Every show with a suicide now has a disclaimer with a suicide hotline at the beginning. Is there any evidence that these warnings make a positive difference?
Suicides can be really easy to prevent.
Like, the hotline itself is incredibly effective, and reminding people it exists would naturally help.
People aren’t getting the number from the intro, but it reminds them it exists.
It also helps normalize actually think about it or discussing the subject.
Even though crisis hotlines are common, they have not been well studied for efficacy.
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.
That really sucks. I hope you’re doing better now.
:( I’ve been in a similar situation, but I’ve never called; I have friends that I can talk to openly about this stuff, and not freak them out or have them be judgemental. I don’t know you, but I hope you are doing better, and can persevere. Life can be awful, brutal. Being alone in a time of need is… I can’t even think of a word with enough emphasis.
If you want, you can send me a message. Might not be helpful, but maybe it will. Just say hi, if you want. You aren’t alone. :)
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.
It’s amazing how effectively just hearing this from someone who has firsthand insight can put it in perspective.
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
I’m OK (now? currently? hopefully forever) but when I’m struggling I too appreciate the warning.
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.
Funny the fictions we contrive for ourselves in our own heads.
There’s a real need to get ones world view/beliefs and the insecurities and inner critics in line in order to survive it seems.
That’s my latest conclusion, anyway. Distraction and drinking haven’t really helped. Shocking, I know…
I’ve said this elsewhere in the thread, but I have had suicidal ideation… ‘events’ as well, never called though. If you want someone to talk to (anyone else, too! yes, that means you, hi!), reach out and message me. I know this shit all too well and I don’t mind in the slightest, talking to someone who needs - or just wants - to communicate with someone who ‘gets it’.
No pressure, I just want to help others like myself.
It is well appreciated.
Idk, but I bet they think it’s the least they can try. If it saves just one life, it has been worth.
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.
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?
How much effort/time/money do you think they put into that white text on black background that’s on screen for like 5 seconds?
It’s negligible, I would be shocked if it wasn’t the same recycled card over and over again that they have some unpaid intern throw in at some point in the final editing stages
It would probably cost more effort/time/money to do a study on its effectiveness than the pre roll does many times over lmao
It’s not about the production cost, its about the opportunity cost.
A quick google search tells me a national ad costs $200k-$1m for a 30s slot. That means 5 seconds of screen time costs $30k-$150k.
That’s not it. It’s simply that if someone comes suicide after watching, no one can point the finger at the producers.
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.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.
The bill is a fairly unique U.S. thing.
Yeah but that horror story is the same in Australia and there’s no bill.
This isn’t anecdotal. It’s really quite a common response that only further traumatizes the victims and leaves them with a financial burden.
This is really reductive and doesn’t really consider how complex these situations can be.
What should police or first responders do when someone is at risk of harming themselves or others?
Whatever your answer, consider that the person is already having a bad day, and there are no on the spot cures for what ails them.
Hospitals in general are not nice places to be, as a patient. If you’re there for a physical illness it’s still traumatic.
You don’t go there to have a nice time, you go there to avoid the worst outcomes, like death.
I am certain that there are very, very few instances where people end up in a psych ward when there’s better places for them.
People are there because their lives suck. Traumatizing them and putting them in debt just makes the suffering worse. Putting them through this process DOES NOT help them.
Sorry mate, this is just plain wrong.
People are there because they have complex medical conditions which require specialist personnel and facilities.
Yes it can be scary and expensive, but it’s the best way to manage a shit situation.
If you are experiencing psychosis, then this will absolutely help you. If you are suicidal, it will not.
That’s not really true.
For a lot of people who are suicidal, a psych ward is precisely the right place for them. There are appropriately trained people to develop a treatment plan, and appropriate facilities to prevent a suicidal person from harming themselves.
I absolutely acknowledge that being taken to a psych ward against your will is going to be traumatic for anyone. I also acknowledge that in some cases the patient might end up feeling worse than they did before they went.
However, I’m certain that you can acknowledge that taking someone to a psych ward against their will is often the only way to prevent them harming themselves.
Well that last part is a US specific issue
and people have the right to refuse treatmentNot if you’re “deemed at threat to yourself or others”
You lose the ability to refuse treatments in any scenario the emergency responders / doctors deem you unfit to make a decision in the best interest of your/someone else health. It’s why “baker acting” in Florida is so controversial. Taking someone against their will and locking them in a facility for a minimum time without any real need of evidence.
Someone calling and telling them you said you were going to kill yourself is often all the evidence they need to start the process, whether you really said that is up to the emergency responders. For my friend that was 9 cop cars in the middle of the night. They dragged him out of bed at 4am because his partner at the time said he hadn’t been responding to her texts and she told them he was depressed so he might kill himself.
Once he got out he told me about it all and I’m fairly certain he won’t ever sleep with his phone on silent/vibrate again. (He broke up with them immediately after, but that has nothing to do with consent)
Wouldn’t that open the door to the bill being declared illegal since you didn’t consent to the services?
It’s been argued for years, The section about involuntary placement was to long to copy and paste here but here is the bill:
The section one would argue unlawful is 1394.467 http://www.leg.state.fl.us/statutes/index.cfm?App_mode=Display_Statute&URL=0300-0399/0394/0394.html
Sidenote: You also have to remember that they have to detain and hold you before diagnosing you, so they may not “force treatment” so much as hold you for 72 hours without any charges against you. Release if no charges, or detain if qualify to be held involuntarily.
not if you live in certain US states and you make a threat that your are going to harm yourself or someone else. depends on the state but they can hold you for a psych eval for a few days, maybe a week
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.
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.
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
Thank you for that response, I think you did a great job helping me understand you and your wife’s perspective. I had a long period of lowness, and though I was not suicidal, some of the things you described sound close to how I thought and felt.
The part about the suicide hotlines reminded me of is a talk my coworker did on mental health, and she said that if you don’t get along with your therapist within the first two sessions, it’s ok to find another therapist. I imagine that’s what these hotlines are like. When you call in you’re basically grabbing a random person from a crowd, and the chances of that person resonating strongly with your story on the first try is probably low. I could see folks just hanging up if it wasn’t helping, but it seems like they may have better luck if they call back again and talk to somebody different.
At the end of the day though, if somebody has a chronic condition, alleviating it significantly is not an easy task. It seems like these hotlines have to struggle with that tension between wanting to help, but knowing that significant long term improvement isn’t easy to achieve, especially when you’re just talking to the person who is looking for help.
I’m not going to say these resources are worthless, but they’re worthless to me and I would assume at least a few people who have similar problems. I’ve never felt compelled to reach out or search for resources like this. They’ve always felt insincere, similar to corporate PR speak or celebrity “apologies”.
I think this is how my brother mostly felt. One thing that he was into that seemed to help was stoic philosophy. I wasn’t into it when he was alive, but happened to get into it shortly after he died and it immediately resonated with me. I wished we had gotten to talk about it more when he was alive. It certainly helped me deal with the aftermath of losing him.
Thanks again for the response. Good luck finding your peace.
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.
There is no harm in it being there, after all.
See, that’s where having the data would be great Because while this is intuitive, it’s not confirmed. I think most shows showing suicide also paint the event in a pretty bad light. What if having the disclaimer there makes someone not want to watch the show, and they continue to glorify suicide, whereas maybe if they watched the show and saw someone in pain after their loved one committed suicide, maybe it’d trigger something in them, to know how much this act would hurt others.
I’m not saying this is the case. I would just like to know the numbers, because unless they show a decrease in suicide attempts since the warning/phone number was introduced, then we’re really just speculating if it’s helping, hurting, or just neutral.
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.
Are you telling me they intentionally avoid playing Van Halen - Jump for anyone put on hold?
No, you see the trick is to play Jump by Van Halen exactly once at the right time followed immediately by Killing in the name of by Rage Against the Machine.
This combo is super effective… As long as the stay listen until the end.
The word hang up threw me off a little given the context
This is interesting. Source?
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.
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.
Also as someone who spent a lot of time when I was younger as an untrained suicide counselor, it’s rough on you. Suicidal people should reach out to friends, but understand that if your friends aren’t able to help or keep boundaries there it’s not you, it’s not you being a burden, they may love you very much, but they need to engage in self preservation and the experts have better coping mechanisms, are in therapy, and have professional distance. Being an untrained suicide counselor was both a form of self harm and working through my trauma. I did real good for others and I don’t really regret it, but if you’re feeling the urge to do it, either get trained or get therapy, ideally both. I did later get trained in a form of counseling relevant to my traumas and I’m still comfortable doing that, but suicide counseling is rough at the best of times like being an emotional emt. And like emts they want to get to you in time to help, so if you need them use them, but the untrained are more like first aid, they can keep you around until an emt can get you to a doctor.
Serious question: How do you tell someone suicidal that opens up to you, that you can’t handle the topic without making them feel worse?
“I care deeply for you and that’s why I’ll acknowledge I can’t give the help you need. You need an expert not just a friend, and I can’t hurt myself helping you”
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.
Tone matters, like the difference between telling someone they should consider seeing a therapist, and telling someone they need a therapist.
In text it is still hard, but convincing someone to talk to a professional (not saying they are all doctors or something) because you don’t feel equipped to handle the situation on your own shouldn’t be devastating if you go through a small course like that. Never taken one but just off the cuff I’d say offering to call with them and staying for the conversation until you/they agree they feel comfortable carrying on with the help line or what not on their own before walking away would probably be a decent step in the right direction. The line could advise you of the next steps you might not be thinking of in that moment, getting them around other friends/family/bringing them to a medical professional, I’m sure it varies.
I don’t think it’s about making a positive difference, it’s about liability.
I don’t doubt that someone might be thinking that, but I do doubt that any lawyer thinks it’s necessary. As far as I know nobody has ever brought suit against a TV show for a suicide case.
But I’m not an attorney.
I’m pretty sure that 13 Reasons Why show had a whole thing involving just this
Lawsuits of “my child died because they copied your TV show” have been going on for decades.
There’s evidence that trigger warnings actually worsen anxiety and are counterproductive
The way to treat anxiety is to face the source of anxiety to try and change your relationship and reaction. The best way to do this is via controlled access that exposes one to the trigger gradually in a context that has no risk of harm (eg a media depiction, discussing the concept, building up to discussing the source of trauma that led to the phobic response if applicable)
Trigger warnings enable active avoidance. This sensitizes one to the aversive stimuli and makes the phobic response stronger. As a result when one encounters the stimulus (eg a friend, family, celebrity etc commits suicide, suffers an eating disorder, etc) your resilience to the trigger is now even lower and the response is more likely to be more significant than it was before.
That said education on access to resources like 988 or other warm lines can lower suicide rates, maybe. Research is more mixed here because it’s difficult to prove causation
There’s evidence that trigger warnings actually worsen anxiety and are counterproductive
I’d be interested in seeing these studies.
The way to treat anxiety is to face the source of anxiety to try and change your relationship and reaction. The best way to do this is via controlled access that exposes one to the trigger gradually in a context that has no risk of harm (eg a media depiction, discussing the concept, building up to discussing the source of trauma that led to the phobic response if applicable)
Trigger warnings enable active avoidance. This sensitizes one to the aversive stimuli and makes the phobic response stronger. As a result when one encounters the stimulus (eg a friend, family, celebrity etc commits suicide, suffers an eating disorder, etc) your resilience to the trigger is now even lower and the response is more likely to be more significant than it was before.
These two paragraphs seem to contradict each other. Controlled access in a safe setting like a media depiction sounds great. That’s exactly what trigger warnings are for. How can you possibly do controlled exposure without knowing if the content is there or not?
Trigger warnings enable active avoidance.
Incorrect. Trigger warnings inform you that the content is present in the media you’re about to watch. What you do with that information is up to you.
https://journals.sagepub.com/doi/10.1177/2167702620921341 - the bigger takeaway from this one is that trigger warnings reinforce trauma as a central part of the traumatized individuals identity but they did find some incidence of drawback/harm
https://journals.sagepub.com/doi/10.1177/21677026231186625 meta finding no benefit and actually can cause an anticipatory reaction making the person more engaged with the material
There are others, this is just what grabbed from 30 seconds on google scholar. Its been a bit since I’ve done more serious lit review and it’s not like I keep a directory of papers I’ve read
The issue is the culture surrounding trigger warnings. Let’s be real here, people looking for trigger warnings are generally (perhaps overwhelmingly) not looking for material to help with their exposure therapy. They are looking for a “warning” to help them screen material to avoid. The issue is that this creates an unrealistic expectation that is incompatible with the real world. You can avoid suicide, sexual assault, eating disorders, or whatever in your media (maybe) but real life won’t sanitize itself or warn you. You will encounter these topics, whether through the news, careless speech from friends, or even intrusive thoughts of your own. Research continues to show that avoidance of upsetting topics can worsen anxiety and ptsd symptoms
To your final point the idea of it helping to create a choice isn’t even as clear cut as you describe
https://journals.sagepub.com/doi/10.1177/21677026221097618 content warnings actually increase the likelihood someone will view problematic content. This point is further reinforced by similar findings in the meta linked above
So you have a system that ultimately makes creators feel like they’re doing something noble, that is likely at best useless and potentially harmful. Said system increases the likelihood that a person will view the problematic content but also enables the reality that a person will simply avoid the things that provoke their anxiety which again is more strongly established as harmful
https://www.sciencedirect.com/science/article/abs/pii/S0005796712001064 - ptsd worsens with avoidance
https://www.sciencedirect.com/science/article/abs/pii/S0962184904000290 - anxiety disorders do the same
One tricky thing here is that existing literature is really examining the potential effects of trigger warnings in and of themselves, devoid of context or non-immediate decision making. Does seeing a literal trigger warning make someone feel less anxious? Almost certainly not, why on earth would it?
In studies that find no or slight negative effect, the outcomes are immediate measures. How do you feel right now? If it assesses decision making, it’s whether you do or do not immediately consume the content.
But for trauma survivors the potential to be triggered is always in flux, always dependent on everything else going on in your life, often set off by things that seem unrelated or irrational. Trigger warnings give someone a choice in that exact moment for what to do based on what they believe they can* manage. Yes, it may promote avoidance, but avoidance can increase feelings of agency that allow for reduced avoidance behavior in the future.
As an example from the great college campus syllabus trigger warning kerfuffle: I assign chapters from Durkheim’s Suicide in some seminars, as well as complementary readings with less obvious titles. My students get a warning about this ahead of time, but they don’t get to just skip that part of the class. Some things students have done: scheduled extra therapy sessions during those weeks, read in small groups in the library instead of isolated in dorm rooms, missed a class meeting and made up for it with office hours and a short additional assignment (so they didn’t out themselves to their peers with a panic attack in class). It’s about agency and self-assessment.
A screen with a suicide hotline number isn’t going to magically make someone ok with seeing suicide represented, but it offers an action the person can take to regain agency.
*Or just want to manage. Sometimes you’re just living your life and not super in the mood for exposure therapy, and if you can get your brain somewhere else for a while that’s a very good thing.
What do you propose as the solution, then? Without any up-front disclosure of the triggering content being present, how can anybody make the choice whether or not to expose themself to it?
Thank you.
A big part of why I have severe anxiety to this day is because I was exposed to traumatic things far too young/quickly. I was pushed into situations where I was not ready or emotionally/mentally equipped to handle. Constantly.
Exposure is only good if a person is ready for it. Desensitization is only helpful when you are equipped to handle such a thing.
I had an ex who would say that we were doing one thing, then take me to do something completely different, then boast that he was “helping me”, which only heightened my fears in the end. As a foil to that, I had an ex after that who was encouraging and supportive and kind, and gently led me into the same situations, where I knew what I was getting into. Guess how which one had me overcoming my fears?
Exposure works best if you are prepared for the exposure and have the support you need in those kind of situations.
I am always thankful for trigger warnings.
good points! this is a decent depiction of exposure therapy.
TW have an odd history. they originally were very useful, because one thing you forgot to mention about exposure therapy is all the work that needs to be done leading up to it. you have to have physical grounding skills in place before exposing someone to adverse stimuli.
so imagine you have severe PTSD from SA and a college class is gonna show a film that depicts it in an ugly scene. it could fuck up your whole semester to have traumatic stress symptoms come back unexpectedly. I’m talking panic attacks, flashbacks, mood disruption, difficulty controlling violent impulses, difficulty concentrating, difficulty connecting with others… PTSD can be wild.
so the prof might give a TW on the syllabus, so people just dont come in that day if they don’t wanna see it.
nowdays TW is just “here’s a thing you dont like!” not “here’s something that could potentially ruin your life again”
It makes a very positive difference, according to their lawyers.
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.
TBH, I think that’s why shows have this now. Fear of legal liability.
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.
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.
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.
I wish I could opt out of those messages. On streaming platforms that should be doable! (I really hate spoilers.)
