Every show with a suicide now has a disclaimer with a suicide hotline at the beginning. Is there any evidence that these warnings make a positive difference?
Every show with a suicide now has a disclaimer with a suicide hotline at the beginning. Is there any evidence that these warnings make a positive difference?
Suicides can be really easy to prevent.
Like, the hotline itself is incredibly effective, and reminding people it exists would naturally help.
People aren’t getting the number from the intro, but it reminds them it exists.
Even though crisis hotlines are common, they have not been well studied for efficacy.
en.wikipedia.org/wiki/Crisis_hotline#:~:text=6 Re….
Somewhat related, but I think suicide hotlines can be a big problem if they are understaffed. I feel like in my country they are just there to check a box. I’ve had two suicidal crises, both times I called the hotline, waited 20+ minutes and gave up. It made me feel even worse and more lost.
:( I’ve been in a similar situation, but I’ve never called; I have friends that I can talk to openly about this stuff, and not freak them out or have them be judgemental. I don’t know you, but I hope you are doing better, and can persevere. Life can be awful, brutal. Being alone in a time of need is… I can’t even think of a word with enough emphasis.
If you want, you can send me a message. Might not be helpful, but maybe it will. Just say hi, if you want. You aren’t alone. :)
It’s a job creator, so in effect it makes money.
/s
But do we have evidence they’re effective?
It still takes effort/time/money to do this, and if it has no impact, then that effort/time/money could be used on things that are known to be effective.
I have no idea how much affect they have. It’s possible they have a negative effect.
Op’s question is do we have that information?
How much effort/time/money do you think they put into that white text on black background that’s on screen for like 5 seconds?
It’s negligible, I would be shocked if it wasn’t the same recycled card over and over again that they have some unpaid intern throw in at some point in the final editing stages
It would probably cost more effort/time/money to do a study on its effectiveness than the pre roll does many times over lmao
It’s not about the production cost, its about the opportunity cost.
A quick google search tells me a national ad costs $200k-$1m for a 30s slot. That means 5 seconds of screen time costs $30k-$150k.
Businesses do not care about people, I can pretty much guarantee those were added in order to waive liability. Example: person commits suicide because they see it in a show, family sues show company because that is linked to the person’s suicide, arguing the show encouraged the person to do it.
Would that hold up in court? I don’t know, probably not, but the company doesn’t want to deal with that. So they add a warning instead so they can just point to that and it gets thrown out immediately.
I don’t doubt that someone might be thinking that, but I do doubt that any lawyer thinks it’s necessary. As far as I know nobody has ever brought suit against a TV show for a suicide case.
But I’m not an attorney.
All the lukewarm attempts to help, rooted in shallow understanding, reinforced my suicidal ideation. What’s the value of false love from a paid hotline worker one will never speak to again? It’s negative.
Be ready to love the shit out of someone yourself. Share their sorrow. Don’t try to fix it. Just try to understand. It’ll fucking suck. The other person knows it sucks for you. Tell them it sucks and that you’re choosing it.
I’m not the person you replied to but I’ve been passively suicidal for about a decade. I read this article. It seemed a bit prescriptive and patronizing to me. I get the impression that the article is targeted towards people who are acutely suicidal. As someone who’s been chronically suicidal, I’ve noticed that there aren’t many resources that are similar to this for people in my situation. These suicide hotlines seem to be targeted at people who are experiencing acute distress over someone who’s been struggling with mental health for extended periods of time. I’m not going to say these resources are worthless, but they’re worthless to me and I would assume at least a few people who have similar problems. I’ve never felt compelled to reach out or search for resources like this. They’ve always felt insincere, similar to corporate PR speak or celebrity “apologies”. Like these hotlines are there so that people who aren’t suicidal can go “well, we have them a phone number. We don’t need to feel bad that people are suffering cause we did what we could.” I’m sure these hotlines have helped people and they should stick around. I’m just jaded and cynical.
I asked my wife about suicide hotlines too, she has periods of suicidal ideation and has attempted suicide when she was younger. She said it’s a coin flip for her. They either made her feel more distressed and therefore more suicidal, or they made her slightly less suicidal (enough to not act on it). She said in the moments they helped, they served as a reminder to not provide a permanent solution with a temporary problem. She also hates that phrase but couldn’t find a better way to word it haha.
I’m not sure if what we said will help or hurt in your processing, but those are our honest perspectives
Thank you for that response, I think you did a great job helping me understand you and your wife’s perspective. I had a long period of lowness, and though I was not suicidal, some of the things you described sound close to how I thought and felt.
The part about the suicide hotlines reminded me of is a talk my coworker did on mental health, and she said that if you don’t get along with your therapist within the first two sessions, it’s ok to find another therapist. I imagine that’s what these hotlines are like. When you call in you’re basically grabbing a random person from a crowd, and the chances of that person resonating strongly with your story on the first try is probably low. I could see folks just hanging up if it wasn’t helping, but it seems like they may have better luck if they call back again and talk to somebody different.
At the end of the day though, if somebody has a chronic condition, alleviating it significantly is not an easy task. It seems like these hotlines have to struggle with that tension between wanting to help, but knowing that significant long term improvement isn’t easy to achieve, especially when you’re just talking to the person who is looking for help.
I’m not going to say these resources are worthless, but they’re worthless to me and I would assume at least a few people who have similar problems. I’ve never felt compelled to reach out or search for resources like this. They’ve always felt insincere, similar to corporate PR speak or celebrity “apologies”.
I think this is how my brother mostly felt. One thing that he was into that seemed to help was stoic philosophy. I wasn’t into it when he was alive, but happened to get into it shortly after he died and it immediately resonated with me. I wished we had gotten to talk about it more when he was alive. It certainly helped me deal with the aftermath of losing him.
Thanks again for the response. Good luck finding your peace.
Oh please, there are hundreds of not thousands of so G’s about suicide out there and they don’t have warnings
Stop being so overly cynic, trust me, it’s not as edgy as you think it is
Nothing here is about you bud… Self centered much?
I’ll just stop feeding the attention hungry hippo
To my knowledge, there hasn’t been a major peer reviewed study to show whether these warnings make any difference.
Now, my own anecdotal non-peer reviewed personal opinion would be that they probably make no difference at all. Businesses likely began adding them only to waive potential liability and not to actually do anything helpful. They can be frustrating because they spoil upcoming events in media that may have been unexpected or unknown, but because of the warning are now definitely known and thus feels “ruined” when it happens. They can also reinforce ideation of suicide because a person may feel like the ones that added the warning did it as a token thing, treating the person like they are a badge of honor or some kind of selling point. Whether that is true or not doesn’t really matter, a person that is suicidal is almost never “in their right mind,” and if they feel that way, they feel that way. Nobody can tell them how to feel, not even themselves sometimes.
Optics.
Sooner or later someone will commit suicide while watching your show, no matter what you do. If that episode happens to contain a suicide scene, and somebody rightly or wrongly connects the dots, you want the disclaimer to be there.
My comment is meant to bring the perspective of someone who’s facing depression so to try to answer the main question (“a warning with suicide hotline really make positive difference?”) through that perspective. It’s not to seek mental help for myself.
For context, I’m a person facing depression, and my depression has broad and multifaceted reasons, from unemployment, going through familiar miscommunication (my parents can’t really understand my way of thinking), all the way to my awareness of climate change and transcendental concepts that lead myself to existential crisis. I’m unemployed to seek therapy (it’s a paid thing) and I don’t really have someone face-to-face capable of understand the multitude of concepts and ideas that I face in my mind (even myself can’t understand me sometimes).
That said, every depressive person has different ways to cope with depression. While some really need someone to talk to (and the talking really helps in those situations), it’s naive to think a conversation will suffice for every single case. I mean, no suicide hotline will make me employed, nor will magically solve the climate changes we’re facing.
So how I try to deal with my own depression? With two things: occult spirituality (worshiping The Dark Mother Goddess) and writing poetry and prose. I use creative writing to “exhale” (not the exact term I wished to use, there’s a better one but I forgot) my suffering, in order to “cope” with the state of things that I can’t really control (I can’t “employ myself” or “sell my services to myself”, I can’t “befriend myself”, I can’t stop temperatures from rising till scorching temps, nor the other already-ongoing consequences of climate change; I try to make some difference but I’m just a hermit weirdo nerdy nobody among 8 billion people, and I have no choice but to accept it).
I’m no professional writer (I’m just a software developer), but thanks to The Goddess, I can kinda access my unconscious (dark) mind and let it speak freely (it’s called stream-of-consciousness writing style). Sometimes I even write some funny surrealist prose/story, but sometimes it takes a darker turn, such as dark humor, or nihilistic, or memento mori. Doing this relieves the internal pressure inside my unconscious mind. After writing, I sometimes decide to publish it through fediverse , but when I do it, I constantly feel the need to “self-censor”: sometimes the stream-of-consciousness can lead to texts that people could interpret as some “glorification of suicide/self-harming” (especially when my texts take a nihilistic/memento mori turn), so I often censor myself and change the way I wrote the text. Well, it’s kinda frustrating not being able to fully express it, but I kinda understand how these texts could trigger other people also facing depression.
The fact is: when I write, it’s really relieving, way more than talking to people because, with poetry/prose writing, I can express symbolic things, I can have multiple layers of depth, I can use creative literary devices such as acrostics and rhymes, I can learn new English words while being a Brazilian, I can blend scientific concepts with esoteric and philosophic (my mind really thinks this way, blending STEM, philosophy and belief/esoteric/occult/religious concepts) without the need to fully explain them (because it’d take several hours and it’d be boring to anybody else other than me).
So, in summary (TL;DR): it depends on how multifaceted is the depressive situation. It won’t work for me. It surely can work for others that just need to talk to someone. Not exactly my case.
Based on what I’ve heard about the US’s 988, it may rather be negative.
Oh, you’re thinking of killing yourself, let us reinforce that by being absolutely rude, or better yet, time to get taken away by cops into a psych ward.
Let’s see what’s out there with some example (Reddit)
Summary: Person called 988, police showed up 90 minutes later, got taken for mandatory psychological evaluation, forced to stay 2 days in ER, ended up getting billed $6,470.
You lose the ability to refuse treatments in any scenario the emergency responders / doctors deem you unfit to make a decision in the best interest of your/someone else health. It’s why “baker acting” in Florida is so controversial. Taking someone against their will and locking them in a facility for a minimum time without any real need of evidence.
Someone calling and telling them you said you were going to kill yourself is often all the evidence they need to start the process, whether they really said that is up to the emergency responders. For my friends that was 9 cop cars in the middle of the night. They dragged him out of bed at 4am because his partner at the time said he hadn’t been responding to her texts and she told them he was depressed so he might kill himself.
Once he got out he told me about it all and I’m fairly certain he won’t ever sleep with his phone on silent/vibrate again. (He broke up with them immediately after, but that has nothing to do with consent)
It’s been argued for years, The section about involuntary placement was to long to copy and paste here but here is the bill:
The section one would argue unlawful is 1394.467 www.leg.state.fl.us/statutes/index.cfm?App_mode=D…
I think this kind of anecdotal horror story exists in every country, but of course it’s not the usual outcome.
There’s a whole chain of people involved in a process like this, and I have a hard time believing that everyone in that chain routinely locks up healthy people just to give themselves more work to do.
I think it’s far more likely that there are many people who genuinely should spend a few days in a psych ward but are unable to due to a lack of resources.
This is really reductive and doesn’t really consider how complex these situations can be.
What should police or first responders do when someone is at risk of harming themselves or others?
Whatever your answer, consider that the person is already having a bad day, and there are no on the spot cures for what ails them.
Hospitals in general are not nice places to be, as a patient. If you’re there for a physical illness it’s still traumatic.
You don’t go there to have a nice time, you go there to avoid the worst outcomes, like death.
I am certain that there are very, very few instances where people end up in a psych ward when there’s better places for them.
Sorry mate, this is just plain wrong.
People are there because they have complex medical conditions which require specialist personnel and facilities.
Yes it can be scary and expensive, but it’s the best way to manage a shit situation.
That’s not really true.
For a lot of people who are suicidal, a psych ward is precisely the right place for them. There are appropriately trained people to develop a treatment plan, and appropriate facilities to prevent a suicidal person from harming themselves.
I absolutely acknowledge that being taken to a psych ward against your will is going to be traumatic for anyone. I also acknowledge that in some cases the patient might end up feeling worse than they did before they went.
However, I’m certain that you can acknowledge that taking someone to a psych ward against their will is often the only way to prevent them harming themselves.
I’ve lost too many people in my life to suicide, and it’s a really hard topic for me to watch on screen.
So even though I’ve got no use for a hotline, just knowing that the show will center suicide as a theme is important to me being able to decide if/when to watch it.
There’s evidence that trigger warnings actually worsen anxiety and are counterproductive
The way to treat anxiety is to face the source of anxiety to try and change your relationship and reaction. The best way to do this is via controlled access that exposes one to the trigger gradually in a context that has no risk of harm (eg a media depiction, discussing the concept, building up to discussing the source of trauma that led to the phobic response if applicable)
Trigger warnings enable active avoidance. This sensitizes one to the aversive stimuli and makes the phobic response stronger. As a result when one encounters the stimulus (eg a friend, family, celebrity etc commits suicide, suffers an eating disorder, etc) your resilience to the trigger is now even lower and the response is more likely to be more significant than it was before.
That said education on access to resources like 988 or other warm lines can lower suicide rates, maybe. Research is more mixed here because it’s difficult to prove causation
There’s evidence that trigger warnings actually worsen anxiety and are counterproductive
I’d be interested in seeing these studies.
The way to treat anxiety is to face the source of anxiety to try and change your relationship and reaction. The best way to do this is via controlled access that exposes one to the trigger gradually in a context that has no risk of harm (eg a media depiction, discussing the concept, building up to discussing the source of trauma that led to the phobic response if applicable)
Trigger warnings enable active avoidance. This sensitizes one to the aversive stimuli and makes the phobic response stronger. As a result when one encounters the stimulus (eg a friend, family, celebrity etc commits suicide, suffers an eating disorder, etc) your resilience to the trigger is now even lower and the response is more likely to be more significant than it was before.
These two paragraphs seem to contradict each other. Controlled access in a safe setting like a media depiction sounds great. That’s exactly what trigger warnings are for. They tell you that the content is present in the media you’re about to watch. How can you possibly do controlled exposure without knowing if the content is there or not?
journals.sagepub.com/doi/…/2167702620921341 - the bigger takeaway from this one is that trigger warnings reinforce trauma as a central part of the traumatized individuals identity but they did find some incidence of drawback/harm
journals.sagepub.com/doi/…/21677026231186625 meta finding no benefit and actually can cause an anticipatory reaction making the person more engaged with the material
There are others, this is just what grabbed from 30 seconds on google scholar. Its been a bit since I’ve done more serious lit review and it’s not like I keep a directory of papers I’ve read
The issue is the culture surrounding trigger warnings. Let’s be real here, people looking for trigger warnings are generally (perhaps overwhelmingly) not looking for material to help with their exposure therapy. They are looking for a “warning” to help them screen material to avoid. The issue is that this creates an unrealistic expectation that is incompatible with the real world. You can avoid suicide, sexual assault, eating disorders, or whatever in your media (maybe) but real life won’t sanitize itself or warn you. You will encounter these topics, whether through the news, careless speech from friends, or even intrusive thoughts of your own. Research continues to show that avoidance of upsetting topics can worsen anxiety and ptsd symptoms
To your final point the idea of it helping to create a choice isn’t even as clear cut as you describe
journals.sagepub.com/doi/…/21677026221097618 content warnings actually increase the likelihood someone will view problematic content. This point is further reinforced by similar findings in the meta linked above
So you have a system that ultimately makes creators feel like they’re doing something noble, that is likely at best useless and potentially harmful. Said system increases the likelihood that a person will view the problematic content but also enables the reality that a person will simply avoid the things that provoke their anxiety which again is more strongly established as harmful
www.sciencedirect.com/…/S0005796712001064 - ptsd worsens with avoidance
www.sciencedirect.com/…/S0962184904000290 - anxiety disorders do the same
One tricky thing here is that existing literature is really examining the potential effects of trigger warnings in and of themselves, devoid of context or non-immediate decision making. Does seeing a literal trigger warning make someone feel less anxious? Almost certainly not, why on earth would it?
In studies that find no or slight negative effect, the outcomes are immediate measures. How do you feel right now? If it assesses decision making, it’s whether you do or do not immediately consume the content.
But for trauma survivors the potential to be triggered is always in flux, always dependent on everything else going on in your life, often set off by things that seem unrelated or irrational. Trigger warnings give someone a choice in that exact moment for what to do based on what they believe they can* manage. Yes, it may promote avoidance, but avoidance can increase feelings of agency that allow for reduced avoidance behavior in the future.
As an example from the great college campus syllabus trigger warning kerfuffle: I assign chapters from Durkheim’s Suicide in some seminars, as well as complementary readings with less obvious titles. My students get a warning about this ahead of time, but they don’t get to just skip that part of the class. Some things students have done: scheduled extra therapy sessions during those weeks, read in small groups in the library instead of isolated in dorm rooms, missed a class meeting and made up for it with office hours and a short additional assignment (so they didn’t out themselves to their peers with a panic attack in class). It’s about agency and self-assessment.
A screen with a suicide hotline number isn’t going to magically make someone ok with seeing suicide represented, but it offers an action the person can take to regain agency.
*Or just want to manage. Sometimes you’re just living your life and not super in the mood for exposure therapy, and if you can get your brain somewhere else for a while that’s a very good thing.
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