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.
> 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 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”?
> 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.
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.
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.
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.
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.
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?
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"
> 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.
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.
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.
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
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.
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.
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.
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 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 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.
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
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 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.
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 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?