Monday, December 05, 2022

A review of citations to "Recalculating the economic cost of suicide" by Yang and Lester





David Lester & Bijou Yang


          Abstract: An analysis of 91 citations for an article by Yang and Lester (2007), which argued that suicides result in savings to the society, showed that only 9 reported Yang and Lester’s thesis correctly, and only one article conducted a serious discussion of the issues raised by Yang and Lester.




          Viscusi (1984) argued that the financial savings from the premature deaths of those who smoke cigarettes (as a results of reduced nursing home care costs and pension and social security payouts) were greater than the costs of medical care and life insurance. Viscusi calculated that each pack of cigarettes sold saves the society $0.72.


          Yang and Lester (2007) applied Viscusi’s arguments to those who die by suicide. Suicides results in savings from healthcare and nursing home costs later in life, as well as pension and social security payouts. When estimating the loss from future earnings by suicides, researchers typically forget that suicides may not be the most productive members of society. Many psychiatric researchers (e.g., Robins, 1981) argue that almost all suicides merit a psychiatric diagnosis, often a severe and disabling psychiatric disorder, and so their future earnings may be far lower than those of average citizens. Their psychiatric disorder may also incur large economic costs for psychiatric treatment had they lived.


Yang and Lester estimated the cost of suicides in 2005 in the USA to be $16.83 billion, the savings from not having to treat the psychiatric disorders of the suicides had they continued to live to be $8. 11 billion, the savings from pensions and nursing home care to be $12.99 billion, and the savings from assisted suicide to be $0.80 billion, giving a net savings from the suicides to be $5.07 billion in 2005 dollars.


          As of the time of writing this article, Yang and Lester (2007) had 91 citations noted in Google Scholar. That seems to be impressive. The present review examined these 91 citations to see how they cited Yang and Lester.


Reviewing the Citations


Google Scholar examines a variety of writings for citations, including, of course, articles in scholarly journals and books, but also dissertations, blogs and unpublished papers uploaded to websites such as ResearchGate. This is an impressive achievement, but Google Scholar citations are, therefore, not restricted to scholarly publications.


Thirteen of the citations were not in English and so not examined for this review. Five authors simply included a reference to Yang and Lester is a list of references without mentioning the article in the text, and two “citations” did not contain any reference to Yang and Lester.


          On six occasions, the same article was included twice, for example, as a pre-print on a university website and as the published article.


          Seven articles misquoted Yang and Lester. For example, Savage (2018) said that Yang and Lester discussed the rationality of suicide. This was not the focus of Yang and Lester. Other misquotes were made by Fredette (2014), Li and Zhang, (2010), Ring, et al. (2015), Rivera, et al. (2017), Saleh (2016), while others simply included a non-specific citation to Yang and Lester in a series of cites, such as 1-21 (Poduri, 2016).


Yang and Lester reviewed briefly research on the estimated costs to the society of attempted suicide, although Yang and Lester did not present new calculations, and 20 articles quoted Yang and Lester for the estimated costs of attempted suicide (Barrigan, et al., 2022; Bolton, et al., 2015; Brann, et al., 2021; Francisco, et al., 2020; Ghahramanlou-Holloway, et al., 2012; Gysin-Maillart, et al., 2016;  Keefner & Stenvig, 2021; Kim, et al., 2022; Kochanski, 2012; Lee, 2016; Lynch, 2014; Mickle, 2011; Milner & De Leo, 2010; Murrell, et al., 2014; Myrick, et al., 2017; Polits, 2016; Rothes, 2014; Sheftall, et al., 2013; Shepard, et al., 2016; Woodland, 2014).


Twenty authors cited Yang and Lester for saying completed suicide incurs costs for the society, which is the opposite of what Yang and Lester argued (Bermeo, 2019; Bolton, et al., 2015[1]: Brann, et al., 2021; Dunn, 2013; Johnston, 2013; Kim, et al., 2022; Kirigia, et al., 2020; Layden, 2017; Lynch, 2014; Moutier, 2014; Murphy, et al., 2021; O’Brien, 2010; Onoya, et al., 2021; Rothes, 2014; Sand, 2012; Sels, et al., 2021; Sheehan, et al., 2019; Singer, et al., 2022; Tondo, et al., 2008; Vannoy[2], et al., 2010). These 20 authors do not appear to have understood Yang and Lester’s thesis.


Kinchin and Doran (2017, 2018) looked at the cost of suicide in Australia. As well as calculating the cost of the legal and medical procedures following a suicide (direct costs), they also estimated the loss of economic productivity resulting from the lost years of life, but they admit that they ignored the savings discussed by Yang and Lester. A similar tactic of ignoring the essence of Yang and Lester’s analysis was made by Shepard, et al. (2016)[3] and Alfonso-Sánchez, et al. (2020). Others simply ignored Yang and Lester without mentioning that they were ignoring their argument (Lyszczarz, 2021).


Seven authors cited Yang and Lester correctly, admitting that suicides can result in an economic benefit for the society (Gunn, 2019; Ohayi, 2019; Snow, et al., 2016; Sueki, 2016; Torp, 2014; Ying & Chang, 2009; Zak, 2015). Luckily, two self-citations also correctly reported the results of Yang and Lester. Two more researchers cited the thesis of Yang and Lester correctly and did additional calculations (see the next section).


Research on the Economic Cost of Suicide


Sarma (2018) estimated the economic cost of suicides in India is 2015 and did consider both economic losses and gains resulting from those suicides, but he calculated that the losses far exceeded the gains.


The most complete discussion of Yang and Lester’s article was made by Stack (2007). Stack drew attention to three issues. First, although it is true that suicides, by dying at a younger age than those dying from other causes, save on the direct costs of healthcare (medical and psychiatric), the longer people survive, the more healthcare jobs created. In this regard, suicides incur a cost to the society.


Second, the costs incurred by those grieving for those who died by suicide may differ from the costs incurred by those grieving for those dying of other causes. Stack noted that suicides are typically sudden deaths, a factor which may affect grieving. On the other hand, suicides typically have smaller social networks than those dying from other causes, and so there are fewer people grieving.


Third, Stack argued that Yang and Lester overestimated the costs of healthcare for suicides. In his discussion, Stack focused on what percentage of suicides sought mental health treatment in the last year of their life. However, Stack also noted that the average age at death was 45 for suicides, and so they avoid roughly 30 years of life. It is during these 30 years that healthcare costs may be large.




          The present analysis of citations to our article indicates that citations may not be a valid measure of the significance of an article. Only nine researchers cited Yang and Lester’s article correctly, and only one (Stack, 2007) conducted a serious discussion of the issues raised by Yang and Lester. In the years since 2007, the thesis of Yang and Lester’s article has died a natural death.




Alfonso-Sánchez, L., Martin-Moreno, J. M., Martinez, R. M., & Martinez, A. A. (2020). Epidemiological study and cost analysis of suicide in Spain. Archives of Suicide Research, 24, S356-S369.

Barrigan, M. L., Porras-Segovia, A., Courtet, P., et al. (2022). Smartphone-based ecological momentary intervention for secondary prevention of suicidal thoughts and behavior. BMJ Open, 12, e051807.

Bermeo, M. I. T. (2019). Understanding self-harm behaviour in older adults. PhD dissertation, Keele University, UK.

Bolton, J. M., Walld, R., Chateau, D., Finlayson, G., & Sareen, J. (2015). Risk of suicide and suicide attempts associated with physical disorders. Psychological Medicine, 45, 495-504.

Brann, K. L., Baker, D., Smith-Millman, M. K., Watt, S. J., & DiOrio, C. (2021). A meta-analysis of suicide prevention programs for school-aged youth. Children & Youth Services Review, 121, #105826.

Dunn, E. (2013). The influence of belief in a positive afterlife on youth suicide in a Northwestern Ontario First Nation. PhD dissertation. Walden University.

Francisco, A. P., Motta, G. L. C. L., Zortea, F., et al. (2020). Lower estimated intelligence quotient is associated with suicide attempts in pediatric bipolar disorder. Journal of Affective Disorders, 261, 103-109.

Fredette, G. J. (2014). Tribulations and tears. MA thesis. University of Manitoba, Canada.

Ghahramanlou-Holloway, M., Cox, D. W., & Greene, F. M. (2012). Post-admission cognitive therapy. Cognitive & Behavioral Practice, 19, 233-244.

Gunn, J. F. III (2019). Suicide in younger and older adults.  PhD dissertation, Montclair University.

Gysin-Maillart, A., Schwab, S., Soravia, L., Megert, M., & Michel, K. (2016). A novel brief therapy for those who attempt suicide. PLOS Medicine, 13(3), e1001968.

Johnston, A. K. (2013). Suicidality in Australia. PhD dissertation, University of New South Wales, Australia.

Keefner, T. P., & Stenvig, T. (2021). Suicidality. Issues in Mental Health Nursing, 42, 227-238.

Kim, M. J, Lee, H., Shin, D., Hong, M., Rhee, S. J., Park, J. I., & Ahn, Y. M. (2022). Effect of attitude toward suicide on suicidal behavior. Psychiatry Investigations, 19, 427-434.

Kim, S., Jeon, H., & Park, J. (2022). The association of physical and mental illness and self-harm resulting in hospitalization. International Journal of Environmental Research & Public Health, 19, #8303.

Kim, Y. J. (2009). Influential factors on adolescent’s suicidal behavior. MSci thesis, University of Texas at Arlington.

Kinchin, I., & Doran, C. M. (2017). The economic cost of suicide and non-fatal suicide behavior in the Australian workforce and the potential impact of a workplace suicide prevention strategy. International Journal of Environmental Research & Public Health, 14, #347.

Kinchin, I., & Doran, C. M. (2018). The cost of youth suicide in Australia. International Journal of Environmental Research & Public Health, 15, #672.

Kirigia, J. M., Muthuri, R. D. K., & Muthuri, N. G. (2020). The monetary value of human lives lost to suicide in the African continent. Healthcare, 8, #84.

Kochanski, K. (2012). Characteristics of living and deceased suicidal military personnel based on single versus multiple suicide attempt status. MSci thesis, Uniformed Services University.

Layden, B. K. (2017). Structured professional assessment and management of self-directed violence (SDV). PhD dissertation. Simon Fraser University, Canada.

Lee, B. X. (2016). Causes and cures IX. Aggression & Violent Behavior, 30, 110-114.

Li., N., & Zhang, J. (2010). Influencing factors for depression among Chinese suicide survivors. Psychiatry Research, 178, 97-100.

Lynch, F. L. (2014). Population health outcome models in suicide prevention policy. American Journal of Preventive Medicine, 47, S137-S143.

Lyszczarz, B. (2021). Production losses attributable to suicide deaths in the European Union. BMJ Public Health, 21, #950.

Michel, K., Valach, L., & Gysin-Maillart, A. (2017). A novel therapy for people who attempt suicide and why we need new models of suicide. International Journal of Environmental Research & Public Health, 14, #243.

Mickle, T. A. (2011). LGB youth suicide risk. MA thesis, St Mary’s College of California.

Milner, A., & De Leo, D. (2010). Who seeks treatment where? Journal of Nervous & Mental Disease, 198, 412-419.

Moutier, C. (2014). Tactics of the war on suicide. Depression & Anxiety, 31, 961-963.

Murphy. L., Lyons, S., O’Sullivan, M., & Lynn, E. (2021). Risk factors for suicide among people who use drugs. HRB Open Research, 3, #45.

Murrell, A. R., Al-Jabari, R., Moyer, D., Novamo, E., & Connally, M. (2014). An acceptance and commitment therapy approach to adolescent suicide. International Journal of Behavioral Consultation & Therapy, 9(3), 41-46.

Myrick, A. C., Webermann, A. R., Langeland, W., Putnam, F. W., & Brand, B. L. (2017). Treatment of dissociative disorders and reported changes in inpatient and outpatient cost estimates. European Journal of Psychotraumatology, 8(1), #1375829.

O’Brien, R. M. (2010). Offender trajectories, crime trends, and costs. Criminology & Public Policy, 9, 313-319.

Ohayi, S. R. (2019). “Doctor, please don’t say he died of suicide.” Egyptian Journal of Forensic Sciences, 9, #48.

Onoya, E. D., Makwakwa, N. L., & Motioba, D. P. (2012). Temporal variation in suicide in peri-urban Pretoria. South African Family Practice, 63(1), e5260.

Poduri, G. S. Short-term cost of suicides in India. Indian Journal of Psychological Medicine, 38, 524-528.

Polits, M. (2016). Factors that affect recidivism for psychiatric patients in the emergency department. PsyD thesis, George Fox University.  

Ring, M., Walther, S., & Gysin-Maillart, A. (2019). The association between therapeutic alliance and individuals’ wish to die or live. Psychology, 10, 1711-1725.

Rivera, B., Casal, B., & Currais, L. (2017). Crisis, suicide and labour productivity losses in Spain. European Journal of Health Economics, 18, 83-96.

Robins, E. (1981). The final months. New York: Oxford University Press.

Rothes, I. M. S. A. 2014). Suicidal behaviours: explanations, current practices and difficulties of health professionals and the impact of a patient suicide. PsyD dissertation, University of Porto, Portugal.

Saleh, S. N. M. (2016). A novel dynamic feature selection and prediction algorithm for clinical decisions involving high-dimensional and varied patient data. PhD dissertation, Aston University, UK.

Sand, E. C. (2012). An examination of the effect of nostalgia on risk factors for suicide. MSc thesis, North Dakota State University.

Sarma, P. G. (2018) Financial aspect of Indian suicides in 2015. Indian Journal of Psychological Medicine, 40, 201-204.

Savage, D. A. (2018). A rational choice to die. University of Newcastle, Australia.

Sels, L., Homan, S., Ries, A., Santhanam, P., et al. (9021). SIMON: A digital protocol to monitor and predict suicidal ideation. Frontiers in Psychiatry, 12, #554811.

Sheehan, C. M., Rogers, R. g., & Boardman, J. D. (2015). Postmortem presence of drugs and method of violent suicide. Journal of Drug Issues, 45, 249-262.

Sheftall, A. H., Mathias, C. W., Furr, R. M., & Dougherty, D. M. (2013). Adolescent attachment security, family functioning, and suicide attempts. Attachment & Human Development, 15, 368-383.

Shepard, D. S., Gurewich, D., Lwin, A. K., Reed, G. A., & Silverman, M. M. (2016). Suicide and suicidal attempts in the United States. Suicide & Life-Threatening Behavior, 46, 352-362.

Singer, S., Sievers, L., Scholz, I., Taylor, K., Blanck, J., & Maier, L. (2022). Suicidal ideation and attempts in adults seeking outpatient psychodynamic psychotherapy. Clinical Psychology & Psychotherapy, in press.

Snow, C. E., & Abrams, R. C. (2016). The indirect costs of late-life depression in the United States. Geriatrics, 1, #30.

Stack, S. (2007). Societal and economic costs and benefits from death. Death Studies, 31, 363-372.

Sueki, H. (2016). Willingness to pay for suicide prevention in Japan. Death Studies, 40, 283-289.

Tondo, L., Lepri, B., & Baldressarini, R. J. (2008). Suicidal status during antidepressant treatment in 789 Sardinian patients with major affective disorder. Acta Psychiatrica Scandinavica, 118, 106-115.

Torp, E. (2014). Development of YLL due to suicide in young people in Norway. Master’s thesis. University of Oslo, Norway.

Vannoy, S., Whiteside, U., & Unützer, J. (2010). Current practices of suicide risk management protocols in research. Crisis, 31, 7-11.

Viscusi, W. K. (1984). Cigarette taxation and the consequences of smoking. Cambridge, MA: NBER.

Woodland, J. M. (2014). Native American youth and suicide. PhD dissertation, Widener University.

Wortzel, H. S., Gutierrez, P. M., et al. (2010). Surrogate endpoints in suicide research. Suicide &Life-Threatening Behavior, 40, 500-505.

Yang, B., &Lester, D. (2007). Recalculating the economic cost of suicide. Death Studies, 31, 351–361.

Ying, Y. H., & Chang, K. (2009). A study of suicide and socioeconomic factors. Suicide & Life-Threatening Behavior, 39, 214-226.

Zak, D. (2015). Mental Health—An Issue Neglected by European Public Health Systems? In D. Claborn (Ed.) Topics in public health.


[1] Already cited above.

[2] Vannoy, et al. (2010) and Kim (209) had the authors’ names incorrect.

[3] Already listed above.

Thursday, January 27, 2022

Predatory journals: Do they really exist?


Predatory Journals: Do They Really Exist?


David Lester


          We read a lot about predatory journals. This seems to mean that they charge large amounts of money for your article to appear in them. It does not mean that the articles are not reviewed, but it does mean that the articles may not be listed in the abstracts of the disciplines that provide listings and abstracts of published articles (such as PsycInfo).


          But are the other, high prestige, journals non-predatory? I just submitted a brief article to a high prestige publisher which publishes hundreds of journals. The journal was open-access, and the charge would have been $900. I continued with the submission because, in this instance, the charge was waived.


          High prestige journals charge for open access articles. Predatory journals charge for open access articles. There really is no difference. If you want open access for your article, you will have to pay, period. On occasions, I receive requests for submissions from the predatory journals saying that the charges are waived and, as a result, I have published in those journals. In the present instance, the high prestige journal waived the publication charge and, so again, there really is no difference in their behavior.


          The difference is that you can get an article published without charge in the high prestige journals if you reject open access. Of course, you may have to wait two years or more for it to appear!!!

Tuesday, December 07, 2021

How to Contact Me

 If you want to contact me, my e-mail is


Suicide Studies


Suicide Studies

          I recently started “publishing” some of my essays and research in a self-published journal which I have called Suicide Studies. I published two issues in 2020, four in 2021, and already one for 2022. Some of the articles are not good enough for scholarly journals (especially since Psychological Reports changed hands and stopped accepting one-page notes). But another reason was that, at my advanced age, I no longer have the patience to deal with fussy editors and reviewers. I much prefer to let my co-authors deal with them.

          The issues of Suicide Studies are loaded on to my website ( and also on ResearchGate.

          However, this is not the first time I have had my own scholarly journal When I was working for the Suicide Prevention and Crisis Intervention Center in Buffalo [NY] during 1969-1971, I started my own journal called Crisis Intervention. My boss, Gene Brockopp, and I sent the issues free to every suicide prevention center in the USA at the time and to leading suicidologists. I published 4 issues each year, and also supplements. One of the supplements became the first edition of Why People Kill Themselves, published by Charles Thomas. The book had four editions. In addition, many of the essays in the journal were included in the manual for crisis interveners, also published by Charles Thomas as Crisis Intervention and Counseling By telephone {3 editions].

          All of the issues of Crisis Intervention (plus supplements) are also loaded on to my website.


Thursday, December 02, 2021

Aaron T. Beck


Aaron T. Beck

The Economist of November 13, 2021 contained an obituary for Aaron Beck, who died on November 1, aged 100. One has to be special to merit an obituary in The Economist, and Tim was special. In the late 1900s, almost every article on depression cited publications by Tim. The Beck Depression Inventory was and still is widely used in research and clinical settings. After Albert Ellis’s initial contribution, Tim was the major developer of cognitive therapies and, in addition, he made major contributions to suicidology.

I was fortunate to meet and work with Tim in the 1970s. He organized and hosted a symposium, closed to outsiders, which resulted in a book, The Prediction of Suicide, published in 1974. We published the Hopelessness Scale which, as of today, has 7,002 citations.

Beck, A. T., Weissman, A., Lester, D., & Trexler, L. The measurement of pessimism: the hopelessness scale. Journal of Consulting & Clinical Psychology, 1974, 42, 861-865. 

We also worked together on papers suggesting how to overcome the problem of the use of substitute subjects in suicidology, that is, the use of attempted suicides to learn about those who died by suicide.

Lester, D., Beck, A. T. & Trexler, L. Extrapolation from attempted suicides to completed suicides. Journal of Abnormal Psychology, 1975, 84, 563-566. 

Lester, D., Beck, A. T. & Mitchell, B. Extrapolation from attempted suicides to completed suicides: a test. Journal of Abnormal Psychology, 1979, 88, 78-80.

More than this, Tim was an incredibly warm, modest and friendly person. The Economist noted that “By the end of his life, nothing daunted his positive outlook.” It was a pleasure and an honor to know Tim.


Saturday, August 21, 2021

Keeping up with research on suicide


David Lester

          My reviews of suicide research and theory spanned the years 1887 to 1997, and then I stopped because the volume of papers became too great if I wanted to peruse every paper, chapter and book on suicidal behavior. Retirement can be boring at times. Maybe I could take up my reviews in my retirement?

          How many papers were published with suicid* in the title in 1998. PsycInfo gave me 571 items, PubMed 934 items, Sociological Abstracts 196 items, Criminal Justice Abstracts 73 items, Criminology Collection 136 items, and Business Source Premier 105 items.

          That is why I stopped in 1997!

Thursday, August 05, 2021

Police officer suicides after the Capitol riot


Police Officer Suicides after the Capitol Riot

David Lester

          On January 6, 2021, hundreds of people, urged on by Donald Trump, stormed the United States Capitol in Washington DC to prevent congress from certifying the election results. The Capitol and Metropolitan police departments were unprepared for this attack. The Capitol was breached, and massive damage occurred. The police officers there managed to protect the senators and members of congress from harm. However, the police officers were assaulted. During the riot, about 140 police officers were injured and, afterwards, 15 officers were hospitalized. So far, four police officers involved in protecting the Capitol have died by suicide. Only limited information is available on these four individuals.

          Capitol Police Officer Howard Liebengood on January 9. He was 51 and a 16-year veteran of the department. He was married and had been a racing car driver before joining the Capitol Police. Liebengood looked up to his father, Howrd S. Liebengood Sr.,  who served from 1981 to 1983 as Senate sergeant at arms, charged with ensuring security in the Capitol and Senate buildings, as well as protecting members of the Senate. After the riot, Liebengood was assigned to lengthy shifts for the next three days and became sleep deprived. He killed himself after the third shift.


          Washington DC police officer Jeffrey Smith died by suicide by suicide on January 15. He was 35 and a 12-year veteran of the department. He shot himself with his service revolver in his car on the George Washington Parkway after being ordered back to work. At the riot, he was punched and hit in the head with a flying metal object (a metal pole). In subsequent days, he was assigned to guard a hotel, but he refused to remove his helmet for fear of being hit in the head. His sergeant sent him to the Police and Fire Clinic where he was prescribed ibuprofen and sent home. At the follow-up a week later (on January 14), there was no assessment made of his mental state. Smith had no history of depression or mental illness prior to the riot.

          Washington DC police officer Kyle DeFreytag died by suicide on July 10. He was 26 years old and had been on the force for four years (since 2016) and was assigned to the department’s Emergency Response Team within the Special Operations Division. An online obituary for DeFreytag said he “liked hiking, camping, riding his motorcycle, he liked traveling and playing the drums, he enjoyed trying different ethnic foods and always knew the best places to eat…..Kyle was kind, he had a quick wit and a great sense of humor & kept us laughing for 26 years.”

          Washington DC police officer Gunther Hashida, an 18-year veteran of the Washington DC department (since 2003), died by suicide at his home on July 29. Hashida was a Japanese American, with Japanese and German heritage. He had served in the military before becoming a police officer. He was 43 years old (almost 44), married (for 17 years) with three children. His wife was a licensed practical nurse who worked in oncology. He was assigned to the department’s Emergency Response Team within the Special Operations Division.

Speculations on These Suicides

          There is very little information available on these four men and, therefore, we can only speculate about the causes of their suicides. Those responding to the attack reported physical abuse and racial slurs. The officers responding to the attack have reported severe psychiatric symptoms since the riot.

"Four law enforcement officers testified last week about their harrowing, and in some cases, near deadly experiences responding to the riot. “That day continues to be a constant trauma for us literally every day, whether because [of] our physical or emotional injuries or both,” Capitol Police sergeant Aquilino Gonell told a select committee investigating the attack." (Solender, 2021)[1]

It is clear that most of the police officers involved in the riot control have experienced full PTSD or symptoms of PTSD, a risk factor for suicide.

          The police departments appeared to have had no provision for providing counselling and other treatments for their officers under stress. Ibuprofen is not a treatment for suicide risk! Hopefully, the departments have learned from this experience.

         Only one report of the method used for suicide was found. Jeffrey Smith used a gun and was away from home. That is a typical scenario for police officers who die by suicide. (Car crashes are another common method.)

          Hashida died by suicide at home, and the location of the other two suicides has not been reported. The location of the suicide is important. If Hashida, and perhaps the other two officers, died by suicide at home, then they would be discovered by their wife or children. If they shot themselves, then the scene would be extremely traumatic. (Hanging would also create a traumatic scene.) It is, therefore, interesting to ask (but not easy to answer for these particular suicides) why they chose to subject their family members to this trauma.

          A final thought. Veterans who have served in wars and other military operations are known to have a high suicide rate after they return home. However, their suicide risk extends for years after their return. These four suicides occurred soon after the riot, two in fact within nine days of the riot. This high risk so soon after the traumatic experience is noteworthy and important to know for those involved in suicide prevention.


Monday, June 28, 2021

Thoughts on who are the most influential suicidologists


June 28, 2021

9:30 am




David Lester


            There is a great deal of interest these days on ranking the leading suicide researchers (as there is in other fields). It is far from easy to make judgments about this issue.


Problems with Criteria for Greatness


            The use of Google Scholar for determining the top suicidologists is hindered by the fact that most researchers explore topics other than suicide. For example, of my own 35 papers published in 2020, only 22 were on the topic of suicide or related issues. To take other examples, Thomas Joiner also studies eating disorders, while Steven Stack studies marriage and many other topics. Therefore, the total citations, h-index and i10-index are not accurate as measures of suicide research productivity and influence for researchers with multiple interests.


            The titles of articles may also be misleading, with or without subtitles. Heidi Hjelmeland and Birthe Loa Knizek’s article in Death Studies in 2021 has the title: The emperor’s new clothes? A critical look at the interpersonal theory of suicide. The word suicide is in the subtitle but not the title.


            My most cited article (6,785 citations as of June 25, 2021) is:


Beck, A. T., Weissman, A., Lester, D., & Trexler, L. (1974). The measurement of pessimism: the hopelessness scale. Journal of Consulting & Clinical Psychology, 42, 861-865.


This paper is based on psychiatric patients who have attempted suicide, but the word suicide does not appear in the title or subtitle.


            Many researchers collaborate with others, and some work in teams. How much credit should each author get for one publication? Steven Stack and myself have published 16 articles and two books together. Here is a recent contributor list from a recent article of mine appearing in Psychiatry Research.


Conceptualization: Isabella Berardelli

Data collectiion: Salvatore Sarubbi, Elena Rogante, Denise Erbuto, Maria Rosaria Cifrodelli

Formal analysis: Salvatore Sarubbi, Marco Innamorati

Methodology: Isabella Berardelli, Elena Rogante, Denise Erbuto

Project administration: Maurizio Pompili, Isabella Berardelli

Supervision: Marco Innamorati, David Lester Maurizio Pompili

Original draft: Isabella Berardelli, Salvatore Sarubbi

Writing - review; editing: Marco Innamorati, David Lester, Maurizio Pompili


Does each contributor get one point for this article? In addition, in some departments, the head of the department gets his or her name on the article even if he or she did not contribute to it. Citation counts are also thought to be inadequate unless one distinguishes between citations by others and citations of one’s own works.


            There are some scholars who focus on one area of suicidology. For example, Andriessen, et al. (2015) identified the ten most cited articles on bereavement after a suicide which were published in (only) three core journals on suicide.


            The era may be thought to play a role. Researchers who were cited and influential in the 1950s may now no longer ever be mentioned. Because the volume of studies of suicide has increased dramatically in recent decades, so have citations. Perhaps the number of articles on suicide each year should be used to weight citation amounts?


Personal Judgments


            Then, of course, we can make our own personal judgments. I wrote reviews of the suicide literature from 1897 to 1997, trying to read every scholarly article, chapter and book on suicide. The review was published in four books with the title Why People Kill Themselves, covering the periods 1897 to 1967, the 1970s, the 1980s, and 1990-1997 after which the task became too time-consuming for me. Had I kept going, I would not have had enough time to conduct my own research.


            My choices were for greatness were:


1800s:  Emile Durkheim, of course. I would also now add Sigmund Freud who is responsible the theory of suicide as aggression directed toward the self, what Shneidman has called murder in the 180th degree.


1950s:  Andrew Henry and James Short (whose work has been relatively ignored (except by me) but whose integrated theory (sociological plus psychological) is quite remarkable.


1960s:  Edwin Shneidman and Norman Farberow, of course, but also Charles Neuringer for his ground-breaking work on the cognitive processes of suicidal individuals, and Alex Pokorny for drawing attention to the role of climate and other factors which had been neglected.


1970s:  Aaron Beck and David Phillips. Phillips is rarely cited these days, but his work on the role of the media was ground-breaking.


1980s:  Antoon Leenaars for his work on suicide notes, Steven Stack for his sociological studies, Stephen Platt for his work on unemployment, and David Lester (myself).


            It might be thought inappropriate to include myself, but here is part of my Wikipedia entry.


His work on suicide has focused on (1) crisis intervention by telephone, (2) preventing suicide by restricting access to the means for suicide, (3) studies of the diaries left by suicides, (4) suicide in the oppressed, including African American slaves, Native Americans, Holocaust victims, the Roma, and prisoners, (5) reviews of research on and theory concerning suicide from 1897 to 1997, and (6) innovative ideas including suicide as a dramatic act, suicide and culture, and suicide and the creative arts.


            Who would I choose for the 1990s? For the period1990-1997, I chose no one. I did not think that any creative researcher or theorist had appeared in those years. [1]


            For the period 1998-2021, I have not kept up with the literature, but I have written negative reviews on the state of the art in suicidology (The End of Suicidology, Nova, 2019). From my limited awareness of the suicidology literature (for 1897 to 1997, I was obsessive and compulsive in my search and perusal of everything), I would choose Thomas Joiner. There have been many critics of his theory and the domination by his former students and by himself of research, but there was a novel feature of the theory (the inclusion of burdensomeness), and there is no comparable recent theory to compete with Joiner’s.


            I would also choose Cas Soper whose writings are not well known, but he has thrown down the gauntlet in his arguments against traditional theory and research and argued for an evolutionary theory of suicide. In addition, Jie Zhang has proposed a new theory of suicide and conducted some major research studies in China.


            Two of my close colleagues (John Gunn and Steven Stack) also nominated Angus Deaton, Edward Klonsky, Matthew Nock, Rory O’Connor, and Ian Rockett.


            I may have missed an important figure or two, and each of you may choose different researchers and theorists. (You would be wrong, of course!)


Published Lists




            Expertscape ( ) based their rankings for 22,043 articles published since 2008 and compiled as of February 3, 2019. However, Expertscape searches only medical journals (PubMed) and so misses psychological and social sciences research. It is therefore, biased.


  Pompili, M

  Hawton, K

  Turecki, G

  Brent, D

  Joiner, T

  Oquendo, M

  Lester, D

  Nock, M

  Gunnell, D

  Mann, J John

  Sher, L

  De Leo, D

  Pirkis, J

  Serafini, G

  Yip, P S F

  Conwell, Y

  Girardi, P

  Rihmer, Z

  Innamorati, M

  Nordentoft, M

  Baca-García, E

  Gonda, X

  Sareen, J

  Milner, Allison

  Anestis, Michael

  Stanley, B

  Courtet, Philippe

  Hom, Melanie A

  Conner, K

  Apter, A

  Kõlves, Kairi

  Bossarte, R

  Large, M

  Wasserman, D

  Ilgen, Mark

  Robinson, Jo

  Erlangsen, A

  Kapur, Nav

  O'Connor, R

  Jollant, F

  Miller, Matthew

  Ballard, E

  Stanley, Ian H

  Chang, S-S

  Ribeiro, J D

  Bryan, Craig

  Caine, E

  Fazel, Seena

  Kessler, R C

  Baldessarini, R J

  Borges, G

  Zhang, Jie

  Gibbons, R

  Fountoulakis, Konstantinos N

  Wilcox, H

  Guillaume, S

  Amore, M

  Møller, H

  Page, A

  Bridge, Jeff


            Omitted 27,568 lower-scoring


            Apparently this list was based on simply the number of articles published with suicide in the title. One assumes that they searched for titles with suicid*. However, this list does not discriminate between articles and editorials/comments. Several of those on the list carry out very little research but, rather, publish brief comments on suicide (and other topics).


Vogelzang, et al. 2011


            Vogelzang, et al. (2011) search the Web of Science for articles on suicide PLUS depression, which obviously limits the range of articles on suicide, for the period 1900-2007. The top 15 researchers in order of number of publications were:


JJ Mann

MA Oquendo

Y Conwell

J Lönnqvist

A Apter

DA Brent

CF Reynolds

HY Meltzer

HS Akiskal

K Hawton

RJ Baldessarini

A Roy

J Angst

V Arango


            Clearly, this does not tap leading suicidologists. Only some of those on this list contribute meaningfully to suicidology.




            The lists provided by Ioannadis (2016) do not focus on suicide, but rather on all papers published by scholars. It is not easy, therefore, to identify the suicidologists, and it is impossible to identify the scores for only suicide research. Ionnadis ranks the top 2% of scholars in the world and his c scores for the top ten on the Expertscape list are shown below:


  Pompili, M                  3.83

  Hawton, K                  4.65

  Turecki, G                  4,23

  Brent, D                      not scored

  Joiner, T                      4.56

  Oquendo, M                4.02

  Lester, D                     4.40

  Nock, M                      4.45

  Gunnell, D                  4.40

  Mann, J John              3.77


Keith Hawton leads, with Thomas Joiner second.


Web of Science


            The Web of Science publishes the top 100 suicidologists based solely on the number of articles on the topic. The top 10 are shown below. I do wonder who anonymous is and how he or she is so prolific! The Web of Science appears to do the best job of capturing articles on suicide in all disciplines. 


D Lester                      1163

Anonymous                659

JJ Mann                      470

K Hawton                   370

M Pompili                   314

G. Turecki                   296

TE Joiner                    295

D Gunnell                   293

MA Oquendo 280

N Kapur                      234

D De Leo                    227




            Of course, it would appear to be objective if greatness could be quantified, but the numbers generated will always be criticized on some grounds. For myself, I prefer the subjective method, that is, my own evaluation of the contributions made by suicidologists!




Andriessen, K., Krysinska, K., & Stack, S. (2015). Predictors of article impact in suicidology. Suicide & Life-Threatening Behavior, 45, 18-24.

Ioannadis, J. P. N., Klavans, R., & Boyack, K. W. (2016). Multiple citation indicators and their composite across scientific disciplines. PLOS Biology, 14(7): e1002501

Lester, D. (1972, 1983, 1992, 2000). Why people kill themselves. Springfield, IL: Charles Thomas.

Lester, D. (2019). The end of suicidology. Hauppauge, NY: Nova.

Vogelzang, B.H., Scutaru, C., Mache, S., Vitzthum, K., Quarcoo, D., & Groneberg, D. A. (2011). Depression and suicide publication analysis, using density equalizing mapping and output benchmarking. Indian Journal of Psychological Medicine, 33(1), 59-65.


[1] For my proposals for these eras, I am not sure that, today, in 2021, I would include all of those listed above.