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Tuesday, April 5, 2022

The Emerging Science of Suicide Prevention

Kim Armstong
Originally published 28 FEB 22

The decisions leading up to a person’s death by suicide are made under conditions unlike almost any other. Although we may spend weeks or even months considering whether to purchase a home, change jobs, or get married, the decision to attempt suicide is often made in the spur of the moment amid a crush of emotions, according to Brian W. Bauer and Daniel W. Capron (University of Southern Mississippi). A person may live with suicidal thoughts for years, yet anywhere from 25% to 40% of suicide attempts may take place less than 5 minutes after the individual decides to take their life, Bauer and Capron wrote in a 2020 Perspectives on Psychological Science article. 

These circumstances make people experiencing suicidal ideation uniquely vulnerable to common cognitive biases that can result in irrational decision-making, causing them to act against their own self-interest. We are particularly bad at predicting how our emotional state may change in the future and tend to value short-term relief over long-term outcomes, Bauer and Capron noted. Both of these tendencies can contribute to the decision to end severe psychological pain through suicide despite the strong possibility that those feelings will change given time. 

Nudges could offer some hope to people in crisis. Based in behavioral economics, these microinterventions are designed to push people toward making choices that align with their own self-interest, such as conserving energy or getting vaccinated, by providing easily digestible information about the benefits of those choices (e.g., stickers on washing machines reading “Fuller laundry loads save water”) or even removing barriers to making those choices (e.g., offering walk-in vaccinations instead of requiring appointments). 

Nudges have been used in mental health contexts to help people cut back on their drinking and enroll in treatment programs. In the case of suicide prevention, pre-crisis interventions can occur at several levels, Bauer said in an interview with the Observer.  

Public safety campaigns, for example, might advise gun owners to store their firearms and ammunition separately, creating a barrier to impulsive self-harm, and encourage them to save the number for a local crisis hotline in their phone. In clinical care settings, reframing education on coping skills as a way to assist peers, rather than oneself, may increase patients’ willingness to complete safety plans and participate in suicide prevention workshops. And for individual patients, smartphones may offer an avenue for effective “just-in-time” interventions. 

Unfortunately, no nudge is a one-size-fits-all solution, Bauer said.