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The Suicide Rate is Going Up. Here’s What We Can Do to Stop It.

Dr. Christine Moutier of the American Foundation for Suicide Prevention continues our series "Big Thinkers on Mental Health" with ways society can combat the rising suicide trend.

Christine Moutier: Suicide is one of the leading causes of death in our country and actually in the world, and yet it's largely preventable. It has been trending up in terms of our national rate of suicide over the last decade or so. It had trended down prior to that. So we're at a place now where we really want to make a difference; we want to use the methods that we know can work to lower the suicide rate and allow those who are struggling to get the help that they need.

Mental health problems play a significant role for suicide risk. In fact if you had to pick out one of the many risk factors that tend to come together to create suicide, mental health problems could be called actually a necessary, but not sufficient factor in place. In greater than 90 percent of cases of suicide, as shown in the research, there is a diagnosable mental health condition at play, whether or not it was diagnosed or treated. Now, many other factors then lay on top of that to rise up to create an imminent risk for that sense of desperation, hopelessness, but then also the thought and the planning and the ability to act on those suicidal impulses.

It is really important to note that white males in their middle age account for about 70 percent of the death toll from suicide each year. And in fact over the last decade, the rate of suicide for that part of our population went up the most, it went up almost 30 percent. You can think about things like they are just as prone to mental health problems as any other segment of society, and yet they might be some of the folks in our society who are the least willing or able to seek help because of the social norms and frankly because men don't seek medical care as frequently as women do in general, let alone when it comes to mental health factors.

One other factor that's really important to understand is that for the baby boomer generation, that group as a cohort starting many decades ago actually had already shown an increased risk for mental health problems and suicide, addictions, and other psychosocial problems. Ten years ago, within the suicide-prevention world, which is a pretty specialized world, there were very limited activities going on, on a grassroots level. There were some and it was largely families who had lost a loved one to suicide. In our organization, for example, we went from a few people banning together to over 150,000 people walking, speaking out about their experience of even lived experience of having lived through suicidal thinking or attempts. That level of awareness raising and sort of shedding of the stigma is one of the signs of just the changing times and the readiness and the desire to make an impact on suicide.

Big Think and the Mental Health Channel are proud to launch Big Thinkers on Mental Health, a new series dedicated to open discussion of anxiety, depression, and the many other psychological disorders that affect millions worldwide.


In the third video in the series, Dr. Christine Moutier of the American Foundation for Suicide Prevention suggests several of the ways society can combat the rising suicide trend. Did you know white, middle-aged men are most at risk? What would it be like if mentally ill people got the treatment they needed before taking their lives? How would things be different if our opinions on suicidal tendencies changed overnight?

Does conscious AI deserve rights?

If machines develop consciousness, or if we manage to give it to them, the human-robot dynamic will forever be different.

Videos
  • Does AI—and, more specifically, conscious AI—deserve moral rights? In this thought exploration, evolutionary biologist Richard Dawkins, ethics and tech professor Joanna Bryson, philosopher and cognitive scientist Susan Schneider, physicist Max Tegmark, philosopher Peter Singer, and bioethicist Glenn Cohen all weigh in on the question of AI rights.
  • Given the grave tragedy of slavery throughout human history, philosophers and technologists must answer this question ahead of technological development to avoid humanity creating a slave class of conscious beings.
  • One potential safeguard against that? Regulation. Once we define the context in which AI requires rights, the simplest solution may be to not build that thing.

A new hydrogel might be strong enough for knee replacements

Duke University researchers might have solved a half-century old problem.

Photo by Alexander Hassenstein/Getty Images
Technology & Innovation
  • Duke University researchers created a hydrogel that appears to be as strong and flexible as human cartilage.
  • The blend of three polymers provides enough flexibility and durability to mimic the knee.
  • The next step is to test this hydrogel in sheep; human use can take at least three years.
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Hints of the 4th dimension have been detected by physicists

What would it be like to experience the 4th dimension?

Two different experiments show hints of a 4th spatial dimension. Credit: Zilberberg Group / ETH Zürich
Technology & Innovation

Physicists have understood at least theoretically, that there may be higher dimensions, besides our normal three. The first clue came in 1905 when Einstein developed his theory of special relativity. Of course, by dimensions we’re talking about length, width, and height. Generally speaking, when we talk about a fourth dimension, it’s considered space-time. But here, physicists mean a spatial dimension beyond the normal three, not a parallel universe, as such dimensions are mistaken for in popular sci-fi shows.

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Predicting PTSD symptoms becomes possible with a new test

An algorithm may allow doctors to assess PTSD candidates for early intervention after traumatic ER visits.

Image source: camillo jimenez/Unsplash
Technology & Innovation
  • 10-15% of people visiting emergency rooms eventually develop symptoms of long-lasting PTSD.
  • Early treatment is available but there's been no way to tell who needs it.
  • Using clinical data already being collected, machine learning can identify who's at risk.

The psychological scars a traumatic experience can leave behind may have a more profound effect on a person than the original traumatic experience. Long after an acute emergency is resolved, victims of post-traumatic stress disorder (PTSD) continue to suffer its consequences.

In the U.S. some 30 million patients are annually treated in emergency departments (EDs) for a range of traumatic injuries. Add to that urgent admissions to the ED with the onset of COVID-19 symptoms. Health experts predict that some 10 percent to 15 percent of these people will develop long-lasting PTSD within a year of the initial incident. While there are interventions that can help individuals avoid PTSD, there's been no reliable way to identify those most likely to need it.

That may now have changed. A multi-disciplinary team of researchers has developed a method for predicting who is most likely to develop PTSD after a traumatic emergency-room experience. Their study is published in the journal Nature Medicine.

70 data points and machine learning

nurse wrapping patient's arm

Image source: Creators Collective/Unsplash

Study lead author Katharina Schultebraucks of Columbia University's Department Vagelos College of Physicians and Surgeons says:

"For many trauma patients, the ED visit is often their sole contact with the health care system. The time immediately after a traumatic injury is a critical window for identifying people at risk for PTSD and arranging appropriate follow-up treatment. The earlier we can treat those at risk, the better the likely outcomes."

The new PTSD test uses machine learning and 70 clinical data points plus a clinical stress-level assessment to develop a PTSD score for an individual that identifies their risk of acquiring the condition.

Among the 70 data points are stress hormone levels, inflammatory signals, high blood pressure, and an anxiety-level assessment. Says Schultebraucks, "We selected measures that are routinely collected in the ED and logged in the electronic medical record, plus answers to a few short questions about the psychological stress response. The idea was to create a tool that would be universally available and would add little burden to ED personnel."

Researchers used data from adult trauma survivors in Atlanta, Georgia (377 individuals) and New York City (221 individuals) to test their system.

Of this cohort, 90 percent of those predicted to be at high risk developed long-lasting PTSD symptoms within a year of the initial traumatic event — just 5 percent of people who never developed PTSD symptoms had been erroneously identified as being at risk.

On the other side of the coin, 29 percent of individuals were 'false negatives," tagged by the algorithm as not being at risk of PTSD, but then developing symptoms.

Going forward

person leaning their head on another's shoulder

Image source: Külli Kittus/Unsplash

Schultebraucks looks forward to more testing as the researchers continue to refine their algorithm and to instill confidence in the approach among ED clinicians: "Because previous models for predicting PTSD risk have not been validated in independent samples like our model, they haven't been adopted in clinical practice." She expects that, "Testing and validation of our model in larger samples will be necessary for the algorithm to be ready-to-use in the general population."

"Currently only 7% of level-1 trauma centers routinely screen for PTSD," notes Schultebraucks. "We hope that the algorithm will provide ED clinicians with a rapid, automatic readout that they could use for discharge planning and the prevention of PTSD." She envisions the algorithm being implemented in the future as a feature of electronic medical records.

The researchers also plan to test their algorithm at predicting PTSD in people whose traumatic experiences come in the form of health events such as heart attacks and strokes, as opposed to visits to the emergency department.

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