What do music festivals, football matches and religious gatherings have in common? They are all associated with changes to the citizens of the host city’s risk of suicide, some for better, some for worse. New research supports the premise that it is the power of the “broken promise effect” that makes some mass gatherings a blessing for a community, and for others, a curse.

Mass gatherings such as religious occasions, music festivals and sports events are becoming larger and more frequent, attracting thousands, and even millions of people at one time. With it being summer music festival and football World Cup season, as well as a busy time of year for religious events such as Ramadan, it means that heatstroke, disease outbreaks or human stampede headlines are, sadly to say, expected.

However, how mass gatherings affect not only attendees but the mental health of the residents of the cities hosting the event have so far, been pretty much sidelined. An enlightening statistical study set to identify the possible relationship between different kinds of mass gatherings and how this affected the host city’s suicide risk in both men and women.

Specifically, the researchers used data gathered in 2005-2010 from the Ukranian city of Dnipropetrovsk, which has a population of around 1 million people. They looked at three factors: the number of suicide attempts, deaths by suicide, and the amount of suicide-related behaviors registered daily for each sex, either 7 days before and/or 7 days after 427 mass gatherings. The events fell under three broad categories; music, sports and religious events.

Music events

There has been next to no information on the effect of music concerts on suicide risk. However, lifetime studies have indicated that they can have a beneficial effect on physical health, social functioning and vitality. Putting the well-recognized, fanatical mass fainting phenomenon demonstrated by Elvis Presley and Beatles rock concert audiences aside, the relationship between music events and mental health has been neglected in the medical literature.

In the present study, the rate of suicide-related behavior in women was significantly decreased by about 20% over the 7 days after the 88 large music concerts included in the analysis. The researchers found this result difficult to interpret as the number of attendees at the music events in question added up to only 0.6% of the total population of the city and the multivariate analysis did not corroborate the results.

Instead, the data indicates that music events may have co-linearity with one or more other predictors of suicide. In their model, researchers included solar and planetary variables such as number of sun spots; seasonal variables such as temperature; socio-economic variables such as monthly birth, death and divorce rates; and national events such as general elections.

On another positive note, a separate 2014 report indicates that electronic dance raves tend to be safer than other music and sporting events: “Despite the occasional tragedy in the lay press regarding medical incidents at electronic dance raves, such events are relatively safe when compared to other mass gatherings,” with, “medical usage rates lower than rock concerts and marathons.”

A deeper understanding of the potential psychological benefits for the greater population, as well as drawbacks, that are associated with even relatively small music events could make music gatherings the event of choice where medical costs, health and mental well-being of both event participants and the surrounding population are concerned.

Football matches

Sports events appear to be the only kind of mass gatherings for which the relationship with suicide has been relatively well investigated. While two studies in the literature reported no such relationship, a number of Canadian, British and U.S. studies have reported an increased risk of suicide for various professional sports games. For example in a Canadian study, young males (15–34 years old) had an increased suicide risk during the hockey playoffs.

The current study significantly expanded on past research by looking at the influence of both local and international major sports events on suicide-related behavior for the whole city. Four statistically significant correlations were identified, two for men and two for women. For women, a 117% increased risk of suicide-related behavior was found when a local team’s football match was played in the city, while the build up to the national team playing in the World Cup resulted in a whopping 360% increased risk of death by suicide.

For men, the build up before – and come down after – the national team winning an elimination game, despite winning, was associated with a 350% increased risk of attempting suicide. In contrast, the 7 days after a local team’s home defeat was not associated with an increased risk of suicide attempts, but it did increase the risk of suicide-related behavior by 132%.

As in other studies, suicide risk rising significantly after the failure of one’s favorite team has been suggested to result from “dysphoric and suicidal moods in individuals who deeply identify themselves with the team”. It is common for fans to view a team as an extension of themselves, and the team’s defeat may be perceived as a personal failure, in some cases reaching clinically significant suicide promoting levels.

However, actually winning a World Cup qualifying game had more severe and extensive associations with suicide. Interestingly the most extreme increased suicide risk in both men (350%) and women (360%) was associated with the national team qualifying for or playing in the World Cup respectively. The researchers did not expand greatly on these findings, however, mass TV broadcasting and national pride may be significantly influencing factors.

Religious events

While some regular religious festivities, like Christmas, are followed by an increase in suicide rate, in contrast, in countries where religion retains a real social significance, religiosity is a factor considered to decrease the risk of suicide-related behavior. However, save for the study in question, no research has been conducted on whether mass gatherings carried out by religious organizations influence suicide-related behavior rates.

With respect to mass religious events in the present study, the religion category had by far the greatest number of correlations with suicide risk rates. Only non-regular gatherings were considered, eight of which were for venerate miracle-working relics. Orthodox Church devotees associate these relics with miraculous healing. Additionally and separately, 78 mass public gatherings for new religious movements were also included in the analysis.

Although the number of non-regular mass gatherings organized by the Orthodox Church was relatively small, a significant decrease in both suicide-related behavior and suicide attempts was found in women after exhibitions of miracle-working relics by over 50%. As Orthodox Christianity has a strong social standing in Ukraine, this is in-line with previous research. However, as with the reduced suicide risk after attending music events, this finding was not replicated in the multivariate analysis, and other causal factors may be co-linearly involved.

In stark contrast, events organized by new religious movements generally increased suicide risk. Both suicide attempts in women and death by suicide in men, as well as suicidal behavior in both sexes, increased by about 125% after mass events that were organized by new religious movements. This coincides well with the limited number of similar published studies on new religious movements in which about 20% of the devotees had suicidal tendencies.

With regards to possible explanations for the contrasting results, researchers took into account the doctrines of many new religious movements involving detachment of their devotees’ integration with conventional society, and motivating devotees to cut off relations and instigate conflict with their relatives and friends. Furthermore, when religious leaders persuade their devotees that divine powers will heal them, it may lead to rapid development of suicidal tendencies in devotees due to an intrapersonal conflict “between raised expectancy and stubborn reality”.

The broken promises effect

Researchers concluded that that crowd behavior in its self may not cause suicidal behavior, yet it may exacerbate the ‘broken promise effect’ from Gabennesch’s suicide theories, where despair results from reality not meeting raised expectations. However, they extended on this theory in order to explain how the mass gathering event for a sub-population within a city, can influence the entire urban population as a whole.

More specifically, they suggested that mass gatherings may also result in the intensification of intra- and interpersonal conflicts, not only among the event’s participants, but also in their families and social environment. They also suspect that the larger the event and its attendees risk of suicide, the greater the spillover effect will be for the greater population. On the other hand events that are associated with a dip in suicidal behavior, in this case music concerts and events run by the Orthodox church, which is still a central aspect of Ukranian life, may promote social cohesion.

This pioneering study should stimulate more studies that provide a deeper understanding of the differing effects of different types of social events on suicidal behavior. Ultimately, such studies should lead development of suicide prevention approaches effective at both the macro (societal) and the individual (psychological) levels.

References

Andriessen K, & Krysinska K (2009). Can sports events affect suicidal behavior? A review of the literature and implications for prevention. Crisis, 30 (3), 144-52 PMID: 19767270

Bergen H, & Hawton K (2007). Variation in deliberate self-harm around Christmas and New Year. Social science & medicine (1982), 65 (5), 855-67 PMID: 17517457

Grange JT, Corbett SW, & Downs DM (2014). The games: what can the sports medicine community learn from raves? Current sports medicine reports, 13 (3), 155-62 PMID: 24819006

Usenko VS, Svirin SN, Shchekaturov YN, & Ponarin ED (2014). Impact of some types of mass gatherings on current suicide risk in an urban population: statistical and negative binominal regression analysis of time series. BMC public health, 14 PMID: 24708574

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