5 ms·

It's becoming a difficult situation in the US, where "talking to someone" means being forcibly handled by the brutal mental health system and forfeiting several

by jMyles 11y ago

It's becoming a difficult situation in the US, where "talking to someone" means being forcibly handled by the brutal mental health system and forfeiting several crucial rights perhaps forever, including the right to own a firearm. It's not clear whom in the US to recommend people contact in such a situation. No less than four people who are close to me have sought help through official channels in the US, and in all four cases, were treated disastrously. All of them (including one who was 15 at the time) have told me they'd never, ever do that again. (Actually, I just thought of another - someone whom someone around them "called for help." Same scenario. So that's five.)

mei0Iesh 11y ago
You make it sound like "If you're a criminal, please talk to someone. Call 1-800-CRIMINAL and tell us your crimes. It's time you got help, by being locked up."
tptacek 11y ago
It is extraordinarily unhelpful to suggest that people who are endangered by mental health problems should avoid the mental health system. There is a lot not to like about emergency mental health care. The experience is indeed akin to that of criminal justice, and can at times verge on dehumanizing. Our handling of these issues must improve. But the alternative to being locked in a room with police officers watching the door is something far worse than that. People with suicidal depression, severe anxiety disorders, or post-traumatic stress disorders can endure episodes where they almost completely lose judgement, or experience dissociation and derealization. You can't simply gut these things out: you need to be in a safe space, ideally attended to by professionals who can intervene medically during the worst of it. If you are feeling suicidal, or that you're not in control of your own actions and concerned about harming yourself or others, you should call 9-1-1 or go to a hospital ER. It won't be pleasant, but it will be safer than the alternatives.
- jMyles 11y ago
  > But the alternative to being locked in a room with police officers watching the door is something far worse than that. This seems like a false dichotomy to me.
- 0xcde4c3db 11y ago
  This post comes off as pretty dismissive. For me, the experience did not verge on dehumanizing, it was dehumanizing. "Our handling of these issues must improve" doesn't even come close to acknowledging the severity, depth, or difficulty of the problems I encountered.
  - tptacek 11y ago
    I'm doing my best to capture how bad the experience is and I don't object at all to anyone suggesting that it's worse than I described. I think it's a very bad system.
    - chris_wot 11y ago
      There's a reason I said it doesn't have to be a medical person. I'm in the same boat - I had the worst experience of my life when I spoke to authorities about a suicidal episode. It was degrading and dehumanising. I will never make that mistake again, if I'm feeling suicidal I will never tell authorities, a doctor or anyone who might put me in that situation again.
      - tptacek 11y ago
        That sucks, and, having some little bit of knowledge about the process you went through, I absolutely believe you. Having said that: if you were my friend, and you told me you felt like you weren't in control of your thoughts and were concerned you might harm yourself, and you had no better options lined up (a long term mental health expert you'd built a relationship with, for instance), I'd help coerce you into the emergency mental health care system before I allowed you to become a victim of a controllable illness.
    - teslabox 11y ago
      Psychiatry is an officially-sanctioned pseudoscience. People who get stuck in the system tend to never get better.
      - tptacek 11y ago
- nyan4 11y ago
  You are (incorrectly) implying that the only choices are calling 911 or "being locked in a room with police officers".
- throwaway1 11y ago
  Preface: Please, no advice. Please! You may think that this is coldly logical. It's not. I have dealt with OCD and depression-like systems for a long time now. 90%+ of the time I'm "fine" to "great." Another 9.9% I feel like scum for no good reason. That last 0.1% is what sucks -- that's the suicidal thoughts. Holidays that are the worst, when everybody seems to be paying each other extra attentions and I find myself feeling lonely/forgotten. Last night, I had raging suicidal thoughts for a few hours (about the length of the usual bout). These thoughts are not directed or particularly purposeful. When I have these thoughts, I badly want to talk to somebody about them. It's like the monster in your closet -- in the light of day it's less scary. But I can't, and it sucks! If I go to a shrink about this, I would likely be involuntarily committed and be greatly impacted in my professional life, etc. Suicide is a taboo topic and it's too bad for those who struggle with suicidal thoughts, because they have to keep them inside. I've brought them up to some "friends" before and the reaction is that I must be crumbling, etc. There's almost a sense of shame from these people, like they've accidentally seen you naked. I keep this to myself, but the most productive thing is to confront the issue. The best way I've been able to do that is by reading things written by/about suicide not from the perspective of "gotta save you!" This might sound odd, but places like /r/SanctionedSuicide (which isn't really what it sounds like, if you recoiled) actually makes me feel respected and not ashamed. Looking through a different lens, I see that my life is pretty good and I have many things to live for! When I feel this way I read the generally "gotta save you!" stuff too because hey, it's nice and positive, but in isolation it's quite patronizing. Mentally sound people seem to immediately equate suicidal thoughts with an imminent life-and-death struggle and have the accompanying "EMERGENCY!!" reaction, and that is simply not how this works.
umanwizard 11y ago
I flagged this and tbh I hope dang deletes your comment and this reply. I agree with you that these are serious problems. But you're still much better off dealing with them than being dead. This post is very unhelpful.
- a3n 11y ago
  I don't think that was flaggable. This is a real problem, and it is a real dilemma at times whether calling 911 might make things worse. We should feel absolutely free to call for help and not worry about it. But there are risks. And yes, I agree, if you feel suicidal you should definitely get help, including 911 if your crisis is immediate.
- jMyles 11y ago
  > I flagged this and tbh I hope dang deletes your comment and this reply. So, in your mind, we're not even allowed to discuss this problem?
  - umanwizard 11y ago
    Sure, but not in response to this particular comment, IMO
a3n 11y ago
An acquaintance was feeling suicidal, and I convinced her to talk to her doctor. Her first concern was being involuntarily committed; she referred to some statute by number, that she thought would prompt whatever provider or authority she talked to to lock her up. What a terrible barrier to help. (She did see her doctor.) You call 911 for help, and they send someone with a gun.
- njloof 11y ago
  That number would be 5150. If you ask to be committed, you remain in control and can get help. If you are not in a condition to admit yourself, the only way to deprive you of your civil rights in the US, even for your own safety, is the police.
  - tptacek 11y ago
    That's not quite true in the US. Whether or not you ask to be "committed" (a word you should not use), admitting yourself to the ER or a mental health facility will likely remove most of your control over the situation and will indeed curtail your civil rights. But if you have to ask whether you should admit yourself to a hospital, do it. If you admit yourself voluntarily, you'll have the option to leave within days, and during those days, you won't have to worry as much about the consequences of your own actions, which by itself can help clear your head.
- TazeTSchnitzel 11y ago
  I seem to recall the case of at least one black person with mental health issues whose neighbours called 911 to get help for, and soon enough he was shot dead.
  - DanBC 11y ago
    About half the people that police shoot and kill each year have a mental illness. This amounts to about 500 people with mental illness shot and killed each year. This compares to the 35,000 to 40,000 people who die by suicide in the US each year. If someone needs help there are probably things you can do - be there with them; make sure you say they're calm when you talk about them on the phone; make sure there are no weapons around.
mikeash 11y ago
When you say "official channels," do you mean 911, a suicide hotline, or something else? I wouldn't be surprised if 911 was a bad choice but I'd have thought/hoped the hotlines would be good.
- jMyles 11y ago
  Two cases were 911, one case was a campus health center, and the other two were a mental health hotline.
TazeTSchnitzel 11y ago
Awful mental health services are not exclusive to the US either, though perhaps the US is especially bad.

by jMyles 11y ago

mei0Iesh 11y ago

You make it sound like "If you're a criminal, please talk to someone. Call 1-800-CRIMINAL and tell us your crimes. It's time you got help, by being locked up."

tptacek 11y ago

It is extraordinarily unhelpful to suggest that people who are endangered by mental health problems should avoid the mental health system. There is a lot not to like about emergency mental health care. The experience is indeed akin to that of criminal justice, and can at times verge on dehumanizing. Our handling of these issues must improve. But the alternative to being locked in a room with police officers watching the door is something far worse than that. People with suicidal depression, severe anxiety disorders, or post-traumatic stress disorders can endure episodes where they almost completely lose judgement, or experience dissociation and derealization. You can't simply gut these things out: you need to be in a safe space, ideally attended to by professionals who can intervene medically during the worst of it. If you are feeling suicidal, or that you're not in control of your own actions and concerned about harming yourself or others, you should call 9-1-1 or go to a hospital ER. It won't be pleasant, but it will be safer than the alternatives.

jMyles 11y ago
> But the alternative to being locked in a room with police officers watching the door is something far worse than that. This seems like a false dichotomy to me.
0xcde4c3db 11y ago
This post comes off as pretty dismissive. For me, the experience did not verge on dehumanizing, it was dehumanizing. "Our handling of these issues must improve" doesn't even come close to acknowledging the severity, depth, or difficulty of the problems I encountered.
- tptacek 11y ago
  I'm doing my best to capture how bad the experience is and I don't object at all to anyone suggesting that it's worse than I described. I think it's a very bad system.
  - chris_wot 11y ago
    There's a reason I said it doesn't have to be a medical person. I'm in the same boat - I had the worst experience of my life when I spoke to authorities about a suicidal episode. It was degrading and dehumanising. I will never make that mistake again, if I'm feeling suicidal I will never tell authorities, a doctor or anyone who might put me in that situation again.
    - tptacek 11y ago
      That sucks, and, having some little bit of knowledge about the process you went through, I absolutely believe you. Having said that: if you were my friend, and you told me you felt like you weren't in control of your thoughts and were concerned you might harm yourself, and you had no better options lined up (a long term mental health expert you'd built a relationship with, for instance), I'd help coerce you into the emergency mental health care system before I allowed you to become a victim of a controllable illness.
  - teslabox 11y ago
    Psychiatry is an officially-sanctioned pseudoscience. People who get stuck in the system tend to never get better.
    - tptacek 11y ago
nyan4 11y ago
You are (incorrectly) implying that the only choices are calling 911 or "being locked in a room with police officers".
throwaway1 11y ago
Preface: Please, no advice. Please! You may think that this is coldly logical. It's not. I have dealt with OCD and depression-like systems for a long time now. 90%+ of the time I'm "fine" to "great." Another 9.9% I feel like scum for no good reason. That last 0.1% is what sucks -- that's the suicidal thoughts. Holidays that are the worst, when everybody seems to be paying each other extra attentions and I find myself feeling lonely/forgotten. Last night, I had raging suicidal thoughts for a few hours (about the length of the usual bout). These thoughts are not directed or particularly purposeful. When I have these thoughts, I badly want to talk to somebody about them. It's like the monster in your closet -- in the light of day it's less scary. But I can't, and it sucks! If I go to a shrink about this, I would likely be involuntarily committed and be greatly impacted in my professional life, etc. Suicide is a taboo topic and it's too bad for those who struggle with suicidal thoughts, because they have to keep them inside. I've brought them up to some "friends" before and the reaction is that I must be crumbling, etc. There's almost a sense of shame from these people, like they've accidentally seen you naked. I keep this to myself, but the most productive thing is to confront the issue. The best way I've been able to do that is by reading things written by/about suicide not from the perspective of "gotta save you!" This might sound odd, but places like /r/SanctionedSuicide (which isn't really what it sounds like, if you recoiled) actually makes me feel respected and not ashamed. Looking through a different lens, I see that my life is pretty good and I have many things to live for! When I feel this way I read the generally "gotta save you!" stuff too because hey, it's nice and positive, but in isolation it's quite patronizing. Mentally sound people seem to immediately equate suicidal thoughts with an imminent life-and-death struggle and have the accompanying "EMERGENCY!!" reaction, and that is simply not how this works.

umanwizard 11y ago

I flagged this and tbh I hope dang deletes your comment and this reply. I agree with you that these are serious problems. But you're still much better off dealing with them than being dead. This post is very unhelpful.

a3n 11y ago
I don't think that was flaggable. This is a real problem, and it is a real dilemma at times whether calling 911 might make things worse. We should feel absolutely free to call for help and not worry about it. But there are risks. And yes, I agree, if you feel suicidal you should definitely get help, including 911 if your crisis is immediate.
jMyles 11y ago
> I flagged this and tbh I hope dang deletes your comment and this reply. So, in your mind, we're not even allowed to discuss this problem?
- umanwizard 11y ago
  Sure, but not in response to this particular comment, IMO

a3n 11y ago

An acquaintance was feeling suicidal, and I convinced her to talk to her doctor. Her first concern was being involuntarily committed; she referred to some statute by number, that she thought would prompt whatever provider or authority she talked to to lock her up. What a terrible barrier to help. (She did see her doctor.) You call 911 for help, and they send someone with a gun.

njloof 11y ago
That number would be 5150. If you ask to be committed, you remain in control and can get help. If you are not in a condition to admit yourself, the only way to deprive you of your civil rights in the US, even for your own safety, is the police.
- tptacek 11y ago
  That's not quite true in the US. Whether or not you ask to be "committed" (a word you should not use), admitting yourself to the ER or a mental health facility will likely remove most of your control over the situation and will indeed curtail your civil rights. But if you have to ask whether you should admit yourself to a hospital, do it. If you admit yourself voluntarily, you'll have the option to leave within days, and during those days, you won't have to worry as much about the consequences of your own actions, which by itself can help clear your head.
TazeTSchnitzel 11y ago
I seem to recall the case of at least one black person with mental health issues whose neighbours called 911 to get help for, and soon enough he was shot dead.
- DanBC 11y ago
  About half the people that police shoot and kill each year have a mental illness. This amounts to about 500 people with mental illness shot and killed each year. This compares to the 35,000 to 40,000 people who die by suicide in the US each year. If someone needs help there are probably things you can do - be there with them; make sure you say they're calm when you talk about them on the phone; make sure there are no weapons around.

mikeash 11y ago

When you say "official channels," do you mean 911, a suicide hotline, or something else? I wouldn't be surprised if 911 was a bad choice but I'd have thought/hoped the hotlines would be good.

jMyles 11y ago
Two cases were 911, one case was a campus health center, and the other two were a mental health hotline.

TazeTSchnitzel 11y ago

Awful mental health services are not exclusive to the US either, though perhaps the US is especially bad.