My impression of these services are that they are simply available so people can feel they have "done something" about someone who seems suicidal by giving them the number, then wash their hands of the rest of it. Not that someone else's mental health puts any particular obligation on you, but that's the dynamic I see play out. I've called these services twice over the years when I was young and naive and had friends I was worried about, and their entire objective is to trick you into giving them details so they can sic the police on these people and ruin their lives with an involuntary hold in the psych ward. One of the calls was more of an advice call, as in I (then 16 years old) was trying to ask them what I should do, and when I refused to give them the person's address the person on the line straight up asked me "what do you want me to do?" I don't know! I was a scared 16 year old kid and you're supposed to be the one who knows that! What is the point of you answering the phone!
I'm sorry to hear you had these shitty experiences :( FWIW, I agree with some others who say that it differs between hotlines and it does depend.
I volunteer at one (working at software doesn't provide enough meaning as far as activities go, and this does, as a side thing), and we are very strict about not forcing advice (or rescue) on anyone. (I had to go through multi-month trainings, practice, then supervision etc., we have ongoing seminars and equivalent of QA, etc.) The primary goal is provide emotional support and to give the caller a safe space where they can be heard, openly express and talk about their feelings and thoughts. We are there expressly not to solve any issues they are having. If they need it and consent to it and give an address (the calls are anonymous), we can call an ambulance; but even then the preference is if the caller does that.
I can tell (with some statistics and also lots of feedback) that the support does address the callers' emotional needs to be heard (sometimes to organise thoughts, understand their emotions, to speak to a real human and feel less lonely, etc.)
Trans Lifeline [1] calls that practice "Non-consensual rescue" and they're very strongly against it.
> The organization’s hotline does not engage in non-consensual active rescue,[15] meaning operators never call 911, police, or emergency services on callers without an expressed request and consent, based on research associating involuntary hospitalization with increases suicide attempts after discharge.[16][17] Additionally, they believe that calling the police on transgender people in crisis, particularly trans people of color, causes more harm.
Former Technology Director for TL here - I maintained and deeply extended their hotline software. We took confidentiality and anonymity very, very seriously. Operators never, ever see the phone number of the caller, and vice versa. Only admins can even look up a caller by phone number. There were other technical measures as well, but I'm not going to give them up in a public forum, hope that's understandable.
The same conundrum comes up with the medical forms that ask one to self-report any post-partum depression, or any time you can be found mentally unfit (e.g. at your job, like in 2015 Germanwings pilot-murder-suicide) so that the bureaucracy descends to irrevocably alter your life. As a society, we still haven't figured out a way that allows a suicidal person to get their time-out, while ensuring that that intervention won't impair their future.
I’ve actually found crisis lines to be fairly helpful. Sure, they have little real world power but the people I have spoken to have been calm and reassuring, which more often than not has been what I needed. A few people I’ve spoken to have been particularly memorably great, and I wish I could buy them all a beer.
This isn’t to dismiss those who’ve had bad experiences. I just wanted to offer a different perspective.
I worked at a suicide hotline in Canada. The problem with what you are saying is that, as far as I know, there is no unified organism for suicide prevention centers and hotlines in North America (there are associations, but they don't seem to demand a unified process).
This means that, while your experience totally sucked, it can't be generalized. Most people I've talked to from all over the country genuinely want to help. I assume it's the same in the US. But some centers offer very little training, and their legal means probably vary a lot by location.
That said, there is a lot they can do beyond calling an ambulance, but it still comes down to talking and guidance, no one can physically force people to get better, except maybe some institutions (debatable).
This is more of a reason for reverting police funds to other efforts, such as people that can help in cases like you brought up. Law enforcement has just become a huge bucket that encompasses too much.
You have to understand that this is a poorly paid phone job for the person on the other end.
They don't have a PhD. They are not top 1% intelligence, top 1% compassion and top 1% drive to help others. They are just people who applied for a job, got it and are following a script or whatever little training they've been given.
When you're younger, you think there's adults who know a thing or two. Then you grow up and realize that's 0.0001% of the population. Everyone else knows how to do a couple of repetitive tasks and repeat sentences they heard other people say, not much more than that.
In fact they may not even be employed; a relative of mine had to do a few shifts on such a hotline as part of a community service sentence for a non-violent misdemeanor.
I don't often find people able to articulate their views on the suicide topic, and also aren't comfortable talking about it.
The best thing I've heard though is that there is a large subset of suicides that are spur of the moment decisions. And so an option like a suicide prevention hotline is to serve as a distraction and circuit breaker to get the afflicted human onto something else. That also means there is no use case where you call the hotline on someone's behalf.
Basically same experience. Even the mental health hotlines can be the same way. Unless you tell them you plan on killing yourself they say there is nothing they can do to help.
Yeah there's been 4 or 5 times where I really wanted someone to talk to, but I'm just not a suicidal person, so it feels weird to tie up a suicide hotline for my petty problems.
So then you go to a therapist and they're like "You have to want to change".
I don't know about that. I used to have friends. I don't want to change, I want to have friends again!
Considering how much therapy costs, I've joked about just hiring prostitutes to be my friends for hourly pay. Why can't the gig economy meet that demand, huh? I'll pay $15 an hour to share my opinions on Linux with another trans girl while she pretends to listen. That's an entire work shift for the price of 1 hour of therapy!
> their entire objective is to trick you into giving them details so they can sic the police on these people and ruin their lives with an involuntary hold in the psych ward
This is 100% untrue. Their objective is to prevent suicide. If you intend to harm yourself, and nobody is around to make you safe, yes, they bring people in to enforce safety and yes that is often law enforcement. They will take the suicidal person to an ER, where the ER staff will do an assessment, and then may opt to put you in an involuntary hold if a licensed psychiatric provider deems it is necessary. But it is more likely that even if you do need hospitalization, they will recommend a voluntary hospital stay. Most care providers look to give people the least restrictive care that still gets the job done.
It is also important to note that you called on behalf of friends but refused to give out any info. There is very little they can do in that case. You are not the one at risk. You do not control the environment of the one at risk. You won't tell them who is at risk. I can understand why they got frustrated. I can also understand why you are frustrated. But none of those frustrations make your assertion true.
Two sentences in that piece are particularly amazing taken together:
>"Data science and AI are at the heart of the organization — ensuring, it says, that those in the highest-stakes situations wait no more than 30 seconds before they start messaging with one of its thousands of volunteer counselors[...]"
>"Others questioned whether the people who text their pleas for help are actually consenting to having their data shared, despite the approximately 50-paragraph disclosure the helpline offers a link to when individuals first reach out."
They better start offering a speedreading course together with their suicide prevention service because otherwise that's hard to reconcile. In all seriousness, milking suicide prevention data in any shape or form to make more money, can we go any lower? There is only one legitimate way to handle data here, for law enforcement or medical professionals, otherwise delete it.
I'm not sure, if you're an organization targeting people in distress for suicide prevention help, you can pretend that those people are in a state of mind to agree to any disclosure to terms of use.
Yep, humans are really good at rationalizing decisions made for other reasons. I'm sure the people doing that have convinced themselves that it's totally ethical because they're "saving lives" (using some twisted definition of "save")
AI power text line for suicide seems horrible to me. Every time I am hit customer support and need to face AI first my stress level increases. AI powered virtual assistant seems like the worst thing that happened to customer support in the recent decade. Every time I listen to a presentation by some exec how introduction of AI assistant improved some performance metric of a customer support dept, I actually feel bad for customer and for tech industry, that helped bring this change closer.
> can we go any lower?
They can always offer estate planning services right there in the chat. I bet some lawyers would jump on this ad placement opportunity.
> There is only one legitimate way to handle data here, for law enforcement or medical professionals, otherwise delete it.
What about research? It would be hard to navigate and share it responsibly even with research facilities, but it is a very legitimate use case and potentially useful.
This is quite disgusting. If there is one place where your privacy should be guarded it is there, plenty of places will forcibly admit you (at huge costs) if they see you as a suicide risk.
In NZ I do know the cops like to kick you when you're down. Let's say you've climbed a scaffold that's around a building and you want to jump but you are saved (as you had been on the phone with a suicide help line, and they passed the details to the Police), you get done with a trespass charge and can be convicted. I really hate reading stories like this - way to kick someone while they're at rock bottom, potentially making them actually do it so they don't have to go to court, get publicly shamed and potentially getting a criminal record.
Various laws, such as the Baker Act in Florida, it’s so bad it’s used like this in sentences: “Yeah, Sally was baker act’ed last week, she’s still in”.
Whenever someone says that you should trust psychiatrists and the huge number of other similar professions I just point out that forcible admission is not rare and that they will share anything that they deem a 'risk', such as "I will shoot John if he chews with his mouth open one more time."
If you want to get someone to listen to your problems without telling them to anyone you can't do better than the catholic church:
>Priests may not reveal what they have learned during confession to anyone, even under the threat of their own death or that of others.
Ironically enough the apparatchiks of the Communist Party of Poland would often use uncorruptible priests to vent. Ones they had used the secret service to vet by entrapping them.
Thats thinking outside the box though probably not good advice. I've been to more confessions that I can remember. I can tell you the vast majority of priests are going to mostly keep the topic to religion and joining the church and working on your relationship with god/praying. If you are suicidal this probably is not going to help in any meaningful way.
I suppose you can probably find a priest that is willing to talk but that may take some time and eventually they are going to start cold shouldering you if you don't join the church.
>> Others questioned whether the people who text their pleas for help are actually consenting to having their data shared, despite the approximately 50-paragraph disclosure the helpline offers a link to when individuals first reach out.
Clearly people contacting them are in a state of distress. I bet none of them read that, and many would not be considered legally able to agree to the terms due to their mental state. But IANAL
I've thought for awhile the solution to a better funnel for mental health is to allow multiple organizations to be the ones answering the phone, and implementing their own protocol - process for hiring or accepting volunteers, the training they receive, the script they follow - if any, and then free or for-pay offerings or programs they may know of and feel that person may be a good candidate for. Basically A/B testing and then at least you have a variety of data to analyze to see what the outcomes are.
I think what's mostly lacking though is an intermediate in-person program that's pre-psychiatric ward, an intensive-supportive environment, where the go-to isn't medications - probably where medications aren't prescribed - but basically in-person to determine a person's full state, and see what amount of short-term and/or long-term care they need to feel stable enough, if not good, on their own again. This requires money of course, and the sooner we can get people into these programs then the less dis-ease progression occurs, and arguably people will be easier to help.
Does anyone know of any such program or protocol, where care/treatment cascades and/or escalates and/or continues in-person in wide variety of breadth and depth depending on each person? I feel the current go-to with medications is generally that the medications are a hammer, so everything looks like a nail, but if multi-disciplinary teams (not just a psychiatrist trained in medication) rallied around a person and they had a whole toolkit worth of options then outcomes would be magnitudes better - and without causing additional harm.
Readit News
I volunteer at one (working at software doesn't provide enough meaning as far as activities go, and this does, as a side thing), and we are very strict about not forcing advice (or rescue) on anyone. (I had to go through multi-month trainings, practice, then supervision etc., we have ongoing seminars and equivalent of QA, etc.) The primary goal is provide emotional support and to give the caller a safe space where they can be heard, openly express and talk about their feelings and thoughts. We are there expressly not to solve any issues they are having. If they need it and consent to it and give an address (the calls are anonymous), we can call an ambulance; but even then the preference is if the caller does that.
I can tell (with some statistics and also lots of feedback) that the support does address the callers' emotional needs to be heard (sometimes to organise thoughts, understand their emotions, to speak to a real human and feel less lonely, etc.)
I am extremely glad good ones exist. If you have a list, I’ll share it with my support group.
Edit: removed my horror story… we don’t need another one on this thread.
> The organization’s hotline does not engage in non-consensual active rescue,[15] meaning operators never call 911, police, or emergency services on callers without an expressed request and consent, based on research associating involuntary hospitalization with increases suicide attempts after discharge.[16][17] Additionally, they believe that calling the police on transgender people in crisis, particularly trans people of color, causes more harm.
[1] https://en.wikipedia.org/wiki/Trans_Lifeline
This isn’t to dismiss those who’ve had bad experiences. I just wanted to offer a different perspective.
This means that, while your experience totally sucked, it can't be generalized. Most people I've talked to from all over the country genuinely want to help. I assume it's the same in the US. But some centers offer very little training, and their legal means probably vary a lot by location.
That said, there is a lot they can do beyond calling an ambulance, but it still comes down to talking and guidance, no one can physically force people to get better, except maybe some institutions (debatable).
The fundamental purpose of suicide hotlines is to take burden off emergency services, and to give folks a coping mechanism which doesn't involve 911.
90% of callers are frequent fliers, calling weekly to daily. In the year I worked there I only had 2-3 calls which required serious treatment.
Kind of how old church ladies used to tell you they will pray for your immortal soul to not end in hell.
I have a feeling that those two groups are related in the biological sense.
They don't have a PhD. They are not top 1% intelligence, top 1% compassion and top 1% drive to help others. They are just people who applied for a job, got it and are following a script or whatever little training they've been given.
When you're younger, you think there's adults who know a thing or two. Then you grow up and realize that's 0.0001% of the population. Everyone else knows how to do a couple of repetitive tasks and repeat sentences they heard other people say, not much more than that.
The best thing I've heard though is that there is a large subset of suicides that are spur of the moment decisions. And so an option like a suicide prevention hotline is to serve as a distraction and circuit breaker to get the afflicted human onto something else. That also means there is no use case where you call the hotline on someone's behalf.
So then you go to a therapist and they're like "You have to want to change".
I don't know about that. I used to have friends. I don't want to change, I want to have friends again!
Considering how much therapy costs, I've joked about just hiring prostitutes to be my friends for hourly pay. Why can't the gig economy meet that demand, huh? I'll pay $15 an hour to share my opinions on Linux with another trans girl while she pretends to listen. That's an entire work shift for the price of 1 hour of therapy!
This is 100% untrue. Their objective is to prevent suicide. If you intend to harm yourself, and nobody is around to make you safe, yes, they bring people in to enforce safety and yes that is often law enforcement. They will take the suicidal person to an ER, where the ER staff will do an assessment, and then may opt to put you in an involuntary hold if a licensed psychiatric provider deems it is necessary. But it is more likely that even if you do need hospitalization, they will recommend a voluntary hospital stay. Most care providers look to give people the least restrictive care that still gets the job done.
It is also important to note that you called on behalf of friends but refused to give out any info. There is very little they can do in that case. You are not the one at risk. You do not control the environment of the one at risk. You won't tell them who is at risk. I can understand why they got frustrated. I can also understand why you are frustrated. But none of those frustrations make your assertion true.
Deleted Comment
>"Data science and AI are at the heart of the organization — ensuring, it says, that those in the highest-stakes situations wait no more than 30 seconds before they start messaging with one of its thousands of volunteer counselors[...]"
>"Others questioned whether the people who text their pleas for help are actually consenting to having their data shared, despite the approximately 50-paragraph disclosure the helpline offers a link to when individuals first reach out."
They better start offering a speedreading course together with their suicide prevention service because otherwise that's hard to reconcile. In all seriousness, milking suicide prevention data in any shape or form to make more money, can we go any lower? There is only one legitimate way to handle data here, for law enforcement or medical professionals, otherwise delete it.
> can we go any lower?
They can always offer estate planning services right there in the chat. I bet some lawyers would jump on this ad placement opportunity.
> There is only one legitimate way to handle data here, for law enforcement or medical professionals, otherwise delete it.
What about research? It would be hard to navigate and share it responsibly even with research facilities, but it is a very legitimate use case and potentially useful.
How's that legally done?
Is suicide even a crime in most countries? I don't think it is.
In NZ I do know the cops like to kick you when you're down. Let's say you've climbed a scaffold that's around a building and you want to jump but you are saved (as you had been on the phone with a suicide help line, and they passed the details to the Police), you get done with a trespass charge and can be convicted. I really hate reading stories like this - way to kick someone while they're at rock bottom, potentially making them actually do it so they don't have to go to court, get publicly shamed and potentially getting a criminal record.
https://en.wikipedia.org/wiki/Baker_Act
Shocking, I know.
If you want to get someone to listen to your problems without telling them to anyone you can't do better than the catholic church:
>Priests may not reveal what they have learned during confession to anyone, even under the threat of their own death or that of others.
https://en.wikipedia.org/wiki/Seal_of_confession_in_the_Cath...
Ironically enough the apparatchiks of the Communist Party of Poland would often use uncorruptible priests to vent. Ones they had used the secret service to vet by entrapping them.
I suppose you can probably find a priest that is willing to talk but that may take some time and eventually they are going to start cold shouldering you if you don't join the church.
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https://www.theverge.com/21293176/crisis-text-line-ceo-racis...
Clearly people contacting them are in a state of distress. I bet none of them read that, and many would not be considered legally able to agree to the terms due to their mental state. But IANAL
Dead Comment
I think what's mostly lacking though is an intermediate in-person program that's pre-psychiatric ward, an intensive-supportive environment, where the go-to isn't medications - probably where medications aren't prescribed - but basically in-person to determine a person's full state, and see what amount of short-term and/or long-term care they need to feel stable enough, if not good, on their own again. This requires money of course, and the sooner we can get people into these programs then the less dis-ease progression occurs, and arguably people will be easier to help.
Does anyone know of any such program or protocol, where care/treatment cascades and/or escalates and/or continues in-person in wide variety of breadth and depth depending on each person? I feel the current go-to with medications is generally that the medications are a hammer, so everything looks like a nail, but if multi-disciplinary teams (not just a psychiatrist trained in medication) rallied around a person and they had a whole toolkit worth of options then outcomes would be magnitudes better - and without causing additional harm.
Deleted Comment