A black and white view of mirror on a deserted road

Support Scale, a Suicide Conversation Starter

Summer vacation sucks

We planned a whole week off for Brigita’s birthday. I usually look forward to our birthday getaways. This year was different. I am not quite sure if it is because COVID-19 cancelled both our train trip to Vienna and our plans to maybe visit Porto this summer. Hint: it is, partly.

Failure to manage expectations

Coronavirus stopped my dream of working for a B Corporation dead in its tracks, after months of anticipation. It had everything a creator could dream of, in a marvellous city. I had been studying Dutch again for more than a year in hopes of a chance like this one; a chance to turn my life around.

I have been looking for meaning in my professional life and can’t quite seem to find it. I can’t figure it out on my own. Am I not good enough? Am I too exigent? Is nobody doing good outside of big metropolises? Is there a niche market for the type of freelance work I am looking to do? Why would one become a freelancer in the COVID era…?


Speaking out; a.k.a. being a cry-baby

July 21st, Belgian National Day. On the verge of breaking down one fine sunny morning, I shared a cringe-worthy story with Miles’ assistance, it read:

Daddy’s spending his summer vacation wishing he was dead. Bummer.

Wonderful Alexandra (with whom I had the chance to visit Porto back in 2013) reached out to me, inquiring about my condition. Our little chat quickly lead me to Google some seemingly random words: Suicide Scale, i.e. “How does one quantify how much they think of death to friends, family and physicians?”

Suicide risk assessment

Most academics seem to refer to this concept as a suicide risk assessment. Turns out: there are dozens of scales out there, semantic (described with words) or not. That is all good and well, but at the end of the day how can a person in distress simply (almost passively) convey a message seeking assistance?

Emmengard’s Suicide Scale

Either the kind folks over at Emmengard have a strong SEO game, or maybe the humanity of their meta-description hit right where it should:

We recently lost a friend to suicide. Our best friend, Megan, and us, actually made this scale together years ago. We have used it to help each other through the toughest times. When it was really bad, we could just look at each other and say “What number?” and we always knew what the other one meant.

www.emmengard.com

This artist community suffering from Dissociative Identity Disorder published the aforementioned scale in the form of a comic.

The Suicide Scale Comic

The Suicide Scale is a comic from Emmengard featuring a practical suicide risk assessment tool.
The Suicide Scale Comic, © Emmengard, 2019

Trigger, the good kind

This strip really helped put into words how I felt. For weeks on end I remember describing my state of mind to my psychiatrist with the following idea:

Every single time I commute, twice a day, five days a week;
I visualise myself throwing my brand new car into a tree.

Who would have thought one could use a scale to accurately translate one’s absolute likelihood to take one’s own life? It got me thinking: what if I designed my own system and briefed my friends and family about it? What could make it easier and less cheesy than sob stories? What if I could stop resorting to the duality of a black or white background to portray a very limited state of mental health?


Support Scale

Introduction to Support Scale, my homemade suicide risk assessment scale

Support Scale is called like that for a reason: I’d rather focus on the positive outcome of its use. Support Scale is a series of story backgrounds created for Instagram. Somewhat following into Emmengard’s footsteps, it features 10 absolute levels of risk from 0 to 9. Whilst professionals recommend absolute values, I think that the comic is really handy to translate feelings into numbers. Sharing a whole comic in every story is not very practical. Referring to it and then sharing how you feel in absolute numbers is an absolute breeze, however.

Instagram gradients

From the publishing of this post, I will start using this tool publicly. Farewell, Instagram’s default gradients. 👋

0. Happiness

Support Scale starts at 0. Is it form over function? Maybe, but 0 also represents a level of momentary happiness that doesn’t include a single speck of suicide ideation.


1. Recovery

1 is for recovery. Things are looking up. Sure there may have been rough times and hardships, but things are moving forward. It is not quite being happy, but things are good and the subject is healing.

2. Humour

2 is for humour. Suicide is not a thought, unless it is being mentioned or joked about. Either way, the subject can laugh it off.


3. Sarcasm

3 is for sarcasm and cynicism. Exactly as thought by Emmengard, it usually occurs under stress load and crisis. Is a thesis or payment due? Coronavirus? Climate change? Police brutality? These events can quickly overwhelm the subject, leading to feelings of frustration, helplessness and cynicism.

4. Ideation

4 is for actual ideation. The matter is no longer a joke (or a stale one at best) and the subject is actually picturing ways to die on a daily basis. Distraction is still possible, however, and the subject is not obsessed with death.


5. Passive Death Wish

5 is for passive death wish. It is one step further than just ideating. Not only is the subject picturing ways to die, he/she/they might actually stay in danger’s way and not actively fight for survival.

6. Active Death Wish

6 is for active death wish. It is very similar to the previous level, but the subject is actively seeking ways to get hurt or die. The subject may become a daredevil or start unhealthy habits to achieve death without actually commiting suicide.


7. Actual Planning & Sourcing

7 is for planning. The subject is not only gathering info and resources but also designing a plan and road-map to take his/her/their life. At this level, the subject might already be in danger.

Software reaction in an ideal world: reconnect

Ideally, if this system was built in Instagram and other platforms, their app should implement an automatic software reaction to a level 7 story. An appropriate reaction could be to send both the writer and his/her/their close friends a simple notification encouraging them to reconnect with a close friend, as demonstrated here.


8. Closure & Farewells

8 is for closure and goodbyes. The subject has started settling accounts, getting rid of possessions or even saying goodbye. At this level, the subject is definitely in serious danger and might take action soon.

Software reaction in an ideal world: reach out

An appropriate reaction could be to send close friends an important notification encouraging them to take action by messaging or calling the subject in order to help, as demonstrated here.


9. Parting

9 is for taking leave. The subject is making or has just made an attempt to take his/her/their life. At this level, you should drop whatever you are doing and get to the person immediately or call emergency services with usable information. Don’t panic.

Software reaction in an ideal world: emergency

I am not sure there is any appropriate reaction to this level of emergency. My concept includes sending close friends an important notification encouraging them to call the subject and/or the emergency services, as demonstrated here.


How Instagram flags and handles suicidal publications

Instagram recommends calling emergency services immediately after somebody shares sensitive content with no delay. From my own experience contacting emergency services, especially under stress, I’d like to add that you should probably gather all the info you can get first and have it handy. Location, address, phone numbers, details, etc.

Instagram partnered with suicide prevention experts to understand the best ways to provide support. Instagram’s algorithm automatically flags publications with suicidal or depressive content to provide a first shield. Their team also recommends reporting posts when you see them on your feed. They will then send resources to the subject or even call the emergency services if there is immediate danger.

Could the Support Scale be implemented on social medias?

Implementing a solution like the Support Scale could actually let people self-report, helping the algorithm, helpers, and ultimately themselves. Not everyone will use it, of course. But maybe it could be a conversation starter for people with afflicted loved ones, encouraging them to let them know how they feel in an indirect way.

Read more about how Instagram handles self-injury.


Designing the Support Scale

When setting off to design the scale, I paid particular attention to a few important (and sometimes trivial) things.

  1. Scale: An absolute 10-step scale to map one’s feelings.
  2. Colours: Colours had to be both visually pleasing and translate one’s feelings.
  3. Accessibility: With 1+ billion users, based on statistics, more than 50 million Instagram users might not perceive colours the same way.
  4. Cues: Actually visualising the scale with more than colours, since one shouldn’t rely solely on colours to convey a message.

Colours & accessibility

In order to make the public subconsciously relate to the story, the colour scheme follows a pretty common shift in hue and luminescence, going from bright and calm colours to darker and sombre ones. This alone instantly translates the mindset of the user.

However, going from bright warm colours to darker colder ones wasn’t the best option for everyone. I, therefore, adapted one of the many genial sequential colour schemes offered by Paul Tol, an Instrument Scientist with a ton of work on colour perception.

Sequential colour schemes help to order data from low to high. This iridescent sequential scheme created by Paul, with a linearly varying luminance, also works for colour-blind vision. Two birds, one stone.

Finally, I set to use these colours as gradients, to both fit Instagram’s visual language and give the user some room for incrementation. Effectively speaking, these gradients go from one colour to the next, and kind of signify a range of feelings rather than just one. It could be understood as in: “Listen, I feel anywhere between 4 and 5 right now.” I, for example, usually hover around 5, with some peaks all the way to 7. My plan is there, I know what I need, but I still got things going on here that I just can’t leave. Namely Brigita and Miles.


Ressources & downloads

Availability

Whilst I designed the Support Scale for myself, I think everyone could benefit from such a tool. I am making it available to the public domain (Creative Commons CC0: No Rights Reserved). This means you, or even Instagram, may freely build upon, enhance and reuse this project for any purpose without restriction under copyright or database law.

I mean, if you love the project and want to give me credit or reward me with loads of money, it’s all fine by me. 😉 But I designed it for myself and the greater good. So take it and use it.

Downloads

CC0
To the extent possible under law, Grégory Rorive has waived all copyright and related or neighboring rights to Support Scale. This work is published from: Belgium.



Feedback

I came up with the idea from experience. But if you are a creator and actively have a very similar design in place I haven’t heard off, please let me know. Rest assured I didn’t steal the concept.

I also welcome constructive feedback from professionals: designers, psychologists, and academics; if they think the concept can be improved upon. I would love to hear from you to make the Support Scale useful and safer to use.


Notes

Emergency numbers

Australia: 000
China, Japan, Taiwan: 110
New Zealand: 111
European Union & worldwide (on mobile): 112
North America, Oceania, the Caribbean: 911
Many countries: 999

Suicide crisis lines

They’re all different, but usually looking up “Suicide” online will give you an option to reach your local lifeline through suicide.org.

Additional notes

Space for additional notes and feedback from the community.

P.S.: my dude(tte) from that rainy day on the Polleur highway bridge, I hope you’re still with us and doing better. 🤞

#TinyChanges

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