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If someone is in the state of mind of wanting to take their own life, will they desire to call to talk to a stranger on a hotline?

"In spite of their popularity and attractiveness, so far there is no conclusive evidence on the effectiveness of suicide prevention hot lines and crise centres" (2004) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1414695/



Maybe, maybe not. Regardless, we should still strive to give that person alternatives.

"Be kind, for everyone you meet is fighting a hard battle". -- Plato

Edit: @aaron695: that is what I was trying to communicate


I think the point is we should be careful about "doing something" and then indulging in the satisfaction of "something has been done", especially if there is no evidence that the 'something' we pick is beneficial to anyone.


I would agree with you if the cost was high. Running a suicide prevention hotline strikes me as a low cost preventative measure, moreso if you get actuarial/gruesome and take into account someone's dollar value as a human being (mid to high six figures for most people).


The real cost of doing something because something must be done is the false sense of satisfaction. That cost is potentially very high in this case.


An educated guess now is better then perfect data later.

We should of course continue to research ways to stem suicides and the conditions that cultivate someone feeling they have no other options.


And so is the potential cost of not doing anything, so what's your point?

You seem to conjecture that refering someone to a hotline raises the chance of that person commiting suicide, while AFAIK all the evidence points towards suicide hotlines being effective at reducing stress and suicidality.


Sorry, what? Not doing anything may result in a false sense of satisfaction?

> seem to conjecture that refering someone to a hotline raises the chance of that person commiting suicide

I don't conjecture this at all.

> all the evidence points towards suicide hotlines being effective at reducing stress and suicidality.

What evidence? The entire point of this subthread is that we don't have any evidence that this is true. Or do you have some evidence we don't know about?


Why do we, in general, accept any personal decision that does not interfere with other people, but refuse to accept the ultimate decision a person can make in regards to his live?

I'm not suicidal at the moment and feel that my life has some purpose - but why would I assume that a person who is suicidal knows less about his own life than I do?


The decision to commit suicide is rarely made in a rational state of mind. Unlike most decisions, however, this one is permanent.


This is true for suicide due to depression or other mental health issues.

However, deciding to commit suicide due to intractable terminal illness is often done in a very rational state of mind.

The big difference is that the later is a decision that is/should not be made alone, but with the assistance of your family, friends and or doctor.


Euthanasia is not really relevant to what's being discussed here.


Almost all of our decisions are, really, permanent - and most of the time, we're not making them rationally. Break up with your significant other - then, even if you decide to "reverse" it and get back together, it won't be the same relationship anymore. Quit from your job - most likely, you won't work for the same company ever again.

Yes, these are only parts of life, and suicide ends life as a whole - but you have reasons why you're not stopping all of your friends from making all the small wrong decisions, right? You probably reason that they might know better, and if anything, their freedom includes the right to make mistakes.

Well, the same reasoning logically works for suicide, too - the magnitude of the components change, but the formula is still the same. I agree that it's a good idea to talk to someone who tries to commit suicide and make sure that they really want to make this decision and have thought about it - but our culture, meanwhile, painfully rejects the notion that in the end, you may agree with that person in their pursuit of suicide.

On another hand, you probably (statistically, given HN typical audience) support right to euthanasia; you think that if someone have immense physical suffering and no hope to escape from it, death is a viable alternative. But why do we reject the same treatment for emotional and intellectual suffering? You can't really feel both types, but for some reason, you suppose that one is more 'real' than another. That any emotional trouble can be healed, because "it's just in your head".

Respect for someone's freedom begins with respect for his decisions and respect for his mistakes. Too often the true reason for all this unasked for "help" is in selfish desire to "do good" instead of real empathy for another human being.


Clinical depression is significantly different from terminal illness. Depression doesn't have to be a death sentence. Yes, it is immense mental, emotional, and intellectual suffering. But that doesn't mean death is the right answer, and someone who is suffering from clinical depression is not in the right frame of mind to make that distinction.

I speak as someone who has been there, is currently taking antidepressants, and has seriously considered the option at multiple times in my life. Depression will tell you there is no other method of relief from the pain, but depression lies.


I believe that most people, if prevented from suicide, are glad to have been prevented. You might want to read http://slatestarcodex.com/2013/04/25/in-defense-of-psych-tre...

Personally, if someone told me in advance that, if they ever attempted suicide, they'd like me to not interfere - then I'd accept that. But I have a friend who's alive because she hadn't told me that, and I did interfere, and she's glad I did.


> Regardless, we should still strive to give that person alternatives.

No.

We should strive to help them.

This comment it literally saying we should feel better about ourselves even though I'm sure it wasn't your intention.


It goes beyond just hotlines (which IME are useless at best and actively harmful at worst (having law-enforcement called on you is no fun)) -- the suicide rate for the past 80ish years in US has remained remarkably flat, despite many advances in psychiatry: https://twitter.com/sarahdoingthing/status/68238219583987712...


"Suicides In Rural America Increased More Than 40% In 16 Years"

http://acsh.org/news/2017/03/16/suicides-rural-america-incre...


Unless you know now of a better solution, it is important to, at least, point out the options available.

Are there other interventions that are better than hotlines?


According to science, regulating firearms is effective is reducing suicide rates.

https://soundcloud.com/science-vs/guns https://soundcloud.com/science-vs/gun-control-pt-2


Alternatively, according to what most of the rest of the world would like to call "common sense".


I'm not sure. I just get the feeling the hotlines are more for people to feel like they're doing something to help, when maybe they're really not doing much at all. I'd like to find out more about what really would help, and hope that I and others would be willing to put the real effort in to make a difference, behind something that works.


The next line immediately after the one you quoted was "Admittedly, it seems that their efficacy to help people in crises (not necessarily suicidal) is far greater than their impact on suicide rates."

Crisis hotlines are definitely doing things, even if the suicide prevention analysis bit is inconclusive.


> When they analysed results of studies combined by setting and intervention, and by exposure to intervention, sadly enough, the highest percentage of reduction in suicide rates observed was 4%.

Wow, that's unfortunate. I wonder if any follow-up studies have been done with more modern technology. For instance would / does SMS or other message services fair better than a phone call today than the phone call itself faired in 2004?

I wonder if there are any ways to help when simply existing as an anonymous person on the internet. You always see hotlines and other resources copied and pasted and I had always hoped they helped.


TBH I did once and they were angry and rude.




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