Harvard study predicts most suicide attempts a week in advance(current.fas.harvard.edu) |
Harvard study predicts most suicide attempts a week in advance(current.fas.harvard.edu) |
The study doesn't predict suicide attempts out of some type of biometric or otherwise observable data or surveillance information, it's predicting it from a self-survey. The actual journal article title tells the story much better:
"Using smartphone surveys to predict next-week suicide attempts"
It seems a little silly, that suicide-relared events are well predicted by people announcing their nearness to suicide. It's useful in the sense that it shows that people, at least those people who consented to being monitored, which is a major confounder, are announcing their intent to anyone who is listening.
> They were sent brief (20-item) smartphone-based surveys 6 times/day for 3 months
Is that in any way realistic? 120 answers/day??
I am just saying that if a layperson were told, "I have invented a machine that can accurately predict when someone is going to do Z!", but then, while researching the technology behind how such a prediction is possible, turns out the machine simply has been repeatedly asking the person how likely it is they will be doing Z, how much they think about Z, etc, then the layperson may feel a bit misled by the initial claim. I feel that way towards the editor that wrote this article title.
For most of us, that escape mechanism can be something else instead of taking such a drastic decision. If we can make sure people don’t grow up believing that suicide is even a way to cope with what has happened to them, we could significantly reduce the number of suicides.
We only have one life. There’s no respawn. This world has so much to offer, and once we’re gone, we won’t get to experience any of the good things that are still ahead of us.
So why not keep going?
I’m not sure exactly why I share this, perhaps I think some comments about suicide being an “escape hatch” resonated with me. I’ve since sought support, going just short of self-hospitalization, and I was on a SSRI until recently switching to a non-antidepressant.
While life remains Messed Up, I keep telling myself two things: (1) If you’re really considering killing yourself, try “ killing yourself” in the gym (often super hard exercise makes me feel infinitely better); and (2) “Wouldn’t it make a better story if I didn’t (kill myself)?”
I’m getting through, day by day, and I’ve got some strong “protective factors,” however they’re not invincible or bulletproof so I need to remain vigilant and avoid doing anything impulsive. And just try to remember that if I keep making good decisions one day at a time things will get better in the long-run.
I moved to Austin last week, away from my wife and 3yo daughter. It’s been torture. Today was the first time I could FaceTime with her without completely breaking down crying.
One annoying part about suicide is that if you reveal to anyone that you want to stop living, they usually treat you like a big risk, or think you’re insane, or worry you might hurt them, or be uncomfortable to be around you anymore.
Someone at a party was going through my key chain. “Mail key?” “Nope, gun key if I decide to blow my brains out.” That was basically the last time I talked to them.
For a datapoint of n=1, my biggest factor motivating me to do it is the constant pain. It permeates your whole chest, all day, every day.
I’ve been fortunate to make some friends here. But really, I just don’t want to continue living. In a way, it feels like being in a cult — everyone around me thinks life is so great, and that it’s so horrible if I cut it short. But cutting it short has so many benefits. No more job. No more boss. No more missing my family. No need to rebuild my life after 20 years.
Like, truly, other than seeing my daughter again, I don’t have a reason to keep going. Playing games is fun, meeting people is nice… but I’m alone in a 700sqft apartment with some cereal and Dino nuggets, fantasizing about playing tag with my daughter, and being incredibly jealous that the man who replaced me gets to experience “my” family life every day.
Suicide is appealing because life is hard. It’s so much effort. I just wish people wouldn’t cut me out for admitting it’s appealing, or try to force me into a hospital. I just want to be heard, not “helped.”
These studies presume that suicide is treatable, and that it’s a “thing” that can be “fixed”. But it often isn’t. You want to rebuild my life for me and go to work every day? I’d give anything to be on autopilot in my own head, and just be asleep.
I’m doing a little better. It’s just really hard, you know? I wish I could say “hey, I’ve had a good life. I’ve done a bunch of cool things. I’d like to call it quits please” without it being sacrilege.
Anyway. I wish all of you a great night. Hug your kids or your SO for me.
I do wonder what the story would be if we could somehow ask the people who didn't survive. Likely a purely philosophical question with no answer, but I wonder how many of the people who do end their own lives don't regret it at all.
Most likely the dead are not capable of regret, but if there is some manner of afterlife where people can contemplate their actions, I do wonder how many of them would regret their suicides
If there was more focus on screening for impulsive thoughts and disrupting people who suddenly change behaviour, modern suicide prevention would do much better. The people who really want to die do not engage with therapy or mental health services because they know they'll be having their freedom taken away if they mention their thoughts to anyone else. That's why many of these stories go like "oh he looked so happy! no one could have known" - yeah because he was smart enough not to say anything;)
> The most accurate prediction was achieved using bidirectional long short-term memory and simple lasso-penalized logistic regression models, with the best performing model using bidirectional long short-term memory to predict SRE, which with specificity at .90, had area under the curve = .94, sensitivity = .87, and positive predictive value = .30, and SAs with area under the curve = .90, sensitivity = .74, positive predictive value = .16.
Where SA is "Suicide Attempt" and SRE is "suicide-related event".
> The study included a real-time alert system for intervening if a person indicated a high suicidal intent
Because it sounds a bit dystopian.
And found a little more about it[0]
> For example, in our monitoring studies, we install smartphone apps on participants’ phones. These participants are often recruited from hospitals after presenting with high suicide risk. We tell them explicitly that we monitor responses during certain hours—for example, between 9 a.m. and 9 p.m.—and that we will do our best to respond if we believe they are at imminent risk of harming themselves.
...
> We have real-time alerts when someone crosses a predefined risk threshold, and we follow a very detailed protocol that specifies exactly what actions we take at each level of risk. But we want participants to understand that this is not a replacement for clinical care. We are not a “Minority Report” system that will swoop in and prevent harm in every case.
[0]: https://primr.org/ethical-challenges-in-suicide-research/
en.wikipedia.org/wiki/Observer_effect_(physics)
and a more specific form from psychology
en.wikipedia.org/wiki/Hawthorne_effect
I really don't see how this much different than something like calling/texting 988.
Suicide is a right.
How can you know in advance that someone needs intervention? By what standard?
The fact that there is a plan B (suicide) keeps me going.
I was actively (almost daily) considering suicide around ages 13-16. I made a decision to postpone it every day I thought of it because I believed I had seen too little of life by that point to make a decision to end it. But it being available as an option made things easier. There was a “backup plan” and I could always use it, which made it possible to endure another day.
I’m in my 30s today. I have used the same strategy in some other complicated life situations since my teenage years, although only a few times and very briefly. Knowing that you can just end it and that it’s available to you not just today, but also tomorrow and the day after that, is so unbelievably useful in my opinion that I’d personally like to see it normalized, rather than the opposite.
For example, when I was in enormous physical pain, my thinking was: “If there are no other options left, I can always just end it. But there are other options, so let’s try those first.” Reminding myself that I am working on solutions, and that if I run out of them, there is still one final option, took all the edge off the pain. It lost its power over me. I was fully in control of how this issue was going to be resolved. And it takes the edge off suicide itself - it’s just one of the solutions, nothing special. Compared to other solutions it has one terrible drawback: you can’t try any of the other solutions once you’ve tried this one.
About half of the reason for wanting to kill myself as a teenager was to escape my situation, but the other half was about this “romantical” idea of others finally seeing how much pain I was in. That it would make them care. They would have to finally admit to the harm their actions have on people around them.
As an adult, I recognise that people who don’t care when you’re alive, won’t care when you’re dead. That’s half of the original reason gone. I think there’s some way to communicate this to people who are considering suicide to make it more “rational” and take its power away. Instead of hiding from suicide, clear away the fog around it.
If you could somehow shelter people from the idea of ending it, you'd have created the torment nexus. People who do so usually do it because they see negative things coming up and they're too tired to continue. What you're advocating for is everyone to run an endless marathon where if you fall behind or stop, you'd get endlessly whipped to continue no matter how much your wounds are bleeding from it.
I'm not blaming people for the circumstances they're in or saying their suffering isn't real. I'm questioning the environment that teaches people what to do when they reach that point. Different people go through incredibly difficult situations and develop different ways of coping. My point is that ending your life shouldn't be one of those ways.
If someone is so exhausted that they feel they can't continue, the answer should be to help them, change their circumstances where possible, and help them find another way through it. Otherwise, what is the point of helping someone who is suicidal in the first place?
The goal isn't to force people to keep suffering. The goal is to help them stop suffering without ending their life.
Torment run would be slogging under the student's adviser, the other option being reporting him, or switching advisers, or any other option life presents.
And helping someone who is suicidal improve their life is such an enormous hardship that the little we currently offer to help with it (therapy) is so weak it's insane. No, talking to this person for 30 minutes and telling me little mental tricks to deal with things isn't going to save me. Pills do better but still are pretty weak.
Truth is, the real solution is to FIX THE PROBLEM. Society should help suicidal people by addressing the life crisis that causes them to be suicidal. Anything short of that is either worthless or requires a full time live-in caretaker.
I didn't understand any of this until I had a relationship with someone that had suicidal thoughts from time to time.
This echoes much of what she described - constant pain is hard, and suicide offers immediate relief.
It's an experience of reality that's very hard to understand for anyone who hasn't been close to it.
@sillysaurusx thank you for sharing your experience so clearly. Best of luck
I have been "hear"ing people out, without trying to "help", for over two decades.
In case you wish to talk to me, please mail me: Gmail sigma.ml.
If I had one advice, it would be to find someone who relates to how you feel, because being able to talk about it to someone who's been/is there is the one thing that really helps, in my experience. I don't know where, a friend, a suicide support group, a men's group, but being able to talk about these feelings and be really understood does help.
In the meantime, try just to be around people when it's hardest.
Sorry to not have anything better to offer. Hope you keep going, brother.
I don't know you, but I would encourage you talk to a professional about these thoughts as soon as possible. This isn't a judgment, not trying to cut you out - it's just been helpful to me personally. Therapy is really just one more person to hear you, commiserate, and help process life being as hard as it is.
That sounds awful - sometimes pain is unbearable, and moreso because other people are so blind to it.
And the fear of things being worse if I try but fail to end it..
Often times, for me, it feels like surviving more than living let alone thriving.
I miss having good pain free uninterrupted full nights sleep.
What you feel is valid. And going through it in a new place, with no local support, makes it that much harder. I think most people would feel the same pain you feel, if they were in your shoes. I think most people would want someone to listen/care, too. But the burden of sitting with what you're going through is too much/too heavy, so people reflexively protect themselves from really seeing it..
It sucks, and I'm sorry.
Sometimes animals make better companions than humans through thick and thin... fostering comes to mind as a possible productive distraction from the pain, if that's something you might be compatible with. Though you didn't ask for advice (sorry)
The times I have felt suicidal were when I had nothing to look forward to. Having a little person to care about that I miss so much to break down crying just thinking about them is motive enough to go through hell twice just to reunite with them.
I think he's going through a breakup.
> the answer should be to help them, change their circumstances where possible, and help them find another way through it.
You left that part out originally. You meant it implicitly, so I may seem pedantic, but this kind of thing must be said explicitly.
For example: the asylum system. Abolishing it's ubiquity was unarguably good, but then they just... stopped there, leaving many people in the lurch.[1] To paraphrase and oversimplify MLK, "presence of justice is much harder than absence of tension."
[1]https://lareviewofbooks.org/article/how-defunding-abusive-in...
The shame, and to a lesser extent guilt, associated with a possibility of not acheiving this goal is often too hard to handle that they give up. 4 kids dead this way last year in my school, 2 more so far.
Edit: Implied is that how determined they were to commit suicide influenced their behavior before survival/death was fully out of their control.
A dark take: “We can predict suicides by driving people to commit them”.
What does “most” mean in the story?
> his lab predicted 75 percent of suicide attempts and 87 percent of suicide-related events in the week before they occurred
But what is the false positive rate? I could predict 100% of the worlds suicides a week in advance if I just predict that everyone will commit suicide next week. Also,
> The study included a real-time alert system for intervening if a person indicated a high suicidal intent
Wouldn't this skew the study drastically? "Here you go. Push this button if you're absolutely going to commit suicide". I'm sure that isn't how the alert system worked, but it seems like you'd definitely get a lot higher rate of "suicide attempts" if the participants of the study know it's going to get the attention of the clinic to intervene.
2. Pour it in your open butt.
Yes, that is a straightforward interpretation of the headline!