this post was submitted on 13 Sep 2024
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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?

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[–] [email protected] 124 points 3 months ago (2 children)

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.

[–] [email protected] 38 points 3 months ago

It also helps normalize actually think about it or discussing the subject.

[–] [email protected] 21 points 3 months ago (2 children)

Even though crisis hotlines are common, they have not been well studied for efficacy.

https://en.wikipedia.org/wiki/Crisis_hotline#:~:text=6%20References-,Effectiveness,several%20weeks%20after%20their%20call.

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.

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[–] [email protected] 115 points 3 months ago (5 children)

I struggle with suicidal ideation problems. They have been so severe in the past that I almost went through it. While not all suicidal scenes trigger me, there are a few. And I have found that having the warnings help me from shutting off the TV and running off in a crying fit. I know it's coming and can prepare myself. And knowing that the hotline is there has been one of the most comforting things I know of. I may have never called, but it's there for when I can't deal on my own. So yes, the warnings make a positive difference for me.

[–] [email protected] 36 points 3 months ago (1 children)

It's amazing how effectively just hearing this from someone who has firsthand insight can put it in perspective.

[–] [email protected] 10 points 3 months ago

And yet this thread is full of comments both confidently and cynically proclaiming that it's totally useless and only there for the lawyers yada yada

[–] funkless_eck 24 points 3 months ago

I'm OK (now? currently? hopefully forever) but when I'm struggling I too appreciate the warning.

[–] [email protected] 14 points 3 months ago (1 children)

The worst about ideation for me is that a few days/weeks/months later, I'm almost always thinking "I was willing to do that? Because of XYZ? That would've been so fucking stupid!"

But in the moment your brain can just be like "topping yourself is clearly the only logical solution" and make you actually believe that shit.

It's wild.

Sorry, I realise this is a bit off topic.

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[–] lurch 81 points 3 months ago (4 children)

Idk, but I bet they think it's the least they can try. If it saves just one life, it has been worth.

[–] [email protected] 32 points 3 months ago (1 children)

Yeah it's like a 0 effort thing to try

[–] [email protected] 10 points 3 months ago (1 children)

Except it's not zero effort, zero cost.

[–] [email protected] 8 points 3 months ago* (last edited 3 months ago) (1 children)

Pretty much is in reality. But not literally zero, no.

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[–] [email protected] 10 points 3 months ago

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.

[–] [email protected] 8 points 3 months ago* (last edited 3 months ago) (2 children)

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 effect they have. It's possible they have a negative effect.

Op's question is do we have that information?

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[–] [email protected] 58 points 3 months ago (7 children)

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.

[–] [email protected] 7 points 3 months ago (7 children)

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.

[–] [email protected] 9 points 3 months ago (1 children)

The bill is a fairly unique U.S. thing.

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[–] [email protected] 47 points 3 months ago (2 children)

Good question, but I expect as far as whether it should be there or not, it doesn't really matter. There is no harm in it being there, after all. And in the end, if it helps one single person not kill themself, I'd say that's a win.

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[–] [email protected] 47 points 3 months ago (1 children)

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.

[–] [email protected] 9 points 3 months ago (1 children)

If you have read the content on https://afsp.org/im-having-thoughts-of-suicide/ I'd be interested to hear your take. After my brother committed suicide I found their content for suicide loss survivors to be very helpful, but as a suicide loss survivor I can't judge the content they have for folks who are considering suicide.

[–] [email protected] 12 points 3 months ago* (last edited 3 months ago) (1 children)

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 gave 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

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[–] [email protected] 47 points 3 months ago (3 children)

The national suicide prevention hotline is almost always too busy and callers often need to wait on hold. They've calibrated everything from the hold music, the script, and the recorded voice to keep callers on the line.

This factoid splits people pretty evenly between those who find it horrifying and those who find it hilarious.

I should say that according to the hotline, the changes made to the hold system has resulted in 100,000 fewer hang-ups per year.

[–] [email protected] 16 points 3 months ago* (last edited 3 months ago) (1 children)

Are you telling me they intentionally avoid playing Van Halen - Jump for anyone put on hold?

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[–] [email protected] 8 points 3 months ago

The word hang up threw me off a little given the context

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[–] [email protected] 44 points 3 months ago (3 children)

I remember my college had a suicide awareness day where among other things they told people to tell their suicidal friends to call the hotline if they felt suicidal.

Now imagine you are that person and you reach out to a friend for help only to have them tell you to call someone else in a canned speech you were told to tell others.

[–] [email protected] 21 points 3 months ago (3 children)

Feeling suicidal usually isn't something that talking to a friend can resolve.

Getting a suicidal person to access the right kind of help is the right move.

That doesn't mean you refuse to talk to a suicidal person, it means that part of supporting them as a friend is helping them get help.

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[–] [email protected] 11 points 3 months ago

Two sides to every story. Your friend isn't your therapist and while instantly reacting with "go call hotline" means you don't have a friend at all, you cannot expect your friend to be able to bear the weight of your feelings, of your darkest moments with you. Stuff like this ruins people and I know that from experience from both sides. Dealing with suicidal thoughts of other people is extremely stressful and basically a landmine field. You aren't trained to navigate it properly. You are not objective. And ultimately, other than being a sympathetic ear, you are unable to help them in the way they need help.

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[–] [email protected] 36 points 3 months ago (3 children)

I don't think it's about making a positive difference, it's about liability.

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[–] [email protected] 32 points 3 months ago (3 children)

Legend is the first suicide hotline was created after a girl killed herself because she had her first period.

People kill themselves for lots of reasons, but some of those reasons are just ignorance. I feel certain any suicide hotline could have helped her out if she'd called one.

[–] [email protected] 10 points 3 months ago (1 children)

This makes sense to me. Suicidal ideation has been one of my PMS symptoms since I first started getting my period, and I'm not actually suicidal.

[–] [email protected] 13 points 3 months ago (3 children)

Yuuuup, I ended up getting a tattoo on my wrist that is essentially a personal period joke.

At one stage it was crucial for my survival, it was a kind of grounding token to snap me out of hormonal suicidal insanity when my PMS was at its worst. Something I'd see that would bluntly remind me "it's not you, it's your hormones, you don't actually want this"

When I say the urge came and went zero to sixty back to zero in 30 seconds flat, sometimes that was an understatement. I really struggled because in addition to suicidal ideation during PMS, I had undiagnosed and untreated ADHD, which often gets worse with PMS thanks to the way oestrogen and progesterone play off each other.

Guess who's got major impulsively issues. Guess what two symptoms really shouldn't be combined.

I have zero desire to kill myself.

But my hormones seemed desperate to try and make me do it every month, especially as a teen.

It didn't help that I had endometriosis and at 17 developed a uterine prolapse, on top of a rectal prolapse I'd had since I was 12. I was in agony when I was on my period, so sometimes the desire to make the pain stop overlapped with the suicidal ideation. That sucked. Hard to reason your way out of physical pain.

I've had a hysterectomy (from 17-24 my uterus just kept trying to make its own escape anyway despite attempts to sew it in place) and no longer suffer menstrual dysphoria because it turns out that was gender dysphoria not true PMDD. But I still get suicidal ideation as part of PMS, fortunately my ADHD is much better managed so now my tattoo is less a suicide detterant and just a reminder that I still have ovaries (sometimes I genuinely forget, and it takes me a few days to work out why I'm bloated and irritable and why I'm anxious about my sore boobs)

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[–] [email protected] 30 points 3 months ago (6 children)

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

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[–] [email protected] 24 points 3 months ago

It makes a very positive difference, according to their lawyers.

[–] [email protected] 17 points 3 months ago (1 children)

No idea, but I thought this would be a good time to share that teen suicide attempt rates spiked almost 30% in the month following Netflix's 13 Reasons Why. It's a pretty bad show, so of course it got 4 seasons.

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[–] [email protected] 16 points 3 months ago (1 children)

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.

[–] [email protected] 12 points 3 months ago

That's it, the next show that I really hate that has a suicide episode is the one where I'm killing myself watching it to get it canceled.

[–] [email protected] 14 points 3 months ago

I wish I could opt out of those messages. On streaming platforms that should be doable! (I really hate spoilers.)

[–] [email protected] 14 points 3 months ago* (last edited 3 months ago)

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.

[–] [email protected] 13 points 3 months ago

I would like to think that these hotlines are helpful.

I have experience with somebody calling a sexual abuse hotline and being told to " Work less and go outside tomorrow".

This was a crisis situation and the advice was woefully inadequate and unhelpful.

Overall, I'm sure access to a hotline that is monitored with people who are experts at dealing with these situations is a good thing. I doubt they're funded very well though.

[–] [email protected] 11 points 3 months ago (1 children)

I can't imagine they'd be helpful to me, if anything it makes me feel lesser or condescended to. It's not the right way to talk about suicide with people who are suicidal.

[–] [email protected] 11 points 3 months ago (1 children)

Suicide comes in many different flavors. The most common in my limited experience is desperation. If you are so utterly desperate for literally anyone to listen to you, I don't see how it would hurt. Especially since there's such a positive stigma surrounding the hotline. I personally know a couple of people that the hotline helped.

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[–] [email protected] 9 points 3 months ago (1 children)

I think, at best, it can only help with certain types of potential suicides. Some suicides occur due to apparently hopeless life situations. For instance, I haven't been able to get a real job in 23 years despite, in that time, finishing a B.A., an M.A., and a Ph.D. Nothing that everybody says to do works for me and I'm frankly tired of hearing it. I'm stuck DoorDashing (Uber was way too abusive) and that I'm stuck doing that is intensely depressing.

Psychology can't help with this. The only thing that can help is a real job. And that's what a lot of the babble about suicide prevention seems to miss.

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[–] [email protected] 8 points 3 months ago

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.

[–] [email protected] 7 points 3 months ago (1 children)

I predicted in about 10 years disclaimers at the beginning will include, 'This show depicts murder. Neither the show's creators producers or actors condone the taking of another human life.'

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