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"
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.
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?
Suicide attempt PPV = .16. This means, and correct me if I'm wrong, 84% of positive results would be wrong if the test was applied to the general population.
> The most accurate prediction was achieved using bidirectional long short-term memory and simple lasso-penalized logistic regression models, with the best performing model using bidirectional long short-term memory to predict SRE, which with specificity at .90, had area under the curve = .94, sensitivity = .87, and positive predictive value = .30, and SAs with area under the curve = .90, sensitivity = .74, positive predictive value = .16.
Where SA is "Suicide Attempt" and SRE is "suicide-related event".
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 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.
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.
Yeah, I can't see what the questions were, but if they were about suicidal thoughts and plans, having to read, consider and respond to those questions six times a day would certainly reinforce any tendency to think about it, just through sheer exposure.
> 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.
Presumably the participants don't really want to go through with it. They want to be "saved", they want the attention. I ain't clicking that shit but does it say how many are women?
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.
> 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.
Hey mate, I'm glad you could write this, hopefully the few messages of support you got help.
If I had one advice, it would be to find someone who relates to how you feel, because being able to talk about it to someone who's been/is there is the one thing that really helps, in my experience. I don't know where, a friend, a suicide support group, a men's group, but being able to talk about these feelings and be really understood does help.
In the meantime, try just to be around people when it's hardest.
Sorry to not have anything better to offer. Hope you keep going, brother.
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.
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;)
Improbable to be very significant, but it might actually be. The way/where they jumped off the bridge or how they hit the water may have influenced their chances of survival.
Edit: Implied is that how determined they were to commit suicide influenced their behavior before survival/death was fully out of their control.
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
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."
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 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 unbeliebably useful in my opinion that I’d personally like to see it normalized, rather than the opposite.
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.
In 2025 I was on a road-trip with my then girlfriend of a few months. Life was then, as it is now, a lot. I’ll spare the details, but at some point she asked “what’s the worst case scenario?” Calmly and casually I said, “Worst case scenario is I take my own life.” I was going to continue going, and was just matter of factly stating that suicide was a “ripcord” or last option. This apparently triggered her and she said, “if you feel that way I might was well jump out of the car right now.” I was pretty shocked to hear this, and perceived it as a general lack of support. And I felt ashamed for sharing this. But after unpacking things I learned her mother used to threaten self-harm as a matter of routine and her default response became to threaten to leave the situation, or something.
I’m not sure exactly why I share this, perhaps I think some comments about suicide being an “escape hatch” resonated with me. I’ve since sought support, going just short of self-hospitalization, and I was on a SSRI until recently switching to a non-antidepressant.
While life remains Messed Up, I keep telling myself two things: (1) If you’re really considering killing yourself, try “ killing yourself” in the gym (often super hard exercise makes me feel infinitely better); and (2) “Wouldn’t it make a better story if I didn’t (kill myself)?”
I’m getting through, day by day, and I’ve got some strong “protective factors,” however they’re not invincible or bulletproof so I need to remain vigilant and avoid doing anything impulsive. And just try to remember that if I keep making good decisions one day at a time things will get better in the long-run.
58 comments
[ 0.25 ms ] story [ 19.3 ms ] thread> 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/
> The most accurate prediction was achieved using bidirectional long short-term memory and simple lasso-penalized logistic regression models, with the best performing model using bidirectional long short-term memory to predict SRE, which with specificity at .90, had area under the curve = .94, sensitivity = .87, and positive predictive value = .30, and SAs with area under the curve = .90, sensitivity = .74, positive predictive value = .16.
Where SA is "Suicide Attempt" and SRE is "suicide-related event".
https://psycnet.apa.org/doiLanding?doi=10.1037%2Fabn0001117
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
What does “most” mean in the story?
> They were sent brief (20-item) smartphone-based surveys 6 times/day for 3 months
Is that in any way realistic? 120 answers/day??
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.
Suicide is a right.
How can you know in advance that someone needs intervention? By what standard?
I really don't see how this much different than something like calling/texting 988.
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
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.
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)
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 think he's going through a breakup.
If I had one advice, it would be to find someone who relates to how you feel, because being able to talk about it to someone who's been/is there is the one thing that really helps, in my experience. I don't know where, a friend, a suicide support group, a men's group, but being able to talk about these feelings and be really understood does help.
In the meantime, try just to be around people when it's hardest.
Sorry to not have anything better to offer. Hope you keep going, brother.
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;)
Edit: Implied is that how determined they were to commit suicide influenced their behavior before survival/death was fully out of their control.
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
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 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 unbeliebably useful in my opinion that I’d personally like to see it normalized, rather than the opposite.
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.
I’m not sure exactly why I share this, perhaps I think some comments about suicide being an “escape hatch” resonated with me. I’ve since sought support, going just short of self-hospitalization, and I was on a SSRI until recently switching to a non-antidepressant.
While life remains Messed Up, I keep telling myself two things: (1) If you’re really considering killing yourself, try “ killing yourself” in the gym (often super hard exercise makes me feel infinitely better); and (2) “Wouldn’t it make a better story if I didn’t (kill myself)?”
I’m getting through, day by day, and I’ve got some strong “protective factors,” however they’re not invincible or bulletproof so I need to remain vigilant and avoid doing anything impulsive. And just try to remember that if I keep making good decisions one day at a time things will get better in the long-run.