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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.
Suicide is a cultural problem, not one of availability (or unavailability) of certain means. The suicide rate of, say, the US and Germany is pretty much the same, despite guns being much more accessible in the former than the latter. However, the train network is much more developed in the latter.
People should, however, be educated about really shitty ways of killing yourself, like overdosing on acetaminophen and the like.
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?
it seems to me that making treatment free (it's expensive!) and encouraging people to get help rather than shaming them for feeling badly would be a better way to go.
society doesn't want spend money to help the mentally ill which ironically bites them in the ass because about 1/3 of the homeless have a form of (untreated) mental illnesses which is why they are homeless. it costs more to have social programs for the homeless than it does to actually help them or even give them homes! i'm sure it would cost much less if we had free treatment to prevent them from becoming homeless in the first place.
wake up, society!
Anons need not reply. Questions end with a question mark.
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.
Nobody ever seems to want to solve the problems they have. That's hard. It's easier to solve problems you wish you had.
I locked up my gun today so little Jimmy couldn't blow his brains out. He'll be fine now.
Research shows that 67% of those who use the term "research shows", are just making shit up.
that those concerned about other's ending their life are projecting their own fear of dying. Who owns one's life? Some priest, politician or shrink or the one living it?
An amazing statistic in the USA is that females have significantly more suicide attempts, while males have significantly more "successful" suicides. And that's due to the availability of guns, which provide an easy way to kill yourself with a high success rate.
An anecdote from the Golden Gate Bridge: A man was spotted on the bridge in some rather agitated state, so the police was called, and the got him. It turned out he had decided to kill himself by jumping off the left side of the Golden Gate Bridge. (Un)fortunately he found himself on the right side. Now there is absolutely no difference between jumping from the left or the right side, but he had decided to kill himself by jumping from the left side. (Un)fortunately there were six lanes of traffic between the right and the left side, and he didn't dare running across the traffic for fear of getting killed, which was actually quite reasonable.
A few years ago, when there was a statistically small number of suicides at Foxconn, the company put up suicide nets which would catch and save people jumping from the roof, and more likely prevent them from jumping in the first place (because these people wanted to die, not look like idiots caught in a net). That gave a course a lot of ammunition to the idiots among the Foxconn haters and Apple haters, but it actually worked. Take a simple way of killing yourself away, and suicide rates drop.
It's long known that the majority of suicides are not done for any rational reason, but because of some mental disturbance. The slightest obstacle in the way of killing themselves can save them.
"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"
Nothing but more theory and anecdote.
"You can reduce the rate of suicide in the United States ... if fewer people had guns in their homes ..."
Total nonsense. The number of households with firearms has been on a multi-decade downward trend:
http://www.slate.com/blogs/the...
Meanwhile, the suicide rate per 100k people has been quite stable at 10-15 per 100k over the last 60 years:
http://www.infoplease.com/ipa/...
So where's the evidence that fewer gun-owning households means a lower suicide rate?
The ONLY consistently documented relationship between firearms and suicide is this:
"Some methods have a case fatality rate as low as 1 or 2 percent ... with a gun, it's closer to 85 or 90 percent."
True and I'm sure that in their so-called "study", the 10-15% of people who survived a self-inflicted gunshot wound regret it and claim it was an impulsive act, but that's hardly "proof" that access to firearms was a causal factor in suicide attempts.
This also raises the important question of how many people really want to die and how many are just desperate for attention. The "cry for help" suicide is a well known and documented fact. If you slice your wrists perpendicular to the length of the arm, you're either incompetent or you don't really want to commit suicide. Fire a 12 gauge shotgun in your mouth and there's zero doubt that you're genuinely trying to kill yourself.
Note also that the USA is #30 worldwide in suicide rate, far behind many countries with strict gun control laws. Take Japan for example with a rate of 20.7/100k.
This is just a bunch of leftist academics trying to further the gun control agenda without real evidence. Gun control groups like Michael Bloomberg's astroturf "Everytown" are actually pushing laws requiring that all firearms in private homes be locked up ... where they will be useless for defense. And imagine police getting search warrants and breaking down your door because someone saw a gun on your nightstand? Insanity..
How about we make suicide completely legal? Think about it. We make suicide legal, but you have to apply for it. Then you have to show up at the Department of Social Health and wait in line for 5 hours, and if that doesn't make you go "man this is ridiculous... I'll just go on living" maybe you'll actually get some real help.
Anyway, you might be right. Lets put corks in tailpipes and ban metal cutlery. That'll show those damn commie suicidal bastards that they can't take away our freedom.
Why should you be scared of nonexistence? You already know what it feels like. Just try to remember the time before you were conceived. That's what it feels like to not exist.
Not very scary, is it?
Doesn't matter, because the person committing suicide is thinking "I don't care what it is, it has to be better than this".
I am an Aussie living and working in the States for the past five years. At Uni I worked for a suicide hotline and I keep up with the literature. For a long time after we instituted our stronger gun control, widespread confiscation of handguns, there were claims our suicide rates dropped. Those claims have been debunked. There were both a) methodological changes that caused an 18% drop simply due to the way counting was done. Google Australia suicide undercount" to see the peer reviewed work showing that. b) non gun methods of self caused death rose much more than the reduction in self caused death by gunshot. In Australia, as in the USA, a self inflicted gunshot is per se ruled a suicide. there must be evidence to the contrary to rule it an accident. The OPPOSITE is the case with drug overdose, poisoning, crashes, "falls" tat are really jumps, drownings at sea, co2 asphyxia, etc. Absent affirmative evidence of suicide, these are per se ruled accident. None gun self caused death rose more than double the rate of the drop in gun suicide The research shows having a gun in the household -- within a demographic group -- does not change suicide rates one iota. The 'within demographic group' is important as well. In The highest (counted) suicide and self caused death rate is later middle age men generally , with a sharper spike in in rural areas. That is true in cultures with guns and those with no guns. In the USA, that is the demographic with guns. So there is a logical and statistical fallacy in not controlling for that. The data need to be looked at with and without guns within the same demographic groups. When that is done, the presence of a gun is irrelevant to self caused death rate. This NY Times article is a gigantic disservice. More and more mental health professionals understand we may have up to 100,000 suicides per year, and with about wrongly 65,000 counted as accident, the MINORITYY are with guns. It is the WHY of suicide that is important. The "how" is irrelevant, and it is harmful and distracting to concentrate on the means.
The UK used to sell acetaminophen (AKA Tylenol) in bottles (like in the US).
Some people committed suicide by OD'ing on the pills.
So they changed from bottles to blister packs.
Now if you want to off yourself that way, you have to sit there and pop out ~50 pills, one by one.
It reduced those sucides by something like 30%.
That's a lot of lives saved, with a pretty low barrier.
The person who equated this article to advocating "blocking the exits" is exactly right. The individual who actually plans to end their life in a fully conscious, fit state of mind has also surely come up with a plan that will get around any number of "blocked exit" strategies (like locking up personal guns in a cabinet, or hiding the keys to the car). They're not who this article refers to, IMO.
But the person who is distraught enough to actually go through with a plan that has a high likelihood of ending their life (as opposed to FAR more of them who might talk about it or use a half-hearted attempt as attention-seeking behavior) are going to do it when the mood strikes them. And the original article seems to be saying it's effective and appropriate to remote as many possible means to accomplish this as possible, so the means will be lacking when the mood strikes.
My problem with this is that it's only a band-aid for the underlying issue ... someone's severe depression. If it's not possible to get a person to get back the will to live, what quality of life do they have anyway, while you've "succeeded in preventing their suicide" by locking all of your knives up in a box?
I know the "Darwin Awards" are intended as a joke, but consider a purely animalistic / mathematical perspective: the individual doesn't matter to Mother Nature. Most species produce lots of offspring simply to overcome the high odds of dying before reproducing. Those odds are mostly external from predators and injury, and also include internal causes like illness, "unfitness" (in the Darwinian sense), and any kind of defect. Some calculated risk-taking is useful, but poor calculation skills (or excessive bravado despite calculation) lead to the "Darwin Awards" concept. Maybe, in the same vein, some amount of fear / depression / unhappiness is useful as a moderating influence on behavior - as often stated, courage is not the absence of fear, it is persistence despite fear - but too much of those emotions renders the individual less useful, and enough of those emotions to cause self-damage or self-killing is a trait that will self-cull from the gene pool.
Is it, then, worthwhile from a purely economical point to try to baby-proof the world, or would it be more practical to emphasize recognition and identification of people with problems for targeted help? Not to mention impinging on everybody for the safety of the few (a hot reaction in so many posts here). This has some analogy to the issue of "playground safety" meaning that children get no exercise and learn no skills because the play area must be totally safe for all activities and ability levels. At what point does making the world totally safe mean nobody can have a cooking knife?
legislate a person's desire to ... what makes them horny.
No, but the republicans will try.
I'm a good cook. I'm a fantastic eater. - Steven Brust
Why the fuck don't people remove the REASONS why people commit suicide in the first place? Who are these jokers who want to put all of us in rubber rooms?