In Defense of Psych Treatment for Attempted Suicide

A substantive, humane clinical argument for why society should psychiatrically treat suicide attempters -- written in explicit, respectful disagreement with Sister Y's pro-suicide-rights position. Scott grants the philosophical point (a 'perfect philosopher' might rationally choose death, and such cases may exist) but argues that in PRACTICE the overwhelming majority of real-world attempts are impulsive decisions made in a state where suffering has clouded rationality, and would and should fail a serious psychiatric assessment. His evidence: youth suicide (4% of teens, whose problems -- bullying, breakups, bad families -- are eminently 'wait-out-able'; 'it gets better'); the robust ~90%-of-suicides-have-a-mental-disorder finding (defended against Sister Y's critiques across controlled and prospective methodologies); concrete mechanisms (command hallucinations, psychotic depression's bizarre self-hatred, BPD's hours-long mood swings, alcohol's disinhibition, depression's intermittency -- avg episode <6 months); revealed and stated regret (most prevented attempters don't die by suicide; the Golden Gate jumper who 'instantly realized everything was fixable except having just jumped'; 911 calls from the victims themselves); and that treatment helps (CBT cuts at-risk suicide ~50%, the 72-hour-hold reality, lithium even in trace water-supply amounts). He corrects the One-Flew-Over-the-Cuckoo's-Nest image of psych wards and, in an EDIT, underlines that he's NOT claiming suicide is never rational -- only that the typical case lacks decision-making capacity and is helpable. Clinical authority married to careful, empirically-grounded, humane reasoning on a hard topic.

Quality 75 · Excellent. Low-Excellent (75): a strong, persuasive, empirically-grounded and humane treatment that genuinely changes how a careful reader weighs suicide intervention (the impulsivity/regret/treatability case vs the rational-philosopher idealization), backed by real clinical authority. Held at the Excellent threshold because it's a careful marshaling of evidence and argument within his clinical wheelhouse rather than a novel framework.

Claude’s paradigm shift 50 · Moderate. Moderate-to-Notable (50): the practical case -- separating the rare perfect-philosopher from the typical impulsive/disordered attempter, and foregrounding the regret and treatability data -- is a fresh, well-built synthesis on a contested question, though it draws on standard psychiatric findings.

Real-world impact 2 · Minor. A persuasive, empirically-grounded, humane clinical argument for psychiatrically treating suicide attempters (the impulsivity/regret/treatability case vs the rational-philosopher idealization). Real topical relevance to intervention ethics/practice, but a marshaling of evidence informing the debate with no material change — low RWI.