Unqualified use of the word "predicts" is a little bit of a stretch in this editorialized title.
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"
I don’t think you realize how often depressed people say they will but don’t commit suicide, and also being able to know when is quite remarkable - I think this study is pretty interesting, and not as obvious as you think it is.
I mean, sure. Things can be wrong if you intentionally misunderstand words to mean something that they weren’t intended to mean. Is there anyone that legitimately thought that “most” here meant “majority of all actual attempts”?
It's a pretty straightforward reading of the headline. Of course almost everyone understands it would be impossible. But like, you can also just write more clearly.
> 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.
> The strongest and most consistent predictors of next-week SA included within-study history of SREs (from adult lasso regression: OR = 1.47) and self-reported agitation (OR = 1.11), whereas odds of next-week SA were decreased for surveys submitted on weekends (OR = 0.87) and in the context of feelings that one could resist suicidal urges (OR = 0.88–0.96).
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.
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.
Hmm OK. If it's just that, it's a little hard here to see what you imagine we might think from the headline otherwise? If the 'machine' above is just hypothetical, what else? Is it that we might think the 'Harvard study' in question is literally clairvoyant?
Just my perspective on this: A PhD student at my university recently died by suicide, and it made me realize that the way most of us cope or escape from difficult situations is shaped by what we consume, what we experience, and what we constantly see others doing.
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.
> 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.
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.
To go a bit further, I find it important to discuss suicide rationally, without fear.
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 think you're misunderstanding what I'm advocating for. I'm not saying people should be forced to run an endless marathon regardless of how badly they're suffering. I'm saying that when someone is suffering that badly, we should help them rather than let suicide become the way they escape 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.
> we should help them rather than let suicide become the way they escape from it.
> 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."
I'll go ahead and assume you are from India. While all suicides do carry certain commanalities, the academic ones seem much more Indian. The meritocratic view perpetuated has caused generations of kids who's belief becomes that being academically well-off leads to better life outcomes.
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.
Torment run would be becoming a masochist to cope. The comment likely refers to the ability in being able to identify the alternatives, and being flexible.
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.
Yes, you are right. If someone reaches a point where they feel that their situation is so bad that they have to die because of it, then reporting the adviser, switching advisers, escaping to another place, completely starting a new life, or whatever other option life presents could potentially make their life much better, and in some cases even be life-changing. I mean, what worse could happen by trying these options than ending your life? If someone has the courage to make such a drastic decision as ending their life, you could also help them muster the courage to completely restart their life instead.
> 90 percent of people who survived a suicide attempt reported that they had been feeling an urge to alleviate psychological agitation and pain that turned out to be temporal — like “being in a burning room” or wanting to “shut everything off for a couple of days,” Nock said.
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.
Yeah, that's the truth. Identifying someone is suicidal really kinda means very little. What are they going to do, lock you in a room and take away the little freedom you have to choose? Sure, that's helpful. Gonna be extra great when they eventually let you out and you don't have a house or job to go back to.
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.
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)
I’m having a time parsing your comment: you’d consider suicide because you are far away from the people you love? (i.e. you have something to look forward to)
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 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.
They asked people who survived jumping from the Golden Gate Bridge what they were thinking on the way down. They all said they felt instant regret the moment they let go of the rail.
About 30% of survivors try again and ~7% eventually succeed according to https://hsph.harvard.edu/research/means-matter/means-matter-... , "Nine out of ten people who attempt suicide and survive will not go on to die by suicide at a later date. This has been well-established in the suicidology literature. A literature review (Owens 2002) summarized 90 studies that have followed over time people who have made suicide attempts that resulted in medical care. Approximately 7% (range: 5-11%) of attempters eventually died by suicide, approximately 23% reattempted non-fatally, and 70% had no further attempts."
I believe this, and it mirrors what I have heard from suicide attempt survivors in my personal life too.
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
Only the ones you could ask afterwards;) This is propaganda pretending that suicide is an impulsive decision. That's a category error because in many cases, it is not.
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;)
Was very curious on what was meant by the following:
> 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.
It’s very much an embodiment of the law that says to monitor a system is to interfere with it; it would be very hard to say they “predicted” general suicide attempts vs they set up a scenario that allowed them to nudge people into such actions given everything.
Why do you say that - are you referencing something specific or just a point about his framing of existence? I just finished "a short history of decay"
Yes it sounds like people came in at high risk of suicide and then they gave them an app that surveyed them and would predict they were going to commit suicide. Given they were at high risk for suicide attempts, how does this compare to just predicting the people would always try to commit suicide in the following week?
I'm curious what actions the app takes once a sufficient risk has been determined? Does the app or people managing the service just send paramilitary police units to SWAT people or what?
I really don't see how this much different than something like calling/texting 988.
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"
https://psycnet.apa.org/doiLanding?doi=10.1037%2Fabn0001117
> They were sent brief (20-item) smartphone-based surveys 6 times/day for 3 months
Is that in any way realistic? 120 answers/day??
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.
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.
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.
Yes, that is a straightforward interpretation of the headline!
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?
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.
> 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.
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.
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.
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
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)
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.
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 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.
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 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?