Altering preferences for suicide crisis resources using the decoy nudge: Evidence of context-dependent effects in suicide prevention decision making.

Abstract

Suicide is the 10th leading cause of death in the United States. There are several important decisions that could confer later risk to a suicide attempt (e.g., how to store lethal means). Therefore, understanding how people make decisions that are relevant for suicide risk is an important area of study for suicidology. Human behavior diverges from perfectly rational economic decision making according to observable patterns based on predictable cognitive processes. Nudges attempt to diminish, leverage, or circumvent these deviations to increase the probability of a desired choice being selected or behavior being performed. One deviation from rationality is that human choice is context dependent. This deviation can be observed by introducing an objectively inferior alternative option (a decoy) into a choice array that alters an individual's preference. Using decoys could be one way to nudge people toward best practices in suicide prevention work. Method: This study examined if decoys could reliably alter participant preferences for suicide prevention resources using a hypothetical scenario in three separate online samples (i.e., general population, participants with recent suicidal thoughts, gun owners). Results: Our results found that introducing a slightly (but objectively) worse version of an existing suicide prevention resource increased the preference toward the slightly better option. Conclusions: These findings indicate that using decoys could be an effective nudge for influencing people's preference toward best practices. Most important, these findings highlight the importance of context effects on choice preference in suicide research and prevention efforts, as well as suggest irrational decision-making processes in suicide-relevant decision making. What is the public health significance of this article?Suicide-relevant decisions, such as choosing suicide prevention crisis resources, are context dependent and vulnerable to cognitive heuristics and biased decision making. Results from three studies suggested that using a time-and cost-effective behavioral economic intervention (i.e., nudges) can effectively alter preferences for suicide prevention resources. These studies indicate the importance of considering behavioral economic theory when understanding both distal (and likely proximal) suicide-relevant decision making.

Evaluation of Safe Firearm Storage Messaging in a Sample of Firearm-Owning US Military Service Members

“…Complementary research on behavioral economics–informed nudges has shown promise in prompting suicide prevention–related behavior change through small messaging changes. 21 , 22 , 23 …”

“…Thus, the dosage of the intervention was low, variation in the messages was slight, the context of the intervention delivery differed from normal, and the period during which attitudinal shifts were maintained was minimal. Complementary research on behavioral economics–informed nudges has shown promise in prompting suicide prevention–related behavior change through small messaging changes …”