Thursday, November 6, 2008

Study: Having a Good Reason to Kill Yourself Increases Suicide Risk

A study out of Oxford University has found that prisoners with a lot to lose upon entering prison - ones who are married and employed prior to being imprisoned - are more likely to commit suicide than unmarried prisoners who were unemployed upon entering prison.

This is the expected result if suicide is a rational decision. But, for some reason, the researchers recommend increased investment in mental health services (coercive suicide prevention) for at-risk (married, employed) prisoners. Huh? Because if someone has a good reason to commit suicide, and therefore is at higher risk for committing suicide, he must be . . . crazy.

Other results of the study include the fact that serving a life sentence also increases the risk of death by suicide, as does living in a single cell (the latter, presumably, not just because of loneliness, but because it makes committing suicide easier in practical terms).

Mental health services - generally a euphemism for coercive suicide prevention tactics and other ineffective, humiliating practices - are the wrong solution to the "problem" of rational suicide. The idea that "mental health services" are the right thing to do to reduce suicides is ubiquitous, but it's important to point out failures of rationality like this.

Update: apparently chronic pain - especially head pain and pain in multiple areas of the body - also increases the risk of suicide.

7 comments:

  1. Interesting. Have you addressed the issue of the time- and situational-sensitivity of such suicidal impulses? I presume the risk of suicide in these cases spikes in the first couple of days/weeks of incarceration, but recedes with time, so that an inmate at (say) Day 200 would take himself to have been crazy for thinking at Day 1 that he had good reasons to kill himself (and be glad for the then-unwelcome counseling he'd received). Which "self" should prevail?

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  2. I've dealt with this a little bit, but I think it's an interesting question. I've talked about the idea of impulsive suicides, arguing that, given the existing barriers to suicide, a suicide that appears "impulsive" may actually reflect the genuine rational desires of the suicide. I've talked about the permanence of suicidality. I've talked about when it might be permissible to force someone to stay alive, including issues with temporary "derangement."

    What I'd like is for people to realize that "which self should prevail?" is a genuine question - it's not obvious that someone should be prevented from committing suicide because he will be happy about it afterward.

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  3. "'which self should prevail?' is a genuine question...."

    Yes it is.

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  4. There is a rationale behind this: if people commit suicide in prison they escape the rest of their punishment, thus it is in the interest of justice to prevent them from doing so. Assuming incarceration is meant solely as punishment. It also removes a potentially dangerous individual who thus ceases to be a danger to society (in case of violent crimes) so perhaps suicide in prison should be encouraged instead of prevented. At least this recommendation would result in more psychologists and psychiatrists employed in the legal system, which in these times of financial and economic crisis is a bonus.

    Truly: if you want a steady, high-paying job with an absolute minimum risk of getting fired (so much to do, so little time) and lots of opportunities for advancement I'd seriously consider psychiatry, psychology or social work. Everything is a sign of mental-illness these days! (even rationality) That's what you get when you abandon the scientific method and you rely solely on the authority of self-proclaimed experts to decide what belongs in category A (mental-illness) and what not. O tempora, o mores!

    Zara

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  5. Those who condemn suicide as nonrational or due to depression have not thought things through . Those who do are not insane, depressed ,cowards, or selfish necesarily. (unless you see looking after your self interest as selfish in a negative way)After charting your past, present, and future out it can be quite possible that nonconsciousness is better than an overall negative in living. (having a negative balance is worse than neutrality-nonexistence). To be rational is to bet on the most likely outcome and so you CAN objectivly chart it out and see what's in your self interest. If it makes someone sad that your dead, well is it your responsility to keep them happy? NO. That would be the truly selfish thing to expect. It's not cowardly either, considering most dont have the guts or discipline. And if someone's depressed prehaps its FROM thinking logically constantly.
    Rarly do they do it impulsivly, but instead after MUCH deliberation. Most of history's sages agree with me along with famous pyschiatrists such as Dr. Szasz. ( an acknowledged expert)People are never totally objective with themselves but they know thier own thoughts, intentions, actions, and capabilities better than any other.And so they are the most competent judge regarding themselves. Most dont like someone having the final say when it comes to their own body, thoughts etc. THEY know themselves better than you do! Mind your own business . I would never ask another to go on living because it would make ME feel better ! I didnt ask my father to and he killed himself when i was a child of 18. And now as an adult I realise its each to his own. People let emotions contol objectivity. WISE UP!!

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  6. I'm a mental health worker in a jail. 95% of what we do is not coercive and is much-wanted by the inmates - the chance to sit down with a well-intentioned person who listens to you is rare behind bars. "Increased mental health services" mostly means more hours with a well-intentioned person who listens.

    The suicide prevention piece is icky. When someone says they are thinking of killing themselves, our jobs are on the line if we do not put them on "mental health watch." This means being locked in a cell by yourself, wearing a smock, on camera. Some people find this preferable to life with a cellmate and will threaten suicide in order to spend a few days alone. But others with genuine urges to hurt themselves find the isolation and lack of clothes makes them feel worse. Eventually they get off of watch by telling us they feel better. Some of them probably do feel better after a few days of this (either from medication changes or just some internal change in brain chemistry). Others, I'm sure, lie when they tell us they no longer want to hurt themselves.

    It's stupid and painful to be part of, even from the side with the power. But it can be avoided. A clever and suicidal inmate would just never tell a mental health worker they intended to make an attempt. If you tell me you're suicidal, I have to put you in that cell alone. If you keep silent, you have more freedom to make your attempt, and I keep my job.

    Unfortunately, some of them are too addled to figure that out.

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    Replies
    1. Thanks so much for talking about your experience. Fuck, you have a really hard job that forces you to think about things almost everyone else can kind of just pretend don't exist. Sounds like you're one of the ones genuinely trying to help people in a Royally Fucked situation and I don't think it's delusional if you take a sense of meaning from that. <3

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