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Suicide has been listed as one of the Natural sciences good articles under the good article criteria. If you can improve it further, please do so. If it no longer meets these criteria, you can reassess it.
Article milestones
DateProcessResult
May 25, 2005Featured article candidateNot promoted
March 2, 2013Good article nomineeListed
Current status: Good article

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Hatnote on mental health resourcesEdit

Consistent with this discussion, I am in favor of adding a hatnote to this page with a link to the WMF-maintaned meta:Mental health resources, which highlights information "Based on the location of your browser as detected by the Wikimedia Foundation's GeoLookup". The hatnote would say something like, "If you, or someone that you know, is suicidal, please contact your local emergency services. The Wikimedia Foundation maintains a list of resources in many countries throughout the world". --Pine 06:11, 19 September 2018 (UTC)

Pinging JSutherland (WMF) to request WMF input. --Pine 06:15, 19 September 2018 (UTC)
  • This does address the issue of localization. Evidence for these hotlines however is poor. As we have had previous RfC about this, would need another before adopting it. Doc James (talk · contribs · email) 16:25, 19 September 2018 (UTC)
    Yes, I would personally agree that an RfC seems a good idea. Of course, we're unlikely to stand in the way if the community wishes to make the Meta-Wiki page more visible. :) Joe Sutherland (WMF) (talk) 18:34, 19 September 2018 (UTC)
I also am in favour per Pine. Nocturnalnow (talk) 15:13, 20 September 2018 (UTC)
No offence, but I would not suggest anybody else even look at all those previous discussions. I just wasted time doing that and they are much too adversarial, outdated and wearisome. This should fall under our just do it, now policy. Full speed ahead with the Hatnote on mental health resources, imo. Nocturnalnow (talk) 22:36, 20 September 2018 (UTC)
If there was evidence of benefit I would be more inclined to support. Doc James (talk · contribs · email) 03:29, 21 September 2018 (UTC)
@Doc James: can you provide refs to relevant studies? Thanks, --Pine 04:47, 25 September 2018 (UTC)
There not many reviews on the topic at this point... Will do some searching to see if anything has changed since last I looked. Doc James (talk · contribs · email) 16:08, 25 September 2018 (UTC)

@Doc James: @Pine: You might note I'm about to show an oddly contrasting view on this.

I believe a hatnote linking a maintained list of suicide hotlines does belong on wikipedia, as merely indicating the resource shouldn't imply any morals about whether or how to use that resource. So I agree, but..

Wikipedia should not support any closed communication system with a closed protocol by using addresses issued in accordance with that protocol encouraging their usage in a way making that resource appear as an extension to wikipedia.

Wikipedia's negligence here could contribute to grave harm to a select minority, so please exert caution. Because the telephone system has been very well-demonstrated to grant almost no practical anonymity from cyber-equipped institutions, monitoring governments, or cyber-activist vigilantes, suicidal individuals, who have considerable vulnerability to face abuse from so-called "prevention efforts" in political climates currently storming in many different countries, might face abuse by a government, institution, or malicious individual exploiting the telephone system (and suicide hotlines' reliance on that system) as a honeypot to catch vulnerable individuals.

Yet, I don't know any suicide hotlines which rely only on openly audit-able information security systems. (i.e. open source systems)

That said, I would

  • veto, mentioning "prevention" or other moralizing terms like "help", "medical", or "health" in the hatnote OR metadata, as well as;
  • veto, any self-referencing language in the article indicating the hatnote, especially any advising to follow the link in the hatnote.
  • veto, (obviously) any action requests.

2600:1702:1740:2CA0:6472:2168:F2D4:EBD5 (talk) 04:00, 21 September 2018 (UTC)

I am concerned about maintaining the privacy of sensitive health information, but I think that the resources that WMF mentions are offered for the purpose of offering assistance of people who voluntarily seek it. There may be more private options available, but I don't think that it should be WMF's job to audit the privacy practices of every resource which they reference. In the absence of better options (my guess is that WMF would be eager to hear of better options if you know of any) I think that offering the options which WMF considers to be reasonable is better than offering nothing. I agree that WMF wouldn't want to promote an option as being secure or reliable if WMF has not reviewed it carefully, but that's different from listing available resources that WMF knows and thinks are worth mentioning as possible choices for people who may want to ask for help. I imagine that WMF Legal assessed the risks carefully before making that list public. --Pine 04:43, 25 September 2018 (UTC)
So, we'll probably fundamentally disagree on whether calling a suicide hotline necessitates a health issue, because we'll disagree on whether we'll believe suicide a health issue inherently. I don't believe we need to agree on that. I'll also posit that while you'll talk about mental health, I will talk about existential health. That's an unimportant neologism, for this discussion. I don't believe we'll need to agree on the terms we personally chose either.
Sensitive information won't make someone vulnerable, rather the metadata about where that person calls from and who they call will make them vulnerable. That's not a security concern enforced by any law any where, as far as I know. A clever attacker doesn't need to know the details about why someone feels suicidal so much as the simple indication that target does feel suicidal or vulnerable. Collecting metadata like that does not require any very prohibitively costly equipment, only a skill set and common equipment[1][2].


So the WMF, doesn't do much except organize volunteers and hire staff for tasks no immediate volunteers can accomplish or learn to accomplish, not unlike the Linux foundation. Mediawiki and by extension every WMF supported wiki, forms an open source project[3] which relies on volunteers with many diverse specialties and experience levels to contribute in different ways, not unlike Linux.
The point to an open source project, often means radical transparency from which novices can learn new skills by study logs as well as asking questions. Generally, anyone with interest can do a security audit on mediawiki and fix exploits, because mediawiki has free as in freedom source code with an open source developer community to accept patches.
Most suicide hotlines don't have that, so, if wikipedia lists in suicide hotlines not as a typical almanac article but instead as a supplementary resource extending from wikipedia and someone gets hurt due to poor not-openly-auditable infosec, I would call that negligence on the part of wikipedia. Wikipedia shouldn't audit the security practices, however should only "officially" endorse organizations with at least equally open-and-auditable infosec as wikipedia (i.e. the https implementation).
same IP person 75.39.102.200 (talk) 16:44, 25 September 2018 (UTC)
  • I agree with the ideal of protecting someone's privacy if that person is in need of medical services and wants to contact medical professionals to request those services. I also agree that it would be good to be careful about which services someone endorses. I'm not understanding what your objection is to listing available services in a way that doesn't make promises about privacy protection, so perhaps you could clarify that point. --Pine 19:33, 27 September 2018 (UTC)
Disclaimer: I certainly don't consider a suicide hotline a medical service. I don't believe medical services should take as strong a role in responding to abuse, dysphoria, or potential suicide. I think investigative teams should take the most initiative.
Listing that as an almanac, perhaps as "List of suicide-specific information hotlines".
The text could read:
For immediate information from external sources, see: List of suicide-specific information hotlines.
The same hatnote could appear on other articles, too.
Besides WP:NPOV, my main issue with moralizing language goes as follows: by preventing suicide as a first priority then investigating, we create a situation where in game theory an abusers must only avoid judication to gain a satisfying life causing abuse ;; with society permitting suicide, an abuser must also find ways to restrain their victims or find new victims, thusly making their activities more obvious to an investigating or conscientious society.
That way we discover the unknown or unwitting abusers among us, so we can respond in a deeply ethical hopefully non-criminalizing way.
2600:1702:1740:2CA0:E999:AB0B:FB6E:FCC2 (talk) 08:41, 28 September 2018 (UTC)

EvidenceEdit

Here we have a 2016 review article in Lancet Psychiatry that says hotlines are of unclear benefit.[4] Doc James (talk · contribs · email) 06:19, 26 September 2018 (UTC)

@Doc James: Unfortunately, I concur with your reading of that review. What do you think about, instead of the earlier proposal, adding a hatnote to the article that says, "If you or someone you know is suicidal, please contact your local emergency services. If you or someone that you know is experiencing depression but is not actively suicidal, please contact a mental health professional or ask for a referral from your primary healthcare provider."? --Pine 05:03, 27 September 2018 (UTC)

Calling 911 is what would bring police and EMS in North America. Best evidence is removing guns and potential toxins like opioids. Doc James (talk · contribs · email) 15:42, 27 September 2018 (UTC)
I agree that there are public health measures that evidence supports as described in the article that you liked from Pubmed. I was thinking more about someone who is in crisis or would benefit from non-emergency assistance and might be viewing the Wikipedia article, in which case encouraging that person to call emergency services or ask for a non-emergency referral to a professional would be (I think) the best options. Admittedly, both emergency an non-emergency mental health resources are difficult to obtain for many people around the world including many people in North America, but I think that we should do what we can to encourage people who need help to reach out to professional resources that may be available. --Pine 19:27, 27 September 2018 (UTC)
@Pine: you do realize you're POV pushing, correct?
If you want to WP:IAR, then at least respond to my moral concerns first before you continue suggesting what kind of text to put in the mainspace WP:SOAPBOX which you're proposing.
2600:1702:1740:2CA0:D019:9F33:3E90:585A (talk) 07:14, 27 September 2018 (UTC)
  • I understand that you have concerns about the proposal, but please assume good faith even if we disagree. The assumption of good faith is not absolute, but I think that there's plenty of evidence that other people who are currently active on this talk page, including me, have good intentions here and are trying to benefit the readers of this article. --Pine 19:39, 27 September 2018 (UTC)
sorry, I didn't mean to speak so rudely, the issue affects me considerably. I happen to have been in positions in life to know about too much abuse by proxy and abuse by authorities* from the "mental health" establishment, which I believe needs renaming "existential health" (since we should chase after healthy existences, not mythical healthy minds}.
  • either unwitting, incognizant, or rarely wilfull.
(unhealthy desires, thoughts, etc don't exist given a healthy context.
No one deserves the expectation to conform to their life's context.
They may do so if they choose to do so without duress.}
2600:1702:1740:2CA0:E999:AB0B:FB6E:FCC2 (talk) 08:59, 28 September 2018 (UTC)
  • I think that it's a good point that bad interventions can be a problem. I read secondhand of one that sounded like medical malpractice. Also, Doc James made a point that calling for emergency services might result in a response from police that does more harm than good. However, my guess is that on average, adding information about emergency services would do more good than harm. We can't control the actions of others including emergency services workers who make bad decisions, but I'm hoping that we can be a net positive influence by providing information that would, on average, be beneficial to our readers. --Pine 06:44, 13 October 2018 (UTC)
@Pine: I agree, though I believe one can make contributions even exclusively from an information science perspective elsewhere before wikipedia to help. For example, a programmer adapting full-stack VOIP "libre" software like tox [5] or matrix // riot [6] [7] for a suicide hotline context.
Also, someone organizing a directory hotline that employs investigative rigor both in completionism of the directory list and in testimony of each hotline's processes. Though, that might require linguistic developments to proceed first, since little grammar exists to effectively describe the ways separate thinking beings shape each other.
same IP person 2600:1700:8680:E900:F408:6B7B:5A66:7A4E (talk) 16:15, 26 October 2018 (UTC)

@Pine: @Doc James: I'd be in favor of adding a hat note, similar to what Google does. This seems to me to be a WP:Ignore All Rules sort of situation — I don't invoke that policy lightly or often, but in this (presumably rather unique) case, the importance of harm reduction outweighs the importance of policies like WP:NPOV that might guide us under normal circumstances to leave out such a hat note. This has been brought up a few times now and there seems to be a fairly significant level of support for it, but I'd like to see an RfC or something to establish a clear consensus for or against so that the change can be implemented or the proposal put to rest. Regarding specific wording, I'm not an expert and I haven't looked through all the discussion about that, but I'd say the precise wording is a secondary concern to the question of adding a hat note or not, so let's resolve the latter first. - Sdkb (talk) 08:17, 11 January 2019 (UTC)

User:Sdkb if we are actually serious about decreasing the rate of suicide in the United States through Ignore All Rules, we would put in place a hat note regarding the importance of gun control / gun safety. The evidence that this prevents suicide is much much better than a "suicide hotline".
In my opinion what Google is doing is a PR stunt. It is simple a feel good effort, does not upset the NRA, and accomplishes nothing, but Google can claim they are doing something. This means that they do not really need to actually do anything. Doc James (talk · contribs · email) 16:57, 11 January 2019 (UTC)

Many people have been doing alot of stuff and they should really have some life in them and what i want to say is that probably they have choices but when it comes o things that have no other things you might not want it can have a change of heart and make you live. Not many people know but i know that many of us think that life is like hell but when you commit suicide you dont know if you really enter hell. Many people think that religouse things are a make up and i belive that too. Many of us dont even know if god and jesus christ is real. Many of us should think that when commiting sucide will have some things that might not have some related things. — Preceding unsigned comment added by Theoneandon1y (talkcontribs) 00:33, 20 April 2019 (UTC)

Semi-protected edit request on 13 May 2019Edit

"add the affects of suicide on families and friends" Kikiw171 (talk) 15:55, 13 May 2019 (UTC)

  Not done: it's not clear what changes you want to be made. Please mention the specific changes in a "change X to Y" format and provide a reliable source if appropriate. – Þjarkur (talk) 16:39, 13 May 2019 (UTC)

Suicidal listed at Redirects for discussionEdit

An editor has asked for a discussion to address the redirect Suicidal. Please participate in the redirect discussion if you wish to do so. Interstellarity (talk) 11:44, 26 May 2019 (UTC)

HatnotesEdit

These two were just added. We have discussed these a fair bit in the past. As the article states fairly clearly the best immediate action is to limit access to methods of suicide.

Not sure it is needed to add this as a hatnote though. Doc James (talk · contribs · email) 20:28, 27 June 2019 (UTC)

Doc James, jumping in a little late here but I would be in favor of restoring the hat note. I see in the discussion from Sept 2018 that you note the Lancet meta study. I am not a doctor so I would definitely defer to your understanding of the study but am confused, in reading the abstract's findings by Other approaches that need further investigation include gatekeeper training, education of physicians, and internet and helpline support. This seems to suggest to that we don't know whether helpline support reduces suicides but we also don't know that it doesn't. Best, Barkeep49 (talk) 15:40, 17 July 2019 (UTC)
There are things we know that work. Why would we put up a hatnote for something without evidence to support it? Things we know that work on an individual basis include removing guns and toxins from the home. Things that work on a population scale include strong gun laws and improved treatment of mental illness. Doc James (talk · contribs · email) 15:47, 17 July 2019 (UTC)
Wikipedia is in no position to address suicide in those ways. We do know, however, that people who are at near-term risk of attempting suicide read our encyclopedia. On this particular page, given the topic, offering a resource to our readers which may prove helpful and doesn't, and again correct me if I'm wrong, cause harm seems like something we can do in a way that doesn't impact the overall content of our encyclopedic article. Best, Barkeep49 (talk) 02:19, 18 July 2019 (UTC)

I was the original person who had put up those hatnotes. I’ve just added that hatnotes because it is self-evident that people who are at the verge of suicide may read this exlopypedia, especially this page. By at least adding a simple hatnote, we can attempt to redirect that suicidal person to another page where they can get help, while not damaging the neutrality of Wikipedia and the page itself. I would respectfully want those hatnotes or a similar hatnote to be restored. Neon 01:55, 20 July 2019 (UTC)

This is now being discussed at Village_pump_(proposals)#Proposal_to_add_suicidal_disclaimer_at_Suicide. Best, Barkeep49 (talk) 14:14, 22 July 2019 (UTC)

Evidence on contacting peopleEdit

Here is a decent review from 2016 in the BMJ which comments on giving people crises numbers "Emergency card compared with usual care We don't know whether emergency-card intervention is more effective at 12 months at reducing the proportion of people who repeat deliberate self-harm... However, it is good practice to give patients emergency contact numbers in case they need to seek advice and help in the event of a crisis."

Here is a review from 2015 on contacted people after an attempt "A non-significant positive effect on repeated self-harm, suicide attempt and suicide and a significant effect on the number of episodes of repeated self-harm or suicide attempts per person (based on only three studies) means that brief contact interventions cannot yet be recommended for widespread clinical implementation."

Doc James (talk · contribs · email) 18:49, 8 August 2019 (UTC)

Well not a review, this paper is disturbing from 2007 "There were six calls where an ambulance was sent to a caller during a suicide attempt and it may very well be that the callers lives were saved. However, there were ten instances when a caller appeared to be in the process of a suicide attempt and the helper did nothing, and in at least one case the helper encouraged the caller to complete the attempt." Doc James (talk · contribs · email) 18:57, 8 August 2019 (UTC)

What has better evidenceEdit

"In this latter study, the strongest impact on the suicide rate was related to implementation of the following practices: adherence to depression treatment guidelines, having a clear policy on transfer from adolescent to adult mental health services, availability of dual diagnosis services, availability of home health/crisis response teams, and conducting a multidisciplinary review of patient suicides and going over the findings with surviving family members (Figure 3)"

In Korea "Of the five suicide-prevention strategies outlined in our study, prohibition of the herbicide paraquat and installation of screen doors were proven to be effective, while others need further assessments."

In the USA "Means safety strategies, which emphasize the reduction of practical capability for suicide through the limitation of access to and safe storage of firearms, are effective in preventing suicide and include interventions such as lethal means counseling, firearm legislation, and promoting safe storage practices."

Lancet 2016 "Evidence for restricting access to lethal means in prevention of suicide has strengthened since 2005, especially with regard to control of analgesics (overall decrease of 43% since 2005) and hot-spots for suicide by jumping (reduction of 86% since 2005, 79% to 91%). School-based awareness programmes have been shown to reduce suicide attempts (odds ratio [OR 0·45, 95% CI 0·24-0·85; p=0·014) and suicidal ideation (0·5, 0·27-0·92; p=0·025). The anti-suicidal effects of clozapine and lithium have been substantiated, but might be less specific than previously thought. Effective pharmacological and psychological treatments of depression are important in prevention. Insufficient evidence exists to assess the possible benefits for suicide prevention of screening in primary care, in general public education and media guidelines. Other approaches that need further investigation include gatekeeper training, education of physicians, and internet and helpline support.]"

Doc James (talk · contribs · email) 19:14, 8 August 2019 (UTC)

suicide rates in MuslimsEdit

The section simultaneously says that Muslims "appear to have a lower rate of suicide", but also that "there does not appear to be a difference in rates of attempted suicide rates." If the evidence is weak, why bother mentioning it at all?--Megaman en m (talk) 10:34, 18 July 2019 (UTC)

My interpretation of that line is that evidence suggests that though the rate of attempted suicides is the same, the rate of completed suicides is lower. From the abstract of the cited source: Despite this, and despite the possible under-reporting of suicidal behavior in countries where such behavior is illegal, suicide rates do appear to be lower in Muslims than in those of other religions, even in countries which have populations belonging to several religious groups. Rates of attempted suicide, on the other hand, do not appear to be lower in Muslims as compared to non-Muslims. Red Rock Canyon (talk) 10:47, 18 July 2019 (UTC)
Return to "Suicide" page.