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preventing suicide with text messages

December 6th, 2018 | 2 min read

By Matthew Loftus

This article on the work of Dr. Jerome Motto and the therapists carrying on his work today is fascinating:

The most pivotal response was sent to Douglas Kreider, one of Motto’s researchers, by a study participant who lived in an apartment in San Francisco’s Haight-Ashbury district. The man, who 18 months earlier had written a “kiss-off” letter, now described himself as a broken vase held together by his own hands. His letter spanned five single-spaced typed pages and read as if it had taken days to write. Forty years later, Motto could remember the first sentence: “You are the most persistent son-of-a-bitch I’ve ever encountered, so you must really be sincere in your interest in me.” There it was, a perfect encapsulation of the study’s aims. Motto called it “the bingo letter.”

Still, as promising as these replies were, they were just anecdotal evidence. For solid proof, Motto would pile a few researchers into his station wagon about once a year and drive an hour and a half northeast to Sacramento. They would arrive at the Department of Public Health at 8 in the morning and review the state’s death records, staying until they had looked up the names of every single study participant. They wanted to see if any of them had died by suicide.

“It was kind of a solemn duty,” Kreider said. “There was an undertone of ‘I hope I don’t discover something about someone I know.’” On one occasion, he did. He, like so many of the other researchers, had made real connections with his patients. This one was close to his age. The man had trouble making eye contact and suffered from paranoia. Kreider remembers that no one talked much on the rides home from Sacramento.

After about four years of these trips, Motto and his team had enough data to determine that their work was unprecedented in the history of suicide research. In the first two years following hospitalization, the suicide rate of the control group was nearly twice as high as that of the contact group. And it wasn’t only that no other experiment had ever been able to show a reduction in suicide deaths. Motto had also demonstrated something more profound: People who attempted suicide and wanted nothing to do with the mental health system could still be reached.


Matthew Loftus

Matthew Loftus teaches and practices Family Medicine in Baltimore and East Africa. His work has been featured in Christianity Today, Comment, & First Things and he is a regular contributor for Christ and Pop Culture. You can learn more about his work and writing at