A non-profit that figured out how to massively cut suicide rates in Sri Lanka
80000hours.org
80000hours.org
> the suicide rate in Sri Lanka has dropped significantly. So, from 57 deaths per 100,000 population in ’95, it has dropped now to 17. This is a 70% reduction. So, it’s a very significant success, in fact the greatest decrease in suicide rate ever seen.
So the first thing we see is that 70% reduction amounts to the suicide rate dropping from 0.057% to 0.017%. That would still put Sri Lanka at or near the top (=most suicidal) according to Wikipedia [1], so I guess it's pretty significant; it's just that I always view relative percentages with suspicion ("we reduced the death rate by INFINITY percent!" "oh yeah you saved one life").
Second, if the rate of suicide decreased by 70% in 20 years, that doesn't mean that it can be 100% percent attributed to lack of pesticides (in fact, I cannot think of any scenario where that could be true). 20 years is a lot of time, especially in Asia, so I don't know, maybe it was just the improvement of the quality of life, or (mental) health-care? Edit: I hope the recording sheds more light on why they attribute any part of the drop to lack of pesticides...
Anyways, it's discouraging, and therefore I judge the title as "click-bait-y".
[1] https://en.wikipedia.org/wiki/List_of_countries_by_suicide_r...
[1] https://www.google.com/search?q=sri+lanka+gdp+per+person
> the suicide rate had increased dramatically after the introduction of highly hazardous pesticides into the agriculture
> in ’94, the most toxic insecticides [...] were banned [...] another very toxic pesticide [...] was banned in ’98, and further class two pesticides were banned in 2008 to 2011
So I guess it could be true but it's still making huge leaps of faith from the data.
Now, my moral value system doesn't classify suicide as negative, so I can't really agree with the premise of the article, yet I definitely support limitations on the availability and use of pesticides, e.g. to prevent children accidentially poisoning themselves etc.
I have a similar painpoint with this: even if their attempt at reducing suicide succeeded, they didn't help people much.
Assuming (as they have to) that the situation in Sri Lanka is the same or similar as with toxic pesticides, the only thing they achieved is make escaping that shitty situation harder, not making the lives better, by effectively reducing suicidal thoughts. The point they are trying to make that suicide is a spontaneuous/irrational decision hardly counts in a statistic like that.
How does it not??? If the suicide is a decision made under the influence of a 30-minute-long depressive episode, and outside that episode the person would prefer to live, how is preventing the suicidies by making them harder to perform spontaneously not making people's lives better? Why does it 'hardly count'?
If we are to believe that not much changed, there are still ~57/1000 people who have an episode so severe as to make them consider suicide, of which 40 are stopped by the mere abscence of a simple method, there are still 57/1000 people whose lifes are so bad they honestly consider suicide.
Additionally, the researches do not say the people are not depressed before committing suicide, the research says they consider suicide with that specific method for just 30 minutes prior to killing themselves, their lifes and state of mind outside that 30 minute timeframe is not considered. And my assumption is that their lives had been bad before considering suicide, but something pushed them over the edge.
> Restrictions on the import and sales of WHO Class I toxicity pesticides in 1995 and endosulfan in 1998, coincided with reductions in suicide in both men and women of all ages. 19,800 fewer suicides occurred in 1996-2005 compared to 1986 – 1995. Secular trends in unemployment, alcohol misuse, divorce, pesticide use and the years associated with Sri Lanka’s Civil war did not appear to be associated with these declines.
Here's another study[2]:
> Overall suicide mortality dropped by 21% between 2011 and 2015, from 18.3 to 14.3 per 100,000. The decline in pesticide suicides during this same period was larger than for overall suicides: from 8.5 to 4.2 per 100,000, a 50% reduction. This was accompanied by a smaller concurrent rise in non-pesticide suicide mortality with a 2% increase (9.9 to 10.1 per 100,000).
[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3154644/ [2] http://journals.plos.org/plosone/article?id=10.1371/journal....
Edit: having said that, yeah, I don't have any actual research experience, and the data does look pretty convincing - as in, banning pesticides probably does contribute to a reduction in suicides a non-trivial amount.
It's worth keeping in mind when people wonder how there could be so many people who reject certain scientific findings. A lot of the time it's a similar attitude - "I'm not going to bother looking at the studies, but I'm guessing the people who studied it didn't think of the problem that immediately cam to my mind, and as such their results are probably wrong."
Annie Duke talks about this in her latest book.
Then there are things like https://en.wikipedia.org/wiki/Parameter_identification_probl... and whole books like https://en.wikipedia.org/wiki/Causality_(book) examining the problem and its' difficulty.
Can you explain what you mean?
It's just a reflexive response for some people at this point.
>The decline in pesticide suicides during this same period was larger than for overall suicides: from 8.5 to 4.2 per 100,000, a 50% reduction
The way they picked these statistics just seems self serving to their thesis. Another way of looking at the same numbers is that the drop in pesticide suicides accounted for only 10.75% of the total drop in suicides.
The fact that this study focuses only on the immediate tool used to kill oneself rather than the plethora of long term contributing social factors that lead up to a suicide shows a willful ignorance of the root problems.
From the paper:
> The temporal changes in suicide do not appear to correspond with the period of civil war (1983-2002).[27] By the time of the outbreak of the civil war in 1983, Sri Lankan suicide rates were already extremely high – 37.6 per 100,000 in 1982. In subsequent years, suicide rates stabilised. The civil war was still in progress at the time suicide rates began declining in 1995. By the time of the ceasefire in 2002 rates had already halved, and suicides rates were relatively stable in the 3 years after the ceasefire.
They also link to studies showing that wars tend to be associated with decreased the rates of suicide.
>By the time of the outbreak of the civil war in 1983, Sri Lankan suicide rates were already extremely high
Civil wars don't just spontaneously start for no reason. They start because people have been unhappy for a long time.
Notice also that the suicide rate began peaking during the Elam War II phase of the civil war, a time of "unprecedented brutality", and then began declining at the time of the ceasefire.
"Suicide rates are thought to fall during wartime. Durkheim [1] suggested this was due to increased social cohesion, while others have suggested that competing outcomes may be important, with individuals who might otherwise have died by suicide being more likely to die of other causes [2]. Neeleman [3] cites this as an example of contextual effect modification, with suicide risk modified by the likelihood of dying of other causes.
Examples of reductions in suicide rates in times of war have been described for several time periods and cultures [4-9]. Marshall [10] argued that the reduction in suicide rates reflected a reduction in unemployment, a recognised risk factor for suicide [11], rather than a direct effect of war, an argument offered some support by Lester and Yang [12]. Stack [13] suggested that the suicide rate decreased as the proportion of the population employed in military roles increased."
>Conclusion: In contrast to the established view, our findings suggest that compared to both the pre-War and post-War periods there was an increased likelihood of suicide during the Second World War if the overall declining trend is taken into account.
Moreover, the argument of "increased social cohesion" against a foreign enemy is not applicable to a civil war, where social cohesion has completely broken down.
"the argument of "increased social cohesion" against a foreign enemy is not applicable to a civil war"
You'd get increased social cohesion among each of the ethnic groups which is in conflict with the other.
In any case this focus on the Sri Lankan civil war specifically isn't that interesting - I posted a review article above which includes controls and studies a wide range of cases across different countries, and concludes pesticide control has large effects.
FINDINGS: We identified 27 studies undertaken in 16 countries-five low-income or middle-income countries (Bangladesh, Colombia, India, Jordan and Sri Lanka), and 11 high-income countries (Denmark, Finland, Germany, Greece, Hungary, Ireland, Japan, South Korea, Taiwan, UK, and USA). Assessments largely focused on national bans of specific pesticides (12 studies of bans in six countries-Jordan, Sri Lanka, Bangladesh, Greece [Crete], South Korea, and Taiwan) or sales restrictions (eight studies of restrictions in five countries- India, Denmark, Ireland, the UK and the USA). Only five studies used optimum analytical methods. National bans on commonly ingested pesticides in five of the six countries studied, including four studies using optimum analytical methods, were followed by reductions in pesticide suicides and, in three of these countries, falls in overall suicide mortality. Greece was the only country studied that did not show a decrease in pesticide suicide following a ban. There were no high-quality studies of restricting sales to people for occupational uses; four of the seven studies (in three of the five countries studied-India, Denmark, and the USA) showed sales restrictions were followed by decreases in pesticide suicides; one of the two studies investigating trends in overall suicide mortality reported a fall in deaths in Denmark, but there were also decreases in suicide deaths from other methods.
INTERPRETATION: National bans on highly hazardous pesticides, which are commonly ingested in acts of self-poisoning, seem to be effective in reducing pesticide-specific and overall suicide rates. Evidence is less consistent for sales restrictions. A worldwide ban on the use of highly hazardous pesticides is likely to prevent tens of thousands of deaths every year."
You're right that relative percentages are sometimes a bit dubious (and even in this case you'd fluctuations on the order of 1/sqrt(57) = ~13 percentage points) but 57 is high enough that it actually has some meaning.
I think you're out-of-line here.
It's fine to be suspicious of relative percentages, but that just means you need to dig into the numbers to understand it.
In this case underlying numbers are huge... With a population of 22 million, this is a drop from about 12,500 suicides to around 3,700 per year. And, the suicide rates themselves are high as your own source points out, so a large proportionate change is quite significant from that perspective as well. Your argument would make sense for a similar proportionate change for a country near the bottom of of the wikipedia list, but not the top.
To your second point, yes, it's hard to have complete certainty (there's no way to ethically or morally test something like this in a scientifically rigorous way) but they do attempt to account for other factors.
It's not like people shouldn't try to reduce suicide rates and attempt to measure the results of those efforts the best they can, simply because they can't have rigorous certainty in those measurements.
About a fifth of the world's suicides are done by drinking pesticides. When removing that alternative, people turn to less effective methods. Those that fail are unlikely to try again.
Very eye-opening.
Is there data on this? The article mentions that most people contemplate the decision for less than 30 minutes, so if pesticides aren't accessible they literally might not try anything else. (Or by "less effective methods", you might just mean they are less likely to complete suicide, which is true.)
As they say:
> Leah Utyasheva: Exactly. The research shows that it is in majority of cases with pesticide self poisoning, it is an impulsive event, and people think for less than 30 minutes before actually poisoning themselves, less than 30 minutes. And this of course, is a life altering event. And the other thing is that apart from low planning, it is also low repetition event. Less than 10% of people who tried killing themselves will go on to try to do it again.
Even if the statistics is accurate.
Even if denying people the right to self-determination is a positive in your ethical system.
Even if X, Y, Z are true... I still have to ask: what about the COST? Pesticides exist because they do something useful - kill off pests. They increase food production and decrease labor.
What if we've saved some lives...but also made 200,000 farmers each spend an extra five hours a week bent over in their fields, picking bugs off leaves? Or made them plant more land in order to harvest the same amount of food?
You are not denying people right to self-determination, in any way. If someone really wants to have a suicide method handy so that they can commit suicide immediately when they feel the impulse, you can buy it ahead of the time.
> What if we've saved some lives...but also made 200,000 farmers each spend an extra five hours a week bent over in their fields, picking bugs off leaves? Or made them plant more land in order to harvest the same amount of food?
Do you have any reason to think any of that is true? If you have to go to a specialist shop to buy pesticide instead of the grocery store where it's right next to your food; or if you have to use pesticide that's slightly more expensive but not toxic to humans, suddenly it's like you need to pick bugs off leaves?
Measuring costs is a fine idea; and 80000 hours definitely do that. Making up costs just to seem contrary is something completely different.
I believe the rate has decreased mainly due to improved education, and other suicide prevention services by NGOs, not because of the lack of availability of pesticides.
> So, what he suggested is that radically new approach to the problem. He says instead of telling people to stop having accidents, and become better drivers, he suggested that, “Let’s accept that traffic accidents, road accidents will happen, but let’s minimize the harm from them.”
Tangent: it's interesting how this suggests that getting people to drive less was not an option in this discussion (which is the most appropriate analogy to banning really toxic pesticides, I would say). Yet that was one of the major factors behind why the Netherlands switched to a policy of encouraging other means of transportation, and why we ended up with our bike infrastructure (ignoring that the Netherlands also has the geographical advantage here, being small, flat and typically with compact cities).
Who is 80,000 Hours?
https://en.wikipedia.org/wiki/80,000_Hours
"[80,000 hours is]...one of the nonprofits funded by startup accelerator Y Combinator in 2015...William MacAskill is the Founder and President of 80,000 Hours..."
Who is William MacAskill? https://en.wikipedia.org/wiki/William_MacAskill
He is a proponent of Effective Altruism https://en.wikipedia.org/wiki/Effective_altruism
For an article that says it will cover " What types of events are causing people to have the crises that lead to attempted suicide?"
All the commentary we have is this:
> "Robert Wiblin: Do you know what kinds of events are causing people to have these crises and attempt suicide?
> Leah Utyasheva: Well, as I said, quite often it is a cry for help. It is the acceptability of using suicide as means of solving certain life problems. For example, if a child is having, a student is having problems at school, or an old person feeling sick, or a couple argues. So, all this could lead to an attempted suicide. And quite often, as I said, people just need a little bit more time to think about it, and then maybe they decide that this is not a good solution to their problems.
Then they move on. That doesn't sound like a very robust discussion around the real problem.
More importantly, for such a lengthy discussion about pesticide use, nobody speaks about who benefits from switching pesticides.
Leah informs us that: "I must point out that the United Nations and the WHO agencies are highly behind this, and they are supportive of the ban of the most hazardous substances. There are a lot of guidelines and tools developed to find out what alternatives to highly hazardous pesticides are available, and what other substances or agricultural production methods could be used instead of highly hazardous pesticides."
We have an enormous amount of posturing without a single mention of what the replacement pesticide should be. It sounds more like the UN and WHO woud like some kind of "moral" ground to push their own agenda.
I find it all very disingenuous.