been extremely worried about the declining mental health of some in my community, and where it might end up.

Politicians, from all shades of opinion, have tended to agree. “Suicides are up” insisted President Joe Biden, one of the few things with which he agreed with his predecessor. Just days after the first lockdown was announced, President Trump had warned of “suicides by the thousands”.

But the strange thing is that if you look at the data, it is not at all clear that lockdown has increased the rate of suicide. In an article published last month in the British Medical Journal, “What has been the effect of covid-19 on suicide rates”, Louis Appleby, Professor of Psychiatry at the University of Manchester, writes that reports from several countries, including Australia, Canada, New Zealand, Norway, Peru, Sweden and the US, “carry [a] consistent message. Suicide rates have not risen”.

A recent paper in The Lancet Psychiatry reached a similar conclusion: “Suicide numbers … remained largely unchanged or declined in the early months of the pandemic.” And the same seems to be true about figures coming in from this country too. Only Japan seems to have experienced a statistically verifiable jump in the suicide rate.

There are caveats, of course. One suicide is a suicide too may, and for those who have lost loved ones, the wider statistical evidence and the overall numbers are all rather beside the point. Moreover, in this country, suicide is the leading cause of death for men under the age of 45 — over 6,000 people die of it every year in the UK.

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But, on a societal level, there may be something significant going on here nonetheless. The narrative that lockdown leads to suicide feels intuitively convincing, but it is a narrative not backed up by evidence. Could there be another story to tell?

Professor Appleby allows himself cautiously to speculate: “Perhaps, as well as the risks, there have been protections. We may have been more careful in lockdown to stay in touch, more alert to warning signs. In the face of a crisis, there may have been a greater sense of community, of getting through it together. Perhaps a belief too that it would soon be over, so that the distress that many felt did not become that most dangerous of moods, despair.”

This makes some sense to me. When I was at my lowest, standing outside that rope shop, I felt so profoundly alone. Yes, that was mostly my doing; like others in this situation, I did my best to push people away. But I would scroll through the numbers in my mobile phone and not have a clue who I might call. They were all busy getting on with their lives — why would I burden them with my bleakness? But the funny thing about lockdown is that there is a much greater sense that we are all going through it together. And this allows us to speak about our pain in a more open way.

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Why is the Church so woke?

By Giles Fraser

Over lockdown, my modest church community has grown in numbers and attendance. Before it all began, our little midweek communion service would attract two or three at best. This week we had over a dozen in church and nearly 20 on zoom. And the nature of the conversations people have been having with each other before and after the service feel so much more mutually supportive. I am not citing this as evidence that there is some mini-religious revival going on in South London; more that people are keen to seek each other out, and speak more openly about what they are going through. In this little corner of the world at least, I believe we have become a much more supportive community. There is a different quality to the words “You alright?” — now more a genuine question than a simple greeting.

And yes, hope too. I will inevitably gloss this as a religious thing — I am a priest, after all. But for all that people have gone through, there remains a sense that, as St Paul put it in his letter to the Romans: “I consider that our present sufferings are not worth comparing with the glory that will be revealed in us.” Okay, for some of us, this glory is a white table cloth and a fancy menu — or something equally secular-sounding.

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We're living in a pornstar's world

By Mary Harrington

But these things do channel hope. As it happens, my favorite Soho Italian restaurant, Vasco and Piero’s Pavilion, has just closed down after 40 years. Passing by this week, their familiar welcoming sign has come down and the tables and chairs were being ripped out, a miserable scene. The landlord wouldn’t budge on the rent, and they could survive no longer. Yet for all this, they tweeted out yesterday, defiantly: “We will be back!!”

I don’t know how to evidence hope – it’s very different from optimism, for example. More about attitude than expectation, perhaps. But put it this way, I felt this year’s Easter resurrection sermon had a lot more people nodding and Alleluia-ing than in previous years. The challenge for the church — and for others too — will be not to allow this rising sense of hope to wash away all that solidarity in joint adversity that has bonded so many of us over this last year.

One must be cautious about suicide statistics, and what they explain or don’t. But I, too, can’t help but wonder whether the reason they have not spiked is that we have found, in our various little platoons, religious or otherwise, more determined ways of sharing each other’s burdens.

You can call Samaritans for free on 116 123, email them at jo@samaritans.org, or visit www.samaritans.org to find your nearest branch.

Woolf’s novels are so serious and seriously good that they are, somehow, inexplicably bad. It’s a perverse logic. Take Mrs Dalloway: a little novel of 250 pages so ingeniously structured, elegantly grooved, impeccably polished and deftly brought off that it always takes about two months to read. Nothing so short should take so long.

For a writer so attentive to the twitchy, nervy minutiae of life — she called them “moments of being” — it is amazing how often Woolf died. Not just the watery one eighty years ago, when she left one of the all-time great “I’ve had enough of this nonsense” suicide notes, loaded her pockets with heavy stones and toppled into the River Ouse.

She died first when her mother died in 1895. Julia Stephen was 49, Virginia barely 14. “Nothing was left,” she would later write, “… a dark cloud settled over us; we seemed to sit all together cooped up, solemn, unreal, under a haze of heavy emotion”. Her essayist father, a busy, hill-climbing Victorian scarecrow with a today impossible name (Leslie), was no support to Virginia, her sisters or her brothers.

It was a matter of space as much as anything. After Julia’s death, eleven Stephens’s and seven live-in servants dwelled up, down and under three stories in 22 Hyde Park Gate — like lobsters scuttling about inside a vent. “How,” Virginia wrote in one of her teenage diaries, “is one to live in such a world?” Of course, she would later call for a room of her own; these days she would have justly demanded a Peloton, and a podcast of her own too.

Worse waited outside the house in society, where Virginia would die again. Her priggish cousin George Duckworth, who both sexually assaulted her and published her first novel, started taking her to parties when she was eighteen. She wore long white satin dresses, pinned with three pink carnations.

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The Royal Family always wins

By Will Lloyd

Other people’s parties are generally much more fun to read about than attend. So it is with the ball at Lady Sligo’s mansion which Virginia was spirited to in June 1900. The solid, rumbling reign of Queen Victoria had just a few months left to run; Victorianism — that thicket of customs, manners and morals — would last a few years longer still. Decades later, Woolf wrote about the party: the vinegary dowager aunts swarming about, the long dining tables plastered with silver, the heavy bachelor colonels exhaling expensive cigar fumes, the walls ringing with complaints about gout and the talk of young men not yet pulled into the whirlpool of the new century.

All this in a world where hansom cabs still waited outside theatres, where turtle soup was what rich people called medicine, where self-care meant reading Homer not downloading a used-once meditation app, where every family had a grandfather who lost an eye during the Indian Mutiny. All this, all around; the exquisite champagne arrogance of power that would soon — sooner than the men in the smoking rooms realised — melt away.

So Virginia blushed, and hid behind a curtain.

She wrote to her sister in the following days: “We are failures. Really, we can’t shine in Society. I don’t know how it’s done. We ain’t popular — we sit in corners and look like mutes who are longing for a funeral.” A funeral: dead again.

The memories — and the resentments — are worked on in the later reminiscences, written in 1920. The fault is not hers; the pink carnations were good. The world was wrong: “I could not get young men to talk… the pressure of society almost forbade any natural feeling… society in those days was a very competent machine. It was convinced that girls must be changed into married women.”

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Why it's time to abolish schools

By Will Lloyd

Artists always think the world is wrong. Circumstances are refashioned to fit their ideas. Then they make their own world. Virginia’s was the Bloomsbury group. Bloomsbury was not so different from Lady Sligo’s ballroom. Its members — Virginia, her sister Vanessa, Lytton Strachey, Leonard Woolf, Clive Bell, and John Maynard Keynes — were part of the owning, quality class. Their ancestors were judges and civil servants, imperial operatives and dons, manufacturers and Quakers; none had been peasants for generations. They were never proletarians.

The difference between Bloomsbury and the other toffs was that all its young men were unhappily homosexual, or like Virginia, too cracked up to enter society on its own terms. They were privileged outcasts. They wanted freedom from the constraints and sanctions of traditional morality; there would be no more hiding behind curtains.

In their world within a world, leisurely Bloomsbury developed into what Raymond Williams called a “dissenting fraction” of the English upper-class. Light, Beauty and Truth were the new values. They believed that if they talked openly about sex they would never be hypocrites. “We were full of experiments and reforms,” Virginia wrote of the group’s early days. “Everything was going to be new; everything was going to be different. Everything was on trial.”

The disastrous First World War confirmed every prejudice the group held about England, and made their work sexy and cool. Christianity, patriotism, well-plotted novels and realistic landscape painting looked like bumbling absurdities. The values of the fathers and grandfathers were laughable and philistine. With flawless timing Strachey’s Eminent Victorians was released in May 1918. Using innuendo rather than invective, Strachey doodled moustaches on the heroic statuary of a fading age.

When the grand Tory historian G.M. Young read the book, he said: “We’re in for a bad time.” “We” meant the old establishment, which preached, as Tennyson had, that “the path of duty was the way to glory”. It turned out that the path of duty was the way to the Somme. Victorianism was punctured for good. The young looked to Bloomsbury for its values in the 1920s — which is probably why so many of them ended up as communist spies in the 1930s.

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The village that imagined a godless world

By John Gray

Woolf’s position in all this, T.S. Eliot said, was “the centre, not merely of an esoteric group, but the literary life of London.” In Jacob’s Room, Mrs Dalloway, To The Lighthouse and Orlando, she stirred the heavy dough of English fiction and discovered new forms. Being new was more important than anything else. The aim of her writing, she told Clive Bell, was to “give the feel of running water” — and so each novel is a strange prefiguration of her drowning.

The popular image of Woolf comes from this period. Here she is, the paradigmatic mad lady genius: wronged, misunderstood, impractical, oracular, ahead of her time and consequently not like other people, not quite human at all. Nicole Kidman’s fake nose won an Oscar for playing that Woolf in The Hours (2002), and this caricature was last seen in the grave, trembling lesbian romance movie Vita & Virginia (2019).

It’s the picture postcard version of Woolf — a mannequin on which any number of ideas can be hung, regardless of whether they are true. Those who knew her would be surprised to see her portrayed as a lesbian, or made a hero for the LGBT movement, given that she was terrified of sex. Anything more than holding hands was improbable.

What is true about this image is that Woolf never changes. She writes somewhere that “a self that goes on changing is a self that goes on living”. Woolf never managed it — just read the Diaries, where page after miserable page shows how stuck she became. Bloomsbury thought there were many ways of living, and many ways of feeling, but they were wrong.

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Women have always been better writers

By Tanya Gold

She began work on a new novel in 1932, when she was established as one of the most spectacular writers of the era. It would encompass “everything”. It would be her definitive statement on women and men, politics and society; on art and on life.

Two exacting years produced a useless first draft. In London, Bloomsbury was being attacked with exactly the same weapon — sarcasm — it had buried the Victorians with. Younger writers snapped at her heels. She thought of a provisional title for another book: On Being Despised. This was another kind of death.

Her diary jangled with nerves. Was her “everything” novel merely an essay about herself? (Yes.) When it was finally published in 1936, The Years was an enormous commercial success. Yet it was too detached, too backwards-looking, too voluptuous. Educated taste had moved on. “Live differently,” one character thinks — the same thought Virginia was scribbling in her diary at fifteen.

Once the war began, and Nazi bombs destroyed her London house, Woolf began to change her mind about things. The Bloomsbury judgments about England and the English were evaporating. Always a mega snob, Woolf was amazed to find herself admiring “every sort of person: chars, shopkeepers, even more remarkably… politicians — Winston at least — and the tweed-wearing, sterling dull women here… with their grim good sense.”

The deep conservatism of her country, which she’d disdained all her adult life, proved itself useful in 1940. It was an advantage to be dull, ignorant, sluggish, and unimaginative. The great majority “were hardly able to conceive,” in the words of one historian, “that Britain might lose the war.” It helped to carry them through, but it damaged her.

This is what killed her off one last time. The vast trauma, not only of war, but in discovering, so late in the day, that all her judgments were wrong. Oscar Wilde once said you’d need a heart of stone not to laugh at the death of Little Nell in The Old Curiosity Shop — true, but he didn’t live long enough to see what happened to Virginia Woolf.

Always somewhat detached, I wasn’t broken by the loss of the person I loved most in my life, as is the case with many parents in a similar situation. If anything, it had the effect of making me even more self-contained, or “sociopathic” as unhelpful husbands have invariably put it during domestic squabbles.

I even tried it on for size a few times myself; the onset of tinnitus in the winter of 2017 seemed as good a reason as any, so I took too many sleeping pills before and after Christmas. Evidently, both attempts were unsuccessful. My fabled capacity for taking drugs saw me awaken both times with nothing worse than a mild headache, and a typically immature reaction: what a waste of good sleeping pills, which could have been abused with alcohol to lubricate a few fun nights.

During a Twitter spat a few weeks ago, a number of disturbed people sent me Photoshopped images of my son in various degrees of deathly contortion. In the photos, ranged in age from angelic toddler to the handsome young man he was when he died by hanging at the age of 29. Many of my friends were shocked and reported these people to Twitter. But I felt only mild curiosity at what kind of mind would mistake such a strange action for acceptable behaviour. I even “followed” a few of them in the hope of finding out

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The blight of farm suicides

By John Lewis-Stempel

I am a robust soul, and not one to throw up my hands, clutch my smelling salts and fall down in a swoon when faced with discussion of suicide. And yet even my cold blood has flared up recently for it seems to me that suicide, the last refuge of the desperate, is becoming the currency of the scoundrel ­— and a fast way to shut down debate.

Only last week, Julian Assange was saved from the tender mercies of the American penal system when a judge concluded that subjecting him to incarceration in the US could result in his suicide. He has made no attempts on his life during his spell in Belmarsh. But the scourge of the Western war machine and seducer of Swedes has been spared the American system because he claims to have suicidal thoughts ‘hundreds’ of times a day.

Perhaps I’m being cynical. Perhaps Assange is in a bad way. I do know what that’s like, after all. But I can’t shake the feeling that this latest ruling is symbolic of a creeping tendency in society to allow suicide to be weaponised. Indeed, worse than Assange’s foot-stamping insistence that he could commit suicide if he’s made to go to America (which, of course, no one is allowed to contest), is the incredibly nasty way the threat of suicide is now being wielded by certain institutions charged with the care of fragile children.

I’m thinking of the transgender-affirming Tavistock Clinic and charity Mermaids. Last month, the BBC’s breathtakingly arrogant over-ruling of the Samaritans guide on responsibly reporting suicide was noted by James Kirkup. This holds that journalists should “steer clear of presenting suicidal behaviour as an understandable response to a crisis or adversity”. Yet when three High Court judges ruled last year that children aged under 16 will need court approval to access puberty blockers, the reliably biased state broadcaster saw fit to run an article — since edited — claiming that “Doctors and parents have told the BBC the ruling could cause distressed trans teens to self-harm or even take their own lives”.

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Can our mental health cope?

By Polly Mackenzie

The implication was clear: do you want to be the villain that makes a child want to kill themselves? Yet there’s something creepily unsettling about adults championing the idea that children can be driven to self-destruction by their genitalia. It seems strange to place death alongside sex in such an over-heated way — especially from professionals who have sworn to do no harm. “Let us mutilate these children or they’ll die” sits strangely alongside the Hippocratic oath.

To make it even more heartbreaking, the anxiety-signalling is a distraction from the reality of suicide, now the leading cause of death for men under 50; in part, I suspect, due to a growing sense of alienation and boredom — and the rise of super-strong skunk. Paradoxically, at the same time, there are calls in the West to liberalise restrictions on “voluntary” euthanasia — even though it could be used by waiting inheritors to urge the elderly to do “the decent thing” and die before they become a burden. Surely it’s no coincidence that in Belgium, where liberal euthanasia laws mean that even children can request a lethal injection, one national newspaper recently found that 40% of its citizens would consider reducing the country’s health costs “by no longer administering costly treatments that prolong the lives of over-85s”.

Before the pandemic, the UK was actually relatively jolly: currently 109th in the global suicide chart. (The Swedes used to be near the top, but turned it around in the 20th century, perhaps as a result of Abba winning the Eurovision Song Contest.) But now many of us sit alone, masked, muted and miserable. Those like me, free to work on a balcony overlooking the sea, are few and far between. Millions of my fellow citizens now feel incarcerated — and unlike Assange, they don’t get a round of applause from Pamela Anderson every time they dare to question their current situation. It’s a good job key workers don’t threaten suicide if their conditions don’t improve — but then, the rules for those in showbiz have always been different, and Assange is nothing if not a diva.

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Either way, the reality is that calls to suicide helplines have risen by a third during lockdown, while half of people generally feel that their mental health has suffered. The Office for National Statistics also reported that rates of depression have doubled from around one in ten people before the pandemic to almost one in five. And I worry that in a society where suicide is increasingly evoked as a reasonable reaction to people not getting their own way, it will be increasingly hard to know who to take seriously. I’m pretty sure my son intended to kill himself, as he made such a good job of it with very limited resources. But even when you’ve stared suicide in the face, let alone attempted it yourself like I have, it’s still impossible to fully understand its meaning, especially when it looms over someone else. The balance of a mind needs to be quite seriously disturbed before the issue even arises, so it’s hard to know exactly what people who attempt it are feeling. Maybe, with ineffable sadness, they simply want to be seen.

With suicide, there is no certainty — its very nature calls out for examination. And because of this, we should still be free to question the veracity of the claims without being made to feel as though we have blood on our hands.

After my son killed himself, one of the first things I did was go to volunteer at my local MIND shop. Every day as I walked there, I felt him walk beside me. He sat with me in the alcove where I steamed hundreds of pounds worth of clothes a day, to be sent to the shop floor to raise funds which would hopefully encourage people like him not to lose all hope. The charity shops are all closed now, and the income which helped the likes of MIND to ease the burden of the burning house of mental illness has vanished. From this scorched earth, it’s all too easy to imagine how suicide could spring up to spirit away unknown numbers of our loved ones. In the meantime, we must not diminish its cruel impact by allowing it to be used as a bargaining chip when all rationality fails.

More than one French farmer a day, by some estimates, takes his own life. (And it is almost always ‘his’, which is part of the problem.) Suicide down on the farm is not an international league table one wants to top: in the UK, the agricultural suicide rate is a mere farmer per week (still more than twice the national average). But then we have fewer farmers, 138,000 as opposed to France’s 450,000.

In France, the topic of agricultural sector suicide is currently on the lips of tout le monde, because farmers are part of the national fabric, because of the success of the recent film Au Nom de la Terre, directed by Edouard Bergeon, which recounts the life of farmer Pierre Jarjeau, from 1976 to his self-killing in 1996. It is painful watching: all the more painful because it is true. It is the story of Bergeon’s father.

The reasons for the grotesque suicide rate in agriculture? They are all there in Au Nom de la Terre, and they begin with money.

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By John Lichfield

There is none. In the 1970s, a farmer with a small herd of milk cows, say 30 Jerseys, could make a living. In 2020, a farmer with 300 Holsteins will struggle to make a penny/cent profit per pint. Personally, I do not know any farmers who work fewer than 80 hours a week, or for more than the national minimum wage.

Modern farming is a bonfire of the economic sanities, where prices are continuously driven down by supermarkets, who then take the wolf’s share of the remaining price of the packet on the shelves. The farmer’s conventional answer to the cheapening of food has been to increase production. The Bigging-Up has required pushing machine and man and land ever harder. More hours! More acreage! More technology! (Pierre Jarjeau in Au Nom de la Terre invests in a state-of-the-art, automated chicken shed, financed by the sort of easy credit everybody from City suits to EU bureaucrats like to slip farmers.)

Oh, but the cost of it. A modern tractor retails for in excess of 100k, which causes a farmer to lie awake at night, not counting his sheep but his repayments.

And the miraculous technology goes wrong. Just one piece of kit failing — such as the automated feeders in M Jarjeau’s hen shed — can bring the whole precarious Ponzi scheme of your farm’s financing crashing down to earth.

Modern farms are kept going only by billions of euros/pounds of subsidy. A Welsh sheep farmer on the Brecon hills, for example, will get about 80% of his farm income from subsidy. Sounds great. But farm subsidy is a double-edged plough-blade. The basis of subsidy has shifted so often, it is dizzying — farmers have been paid to produce, then not produce, then for the number of head of livestock, then for their acreage — which makes long-term planning impossible. Also, laugh not, but the form-filling of contemporary farming takes hours per day. Online. With rural broadband. I once spent three hours ‘pre-notifying’ a single pig movement electronically via the eAML2 system. (That ‘eAML2’ speaks volumes.) It was time wasted. Meaning money lost. A perpetuating circle of poverty. No forms filled = no subsidy. Fill in forms = no farming done.

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Finally, Cornwall tells its own story

By Ryan Gilbey

It’s all rules and regulations down on New Macdonald’s farm, with its ever-expanding office. The majority of farmers voted for Brexit. Why? You should have tried dealing with the sprouting of tape from Brussels.

More surreptitiously, subsidy strikes at the soul of the farmer. Farmers like to think of themselves as the last heroic individuals, hard people doing a hard job. But the past 50 years have turned us into slaves on subsidy which, to be brutal, is a state handout.

And we are at everybody’s beck and call, the kites at the end of the string. My grandfather, who farmed for 50 years, used to call farming ‘crisis management’. (Actually, he said rather more earthily, ‘It’s one bloody thing after another’.) The job is by its very nature somewhat tricky, because it is the attempted control of nature. So farmers expect the variable weather, even the plagues such as foot-and-mouth. (Mind you it hurt, the suffering of the animals, the black pyres of their culled bodies.) But my grandfather did not expect his product price to be affected by global markets, City investors speculating in land, inconstant supermarkets paying a pittance and then paying late, Instagrammers influencing what’s in and what’s out on the national plate, ‘re-wilding’ urban journalists launching a culture war against sheep, or politicians in far away places making legal ties that bind.

Stressed? You bet. Then there is that dark corner of the mind that knows, just knows, that the more stressed you are, the more likely you are to have an accident, or to become ill. Can’t work? Farm goes under. (Farming, by the way, has the worst safety record of any job in the UK, with stress frequently the causal factor. According to the Health and Safety Executive farming accounts for 1% of workers but 22% of all worker fatalities.)

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Do we really have a 'suicidal generation'?

By Tom Chivers

Farmers tend to toil in isolation, as befits ‘rugged individualists’. But these days it is entirely possible to spend days in a tractor cab all by oneself, isolated not just from people, but from the very land you work. Technology has led to robotic remoteness from the soil. One of the perks of farming used to be the sheer joy of being out and about with the birds and bees. Well, 10 hours in a tractor cab, watching a computer screen, with the air-con on is hardly connecting with nature. Anyway, more than 50% of the farmland birds have gone in the past 50 years, and wild honeybees may be extinct.

Add alienation to the farmer’s woes. Today farmers supervise open-roofed units of production instead of husbanding fields. Symbolically and poignantly, in Au Nom de la Terre, M Jarjeau suicides by drinking a cocktail of pesticides and herbicides — the very proofs of the new industrialised agriculture.

Farmers don’t talk about the money, the isolation, the alienation, because it is not exactly what manly ‘rugged individuals’ do is it? And, anyway, farmers don’t have time to talk, because time is money…

Of course, we could all give up farming. Surrender. But who would feed the people? What else would we do? If the farm has been in the family for generations, there would be guilt, grief, and the feeling of failure.

And you wonder why the string on the kite is sometimes self-severed?

Where farmers can go to for help:
Royal Agricultural Benevolent Institution (R.A.B.I.), 0808 281 9490, info@rabi.org.uk
Samaritans, 116 123, jo@samaritans.org
The Farming Community Network, 03000 111999, help@fcn.org.uk.

That’s because any statistic that is interesting enough to have become a news story, he claims, has probably passed through “so many filters that encourage distortion and selection”, that “the very fact that I am hearing a claim based on statistics is reason to disbelieve it”.

I have a similar rule of thumb, which I’ve said here before: if a statistic is interesting, it’s probably not true.

The trouble is that we can’t do without them. There are simply too many people and too many things in the world to understand what’s going on without simplifying them and aggregating them into statistics; we can’t think about every individual NHS patient, we need to think in terms of average survival rates or waiting times. We have to treat people like numbers if we want to do the best for those people, so we need to learn to be better at interpreting those numbers.

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Why flawed science should concern us all

By Tom Chivers

But statistics can be misleading — in some fascinating ways. In his book, Spiegelhalter, a Cambridge statistician and former president of the Royal Statistical Society, points some out; Simpson’s paradox, for instance. In 1996, the admissions data for five STEM subjects at Cambridge showed that men were more likely to be admitted: 24% of men’s applications were accepted, compared to 23% of women’s.

Is this evidence of bias? Well: possibly. But not, interestingly, of discrimination against women. In four of the five subjects – economics, engineering, computer science, medicine, and veterinary medicine – women were actually more likely to be accepted (in one, medicine, they were equal). Sometimes, that difference was quite stark – 16% of women compared to 12% of men were accepted onto the veterinary course; 32% of women against 26% of men into engineering.

How is this possible? Because medicine and veterinary medicine were much more popular, so your chances of being accepted were much lower; and because women were much more likely to apply for medical or veterinary degrees. By choosing the harder-to-access courses, women were less likely to be accepted overall, even though, individually, they were more likely to be accepted than a man applying for the same course. Similar findings have been seen elsewhere.

Another example is the “prosecutor’s fallacy”. Imagine a suspect is in court. If they’re innocent, there is only a one in a billion chance that their DNA would match the DNA found at the crime scene, and yet it does. Does this mean that there is only a one in a billion chance that they’re innocent? No; far from it. Nonetheless this has led to real women being wrongly convicted of child murder, after several of their children died of sudden infant death syndrome.

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By Tom Chivers

An analogous problem is cancer testing. Say your new cancer test is 95% accurate; it will answer the question “do you have cancer” correctly 95% of the time. If you test positive, do you have a 95% chance of having cancer?

Not at all! Imagine that 1% of people have cancer. You run your test on 10,000 people. Of the 100 people who do have cancer, it rightly tells 95 of them that they do have cancer. Of the 9,900 people who don’t have cancer, it rightly tells 9,405 that they don’t have cancer. But this means that it has wrongly told 495 people that they do have cancer. If you test positive for cancer, your chances of having cancer are not 95%, but 95 in 590, or about 16%. The DNA-test situation is exactly the same: your test is “accurate” 999,999,999 times out of a billion, but will still regularly be wrong, because the thing it is looking for (the specific guilty person) is very rare.

These are just a couple of the reasons why even straightforward-sounding statistics can be misleading. They’re not even the big reasons – they’re just a couple that I thought you might not have heard of.

Things like statistical bias, small sample sizes, or multiple analyses of the same data will have more of an impact, as well as the Groucho Principle that the most dramatic findings are both more likely to be well-publicised and more likely to be false. But they’re illustrative of the fact that you need to be very careful of almost any statistical story you read.

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If you don't 'get' statistics it's just as bad as not 'getting' Shakespeare

By Graeme Archer

At this point, I should admit that I have a dirty little secret, which is that I am not very good at maths. I mean, I’m fine. I’m OK. I got an A at GCSE, in 1997. But I’m not good. This is a problem, because I write an awful lot about statistics. Spiegelhalter tries to make the case that you don’t need to be very good at maths to be good at statistics, and he sort of succeeds – quite a lot of it you can grasp via the concepts, or through visualisations. But still, as an indifferent mathematician, I often found it hard to follow him.

As a non-mathematician, I have a few shortcuts for working out whether a statistic is worth believing, which seem to have done all right for me so far. One, which Spiegelhalter stresses, is that often the best statistical analysis you can do is simply visualising the data. There was a bit of a recent kerfuffle about suicides among girls and young women going up 83% since 2012; but simply looking at the ONS chart showed that the numbers were small, the data was noisy, and the only way you got the 83% figure was by choosing the lowest year on record. (It’s an old trick.)

Another useful hack is to ask “is this a big number?” Lots of statistics are presented as bald numbers: “X people have died”. But out of how many? If 25 people have died of cancer out of a population of 50, that’s awful; if 25 people have died of cancer out of a population of 50 million, that’s a statistical miracle. That’s one reason why I’m always wary of stories that say, for instance, “10 or more black transgender women have been killed this year” without telling me how many black transgender women there actually are, and whether that is more or less than we should expect.

Similarly, if a story tells you that something has “gone up by 25%”, or that something “increases your risk by 90%”, without telling you what it’s increased it from and to – if it gives you the “relative risk” but not the “absolute risk”, in technical terms – that’s an indicator that it may be worth ignoring. If something doubles your risk from one in 100 million to one in 50 million, you probably don’t care.

A third is asking “can I be sure what’s causing this?” Spiegelhalter dedicates a chapter to how you establish causality. It is amazingly hard to do this in the absence of large-scale randomised controlled trials. Austin Bradford Hill, one of the scientists – with Richard Doll – who first established that smoking causes lung cancer, suggested ways of doing so; looking for plausible mechanisms, making sure that the supposed effect follows the supposed cause, seeing if there’s a “dose response” – that is, the more of the cause there is, the more of the effect you see – and, importantly, making sure that the effect is sufficiently large that it couldn’t be a coincidence or some statistical confounding.

If you’re looking to see if something (say, a rise in teen suicides) is caused by something else (say, social media) then it’s worth looking to see if any rise in teen suicides follows the growth in social media, and whether each doubling in social media use leads to a consistent increase in suicide rate.

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But also, it’s important to see whether the suicide rate tends to jump around a lot anyway. If it does, then perhaps there’s nothing to explain; it just happened to be low one year and high another. (Spiegelhalter has a useful trick for seeing whether you’d expect to see the variation you see, such as using the mean averages to perform a “Poisson distribution”, but just looking at a graph and seeing whether it bounces around a lot is a good start.)

The statistician George Box said: “All models are wrong, but some are useful.” When you’re reducing millions of people and events to a few numbers, you’re building a model of the world, and that model must be simpler than the world, so it will be wrong in some way. You’re always making assumptions and drawing arbitrary lines.

For instance, we talk about the “murder rate” in Britain; statisticians treat it like an arbitrary event that happens at random to people, like decaying subatomic particles, with a 0.0008% or so chance of it happening to any given person per year. But that’s not how it works. Each murder is the result of real people making real decisions, not some lightning bolt out of a clear blue sky; it just happens that in a large enough population, non-random events can be treated as though they were random.

We can’t do it any other way. We can’t look at every person, and you can’t possibly predict every individual event, whether it’s the outcomes of heart operations or teen suicides or murders. You have to aggregate them, round off the corners, make simplifying assumptions; we have to treat people like numbers. You’ll get it wrong a lot of the time, and you have to be immensely cautious about any conclusions you draw.

There is one simple step, though, which will help a lot of the time. It’s a bit nihilistic, perhaps, but it’s powerful. And that is the Groucho principle that we discussed at the beginning: if the statistic makes a headline, it’s probably wrong.

No one can be certain of his motives, but as British Muslims on social media began to talk about it, the suicide acquired a significance beyond the act itself. Suddenly, a place of worship and sanctuary became the cornerstone of a discussion for which no-one seemed really ready. One rooted in issues of cultural trauma, family, honour and an overzealous belief in prayer being the solution to all problems.

There had been uncomfortable attempts by the community to grapple with the issue of mental health previously but this one moment – of a man plunging to his death before what Muslims regard as God’s House – became a signal that silence could no longer persist. People had to talk.

For too long the response of British Muslims, particularly those of south Asian heritage, to such stories has been problematic. Though some have spoken poignantly about the problem, others have underlined the ignorant attitudes prevailing within the community.

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In their eyes, the dead man had committed an abominable act directly before God. The mention of mental illness was not enough to stir them to pause and reflection. As they saw it, he had stained himself in the worst way, in an inexcusable manner.

Sadly, this unforgiving view is why many British Muslims struggle to discuss mental health. The man wasn’t seeking redemption or excuses for his sins, but probably hoping for an end to his suffering; he may have wished God’s House to be the last thing he saw on earth. There’s something deeply saddening in that; worse still is the fact that so many refuse to attempt to understand his case and others like it.

There was little compassion for this man’s suffering – even though it led to his death. Many Muslims see sin as a human flaw, but mental illness is not a flaw in that sense. It’s not a human weakness conditioned by our own behaviours and actions, but something uncontrollable.

The absence of compassion is a symptom of the wider struggle to discuss mental health within British Muslim families, which arises from a toxic fusion of religious misunderstanding and cultural values. Islam supposedly tells people life is a test and that they should embrace its sharp edges and desolate moments. To speak about mental suffering, in that interpretation, is to reject God’s plan and not to have faith in religion to solve the pain.

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It doesn’t matter that that pain can leave you feeling like you’re drowning in constant black waves. Faith, and particularly prayer and its power, is the log you are supposed to hold on to stop you from being swept under. Dr Ghazala Mir, a researcher at Leeds University, argues that “This stigma does involve the idea that maybe if you need treatment, there might be something wrong with your faith identity in the first place.”

This is the retort that has greeted many who try to discuss the issue, or to argue that prayer alone isn’t enough to solve mental illness. People are told their weak faith is the cause of their depression – yet depression can affect enthusiasm for anything, including praying. There is fear and guilt in thinking prayer won’t solve the problem. So when you pray and find the solution slipping further away, you feel helpless. Your despair spirals.

Religion is often entwined with culture; most British Muslims of a south Asian background are influenced by their cultural roots simply by the differences from Muslims of other ethnic backgrounds. In particular, a tight-knit family structure is central to their identity. There is a constant demand to protect a family’s reputation and not to disappoint, to be what religion and culture demands, and avoid what the community gossips about.

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For women, the ties and obligations to family are even tighter. Secrecy, fear, shame and honour mean everything. Reputation is everything, especially for a woman, because – to put it crudely – it can lower her value for marriage in parts of the community. Stories of ‘honour’ violence and supernatural possession are examples of the misogyny they face within families. The concept of demonic possession, in particular, affects women who exhibit signs of mental illness; the prescribed solution requires an exorcism but damages their name and status irrevocably. And of course, how as Muslims can you deny that demons exist?

I lost years of my life to mental illness. It was always there like a shadow, returning when I least expected it. After years of struggle and grind I thrived in university, feeling as if I had been unshackled. But my religion became an obstacle, deepening the problems. Faith strangled me with doubts, shame – and terror that I was sinning for refusing to accept prayer as the only road out of this gloom.

I lost count of how many times I stood on a train platform thinking there was a way for these thoughts to stop. Maybe it was the fear of God that stopped me from acting then, but it was also the fear of God that for years stopped me exploring solutions beyond prayer. Reconciling with roots I felt were holding me down but still couldn’t break from, was and remains a struggle.

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Finding a solution to mental illness is not easy, especially to those of us suffering from it for years. Understanding it is like wading into an ocean of bottomless depths, or as a friend put it, “trying to keep a door open with a piece of string.” Perhaps it’s an inner war with no end that we will always be fighting. That’s how it feels.

But cultural values of family honour and pride, as well as religious demands of confidence in God, should not become deterrents for talking about illness.The mental health charity Mind has begun working with British Muslim communities to tackle this, reporting positive feedback.

What has certainly helped is exposure to western culture. As the older generations of British Muslims were more swayed by their cultural roots, younger generations are more influenced by a British culture which has started to challenge the stigmas around mental health, particularly the gender stereotypes which prohibit men – and women – from displaying emotional vulnerability

Will things change? If the traditional ‘stiff upper lip’ is now allowed to tremble. I can only hope that the same thing will happen within my community. The shameful silence imposed by my religion cannot persist.

“But visiting lecturers were rarely disinvited because their views were deemed unspeakable, course readings were not routinely screened in case they contained material that students might find discomforting, and faculty members who departed from the prevailing consensus did not face attempts to . . . end their careers. An inquisitorial culture had not yet taken over.”[1. John Gray, ‘Un-liberty’, TLS, March 30, 2018]

But it has now – and the shift is becoming more and more marked in politics. The secular liberal State now claims more than its due, including the right to govern a citizen’s conscience and set norms as though the government were the only force in society that mattered. In other words, the so-called liberal State isn’t liberal at all. Among other things, it needs religion to provide a crucial reminder of its limits, as well as richer visions of human flourishing with deeper foundations than the thin soil provided by a principle like ‘tolerance’ alone.

The suggestion of a spiritual cure to our malaise comes from Rowan Williams, in a recent lecture on the Victorian historian Lord Acton’s thinking about political and religious liberty.[2. Rowan Williams, ‘Religious and Political Liberty’, the Las Casas Institute Lecture for 2016] The former Archbishop of Canterbury had a subtext. His not very coded message was that Acton, as a Catholic with a keen eye on the rights of minorities, was rolling the pitch for a classically liberal model of Church–State relations which contrasts sharply with the prescriptive models of liberalism we see today.

Given past and continuing evidence of religious authoritarianism, how can self-aware Christians, Muslims and others answer the very influential view that religion should be a purely private matter? By quarrying the thought of many forebears besides Acton, Williams has long shown a talent for reframing stale-sounding debates in fresh ways. As archbishop, for example, he distinguished between good and bad models of secularism, respectively the ‘procedural’ and the ‘programmatic’.

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Procedural secularism grants no special privileges to any particular religious body, but denies that faith is merely a matter of private conviction. It should at least be allowed to nourish the public conversation. Williams continues to see so-called programmatic secularism in a far less positive light, because it insists on a ‘neutral’ public arena and hives religion off into a purely private domain. Rather than resolving clashes of outlook, programmatic secularism risks inflaming social conflict by stoking resentment among faith groups.

In a series of addresses over the past 15 years, Williams has proposed ‘interactive pluralism’ as a recipe for harmony. This encourages robust dialogue among faith communities and between them and the State. No one has received the whole truth ‘as God sees it’, so all have something to learn. Such a model contrasts with the subjectivity implied by multiculturalist attitudes. As indicated, a tag such as ‘tolerance of diversity’ can conceal a multitude of sins.

Acton’s ideas – spelt out in addresses and essays during the 1870s – are worth revisiting in more detail. The future Professor of Modern History at Cambridge made the eye-catching claim that religious liberty or freedom of belief is the foundation of all other liberties, and that political liberty in turn underpins the health of religious communities. The rationale for this lies in his definition of liberty as: “the assurance that every man shall be protected in doing what he believes to be his duty. Against the influence of authority and majorities, custom and opinion, the State is competent to assign duties and draw the line between good and evil only in its immediate sphere.”[3. Lord Acton, ‘The History of Freedom in Antiquity’, an address delivered to the members of the Bridgnorth Institute, February 26, 1877]

The State and religious communities thus owe something to one another. If one is to be free, the other must be free. And the State has a duty not only to respect conviction and conscience – especially the conscience of a minority. It also has an obligation not to be swallowed up by any religious body and not to assimilate itself to one faith group. The State, then, is not a Church. The State guards the possibility of there being ‘Churches’ – Acton’s shorthand for communities of conviction and conscience – and the existence of these communities of conscience stands before the State as a challenge and reminder of what it is and isn’t. From this follows a crucial inference. Since the State is the authority that permits you to follow your conscience, it cannot claim the right to dictate what you believe. If it does, you have a severe problem. 

It may seem counterintuitive to suggest that religion can only flourish when the State as such isn’t religious, but the point is certainly grasped by T. S. Eliot in his Essay on the Idea of a Christian Society. This is the text in which the devoutly Anglican poet says that he would prefer to have a competent atheist running a government than an incompetent believer. His point is that the State has its business, but that business has boundaries. Williams’s conclusion is forthright, especially in view of his own left-wing allegiances:

“When a State believes – and acts on the belief – that there are no loyalties more serious than political loyalties, the State becomes idolatrous and diabolical. Thus the presence within the State of communities of non-negotiable conviction is unexpectedly the best thing that can happen to a State. A State faced with communities which deny its absolute and universal reach is benefiting from that. Once the State recognises that there are, within it, communities that it doesn’t, so to speak, franchise – that don’t derive . . . their meaning from the State, the State will have reason to hesitate over any attempt to assimilate all communities to itself. The State will have reason to be cautious of any policy that tries to homogenise, totalise and control.” [4. Rowan Williams, ‘Religious and Political Liberty’, the Las Casas Institute Lecture for 2016]

The point is encapsulated equally well by John Neville Figgis, the early 20th-century Anglican theologian, who wrote of the ‘free Church in the free State’. He held that all you need to make a State a champion of liberty is a community within it insisting on its own liberty over against the State. By recognising its limits, the state would become more fully itself.

For many observers, of course, the problem is precisely that the contemporary State often fails to acknowledge such limits. Like Williams, a Jewish leader such as Jonathan Sacks has highlighted the risks of a liberalism that sees itself as a substantive programme rather than a force for defending diversity and the freedom of conscience. To sum up: liberalism which has itself become a programme risks becoming an orthodoxy imposed from above. Acton’s ideal is very different. The liberal State does not have a moral agenda except the preservation of the liberty of all its constituent communities.

In this light we can see the justice of Jonathan Sacks’s description of religion as:

“…part of the ecology of freedom because it supports families, communities, charities, voluntary associations, active citizenship and concern for the common good. It is a key contributor to civil society, which is what holds us together without the coercive power of law. Without it, we will depend entirely on the State, and when that happens, we risk what [the historian] J. L. Talmon called a totalitarian democracy, which is what revolutionary France eventually became.”

And to boost Sacks’s argument still further, we might add that the standard secular narrative whereby the forces of enlightenment gradually threw off religious shackles in the name of freedom and progress is deeply flawed. Ignore the seductive but shallow story told by Steven Pinker in a recent bestseller, Enlightenment Now, and look instead at the work of a figure such as Larry Siedentop, whose grasp of the intellectual history is far more secure.

In his book Inventing the individual, Siedentop argues that the roots of liberalism were firmly established in the arguments of philosophers and canon lawyers by the 14th and early 15th centuries. These included belief in a fundamental equality of status as the proper basis for a legal system; belief that enforcing moral conduct is a contradiction in terms; a defence of individual liberty, through the assertion of fundamental ‘natural’ rights; and, finally, “the conclusion that only a representative form of government is appropriate for a society resting on the assumption of moral equality”.

I have suggested that the illiberal State, by pushing religious conviction into a purely private sphere, ends by instrumentalising its citizens and seeing them as no more than agents of the State’s purposes and subjects of the State’s decisions. Such illiberalism forms a secular counterpart to theocracy. In cases such as abortion or assisted suicide, to cite two especially contentious areas, Christian and other campaigners will advance theologically based arguments about the sanctity of life, as well as practical arguments endorsed by many secularists.

Religious voices will not and should not always get their way in a free society. They need to be held to account on the basis of cogency, viability and other criteria. But if we follow Acton’s arguments,  believers cannot be expected to accept an interpretation of their beliefs that reduces them to the status of a buttress for secular morality.

Williams judges that “the abrasion and tension” in much ethical debate “does still tell us something about the need to remind the State of its limits and to remind the Church that its job is not only to argue for exemption or special status but to remind the State that it is not the sole form of belonging for citizens. You could put it epigrammatically, as some have, by saying that the best citizen is the person who is not only a citizen. His or her loyalty to the political unit is qualified, enriched and fleshed out by other kinds of important, morally significant loyalties.”[5. Ibid]

The relevance of this argument in an age of populism is obvious. Not just because it points to a need to respect minorities, but also because human rights language and the language of religious liberty should not be seen as mutually opposed.

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