Suicides in the Netherlands are not on the rise; deadly falls by elderly in nursing homes are.

Yesterday was not only the 5th anniversary of my sister’s death, it was also the day that the Dutch national statistics office (CBS) made public the number of suicides this year. In 2013 1,854 people committed suicide or 11.0 per 100,000 people. In 1970 the suicide rate was 8.0 per 100,000 people or 1,049 suicides. A rather steep increase, at least when looking at the absolute numbers (Figure 1B). In contrast, the absolute homicide numbers in the Netherlands have been decreasing (Figure 1A), at least between 1997 and 2011. Between 1969 and 2011 the homicide has gradually increased (Figure 1B, green).

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Figure 1. A) Absolute homicide numbers by sex in the Netherlands as reported by the CBS for the period 1996-2011. Blue=males; Red=females; Black=respective trend lines. B) Absolute homicide and suicide numbers as reported by the CBS for the period 1969-2013. Blue=male suicide; Red=female suicide; Green=total homicide; Black=respective trend lines.

What is surprising is the increase in suicides by males, but not females (Figure 1B, black trend lines). Their suicide numbers are remarkably stable. Sure, males commit more suicide, a fact common among all nations in the world. As I mentioned previously, males tend to commit suicide about twice as often compared to females. Yet, the ratio male::female is on the incline (Figure 2, red) for suicides and there is no indication to argue that the increasing disparity between male vs female suicide is leveling of. Surprisingly, and in contrast to the general assumption, the homicide sex ratio is slowly declining (Figure 2, green).

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Figure 2. Sex ratio for suicide (red) and homicide (green). In black the trend lines are shown for both homicide and suicide.

Another factor potentially influencing suicide rate could be age. In contrast to homicide, where the age is roughly constant (fluctuation most likely due to relatively small number), a shift in age is observed for suicide. Now more and more middle aged people commit suicide, whereas in the past younger people committed relatively more suicide. This observation is consistent with data from the US. In this study by Bloomberg found that, despite less men dying from cancer and heart disease, more men between the age of 45-54 die from suicide and drug overdose.

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Figure 3 Comparing age groups for suicide vs homicide between years. Each line represents a year between 1996 and 2011. The numbers represent relative size of each age group (grouped by 10 years) Homicide age groups remain fairly stable, whereas a suicide is becoming more common in middle aged people.

Also maritial status of the person committing suicide (Figure 3A1), method of suicide (Figure 3A2), and why (Figure 3A3). The categories for why people commit suicide is a bit doubtful, as I have pointed out various cases where the police simply assume to know why and how people do what they do without doing a forensic psychiatric autopsy. Yet, it is striking that in about 40% of all suicide it is not known why it was committed. This could be a problem with data collection at the local police departments, but it could also be that the police just didn’t bother to start an investigation because a suicide is not a criminal offense and thus does not require a police investigation. In about 25-30% of all suicide is a goodbye-note found. In many cases a suicide case involves a person with known psychiatric illnesses. I can imagine (but not back up with numbers) that known medical history and suicide notes combined account for the data presented in Figure 3A3.

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Figure 4 A1-3) General statistics for suicides for the period 1996-2011 in the Netherlands. B1-3) general statistics for homicide for the period 1996-2011 in the Netherlands. A1) Marital status of suicide victim. A2) Method of committing suicide. A3) Perceived reason why someone committed suicide. B1) Where a homicide happened. B2) How a homicide was committed. B3) Why a homicide happened.

Similarly the methods/weapons used to commit homicide (Figure 3B2) is fairly consistent, in particular the use of a knife. The use of a firearm to kill was slightly out of fashion the second half of the first decade of the 21st century. It is surprising to see that more and more homicides are committed on the premise where the victim lived (Figure 3B1). All other locations for homicide is remarkably predictable. The reason for homicide is largely unknown (grey line in Figure 3B3). I can only speculate why this is. I think that the reason for a homicide is of little concern to the police itself, but more so to the public attorneys (Officier van Justitie). As the police departments provide the CBS with data and not the public attorneys office (Openbaar Ministerie). I would hope that if a homicide is successfully prosecuted by the public attorney, the reason (or at least a strong suspicion) for the homicide is established. If for 50%+ homicides the reason unknown remains, I cannot see how policymakers would be able to adjust police practices to combat homicides. Obviously, a certain number of homicides will remain, such as crime-passionel.

What also needs to be taken into account is the quality of the forensic doctor (schouwarts), which is heavily questioned, as well as how many forensic autopsies are performed. In the latter case we know that less and less are performed by the Dutch Forensic Institute (NFI) (340 in 2012), a subsidiary of the Department of Justice, the same department is in charge of the national police and the public attorney’s office (College van Procureurs Generaal). It would therefore not be surprising to learn that less and less homicides happen in the Netherlands. One such explanation would be that homicides that happened are mislabeled as suicides. This explanation is bit suspect, as it puts very little trust in the capabilities of the authorities.

Unnatural deaths on the rise

The death rate in the Netherlands is very predictable. Between 1969 and 2013 (blue line in Figure 5) around 0.83% of the population dies annually. It would therefore be natural to assume that the number of suicides per 100,000 inhabitants is an accurate representation and to a certain level this is true. This approach does assume that other factors that could influence the number of suicides remain the same. You have to take into consideration how suicides are determined. When a person is found dead which sparks a police investigation, who require a forensic doctor (schouwarts) to arrive on the scene to help close a case of suicide. In most cases the public attorney will show little to no interest in considering opening a criminal case if the police already suspects a suicide. Suicide is not a criminal act, so it is not their business. Any statistical information will come directly from the police departments, as we have seen above. This also means that specific data will be missing.

One type of data should be readily available and that is how many people die an unnatural death. With an unnatural death I mean any suicide, homicide, and accident/misfortune. Below you can see the red line representing the relative number of unnatural deaths, with in black the trend line (Figure 5). An obvious increase in unnatural death can be observed in the Netherlands between 1996 and 2011. It is even more surprising when taking into account that crime has been on a continuous decline for many years now.

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Figure 5. How many people died in the Netherlands between 1969 and 2013 (blue) and how many of those who died died of unnatural causes (homicide, suicide, or accident) between 1996-2011 (for which data is available) in red. In black the trend line is shown for both the blue and red lines.

Maybe the increase in suicide can explain the increase in unnatural deaths? The suicide rate in the Netherlands went from 8.0 per 100,000 in 1970 to 11.0 per 100,000 in 2013. Yet, the relative suicide rate within the unnatural deaths remains very stable (~30%; Figure 6). The increase of unnatural death cannot be explained by the increase in suicide. If anything, the increase in suicide resembles the increase in unnatural deaths.

We do see two categories show a relative increase within the unnatural deaths (accidents at home and unknown). The unknown category is very troublesome. First, the unknown group could be indicative of two things: a) police departments are not reporting certain type of information any longer, as might be the case for homicides (Figure 3B1-3) or b) the cause of unnatural death is indeed unknown. If the latter is the true it is important to learn why the police is unable to determine the cause of ~10% unnatural deaths in the Netherlands.

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Figure 6. How people died of unnatural causes between 1996 and 2011 in the Netherlands.

On a positive note, less people die due to traffic accidents. In order to reduce the number of traffic deaths the public attorneys office (Openbaar Ministerie) assigned a specialized public attorney Koos Spee. Whether or not Spee was responsible for the drastic reduction, the reduction also came as car became safer due to better tires, electronic driver aids, improved chassis, and more airbags. Either way, the reduction in traffic deaths is welcomed by many.

Deadly accidents in the private sphere: nursing homes are getting deadlier in the Netherlands.

Accidents in the private sphere (home in Figure 6) exclude all deaths from occupational, traffic, or sports deaths. For instance people too often underestimate how dangerous their homes are. Usually parents do try to reduce the risk of kids falling or drowning or being electrocuted by accident. Yet, for anyone older than 5 years of age the dangers are waved away. In 1996 about 37% (1999/5309) of all unnatural deaths were a result for an accident at home, whereas this number increased to over 48% in 2011 (2821/5844). It is a serious problem and the most common cause of unnatural deaths. A closer look (Figure 7) reveals that especially elderly die a unnatural death due to accidents (Figure 7A). In ~80% of the cases people die as a result of a fall (Figure 7B).

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Figure 7. What is known about unnatural causes of death in the Netherlands that happen in the private sphere between 1996-2011. A) Age distribution per year. B) Cause of death. C) If known, what were people doing. D) Where were these people.

In 1996 very few cases were reported to have died from an accident in a nursing home or hospital, but in 2011 over 20% of the accidental deaths in the private sphere happened in nursing homes and hospitals. As about 80% of these accidental deaths result from a fall it can be safely assumed that deaths during a medical procedure, as you might expect to occur in a hospital, are not part of this statistic. This of course ignores the problem that Dutch hospitals are very lacks in keeping statistics about deaths during a medical procedures. Therefore nursing homes become the site of interest to account for the steep increase in accidental deaths in the private sphere. In the past, problems in the quality of care in nursing homes have become apparent. A shortage of people, a shortage of qualified nurses, and a byzantine bureaucratic oversight with all its excess. This makes the quality of care a structural problem that in part manifests itself in elderly falling and dying.

All taken together a murky picture emerges. The absolute numbers of suicide might on the rise, its contribution to all unnatural deaths in the Netherlands remain very predictable: about 30%. I can therefore only conclude that suicide is not on the increase in the Netherlands, but unnatural deaths are on the increase. The most prominent contributor appears to be nursing homes, maybe as a result from ever decreasing nursing quality.

All sources are embedded in hyperlinks and figures were made in excel.

When generalizations miss their mark. Questioning suicide does not equal unable to accept suicide.

Every now and then you read an opinion piece that make your blood pressure rise. Some are aggravating because of their perceived social injustice or political corruptness. Some are just plain ridiculous. The ones that hurt are the opinions that hit close to home. When someone make derogatory comments about families who doubt the conclusion of suicide as argued by the police and public attorney. It is hard to not take them personally.

Today, December 8th, marks the 5th anniversary of my sister’s death. In a month or so we’ll learn how the public attorney will proceed with Eline’s case after their review.

Allow me to start a short rant.

Far too often the argument is made that people like me, simply cannot accept that their loved took their own lives. Sure you can be disappointed by people who are just happy to be uncritical about the authorities, but being disappointed is not the same as being aggravated. People like Mick van Wely or Hendrik-Jan Korterink, two prominent crime journalists in the Netherlands, have focalized on various occasions that people, like myself, just cannot accept the fact that e.g. Eline committed suicide. They use their authority as a crime journalist to make their point. It is not that a journalist doesn’t take your story seriously. Every journalist has to make up their own mind which story to break and which one to leave on the shelf. That is part of their business. It is not that a journalist lacks a willingness to question the field of their choice. They are human after all, even when they display signs of hypocrisy. I understand that. It is that a journalist already claims to know the crux of a story before (s)he has bothered to read up on it and waves away any claim made by families as proof that they simply cannot accept the suicide of their loved ones. It is hard to consider this disdain as part of an expected repertoire of a professional journalist. This disdain hurts. Maybe it is just me who was raised with the thought that a journalist’s job is to question and criticize the ruling powers. If I have to believe journalists such as Mick van Wely and Hendrik-Jan Korterink, this is not the case. At least when it comes to families questioning suicide by their loved ones because we are told by the police and public attorney that is what happened. That evidence to support the claim by the police and public attorney are often hidden away from families such as myself doesn’t seem to perturb these people. The authorities have spoken. So be it.

Maybe I haven’t talked enough with psychiatrists about suicides and other mental diseases whereas Van Wely and Korterink have. Maybe they are just more up to date about the latest research and clinical findings. For instance, Van Wely interviewed the controversial and very vocal psychiatrist Bram Bakker. I wouldn’t be surprised if both Van Wely and Korterink have talked to various Dutch forensic psychiatrists (short intro), something I haven’t, that is to say I haven’t spoken with Dutch psychiatrists.

This is not to say that they don’t have criticisms about the Dutch legal system. In a recent article Chris Klomp articulated that a new law that would allow victims or families of victims gain substantial rights during the trial to argue how the crime affected their lives and any comments they may have towards the suspect. Klomp argues that the position of the suspect is already very precarious as the entire legal proceedings are set up against him/her. A stance I agree with. Just how the court is physically set-up works against the suspect’s anticipated guilt. Also, another recent law that allows for the public attorney to prosecute a suspect for minor crimes proofs that the public attorney punishes harsher than judges. The police frequently records conversations between lawyers and their clients because they use rooms that are also used to interrogate people. The public has to trust the police that they won’t listen to these recordings. Just to mention a few points where the position of suspects is in distress. Klomp goes further than this. He goes to say that the foundation of the Dutch legal system is at risk with this newly proposed law. Maybe he is right. But this argument stands in contrast to his observation that suspects have to prove their innocence in court, more so than the public attorney has to prove their guilt. This discordance would argue that a change in the legal system would be warranted to guarantee a fair trial. In his book, Richard Korver, a Dutch lawyer, suggests that it might be worth to have a two-step trial. First the guilt is determined and next the punishment. During the latter part the victim could have a more pronounced role, whereas in the first one, it really comes down to did anyone break the law. To me this seems like a very reasonable suggestion.

Let’s not forget that a crime always has three parties: a victim (often known), a perpetrator (if all goes well the suspect at trial), and the law (represented by the public attorney). The former party already suffers from a cultural disdain in the Netherlands. I’m not sure why. Maybe it is a remnant of the calvinistic rhetoric that still strongly resonates. Victims are too frequently asked why they allowed themselves to be in a position where they could become a victim of a crime (think of The Rape of Mr. Smith by Borkenhagen). This leaves the suspect as a soul that needs to be saved. The task for the latter party is to present a case and execute upon conviction. The entire trial is focussed on the alleged crime and the person of the suspect. Ergo psychiatric evaluation are commonly requested. Focussing on the person of the suspect. At the end of his article Klomp does mention that a role for victims would be appropriate, but it is unclear what kind of a role he envisions victims would have. Currently, the law allows for victims of serious crimes to express to the court how the crime impacted their lives. A right not often used.

To suggest that I cannot accept suicides is merely laughable. A few months ago I lost a dear friend to suicide. She hung herself after fighting bipolar disorder for many many years. A battle she lost. She is not the first person I know who has committed suicide. This is not to say that I will go along with statements such as “you have to accept their personal choice to end their lives.” A remark I hear and read far too often. These remarks display a gross naïvity with regards to people suffering from pervasive suicidal thoughts. I don’t have them myself or recall that I ever had them, but I do know people who suffer from such thoughts. They do not think rationally anymore. Ask yourself: how many people with pervasive suicidal thoughts would fight for their lives if their lives were imminently at stake? How many of these suicidal people would avert a car-accident-to-happen by slamming the brakes or steering out of danger such as a crossing deer? How many of these suicidal people would run out of a burning house to save their own lives if they wake up to a sudden fire? How many of these suicidal people would jump back from a cliff when all of a sudden a few rocks under their feet let go and fall in the ravine? How many of these suicidal people would give up their wallet when someone tries to rob them at gunpoint?

If all it is that suicidal people want is to do is die, why would they avert imminent death? It is not a matter of making a personal choice. People who suffer from pervasive suicidal thoughts, for whatever underlying reason, do not think rationally. Treating their final action (a successful suicide attempt) as a rationally made decision is ignorant at every level imaginable.

All in all, mental health still suffers from extremely debilitating stigma, but I’ll get to this subject in a later post. The problem of this debilitating stigma is universally pervasive in our society. That people such as Van Wely and Korterink, who devoted their lives to being a crime journalist, simply accept a judgement call by the police and public attorney as if it was as simple as 1 + 1 = 2. No critical note to found, because people like me are too weak to accept the simple equation presented to us. Eline committed suicide because we, the police, say so. Why would you question us? Because she stabbed herself three time in her heart while at arm’s length of her boyfriend and she subsequently ran out of their house? Of course that is a normal suicide for anyone who is psychotic and the boyfriend said she was psychotic. Again, why question us? Many people, including journalist, far too often don’t. Treating people who do with disdain is not only hurtful, it is showing pride in their own ignorance. Status quo is not to be touched. How dare I.

I’ll leave my rant at this. I’ve probably already said too much. I’ve probably already been too emotional.

Iris van den Hooff’s suicide seems less likely following autopsy

A short while back René Diekstra argued that for any death where suicide is suspected but a small amount of doubt might exist, a forensic autopsy would be useful in determining cause of death. He explicitly argued that cause of death (homicide, suicide, accident, or natural causes) cannot be determined by method of dying (e.g. hanging, stabbing, shooting, etc.).

On July 6th earlier this year, Iris van den Hooff was found hanging in her apartment in Groningen. Within 24 hours the police and the public attorney conclude that Iris committed suicide. Yet neighbours heard a fight in her apartment and Iris had been received threatening notes. This made Iris’ family suspicious of her alleged suicide.

The public attorney refused to consider reopening the case, so Iris’ family with their lawyer Richard Korver to the mayor to request her body be exhumed for a forensic autopsy. Something the police and the public attorney did not deem necessary as it was “just” a suicide and therefore not a matter for further criminal investigation. The mayor granted the family the rights to exhume her.

Today Richard Korver revealed that the forensic autopsy does not support the conclusion of suicide. He does suspect a homicide.The public attorney still does not see any reason to reopen the case. To force the public attorney to properly investigate Iris’ death, Korver started an article 12-procedure: a request to the court to order the public attorney to investigate the case. This is the only legal route someone has in the Netherlands to reopen/start an investigation. This option is not cheap (cost for lawyers, court, forensic expert, etc.) which means that most people won’t be able to fight a conclusion of the police and public attorney. Iris’ friends and family therefore have started a fundraiser.

Update 2014.11.26 – There are indications crucial evidence might have already been destroyed by the police and public attorney, including her ripped clothes and dog leash she was found with.

Charges pressed against senior police officer in Talitha’s ‘suicide’

A short while ago I wrote a piece about the suspicious “suicide” of Talitha. Today, Wednesday, November 19th, the saga continues. According to a news report the lawyer of Talitha’s family, Sébas Diekstra, has pressed charges against a senior police officer. Near the body of Talitha the police found a note. According to the senior police officer the note contained times at which the train would depart for the nearby town of Heerhugowaard as well as the route which she needed to walk from the train station to the location just outside Heerhugowaard where she was found. There is also mention of a fence near this remote location.

After some time Talitha’s family received the note. To their surprise the note did not contain a route description or any mention of a fence. It did have times for the train to Heerhugowaard, but these times were for a different than April 16/17th, 2013.

For the police this note was their ‘smoking gun’. It would explain why Talitha took a 1.5 hour train ride to a town she doesn’t know well and walk for 30 minutes to a remote location to commit suicide. The various bruises on her body were ignored, even though these were estimated to have been obtained minutes or hours before her death and not a consequence of having been run-over by a train.

Now Diekstra has taken official steps to try to move the public attorney’s office (Openbaar Ministerie) to prosecute a senior police officer for perjury by filing an official police report (proces verbaal) with the police. Even if Diekstra is correct with his assertions and he has all the evidence to make the case for the police as straightforward as possible, I would be extremely sceptical if the pressed charges would be followed up by a police investigation and subsequent prosecution by the public attorney.

Saint Nicolas and Black Petes are back with a vengeance

A while back I wrote a piece about the Dutch children’s tradition of celebrating Saint Nicolas and his helper Black Pete. About the latter one, Black Pete, a rather violent discussion is currently raging in the Netherlands. About a year ago the latest discussion ensued. It even went up as far the UN. One Dutch judge made it illegal for Saint Nicolas to parade around Amsterdam with Black Petes and then another judge overturned the initial ruling. The extreme-right political part of Geert Wilders wants to make a law guaranteeing that Black Pete remains black. In short, the Black Pete discussion will continue to rage on for some time.

The celebration of Saint Nicolas starts with his arrival by steamboat all the way from Spain. After a few weeks of touring the Netherlands he quietly returns to Spain right after he gave all the good kids their presents on the eve of December 5th. His arrival by steamboat is a big event. Often thousands of kids (and their parents/guardians) will line the streets to get a glimpse of Saint Nicolas and maybe a handful candy from one of the many Black Petes who accompanied Saint Nicolas.

Today, November 15th, was his arrival in the Netherlands and the town of Gouda was the scene of many happy children. As the discussion around Black Pete has been going on for a while, a group of people came to demonstrate against the character of Black Pete. They perceive his character to embody a negative stereotype of black people. For some reason today’s protest did not go smoothly and resulted in at least 90 people being arrested [BBC report]. 60 for demonstrating in a non-assigned area (they were not allowed at the celebration sites) and 30 for disorderly conduct. One of the people arrested was the journalist Sunny Bergman, who is in the process of making a movie critiquing Black Peter, and her camera was convincated as well. Shortly after her arrest the camera was returned to her employer.

This event has elisitated a response from both Saint Nicolas himself as well as the Dutch Prime Minister. Where Saint Nicolas says that all will be fine and not to worry as he embodies a fatherly figure. Prime Minister Mark Rutte was less fatherly in his response. He remarked that he was saddened that a children’s party was disturbed and he hopes that this won’t happen for the remainder of the Saint Nicolas celebrations.

It is apparent that the discussion about the role and physical appearance of Black Pete as part of the Saint Nicolas celebrations evoke many emotions on both sides of the aisle. Except for a very small group, the role of Saint Nicolas is not in contention nor is the celebration itself. Whereas one group argues that Black Pete represents a racist stereotype based on his appearance and the role of the Netherlands in the transatlantic slave-trade. The other group, pro-Black Petr, argues that Black Pete is an integral part of the Saint Nicolas celebration and there is nothing racist about him. He needs to be black, but is not a stereotype. Video’s such as the one below, where the character Black Pete is introduced to a non-Dutch crowd in London, are ridiculed. “These foreigners don’t understand our tradition, so why should be listen to them.” Overall the arguments made by the pro-Black Pete group sound to me like a provincial attitude. Almost isolationist-like. Responding from the gut without taking a second to consider alternative viewpoints (sort of like a national version of the psychological phenomenon of groupthink). This quickly creates an entrenched position which can only upheld by even more extreme comments, such as the PVV wanting to make law demanding Black Petes always be black. This behaviour strongly contradicts how the Dutch economy is heavily dependent on trade with the same silly foreigners. Pretending that foreign opinions don’t exist or matter to you is rather naïve.

It would also be very naïve to assume that there is little to no racism is day-to-day life in the Netherlands. Just like people in the US will become more vigilant if they see a small group of black youth standing at a corner, Dutch people will become more vigilant when they see a small group of youth of Turkish- or Moroccan-descent. The Dutch even invented a word to describe someone of not 100% Dutch origin: allochtoon. Racism is also about stereotyping minorities. It doesn’t matter if this is done with malintent or even consciously. The guise of tradition does not justify stereotyping. When considering the historical position of the Netherlands with regards to black people (establishing settlements or participating in the transatlantic slave-trade) an aware posture would be expected, yet we see the opposite when it comes to Saint Nicolas and Black Pete.

The comments of the mayor Milo Schoenmaker of Gouda, who also functioned as the host of Saint Nicolas, were very typical: “it were outsiders who came to to us to cause ruckus”. The old bogeyman argument. Back in 2011 when UC Davis police pepper sprayed several students, the chancellor used identical arguments. In that case the initial handling of the event was extremely poor. As the mayor is in charge of the police, it is important to know why 60 demonstrators were able to mingle with celebratory crowd in the first place. Of course it is tempting to be cynical about these arrests as all 90 people were charged with a € 220 fine, which mean they expect to receive €19,800 (or $24,795).

With what I have learned I have to revise my former position. I will celebrate Saint Nicolas, but the Black Pete part I will leave out, at least as a Black Pete. It is not so much that Black Pete is an established part of the celebration for the last 150 years. It stereotypes the black population in the Netherlands, which is wrong. Revising the looks of Black Pete would be one way of resolving the issue, as well as changing his name to for instance Pete the Helper. I doubt the kids will care what Pete the Helper looks like, as an argument of the pro-Black Pete camp is.

Doubt about another ‘suicide’ in the Netherlands

There are moments when you go through your regular breakfast of news feeds that you see an article that looks too familiar. Too familiar as in “I’ve seen such type of news before”. You are not shocked per se, but you are disappointed to read about it … again. Then you realize another family is going through the pains you have been through and are still going through.

Today, November 6th, was such a day.

As I scrolled through De Telegraaf website I noticed a headline I dread to read: “Investigation into Talitha’s death one big mess” [Nederlands | English]. On April 17th last year Talitha was killed by a train. Sadly enough a far too common method of suicide. The driver recalled seeing Talitha laying motionless on the track as he approached her. The assistant public attorney (hulpofficier van justitie), the detective who is in charge of the investigation on location, immediately assumed it was an obvious case of suicide. Subsequently, the surroundings of the ‘crime scene’ were not investigated. The forensic doctor (schouwarts) was not able to establish either suicide or homicide, yet no autopsy was requested.

The qualifications / quality of their work of both the assistant public attorney and forensic doctor have recently been publicly questioned. The lawyer Sébas Diekstra (I don’t know if he is family of psychologist René Diekstra) of the family of Talitha argues that the problem in this particular case lays with the former. So he wrote a letter of complaint to the head public attorney Bob Steensma.

The arguments of Diekstra show striking similarities to ours. Yes, suicide cannot be excluded, but the investigation performed does not support such a conclusion. In fact it does support a conclusion at all. A general lack of professional interest by the DA seems apparent in both cases: Talitha’s name was consistently misspelled in official documents, as was the case with Eline’s name misspelled at various moments.

Besides the legal expertise of lawyer Diekstra, Talitha’s family asked the forensic expertise of Mandy van Geuns. Let’s hope their complaint to the head public attorney Bob Steensma will be successful, although past events do not instill much hope.

Again, a family is forced to go through the long and difficult route of fighting the conclusions of the Dutch public attorney’s office. With every media coverage they will be forced to re-live the horrors of what happened to their beloved Talitha. With every request from the media for an exclusive coverage moment they will ask themselves: how much longer do we have to fight before we are taken seriously by the public attorney? Why not just give in because we ‘know’ what happened, even when in reality you don’t. Just for the thought of not having to fight the public attorney’s office anymore. For not having to read Talitha’s in the media anymore. For not having to read the comments ranging from supportive, to personal attacks, to “you are just relatives who just can’t accept that Talitha committed suicide”. The temptation to give up the fight is all too real. Yet, I am glad that one more family has decided to take on the fight to contest the conclusion of swift suicide by the Dutch police and public attorney. I feel for them. I feel for them having lost a loved one. I feel for them that they feel forced to have to go this route. I wish them all the strength and stubbornness they need for this fight. Every suspicious death should be investigated thoroughly. After all, homicide is one of the worst crimes anyone can encounter.

Coincidentally right next to Talitha’s article was article about the Dutch police restarting an investigation into several suspicious deaths [Nederlands | English] near psychiatric hospital Parnassia. After the sixth death found on the premise of the hospital, the police started an initial investigation earlier this year. Quickly a suspect was identified, but after failing to obtain the medical files, the police halted its investigation. Now a man has come forward who suspects his brother might be the suspect. The first death, seven years ago, was their mother, Tineke Verhagen.

Looking at previous cases discussed on this blog and these two recent cases, it is very tempting to think that the Dutch police has little interest in engaging in labor-intensive investigations. Let’s hope this is just a false notion.

Update 2014.11.09 – Both newspaper De Telegraaf and local TV station RTvNH report that the Public Attorney’s Office claims to have done a thorough investigation into the death of Talitha. This is not a surprising comment from the public attorney’s office. I have heard such comments from the Public Attorney’s Office before, including in the case of my sister’s death. Of course on August 17th we learned that the public attorney’s office will review Eline’s case after they reminded us multiple times they had done a thorough investigation.

Local Dutch newspaper discuss need for psychological autopsies

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Yesterday, Tuesday September 23rd and today Wednesday September 24th several articles were published in various local newspapers including De Gelderlander, De Stentor, Brabants Dagblad, Tubantia, BN DeStem, Eindhovens Dagblad, PZC, and De Limburger / Limburgs Dagblad discussing various cases where the local police swiftly called a death a suicide. All these local newspapers have a national editorial staff named De Persdienst. In an earlier post I talked about a column of psychologist René Diekstra. He wrote one of the three articles published [Dutch | English] and he was interviewed for another [Dutch | English]. The third article was an interview by Peter Winterman [twitter | De Persdienst | LinkedIn] with my parents about Eline’s death [Dutch | English].

Joep Timmermans, the lawyer of Mart, reiterated that “he does not agree with the factual and judicial accusations that again have been made against his client. Also, his client finds it very hurtful that incorrect information about his role, involvement, and person are being spread. Without going into detail: none of the accusations have merit.” Of course Mart has every right to defend himself against any defamation or slander, especially if this behinders him in his daily functioning. Afterall, the Netherlands is a democracy, which means that you are presumed to be innocent until proven guilty in a court of law. This also means that Mart has absolutely no obligation to incriminate himself.

But how do you prevent any fingerpointing to Mart In this particular case? I think it is neigh impossible to not make a logical connection between Eline’s death and Mart, as Mart was the only other person present when Eline “committed suicide”. Simply by questioning suicide-by-stabbing, you invariably imply that Mart must have been actively involved, whether or not you intend to or not. If Mart therefore feels cornered as he described in his interview in De Limburger [Dutch | English] on December 31st, 2012, I can understand and sympathise with his feelings. Especially if a thorough police investigation confirms the swift first conclusion of suicide to be correct. It is this swift first conclusion of suicide that we question.

As I described earlier suicide can indeed not be excluded, but the statistics make Eline’s self-inflicted death not very plausible, thus a thorough police investigation is most certainly warranted. I do not consider an investigation of less than 36 hours a thorough investigation, especially when the Sittard police assumes suicide hours after finding Eline’s body. Ergo our call to the public attorneys office to re-open the case.

The column and interview by and with psychologist René Diesktra bring forth three additional cases where the police were very quick in concluding suicide, yet no indication was found that the police ever launched a thorough investigation. This does not appear to be because of lack of indications of foul play. Once the Dutch police suspect a suicide and label a ‘crime’ scene as such, little to no effort is made by the police to try to contradict its own suspicion. You could call this is a form of tunnel-vision or confirmation bias as described by the Posthuma Commission following the Schiedammer Parkmoord. The Dutch police is further supported by the public attorney’s office (Openbaar Ministerie) who simply state that there is no time to investigate all suicides. To quote DA-spokesperson Désirée Wilhelm: “When it appears to be a suicide, the case is closed for us. (…) When there is doubt about the cause of death we do an as thorough an investigation as possible.”

To me it seems that René Diekstra is correct to advocate for mandatory psychological autopsies for any suspicious ‘suicide’ or any suicide by a younger person. I like to add an addendum to Diekstra’s suggestion. If there is a second person present at a suicide, a psychological autopsy/survey of this person also has to be mandated. This all can become part of a much needed overhaul of the Dutch forensic investigation procedures. Very few forensic autopsies (340 in 2012) are performed in the Netherlands and a recent report by the Dutch tv-program Brandpunt showed that too often the forensic doctor (schouwarts) who is called to a crime scene does not follow protocol and provides poor advice to the investigating police and public attorney. (Quick note: a forensic doctor only does an “quick” external inventory, whereas a forensic pathologist performs a full internal and external autopsy.) It can only be expected that many homicides go unnoticed in the Netherlands because of systematic laziness and unwillingness by the authorities to invest in thorough homicide investigations. Ironically the forensic pathologist who performed Eline’s autopsy, Frank van de Goot, has been saying this for years.