The one at MIT, Nightline, was smart because it pitched itself as a general "call for any reason at night" number -- I called a couple times to get urgent help (after someone tried unsuccessfully to mug me, and I needed to figure out who to report to) -- not just for suicidal people.
I suspect there are depressed people who may ultimately kill themselves who, if there were some number solely for "suicidal people", would never call, but would be likely to call "call for any reason", and then get access to mental health care in addition to whatever the phone operator gives them.
Nice to see that somehow the MIT administration fucked up Nightline, too, so it's closed for a year. Good job guys!
We have a Nightline at University of Leeds for anyone to call for anything. It's a great thing for people who just need someone to talk to. Whether they're feeling suicidal or just a bit stressed over exams.
And the number is on the back of every student ID, which means anyone can find their number really easily.
The biggest problem seems to have been that word got out about it outside the MIT community, so that they were getting many calls from non-MIT people. But, their policy was to try to help anyone they could: http://tech.mit.edu/V130/N43/nightline.html
Maybe it would have been better to change the policy than to scrap the whole service.
(BTW I was one of the first Nightline staffers back in 1978.)
I lost most of my faith in the MIT administration in the 1990s when I was a student; they're basically a bunch of BU/small liberal arts college grad professional administrators of colleges running the institute into the ground. That's the biggest failure of the MIT model vs. a place like Stanford; there's not much chance MIT grads will eventually want to be university administrators.
And your lack of ability to understand what was written is even more breathtaking.
The man's point was that it is not suitable for a technical institution like that to be managed and administered by non-technical people. There are a number of reasons for that but the main one is that they lack the expertise needed to run such a place and can't fully appreciate the culture of hacking that many such institutes were built upon.
Same goes for companies. The most successful software companies out there are those run by engineers. Think Google. When "business people" take over, things often have a way of turning for worse. I've seen it time and again.
He's replying to a comment that said their help line was taken down. That's not a technology problem, and I fail to see how an engineer or computer science grad would have better tackled that issue.
I think people are better at running the schools they themselves attended. MIT grads would be better running MIT than non-MIT grads; MIT grads, however, would be horrible at running small liberal arts colleges.
(the idea is probably a MIT undergrad or grad student who then goes to another school or business for some kind of management experience, then eventually returns to MIT, like some of the best administrators; or, a professor who also does admin functions. Professional administrators have grown in number dramatically faster than enrollment, which is part of why tuition is so high. We don't need ~50 deans.
I think you're right that it needs to be more general support, someone I loved had just the last 7% of her life 'covered' by suicide hotlines and 26 years of suffering before them. The final days, weeks, months, it was all just a delaying measure at that point because she'd already come to terms with what she wanted to do.
I don't really think the solution is more hotlines, even generalized ones because you have to want to get help every single time. I think the solution is to shine so much light on mental illness it loses all of the mystery and stigma and becomes as widely discussed and debated as the following 'mentally healthy' ways to kill yourself or someone else:
- Euthanasia, or "mercy" killing because we are glad someone's suffering has ended
- Abortion, literally deciding to end another person's life who is incapable of asking you not to
And of course, the preferred method of suicide that most people will use:
- a slow poison of shitty diets and deadly vices
We never even discussed mental illness or even suicide in high school like we did ethical dilemmas.
I'm glad this is on the front page. Often when I learn of the suicide of someone I knew or respected I briefly experience idle "sympathetic" suicidal thoughts. This always leaves me shaken because we've all been taught to seek help immediately if we ever experience suicidal thoughts, but I know I'm not depressed, even if life is indeed very difficult sometimes. I imagine someone truly depressed and suicidal might experience a very strong impulse to act on their thoughts upon hearing news like this.
In Germany we call it Werther Effekt (following Goethe's novel Die Leiden des Jungen Werther). Public attention to a suicide often triggers additional suicides.
The most effective immediate suicide prevention available is a surprising one. It's Ketamine. It takes effect very rapidly and the anti-depressant effects persist for months from a single dose. It's a wonder how SSRI's are in wide use when there are far more effective treatments which have been around since the 60's. Marketing and business are to blame for that, I suppose.
There are also some novel NMDA antagonists (same mechanism as Ketamine) in the works, which come with less perception alterations, the names of which escape me, which will change things for the better for a lot of people.
Ketamine may be effective, but is it useful for 'immediate' prevention? I suppose this depends on what you mean by 'immediate'. Someone already posted a link here suggesting a significant number of suicides are impulsive, and many people have planned suicides without their friends or family having any idea.
I can't see how in many of these situations a controlled drug is going to help. We could only administer ketamine to those who exhibit depression or suicidal tendencies, but sadly these signs are not always visible or picked up.
I meant in the context of someone about to commit suicide and calling a helpline. Send someone over, give them an injection and you've bought a few months of time during which they can recieve therapy. A lot of failed suicide attempts tend to get repeated. It would solve that issue very well.
Not trying to be facetious here, but are there some kind of statistics somewhere out there that show how effective suicide hotlines are? I always hear about them, but have yet to hear about someone who used one successfully.
E.g. X% of people have been dissuaded by suicide attempts after speaking to a suicide hotline.
I just tried searching Google Scholar, and it turned up studies showing effectiveness:
http://onlinelibrary.wiley.com/doi/10.1521/suli.33.4.400.252... - "Independent raters measured callers' suicidality and mental state at the beginning and end of 100 taped counselling sessions. Changes in suicidality and mental state were measured using a reliable rating scale developed for the study. Significant decreases in suicidality and significant improvement in mental state were found to occur during the course of counselling sessions, suggesting positive immediate impact."
http://link.springer.com/article/10.1023%2FA%3A1022269314076... - "Outcome measures showed observer evaluations of decreased depressive mood from the beginning to the end in 14% of calls, decreased suicidal urgency ratings from the beginning to the end in 27% of calls, and reaching a contract in 68% of calls, of which 54% of contracts were upheld according to follow-up data."
In case people don't know this: these hotlines also help people who are concerned about friends and family members, and there are email-based options like http://www.samaritans.org/.
I volunteer as a crisis and suicide counselor for Didi Hirsch (a national suicide line branch) in Los Angeles. Thanks for posting these studies and validating the important work.
I actually worked for the national hotline as a volunteer. I worked at a local crisis hotline in the Maryland area, and each one of these places ties into the national hotline, as it does (and please feel free to troll me) a round-robin process and tries to find the closest center given the area code of the caller. I personally handled less than a dozen of these calls. I cannot go into details because we all sign NDA's (surprise, surprise), but I will tell you in all my time we never had someone commit suicide. Also, even volunteer people like myself are trained in suicidology assessment, and getting a stage 3 person warrants you calling law enforcement and/or emergency services given your discretion. In my over a year there, I saw that happen only once when they thought it would be close. I personally talked down many people, and it was my personal opinion those who called the hotline were rarely those were at a level so bad they were going to do it on the phone.
Just to clarify, does this mean you don't think it's a worthwhile service? It kind of sounds like you're implying that people who phone aren't really serious, but does it follow then that people should call, or that they shouldn't exist, or what?
I'm very grateful that you volunteered with them, but I'm really curious what conclusion we're supposed to draw from your experience. At worst it sounds slightly dismissive of the line and the people who call.
I don't have any numbers, but I know at least 3 people who have used them in the past. When I was younger, I used an anonymous online suicide hotline site (though I don't recall which), which at least made me stop and think, which is often enough.
I called one once, it's pretty effective, even though his advice didn't work or was dumb, I think just having somebody to listen to you is good enough, during that time nobody, meaning none of my friends, was answering my calls.
A friend of mine worked for one for a while. She says it is a mixed bag, you win a lot, you lose some too. It's the toughest thing anybody could pick to do as a job. She's a pretty successful businesswoman and decided to take a years break and looked for something useful to do, ended up manning one of the phones.
I don't have the numbers at hand, but I've heard of a study saying that suicide very often is a very impulsive action. Saying that in most cases there's less than an hour between deciding to commit suicide and the action itself (numbers might be off here).
Looks like I got it from a Freakonomics podcast [1]: "One academic study looked at attempted suicides in Houston among 15 to 34 year olds. It found that in 70 percent of the cases, the time between deciding to commit suicide and taking action was under an hour. Seventy-percent of the cases. For about one-quarter of the people involved, the time gap was five minutes or less."
Of course, from this it doesn't follow that a hotline it necessarily effective. Luckily britta already posted links to some studies.
Anecdotally I worked as a part-time volunteer on a general counselling service for a couple of years in my twenties - which included some suicide calls. A goodly chunk of the time it felt like you made a difference. We occasionally got "thank you" calls weeks/months later to say that we'd stopped folk doing things that they would now regret (sometimes from folk you thought you hadn't helped...)
Probably more effective earlier. Someone living while being horribly depressed all the time isn't exactly a victory, either. I assume suicide hotlines can refer depressed and "suicidal ideation" people, who aren't yet actually killing themselves, to help as well.
I would imagine that in reality the percentage of callers that actually intend to commit suicide is probably pretty low, regardless of 'studies'. How are you going to really study something like that objectively? I can't imagine that anyone would ever hear about someone who used one successfully. Only the actual suicides are going to make the news like this, which is sad. However, I would think it would be worth it even if a hotline is only able to dissuade even 1/10000 callers intent on committing suicide.
Even if the same amount of money could save five lives elsewhere? As a person who continually deals with depression, I'm glad the hotlines exist and absolutely think they are worth it; but I cringe every time I hear, "if it only saves one life" regardless of the cost (which is usually billions of dollars and a few civil rights when the government is involved).
Possibly inconsequential but you have one right here. I've called a suicide hotline more times than I can remember. They don't tell you something resulting in some great epiphany. What they do is talk to you. Simply talk to you, hear what you have to say, keep you on the line and make you feel heard. That's all I needed to calm down. Maybe that's what most people need. No suicide line has ever sent me a form asking if they've done a good job. I imagine they are constantly swamped.
Here we call them something like a 'crisis line'. They aren't just for people who are considering suicide; I have had friends with extreme anxiety who phoned to talk through their fears. This helped them work through crippling anxiety attacks and allowed them to go to class, work, etc. afterwards.
The people on these lines are very well trained at active listening, and that can be useful in a lot of mental health situations where suicide may never have been the end result.
It is part of media regulations in many countries/organisations that reporting of suicide must be done in certain ways to reduce the negative effect that may have on potentially vulnerable people. A full list of countries that enforce this on a national level is available from the International Association for Suicide Prevention http://www.iasp.info/media_guidelines.php
Google returns a local suicide prevention line number when you google suicide.
Perhaps social media sites should discourage posting on the subject at the time of submission, or trying to wrap such content with reminder to the readership that they matter.
I'd be curious to know what they teach the people manning the phones. Sometimes I ponder volunteering, but honestly, atm anybody talking to me would probably be more suicidal afterwards than before.
Are there even universal things to say? Perhaps somebody religious needs to hear "god loves you no matter what", whereas I for example found solace in thinking about atheism and evolution theory. Probably the first talks are not even about such things, rather about convincing the person that most problems are solvable and that they can get help?
I was a counselor at one and yes they will train you on what to say. Generally, you will be trained not to give a lot of advice, but to do reflective listening. It was interesting for me and has helped a lot in my personal life.
I've always wondered why suicide is so common among us young programmers. (Ilya, Bill Zeller, etc)
As programmers we're able to control how our code behaves, but life on the other hand has too many variables, most of which are beyond one's control - and the only thing one can control is their lives. The will to live can do amazing wonders, but when that will fades -- life doesn't make sense, its just a waste of time and resources.
Suicide is extremely common among males (compared to women, men end up killing them at self at something like a 10:1 ratio, even though more women than men try to kill them self), particularily young males.
Looking at the available UE data from eurostat[0] the ratio would seem more 4:1, which obviously still confirms your point, I am just curious about your source.
Whenever your depression (or anything similar) symptoms are relieved and another person is helping you, that is enough to get you at least 'just a bit' further away from suicide. And, really, this cannot be easily accounted for.
The problem with human interactions and ease of anxiety is that you will probably never be able to get a proper and useful metric.
I'd say most depressive people would not fill a form after calling any help hotline.
I know it doesn't seem feasible but I do wish we could have an "International Suicide Prevention lifeline". When I lived in Fiji, I would often look on the web for some place to call. I often settled for irc chatrooms. It's sad that my first ever foray into irc was because I was lonely and wanted company. I'm lucky that New Zealand, where I live currently, has great support.
With all due respect, I think your interpretations are inane, but if Lessig can't convince you of that, I'm sure there's nothing else I can say that will help you understand.
I suspect there are depressed people who may ultimately kill themselves who, if there were some number solely for "suicidal people", would never call, but would be likely to call "call for any reason", and then get access to mental health care in addition to whatever the phone operator gives them.
Nice to see that somehow the MIT administration fucked up Nightline, too, so it's closed for a year. Good job guys!