4 ms·

Speaking of anonymity, I wish suicide hotlines would be upfront about the possibility of 'active rescue', that is, calling the police if they think you're about

Speaking of anonymity, I wish suicide hotlines would be upfront about the possibility of 'active rescue', that is, calling the police if they think you're about to kill yourself. It seems like a disclaimer they would run at the beginning of the call, but they'd probably lose callers that way. Still, it feels like a violation of informed consent regarding a service that bills itself as anonymous.

cvccvroomvroom 3y ago
Duty to warn is enshrined in HIPAA. The key is whether NAMI requires the conversation to be bound under it even though the caller isn't strictly a patient and the phone operator likely has no medical training being staffed by volunteers. PSA: 988 - US National Suicide Prevention Lifeline
- Animats 3y ago
  What's the whole list now? - 211 - local charities - 311 - city maintenance - 411 - phone directory, discontinued? - 511 - traffic - 611 - phone maintenance, discontinued? - 711 - phone relay for disabled - 811 - call before you dig - 911 - general emergencies - 988 - suicide What else?
  - local_crmdgeon 3y ago
    511 is also public transit directions in a few cities
  - LinuxBender 3y ago
    - 411 - phone directory, discontinued? Very diminished in my area. It used to be they would look up something by category, meaning I could say I need a taxi and they would just connect me to one. Now I have to know the exact business name and location. They assume everyone has a smart phone now.
emacsen 3y ago
I was a volunteer on a crisis hotline, and I thought a great deal about this. Firstly, very few people on the service I volunteered for had authorities called on them- roughly one in every thousand calls. Usually, if I mentioned that emergency services would need to be called, this was actually a motivator for the person to work with me and come up with a strategy to keep them safe for the night. For those few who did need to have authorities, they fell into one of two categories. Firstly, while rare, there was one person where we had to call the police because they knew the system well and knew that if they told me certain things, it would be required that the police would be called. I can't reveal anything about the call, but they told me that they didn't want to be in the situation they were in, and that they'd been in and out of hospitals before. They understood that getting emergency services involved would get them out of their current situation, which happened to be high school. More commonly are people where they genuinely needed help. My feeling about them was that if someone uses a suicide hotline, they are asking to be convinced not to end their life. They're literally asking for help. What upset me more are the times when I strongly felt someone needed to have emergency services called, but they didn't check the boxes, so we couldn't.
- giraffe_lady 3y ago
  IMO the problem isn't the consent because your latter point that someone using this is somewhat implicitly consenting to help save their life. It's that "emergency services" is a euphemism for "the cops, who might harm, kill, or traumatize the person or anyone else who happens to be nearby." I know someone who had police guns drawn on them and was ultimately tazed and arrested because of their roommate's call to a hotline. Extremely dangerous situation. It's not the fault of the hotline that police exist, but they do exist and so it needs to be considered carefully. Cops are one of the most dangerous things you could possibly expose someone in a mental health crisis to.
  - lilboiluvr69 3y ago
    Are you me? My ex had that same thing happen to him, police showed up, got tazed and arrested after defending themselves. Now they have a criminal record. So, obviously there is some bias on my end, its probably why I'm so skeptical regarding justifications of 'implicit consent'. I mean what justification do hotlines have about not warning of this possibility at the beginning of the call in a 5 second automated message aside from people not agreeing and hanging up. But if they don't agree, it obviously isn't consent.
psychphysic 3y ago
Too many questions here - does informed consent even apply here? They aren't providing a medical intervention, they aren't medical staff, and the caller is not their patient - even if it does, is it reasonable to assume that someone who is imminently about to commit suicide lacks capacity? Other than by legally available mechanisms? Probably. - if you want to kill yourself why would you make it clear to someone over the phone first? - is consent even necessary for such action by emergency services? I don't think so.
pvaldes 3y ago
That would put suicide hotlines, many driven by volunteers, in serious trouble of being sued.

cvccvroomvroom 3y ago

Duty to warn is enshrined in HIPAA. The key is whether NAMI requires the conversation to be bound under it even though the caller isn't strictly a patient and the phone operator likely has no medical training being staffed by volunteers. PSA: 988 - US National Suicide Prevention Lifeline

Animats 3y ago
What's the whole list now? - 211 - local charities - 311 - city maintenance - 411 - phone directory, discontinued? - 511 - traffic - 611 - phone maintenance, discontinued? - 711 - phone relay for disabled - 811 - call before you dig - 911 - general emergencies - 988 - suicide What else?
- local_crmdgeon 3y ago
  511 is also public transit directions in a few cities
- LinuxBender 3y ago
  - 411 - phone directory, discontinued? Very diminished in my area. It used to be they would look up something by category, meaning I could say I need a taxi and they would just connect me to one. Now I have to know the exact business name and location. They assume everyone has a smart phone now.

emacsen 3y ago

I was a volunteer on a crisis hotline, and I thought a great deal about this. Firstly, very few people on the service I volunteered for had authorities called on them- roughly one in every thousand calls. Usually, if I mentioned that emergency services would need to be called, this was actually a motivator for the person to work with me and come up with a strategy to keep them safe for the night. For those few who did need to have authorities, they fell into one of two categories. Firstly, while rare, there was one person where we had to call the police because they knew the system well and knew that if they told me certain things, it would be required that the police would be called. I can't reveal anything about the call, but they told me that they didn't want to be in the situation they were in, and that they'd been in and out of hospitals before. They understood that getting emergency services involved would get them out of their current situation, which happened to be high school. More commonly are people where they genuinely needed help. My feeling about them was that if someone uses a suicide hotline, they are asking to be convinced not to end their life. They're literally asking for help. What upset me more are the times when I strongly felt someone needed to have emergency services called, but they didn't check the boxes, so we couldn't.

giraffe_lady 3y ago
IMO the problem isn't the consent because your latter point that someone using this is somewhat implicitly consenting to help save their life. It's that "emergency services" is a euphemism for "the cops, who might harm, kill, or traumatize the person or anyone else who happens to be nearby." I know someone who had police guns drawn on them and was ultimately tazed and arrested because of their roommate's call to a hotline. Extremely dangerous situation. It's not the fault of the hotline that police exist, but they do exist and so it needs to be considered carefully. Cops are one of the most dangerous things you could possibly expose someone in a mental health crisis to.
- lilboiluvr69 3y ago
  Are you me? My ex had that same thing happen to him, police showed up, got tazed and arrested after defending themselves. Now they have a criminal record. So, obviously there is some bias on my end, its probably why I'm so skeptical regarding justifications of 'implicit consent'. I mean what justification do hotlines have about not warning of this possibility at the beginning of the call in a 5 second automated message aside from people not agreeing and hanging up. But if they don't agree, it obviously isn't consent.

psychphysic 3y ago

Too many questions here - does informed consent even apply here? They aren't providing a medical intervention, they aren't medical staff, and the caller is not their patient - even if it does, is it reasonable to assume that someone who is imminently about to commit suicide lacks capacity? Other than by legally available mechanisms? Probably. - if you want to kill yourself why would you make it clear to someone over the phone first? - is consent even necessary for such action by emergency services? I don't think so.

pvaldes 3y ago

That would put suicide hotlines, many driven by volunteers, in serious trouble of being sued.