Slashdot Mirror
Mental Health Experts Seek To Block the Paths To Suicide
HughPickens.com writes: Experts and laymen have long assumed that people who died by suicide will ultimately do it even if temporarily deterred. Now Celia Watson Seupel reports at the NY Times that a growing body of evidence challenges this view, with many experts calling for a reconsideration of suicide-prevention strategies to stress "means restriction." Instead of treating individual risk, means restriction entails modifying the environment by removing the means by which people usually die by suicide. The world cannot be made suicide-proof, of course. But, these researchers argue, if the walkway over a bridge is fenced off, a struggling college freshman cannot throw herself over the side. If parents leave guns in a locked safe, a teenage son cannot shoot himself if he suddenly decides life is hopeless.
Reducing the availability of highly lethal and commonly used suicide methods has been associated with declines in suicide rates of as much as 30%–50% in other countries (PDF). According to Cathy Barber, people trying to die by suicide tend to choose not the most effective method, but the one most at hand. Some methods have a case fatality rate as low as 1 or 2 percent," says Barber. "With a gun, it's closer to 85 or 90 percent. So it makes a difference what you're reaching for in these low-planned or unplanned suicide attempts." Ken Baldwin, who jumped from the Golden Gate Bridge in 1985 and lived, told reporters that he knew as soon as he had jumped that he had made a terrible mistake. "From the instant I saw my hand leave the railing, I knew I wanted to live. I was terrified out of my skull." Baldwin was lucky to survive the 220 foot plunge into frigid waters. Ms. Barber tells another story: On a friend's very first day as an emergency room physician, a patient was wheeled in, a young man who had shot himself in a suicide attempt. "He was begging the doctors to save him," she says. But they could not.
Reducing the availability of highly lethal and commonly used suicide methods has been associated with declines in suicide rates of as much as 30%–50% in other countries (PDF). According to Cathy Barber, people trying to die by suicide tend to choose not the most effective method, but the one most at hand. Some methods have a case fatality rate as low as 1 or 2 percent," says Barber. "With a gun, it's closer to 85 or 90 percent. So it makes a difference what you're reaching for in these low-planned or unplanned suicide attempts." Ken Baldwin, who jumped from the Golden Gate Bridge in 1985 and lived, told reporters that he knew as soon as he had jumped that he had made a terrible mistake. "From the instant I saw my hand leave the railing, I knew I wanted to live. I was terrified out of my skull." Baldwin was lucky to survive the 220 foot plunge into frigid waters. Ms. Barber tells another story: On a friend's very first day as an emergency room physician, a patient was wheeled in, a young man who had shot himself in a suicide attempt. "He was begging the doctors to save him," she says. But they could not.
If parents leave guns in a locked safe, a teenage son cannot shoot himself if he suddenly decides life is hopeless.
People have been proudly campaigning for irresponsible gun ownership in the US for a very, very, long time. Suggesting things like locking up guns - even in the gun owner's home - will be quickly shot down by people claiming you are impeding on their constitutional right to overthrow the government.
I really, really, wish I was exaggerating or kidding on this one.
Damn_registrars has no butt-hole. Damn_registrars has no use for a butt-hole.
Since we've made remarkably limited advances in the treatment of patients who think that the world is worth escaping; we've decided to just start blocking the exits. On the plus side, we have some emotionally salient anecdotes, of the sort that will probably cheer you right up unless you are one of those pesky people we can't really treat!
This feels pertinent to me because this morning I was woken up at 6:45am by a loud helicopter hovering overhead for over an hour. A teenager had jumped in front of the CalTrain by where I live in Palo Alto in an apparent suicide. Turns out this is the 8th such CalTrain suicide so far this year, up from 8 suicides total (10 deaths) over the whole year last year. Locals are loudly requesting for the crossroads to be made into underpasses, and for improved fences etc.
On the one hand I keep thinking that if someone is determined to commit suicide, they'll find a way. (There was a police guard posted at the crossing after previous suicides to prevent this, but the teenager simply jumped the fence 200 yards from the crossing and jumped in front of the train there instead.)
On the other hand, I see the wisdom in trying to make the world a place where it's in no convenient way to commit suicide. As Banksy tweeted this morning, "Suicide does not end the chances of life getting worse, suicide eliminates the possibility of it ever getting better."
Suicide is a symptom of mental illness. Taking away the possibility to commit suicide doesn't solve the underlying cause.
As someone who suffers from medical depression I feel pretty strongly about this subject, at least as strongly as I can allow myself to feel.
It may sound paradoxical but having the option to commit suicide was one of the things that helped me to finally seek treatment. Before I approached counseling I decided on method and location for a possible suicide. Had that option not been available to me I might not have been able to push through.
Had there been a policy in place to put people with depression on a 24/7 watch-list to prevent suicide the I would have probably gone for the suicide option first.
When the subject of suicide comes up I often see people claiming that suicide is the "easy" way out. What they don't seem to realize is that more importantly it is a way out.
Some people support assisted suicide for non-treatable painful diseases. Typically autoimmune disorders or certain forms of cancer where the body attacks itself. They have seen how much victims of those diseases have to suffer.
It is much harder to see how much you suffer when the mind attacks itself. People think that therapy cures those problems. It doesn't. Bipolar disorder, schizophrenia and depression are permanent. You can only learn how to endure it or acquire the discipline to keep it back.
To me the depression is much like one would expect from alcoholism. I function, but I can not allow myself to think freely. I have to keep my mind busy in complex projects and not let it wander off. Some relatives seem to have a hard time understanding that I will never want to talk nostalgia with them, ever.
Preventing suicide kind of lacks relevance since the person my mind was before died with the depression anyway.
Taking away to option of suicide doesn't solve anything of that. It only removes the inconvenience of having to deal with a body.
Trying to address the issue of suicide by taking away the means of killing yourself is probably entirely the wrong way to go about it. People who are serious about suicide will always find a way, for starters, and unless something substantial is done to address the mental suffering that drives a person to suicide, all you achieve is to prolong the suffering. It is the kind of boneheaded, incompetent idiocy that you get from politicians, when their only goal is to get re-elected.
I think a much better approach would be
1) Give people the right to suicide and the help to do so safely, if that is the right word. This will show people who are suicidal, that you respect them, something is all too often not the case. I think respect is crucial, because if you see suicide as the only way out, you don't want to seek help if you fear that this way out will be taken away; so you have to know that you can go ahead, if you really want to.
2) Make that right dependent on them having been through good quality advice and assessment. Many people only want kill themselves because they can see no other way - they can often be helped to find a better way out.
There is still too much religiously motivated prudishness towards death - life does not belong to some 'God', it belongs to the individual and it is ultimately the responsibility of the individual what they want to do. It is IMO deeply unethical to force life on somebody who really doesn't want it.
I understand the motivation, but there are simply far too many ways to die if you want to. Even if we nerf the whole world and baby proof everything, we won't stop an adult or teen that wants to die from doing so. But we will make the world a worse place to live.
There is a significant chance that we will just force people to choose a horrific way to die or (perhaps worse) a way that is as likely to leave them in a horrific but not dead state as it is to kill them.
Besides, how will we cook without knives?
I can only imagine the costs of changing every last bridge, high area, train track, city sidewalk, etc. into hampster style fenced off tunnels to be, at a minimum, in the hundreds of billions of US dollars (world costs in the tens of trillions) while leaving hundreds of millions of homes in the US alone still chock full of methods to commit suicide anyway. Not to mention natural areas - are we going to fence off every cliff within a few miles of a homestead too?
Here's a thought that's way out there; let's spend those billions on research and development of new medication and treatments instead - that would likely have a far bigger impact. Sadly it's just poorly thought through emotional click bait instead of a sane approach to solving a serious problem. It's as if the rationality of humans is as well evolved as our lower spines.
"People who are serious about suicide will always find a way"
No You don't. At some point in my teenage life I came to that dark place. But since the easy method was removed from my reach, I did not go for other method. the moment *passed*. In fact suicide is not always associated with a mental illness. I see many poster here pretend that, but it is not. Suicide is a symptom that somebody feels is in a situation where living further is more painful than dying. It CAN be a symptom of mental illness but also simply a symptom of intense physical pain or a symptom of plain stupid teenage angst. And for the last group, removing the easy means can simply make the person force to have more time to think.And thus prevent suicide. And then post about it on slashdot 25 years later.
C. Sagan : A demon haunted world:
http://www.amazon.com/gp/product/0345409469/
visit randi.org
Oddly enough, most religions do not predict a pleasant afterlife for suicides.
"I do not agree with what you say, but I will defend to the death your right to say it"
Just one point: Talking or "joking" about committing suicide are high risk factors. It may be "attention seeking" as well, but in many cases, suicidal people feel socially isolated and genuinely need attention.
https://www.eff.org/https-everywhere