Talk:Suicide

Hatnote on mental health resources

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)

• Link to subpage that contains links to previous discussions on the topic. cymru.lass (talk • contribs) 16:24, 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 I just wasted time doing that and they are much too adversarial, outdated and wearisome.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)

Evidence

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)

Term "risk factor" objectifies people.

Closing off-topic rant. — The Hand That Feeds You:Bite 15:32, 13 November 2018 (UTC)
The following discussion has been closed. Please do not modify it.
The term treats an individual's decision as a physical or economic phenomenon, rather than a social or cultural one. One may term a circumstance which might motivate a decision by an outsider affecting one's organization as a "factor", particularly terming circumstances motivating a decision with a negative affect as a "risk factor". Thusly "risk factor" in an economic context, implies speaking to an ingroup affected by the decisions of an outgroup. Since wikipedia as a public text without implied antagonist has no outgroup and has everyone able to read internet webpages as an audience, wikipedia labeling circumstances as "risk factors" in an economic context violates the logic between those two principles addressed in the preceding two sentences respectively. Therefore, a reader would likely default to the most applicable inviolate interpretation, which turns out as circumstance contributing to a physical phenomenon happening which would result in death (i.e. a hurricane). That way, the term "risk factor" to describe circumstance contributing to a suicide equates the existence of suicidal people to the existence of natural disasters or---simply---equates suicidal people to natural disasters. So, for the sake of NPOV and WP:Gratuitous, I claim wikipedians should not allow the term "risk factors" applied in such way on wikipedia. 2600:1700:8680:E900:F0B9:62DB:3DE0:ED35 (talk) 02:34, 5 November 2018 (UTC) Are you ever going to give this a rest? No one agrees with you. The RFC settled this issue, accept the consensus. Calling "risk factor" objectifying is like saying "unemployment rate" objectifies people. It's just a way of measuring a social phenomenon. More and more I'm getting the impression that you aren't here to improve the encyclopedia, you're here on some grand crusade to change the way suicide is discussed in society. Red Rock Canyon (talk) 12:04, 5 November 2018 (UTC) Not demeaning or pejorative. Eliminating the phrase will not change the facts. It will simply distort and dumb down the discussion. 7&6=thirteen (☎) 14:54, 5 November 2018 (UTC) I don't know about your facts, but the predominantly believed facts stipulate suicide happens because of motivations not "risk factors". 2600:1700:8680:E900:F0B9:62DB:3DE0:ED35 (talk) 10:28, 7 November 2018 (UTC) Again WP:NOTDEMOCRACY, whether anyone agrees with me or not matters not, but rather the merit and willingness to follow through attribute-able to the points made and makers of the points. Again, whether anyone agrees with me or not, doesn't change whether or not they can or will respond to the points raised. Having a majority doesn't beget correctness. Claiming "risk factors" exist for suicide, implies individuals are not agents to their own decision. I don't believe no one agrees with me, rather I only believe that the majority of people with the most interest in editing a wikipedia article have dedicated their lives to disagreeing with the opinion I express and would have significantly different employment if they hadn't. I can't say with certainty, however seems like most editors who participated in the RfC have a medical bias in what articles they choose to edit. I digress. How does asking me to stop editting confront the issue I pose? This section addresses a different, much more specific issue. "Risk factor" doesn't associate with "unemployment rate", rather "suicide rate" associates with "unemployment rate". I would not say talking about statistics in general objectifies people, but detaching the term motivation from decision does. If we say "risk factors for willful unemployment" that objectifies people the same way, by implying "no one decided to decide" to remain unemployed. Grammar like that treats a decision as an outcome, rather than a desire, much like the outcome of a hurricane or an election or a harvest; not like the outcome of a decision though because the decision gets treated as the outcome. Suicide, the article, ceases to treat death as an outcome of suicide, the decision, instead treating the suicidal person as a person without a will which matters. The feminist movement talked about objectification, as treating feminine voices on femininity as voices without opinions which matter. (Of course, masculine voices on masculinity got similar treatment while receiving more shame for vocalizing their discontent.) In other words, if someone felt stereotyped or depicted annoyingly simple, that person too often got treated as a person whose will did not matter. Now you might continue to push your idea about "risk factors" relating to statistics (due to genetic grammar), but the article doesn't talk about "risk factors" that way, otherwise we would find more "risk factors for a greater suicide rate". The article talks about risk factors relating to the individual as-if to say "this might cause this person to do what they didn't decide to decide to do", much like "sexual conquests don't decide to decide to have sex, instead they decide because of what we made them decide" likewise with marital or otherwise monoamorous "conquests". How can anyone call those treatments different? 2600:1700:8680:E900:F0B9:62DB:3DE0:ED35 (talk) 10:19, 7 November 2018 (UTC)

Suicide among medical patients

Suicide among medical patients needs help from other editors. Thanks, Biogeographist (talk) 16:17, 13 December 2018 (UTC)

Should the content of Template:Suicide sidebar and Template:Suicide navbox be the same?

See the discussion at: Template talk:Suicide sidebar § Should the content of Template:Suicide sidebar and Template:Suicide navbox be the same?

See also the related deletion discussion at: Wikipedia:Templates for discussion/Log/2018 December 13 § Template:Suicide by country. Thanks, Biogeographist (talk) 00:40, 14 December 2018 (UTC)

Linking

We generally do not link like this Matthew 19:18

https://www.biblegateway.com/passage/?search=Matthew+19%3A18&version=NRSV

Thus I have restored the prior version. Doc James (talk · contribs · email) 20:58, 14 December 2018 (UTC)

- who is "we"? - this is a common way of linking in Wikipedia articles Wikipedia:Citing sources/Bible Template:Bibleverse- Epinoia (talk) 21:04, 14 December 2018 (UTC)

Both {{Bibleref2}} and {{Bibleverse}} advise against linking in the text, preferring to use a footnote. I've therefore followed this advice. Furthermore, it is preferable to use Wikisource rather than an external website, so I've used KJV. Finally, whilst shortening the book to "Matthew" is clear to those familiar with the Bible, we should not assume this of our readership, so I have expanded it back to "the Gospel of Matthew". I hope that satisfies both of you. Martin of Sheffield (talk) 09:36, 15 December 2018 (UTC)

It has just dawned on me that we’re supporting the wrong point (and therefore citing the wrong verse!) The point we’re supposed to be supporting is (article text)

made applicable under the New Covenant by Jesus in the Gospel of Matthew

So it’s verse 17 that is relevant: “And he said to him, “... If you wish to enter into life, keep the commandments.”

(We’ve got sidetracked supporting the point appearing immediately before it in the article:

the argument is based on the commandment "Thou shalt not kill"

This earlier point does not need a citation provided to support it. (It would obviously be possible to provide a citation - and it’s a requirement of WP that it’s possible to do that. But the point is hardly likely to be challenged and so - WP again - doesn’t need any citation provided in the article. Compare the broader argument(s)

that life is a gift given by God .., and that suicide is against the "natural order" and thus interferes with God's .. plan 

- for which the citation is both needed and provided.)

So I suppose I ought to amend accordingly.

SquisherDa (talk) 23:01, 16 December 2018 (UTC)

On other aspects:

linkage via footnote (User:Doc James): good by me!

[Gospel of] Matthew (User:Martin of Sheffield): yes, of course, the fuller form is right!

KJV (User:Martin of Sheffield): uh .. a translation four centuries old? into a language as fast-changing as English has been? and when linguistic sciences, within the last century, have done so much for the quality of translation? (But is there a WP:Something re KJV?)

Seriously? You can't understand "He saith unto him, Which? Jesus said, Thou shalt do no murder, Thou shalt not commit adultery, Thou shalt not steal, Thou shalt not bear false witness"? Martin of Sheffield (talk) 09:23, 17 December 2018 (UTC)

It seems to me that the consensual priority, re references, favors quality of reference over convenience of access, WikiSolidarity etc.

Anyone agree / disagree re choice of translation?

SquisherDa (talk) 00:00, 17 December 2018 (UTC)

- in articles about the Bible the NRSV is usually referenced due to its readability and neutrality of translation - the most common way to reference scripture is by the Bibleref template to Bible Gateway - for example, this section on Paul the Apostle has several Bibleref links, Paul the Apostle#Names - if you scroll through the article you will see that this style of Bible reference is used throughout - it is the most common form of Bible reference on Wikipedia - Epinoia (talk) 00:22, 17 December 2018 (UTC)

Removing the last sentence of the first paragraph and replacing it with an accurate statement supported by overwhelming scholarly research

Hello,

My 10 year old son is in therapy for suicidal ideation and last weekend made a serious Suicidal Gesture. I'm contributing to this page in the hope of improving all of our understanding of how to prevent suicide.

I suggest that the first paragraph be amended to introduce the positive impact of social media forums to prevent suicide... instagram for example (I'm referencing Pete Davidson's call for help on Instagram and the immediate help he received)

But, most importantly, the last sentence of the first paragraph should be changed. There is overwhelming evidence that Telephone Hotlines, Texting Hotlines, and Online Chat help immediately prevent suicide.

Here is a 2017 article in support of my claim: https://www.healthyplace.com/suicide/how-does-a-suicide-prevention-hotline-prevent-suicide

Here a 2012 report about the efficacy of New Jeresy's suicide hotlines: https://www.state.nj.us/humanservices/news/reports/NJ%20HOTLINE%20SURVEY%20REPORT%2011%2028%2012.pdf

This discuses how Hotlines have grown and improved over the last 10+ years: https://www.sprc.org/news/national-suicide-prevention-lifeline-first-ten-years

And finally, this study shows conclusively that calling a hotline can prevent a person from immediately killing themselves: https://onlinelibrary.wiley.com/doi/full/10.1111/sltb.12339

The referenced article in the last sentence in the 1st paragraph does not actually support the sentences claim, and the link provided doesn't lead to an actual article or paper... https://www.ncbi.nlm.nih.gov/pubmed/17824349

Please let me fix this situation by removing the current last sentence and adding a sentence that says, " Calling a suicide help line can prevent a person from immediately committing suicide" citing this study: https://onlinelibrary.wiley.com/doi/full/10.1111/sltb.12339

THIS IS AN EXACT QUOTE FROM THE STUDY: "Although research has focused on suicidal individuals treated in hospitals and emergency departments, crisis hotlines are known for providing immediate access to care for individuals in suicidal crisis, including many who face barriers to engaging in formal behavioral health care."

Petebertine (talk) 19:12, 16 December 2018 (UTC)

You could qualify your material by starting, "Although some doubt the effectiveness of crisis hotlines" and include the Sakinofsky citation already in the article, then add your material supporting crisis hotlines - this would preserve neutrality, preserve the existing citation, and include important alternate refernces - ps: hope your son is ok - cheers - Epinoia (talk) 19:42, 16 December 2018 (UTC)

Thank you! I'll try editing it now along these lines: Although some question the effectiveness of crisis hotlines, and others call for resources to be better allocated; calling a crisis hotline can prevent a suicidal caller from 'immediately' taking their life, and crisis hotlines that make follow up calls and provide access to mental health resources reduce the chance that a caller attempt suicide in the future.

And thank you for the kind words, my son is getting wonderful professional support now. Petebertine (talk) 20:28, 16 December 2018 (UTC)

Reverted. Needs better wording. Use of "some" is vague; see WP:Weasel wording. Flyer22 Reborn (talk) 22:51, 16 December 2018 (UTC)

"some" is only vague if unsupported by citations - if you check WP:WEASEL the section is called "Unsupported attributions" - it is quite normal on Wikipedia for an article to say, "Some scholars believe this and other scholars believe that" as long as both positions are supported by citations - Epinoia (talk) 23:35, 16 December 2018 (UTC)

I am very familiar with all of what WP:Words to watch states. I commonly weigh in on that guideline's talk page. "Some" can be vague regardless of if it's sourced, which is why WP:Weasel states, "Likewise, views that are properly attributed to a reliable source may use similar expressions, if they accurately represent the opinions of the source." It's also why Template:Who states, "If greater specificity would result in a tedious laundry list of items with no real importance, then Wikipedia should remain concise, even if it means being vague. If the reliable sources are not specific—if the reliable sources say only 'Some people...'—then Wikipedia must remain vague." In this particular case, the wording didn't even state "some scholars." And which of the sources state "some people" or "some scholars"? Flyer22 Reborn (talk) 00:19, 17 December 2018 (UTC)

Well, it is extremely common to use some/other in cases of contentious scholarship as long as there are citations for both positions. Here is an example from the article on Paul the Apostle:

"The other six are believed by some scholars to have come from followers writing in his name, using material from Paul's surviving letters and letters written by him that no longer survive.[8][9][17] Other scholars argue that the idea of a pseudonymous author for the disputed epistles raises many problems.[18]"

so using the some/other construction is common usage and not always weasel words. - Epinoia (talk) 18:20, 17 December 2018 (UTC)

Sourced or not, such wording is commonly tagged with Template:Who. I should know; I see it all the time, which is why I avoid "some people," "many people" and similar when possible. There are editors who still want clarification as to who those people are, even if the source is talking about people in general and/or no one worth mentioning by name, or they are simply applying WP:Weasel words strictly and/or wrongly. It's why Template:Who states, "If greater specificity would result in a tedious laundry list of items with no real importance, then Wikipedia should remain concise, even if it means being vague." I've had to point editors to Template:Who times before so that they can understand that words like "some" and "many" are not banned, and that giving names can create misleading WP:In-text attribution. See, for example, Talk:Campus sexual assault/Archive 4#"The majority of rape and other sexual assault victims do not report their attacks to law enforcement.". Using "some people," "many people" and similar is a case-by-case matter, and they are better if used in the lead as a summary. If the source actually uses the wording "other scholars," for example, you are safer than stating "other scholars" just because the source mentions some scholars or stating "some scholars" because you've stringed together a few sources. Flyer22 Reborn (talk) 20:23, 18 December 2018 (UTC)

Petebertine’s contribution has raised several important points. I’m seeing real risk that in discussing some of the more detailed / complicated issues, we’ll lose sight of some that are rather uncomplicated and central.

Notably, that the *existing* article includes a blunt statement

Even though crisis hotlines are common, there is little evidence for their effectiveness

and cites a source which doesn’t say anything about it!

The source cited is the Sakinofsky article; I have access only to the abstract; and it seems to me clear from the abstract that the article has nothing substantial on hotlines and is not a valid source for anything that we might want to say about them.

Let’s be sure that whatever we do, we do something about that!

- SquisherDa (talk) 00:52, 17 December 2018 (UTC)

____

References

I've done a bit of research and can find absolutely zero supporting documentation that claims that Call In Centers are ineffective. I've changed that last sentence on the Suicide Page to quote from sentence #1 of paragraph #4 of this article: https://onlinelibrary.wiley.com/doi/10.1111/sltb.12128

I'd prefer to make that a clearer and even more declarative sentence, such as, "The American Association of Suicidology attests to the effectiveness of Call in Centers" Petebertine (talk) 02:25, 17 December 2018 (UTC)

The 2016 systematic review says "Other approaches that need further investigation include gatekeeper training, education of physicians, and internet and helpline support."

We do not use primary sources per WP:MEDRS

There is lots that can be done to decrease suicide like decrease access to guns.

Doc James (talk · contribs · email) 02:58, 17 December 2018 (UTC)

Can you give us the citation details of the 2016 review you mention? (Apologies if I’ve missed something, and you already have; if so, can you repeat?!)

- SquisherDa (talk) 13:19, 17 December 2018 (UTC)

The 2007 review says "Other suicide prevention strategies that have been considered are crisis centres and hotlines, method control, and media education. Public awareness campaigns can increase knowledge, self-identification of depression, and help seeking.133 There is minimal research on these strategies. Even though crisis centres and hotlines are used by suicidal youth, information about their impact on suicidal behaviour is lacking." by the way

Doc James 

(talk · contribs · email) 03:14, 17 December 2018 (UTC)

I'm referencing an article from 2018 in The Official Journal of the American Association of Suicidology that clearly says that crisis centers and hotlines prevent suicides. You are referencing a decade old article written by a single author in Canada that says information about their impact is lacking. It is an article that no one has access to so as to verify context. Interestingly enough, you are also referencing a Lancet article that no one can access without paying for it.

Are you telling me that I can't use The article from the American Association of Suicidology? — Preceding unsigned comment added by Petebertine (talk • contribs) 04:33, 17 December 2018 (UTC)

Can you give us the citation details of the 2018 Association article you mention? (Apologies if I’ve missed something, and you already have; if so, can you repeat?!)

I doubt that Doc James is simply saying you can’t use it. The point I think he has in mind is that the main text of an article would normally be more direct:

Call in Centers are known to be effective 

with a *reference* to what the Association of Suicidology has said - *if* whatever they’ve said is a source we can rely on . . *and* it’s the accepted view among relevant experts / authorities / etc.

If it’s *not* the established view - that is, if other opinions are recognized as reasonable - we’d need to present both / all views. (That’s likely in this case, I guess.)

If the Association’s publication(s) *can’t* be regarded as “reliable” for any reason, there’s a need to dig deeper / widen the enquiry - to confirm that their view is accepted as reasonable, well-informed etc (likely; I’d think) *and* to identify and cite reliable sources that state it.

The pay-wall thing, by the way (re Doc James’s Lancet article): consensus as I understand it is that the quality of references is primary. For Further Reading etc, pay-walls are really not what you’re hoping to find; and for references, if a source behind a pay-wall can be replaced by another that is equally relevant and equally authoritative, that is definitely what to do. But if the only reliable source that actually states the point is behind a pay-wall (or is otherwise hard-to-get-at), it’s still the one to cite and it has to be cited.

( Personal note: I think of your son, and what he and you are going through, each time I visit this discussion: my / our heartfelt best wishes! )

- SquisherDa (talk) 13:19, 17 December 2018 (UTC)

Thank you SquisherDa :)

I appreciate the feedback from Doc James and his obvious desire to see such an important topic properly researched and presented. Obviously I want to encourage the presentation of that information to give hope and encourage people to seek help...

...toward that end I present these 3 quotes:

"Continuity of care for suicidal individuals engaged with a variety of health and mental health care systems has become a national priority, and crisis hotlines are increasingly playing a part in the risk management and continuum of care for these individuals"*

• 2018, American Association of Suicidology

"Two main data sources provided the information for the current study: a self-report counselor questionnaire on the follow-up activities completed on each clinical follow-up call and a telephone interview with follow-up clients, providing data on their perceptions of the follow-up intervention’s effectivenes"**

• • 2018, American Journal of Suicidology

"The majority of interviewed follow-up clients reported that the intervention stopped them from killing themselves (79.6%) and kept them safe (90.6%)."***

• • • 2018, American Journal of Suicidology

Those 3 direct quotes come out of the first paragraph of this article: https://onlinelibrary.wiley.com/doi/epdf/10.1111/sltb.12339

These are the authors of the article: Madelyn S. Gould PhD, MPH; Alison M. Lake MA, LP; Hanga Galfalvy PhD; Marjorie Kleinman MS; Jimmie Lou Munfakh BA; James Wright LCPC; Richard McKeon PhD, MPH

Due to her qualifications, I have emailed Dr. Madelyn Gould for a comment about the first paragraph of the Wikipedia page and how best to use the article in it. E-mail address: [[8]] Child and Adolescent Psychiatry, Columbia University, , New York, NY, USA New York State Psychiatric Institute, , New York, NY, USA Address correspondence to M. S. Gould, Division of Child & Adolescent Psychiatry, NYSPI, 1051 Riverside Drive, Unit 72, New York, NY 10032

Doc James is right, all guns should have trigger locks and be in safes... and proven medication like lithium should be free of charge and prescribed by psychiatrists that cost nothing to attend.

Until then knowledge is free (unless it's behind a paywall) and so are hotlines that provide information and an intermediary step between a suicidal person and the immediate medical help that person needs.

So, "Although research has focused on suicidal individuals treated in hospitals and emergency departments, crisis hotlines are known for providing immediate access to care for individuals in suicidal crisis, including many who face barriers to engaging in formal behavioral health care."****

• • • • This is a direct quote from the article in the Official Journal of the American Association of Suicidology that I have referenced. I referenced the article in the 2 edits that I published and quoted the first sentence of the 4th paragraph of the Abstract:

[9]

I'll attempt an new edit softening the negativity of the sentence while acknowledging that continued research is vital.

This is my edit incase it gets redacted. It references: https://www.sprc.org/news/national-suicide-prevention-lifeline-first-ten-years

and

https://onlinelibrary.wiley.com/doi/full/10.1111/sltb.12339

Crisis hotlines are common and in the past their effectiveness has been questioned.[9][10] Due to this scrutiny suicide prevention has evolved as a discipline and national suicide risk assessment standards have been developed, randomized controlled trials are being used to demonstrate programs effectiveness,[11] and the importance of follow up calls to suicidal callers is now seen to be so effective that a recent study showed that 79% of suicidal callers who received a clinical follow up call claimed that the follow up intervention call stopped them from killing themselves.[12]

Personally I think that it is unnecessary to mention that Crisis Hotlines have been questioned in the past while referencing articles and data from 10 years ago.

I would like to say:

"Crisis Hotlines and suicide prevention is effective with national suicide risk assessment standards that have been developed using randomized controlled trials that recommend follow up intervention calls. Today, 79% of callers who receive follow up calls claim that the follow up call stopped them from killing themselves."

Any objections? — Preceding unsigned comment added by Petebertine (talk • contribs) 19:36, 17 December 2018 (UTC)

By the way, Dr. Madelyn S. Gould and her team at Columbia University is referenced by John Draper, PhD, Director, National Suicide Prevention Lifeline Member, SPRC Steering Committee, the author of the other article I referenced. Is this see as inappropriate?

Petebertine (talk) 19:40, 17 December 2018 (UTC)

We DO NOT use primary sources to refute secondary ones. Please read WP:MEDRS.

You are more than welcome to try a WP:RfC though. Best Doc James (talk · contribs · email) 04:04, 18 December 2018 (UTC)

as Doc James has indicated Wikipedia:Identifying_reliable_sources_(medicine) is very clear on using secondary sources--Ozzie10aaaa (talk) 04:46, 18 December 2018 (UTC)

My next edit makes the sentence true to the source article because the secondary source reference is being taken out of context. The source does not say that there is "Little Evidence" it says that there is "Insufficient Evidence"

It is too ambiguous AND I cannot read the entire article to gain context because it is behind a pay wall.

Ideally the sentence should read: "There is ongoing debate about how to prevent suicide"... it is incredibly irresponsible to dissuade people from calling a help line given the enormous amount of Primary Source material supporting the effectiveness of help lines.

I will continue to search for a source that meets Wikipedia requirements Petebertine (talk) 17:17, 18 December 2018 (UTC)

The last edit I made reflects my unsuccessful attempt to locate suitable source material to support the effectiveness of call centers. I have received a reply from Dr. Gould at Columbia University, one of the authors of the primary source I was using as a reference and I have requested that she send me secondary sources to support the effectiveness of call centers.

The Tonic article that I added as a citation at the end of the sentence does a great job of discussing the issue with Hotlines AND it references Dr. Gould's primary source material that I have been using.

All in all this has been a great education and a form of catharsis for my pain, and I thank everyone for their patience, friendly guidance and support. Doc James you have inspired me to focus on improving the presentation of Suicide information in a way that best helps those in crisis AND guides professionals to the latest resources. Petebertine (talk) 20:12, 18 December 2018 (UTC)

Vice is not a suitable source (as it is popular press)

It is better to paraphrase generally than to quote. How about "unclear"?

Nowhere does our article say people should not call these lines. Yes agree suicide is horrible, which is one of the reasons I have put a fair bit of work into this article. Best

Doc James (talk · contribs · email) 00:39, 19 December 2018 (UTC)

I'm actually convinced now that there is clear evidence that Hotlines are ineffective, especially after looking at research from Denmark, so please return it to your original wording... I'm now very interested in what IS effective in preventing suicide. Maybe something more be said about firearms as they are the #1 means of suicide in the US? Are trigger locks effective? Petebertine (talk) 03:39, 19 December 2018 (UTC)

I paid The Lancet for the article "Suicide prevention strategies revisited: 10-year systematic review" https://www.thelancet.com/pdfs/journals/lanpsy/PIIS2215-0366(16)30030-X.pdf

Behind the paywall this is what they found regarding Hotlines:

"Studies of telephone and internet services usually have relatively low levels of evidence. These studies have mainly focused on outcome measures such as acceptability of services by users, identification of people at risk and referral to help services, and compliance with referrals. Other studies have identified specific effective characteristics in these interventions and service providers, as well as service-use barriers. Some report reduction in suicidal ideation following interventions such as a brief mobile treatment intervention in Sri Lanka, unguided online self-help, and a telephone aftercare intervention. Intervention is more efficient than wait-listing."

Let's go back to saying that there is little evidence Petebertine (talk) 04:11, 19 December 2018 (UTC)

yes, to your statement above, however on another matter of references...in the future do stay away from references such as 'Vice', as it is incompatible with MEDRS, thanks--Ozzie10aaaa (talk) 10:30, 19 December 2018 (UTC)

From my reading of the literature this is the easiest / the most effective in the short term "Effective suicide prevention efforts include limiting access to methods of suicide — such as firearms, drugs, and poisons"

One can easily personally limit firearms in the home. In Switzerland, from what I understand they generally keep their guns in locked storage units a fair distance from their home.

Suicide is often a split second poor decision. Barriers on bridges also have some support. Doc James (talk · contribs · email) 12:56, 19 December 2018 (UTC)

agree--Ozzie10aaaa (talk) 16:51, 19 December 2018 (UTC)

References

Replacing the current "Suicide Image" of the Manet painting of the dead man on the bed with a gun

I'd like to suggest that the "hopeless" Manet painting of a blood soaked, unknown dead man with a hole in his chest and a gun in his hand lying on a bed be replaced with something less violent.

I suggest it be replaced with the identifiable hero, Alan Turing, in this image: https://commons.wikimedia.org/wiki/Category:Suicide_in_art#/media/File:Alan_Turing._2_Cornwall_LGBT_History_Project_2016._Sculpted_by_Malcolm_Lidbury.JPG

The Turing image has no overt violence, no sign of a weapon and it implies that we have become a better world than the one Turing lived in.

Am I overthinking the impact of the current image? Petebertine (talk) 01:21, 17 December 2018 (UTC)

The current image is fine. Suicide is generally fairly horrible and we should not try to hide the fact. We should also not try to associate it with "heros" as that might promote suicides. Doc James (talk · contribs · email) 02:49, 17 December 2018 (UTC)

agree w/ Doc James comments above--Ozzie10aaaa (talk) 04:41, 18 December 2018 (UTC)

Risk factor: Inability to pay taxes

This story in the New York Times is anecdotal, but I wonder if we could find better reliable third-party sources about the people who commit suicide when they realize they cannot afford to pay taxes. Are there studies we could cite to know how many people commit suicide each year for this reason?Zigzig20s (talk) 12:42, 31 January 2019 (UTC)

Edit request: Missing information under animal suicides section

Great white sharks have been documented starving themselves in captivity until death. This information is conclusive evidence of animal suicide and should be included on the page.

Sources: Hale, Tom (November 1, 2016). "Great White Shark Dies After Just THREE Days In Captivity". IFL Science!. Retrieved 2017-04-12. Fong, Joss (2016-07-08). "Why there aren't any great white sharks in captivity". Vox. Retrieved 2017-06-20. Essapian, F. (1962). Notes on the Behavior of Sharks in Captivity. Copeia, 1962(2), 457-459. doi:10.2307/1440936 Nellionidas (talk) 04:10, 3 February 2019 (UTC)

No, that is not conclusive evidence. One could easily conclude that humans just don't know how to properly meet the physical needs of these sharks in captivity. The suggestion that the sharks have formed an intent to kill themselves is unfounded. Deli nk (talk) 12:54, 3 February 2019 (UTC)