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You were not suicidal. Not passively, definitely not actively. The needs of the actively suicidal are not the same as someone who is unhappy and just calling to check the experience. I don't know if you've ever been around someone who is actively suicidal, but it is a completely different state of mind than normal interactions. What they need is not a connection or a therapy session to talk them down - that comes later. They need help. That could be talking, but it could be figuring out whether to send an ambulance, law enforcement, whether someone is there who can restrain them from taking irrevocable actions, or to drive them to a hospital.

So yes, maybe you got someone who had no idea what to do with you. Maybe they did suck at that job. But you were applying the wrong tool to the problem. If you are unhappy, call a therapist. If you are suicidal, call a hotline.

I agree.

> Years ago, unhappy but not suicidal, I decided to call a suicide hotline.

They tried to use a tool for a state of mind they were not in, then got surprised that it wasn't helpful.

If you are suicidal, don't call a hotline. See a friend, talk to family, but don't consult a professional. Professionals, in many countries, are bound by law to refer you to a psych ward. Even if your state of mind is temporary, you'll be stuck there for days, weeks and sometimes even months. Often, staff are abusive.

If you are suicidal, do not call a hotline.

It's 3am, you ring a friend, they don't pick up. You ring home, your parents are asleep. "do NOT call a hotline" you remember. Nobody to talk to. Nobody loves you. Worthless piece of human fucking garbage. Better off dead. Better off dead when the people who "love" you aren't there when you need them. Waste of space, waste of air. A bother. You're just bothering them. The last thing they'll think of you as is a bother. That's how worthless you are. Piece of shit. Absolute garbage. Better off dead. Just fucking end it already.

^ Thought process of a suicidal person.

"do NOT call a hotline" is, IMO, actively harmful advice. If you're debating whether or not you should call, remember that normal people wouldn't even think about it, and call the damn hotline. Save your life.

I speak from personal experience. What happened to me is quite real.

Don't forget - you are not anonymous when you call these hotlines. Far from it. If you call expecting your anonymity to be honoured, then you are making a grave mistake.

> If you are suicidal, do not call a hotline.

Everything you said above is true, but this is advice that I feel on the fence about giving.

If you call a hotline, it is not unlikely that your life will be disrupted. You may very well be involuntarily committed to a psych ward for days/weeks/months, depending on your mental state. Some psych wards aren't great, but some really aren't all that bad.

It may sound scary to have your life disrupted like this, but hey...

If you are feeling suicidal... Ya know, considering ending your life suicidal... Maybe this kind of disruption is exactly what you need.

As someone who was very badly affected by the Australian medical system, let me just say that what happens to you in the system will almost certainly traumatize you as much as the event that led up to it.

It's very easy for someone to say otherwise, unless they have experienced it first hand. Have you?

No judgment or anything else implied, but I can't help thinking that the alternative might be you not being here to tell this. Would you find this a better option, now? It's hard to imagine (for me).

Somewhat ironically, the person I spoke to actually calmed me down enough to allow me to go and call on a friend. By the time the authorities arrived I was in a much better state. All they did was waste resources and reintroduce my negative thoughts.

I called them to be anonymous and not disturb my family, so I could get into a calmer state where I could get help from my loved ones. They utterly failed.

Which wonderful place do you live in where there is all this spare capacity in MH services? Speaking for the Uk, you're not getting sectionned unless you're really at imminent unavoidable risk, and you'll probably be out in a few days

> If you are unhappy, call a therapist. If you are suicidal, call a hotline.

This is very reductive, basic advice. Sounds great, but fails to consider the very real possibility that a suicidal person cannot diagnose themself effectively.

Telling a non-suicidal person to call a hotline isn't the best advice, but accidentally telling a suicidal person to call a therapist is much worse.

Being suicidal just means that you are at imminent risk of committing suicide. It isn't necessary to be in a completely different state of mind than normal for this to be the case.

Yes, most people who are acutely suicidal probably wouldn't even bother calling a hotline. You call the hotline when you start to get an unsettling feeling that you might be out to hurt yourself but didn't decide, yet. For me this is obvious. Suicide hotlines are probably mostly just an excuse by the health system so they can state "we gave it a try".

>I do wonder if my experience is representative of the norm or not.

When you need help, you find out pretty quickly that institutional support is like bumpers in a bowling alley gutter - it's crude and manufactured. It might keep you on the lane, it sure doesn't help you bowl any better. You also find out that even well-intentioned people aren't much better.

What sucks about suicidality is that everyone is so sterile about it.

Maybe it's that everyone is so on guard against personal connections except from select loved ones. For some people, it might even require talking to someone in a similar headspace just to get on the same page and start talking for real. But I've found out I helped people after the fact, and if I knew I was playing defense going in, I'd probably would have been too scared to say the things I did.

Anyway, here's a nice article, the first half of which explains that failure to communicate better than I ever could: https://eggreport.medium.com/envying-the-dead-skyking-in-mem...

I used to work at a hotline, and OF COURSE the 'quality' of the volunteer varied. We were not trained to avoid anything, we were there to stay on the line as long as people wanted, and talk about whatever people needed unless there were more calls than we could handle. Many people called who were in crisis, rather than overtly suicidal, we were there for them.

A single hotline experience not working for you doesn't warrant a blanket "I would never suggest to anyone to call a suicide hotline".

There are lots of studies that show that such programs are at least moderately effective (https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12...)

Look at the methodology - borderline laughable. Tells us no more than his anecdote does, for there are a million other potential explanations - including that it isn't calling those hotlines that helps, but knowing that one can, which dovetails nicely with research on the benefits of friendship. Some things you simply can't test.

There's also studies that show the more times you are committed the more likely you are to commit suicide, i.e., that psychiatric hospitals cause suicidal ideation.

Would love to see the methodology on this. I wonder how they controlled for the cofounders are addressed. it stands that more seriously distressed people are committed more.

It is like saying that the more times you are hospitalized for illness, the more likely you are to die.

Or perhaps the most suicidal people are more likely to be committed? Causation seems very hard to show here.

If incidence of suicidal ideation goes up with number of involuntary holds then it means that psych facilities are not treating the problem. That is enough: that they are provably not treating it. First do no harm means you have to be causing good; ambivalence is treated as likely harm because it is invasive.

Can people more or less easily kill themselves while in psych wards?

You mention a correlation, and then you presume cause and effect. An alternative is that the people most likely to commit suicide are more likely to be treated with multiple involuntary holds.

If psych facilities prevent suicides 50% of the time in the long term, the correlation exists for the 50% where they were unsuccessful. Psych facilities could be wildly successful, and still suicides would be more common with multiple admittances to the facilities.

I’m not saying you are wrong, but I am asking you to consider you could be wrong, before wading into such a dangerous area.

That said, I personally think calling mental health services is only for true emergencies: they are highly toxic environments where a bunch of loonies are locked up together and the nurses and doctors can also be toxic as hell. Putting an 18 year old girl under the power of a 40 year old male psychologist who demands obeisance is deeply sickening. She told me she had been previously committed “for her own safety” (I guess manic sexual behaviour), and she said she was raped while in the facility. Sometimes someone is mental as fuck and committing someone to the psych ward is necessary, but I personally would try all other avenues I could safely do so, even at risk to myself. It is a nasty situation and there usually is lots of downside risks regardless of choices made.

Evidence of suicidal ideation is a specific example (and probably the most common) of what gets people involuntarily admitted to a mental ward.

In fact, there are almost certainly more people admitted on that basis than actually have it, because if someone is not clearly a danger to themselves or others, but seriously needs help, the easiest way for emergency personnel to fudge it is by reporting a mention of suicide.

Can you provide further context on what makes you think there is significant causation in the opposite direction?

No, you prove it.

If incidence of suicidal ideation goes up with number of involuntary holds then it means that psych facilities are not treating the problem. That is enough: that they are provably not treating it. First do no harm means you have to be causing good; ambivalence is treated as likely harm because it is invasive.

That's nonsense. You are not "provably not treating it" – you are provably not curing it.

If the people who receive the most chemotherapy sessions have the highest rates of cancer deaths, does that mean that oncologists are "provably not treating" cancer?

In those treatment there is a metric that indicates success. For this it is not so clear, the main indicators saying "does not knowably prevent death and raises possibility of future death."

The same metric exists here. Various cancer survivor rates are measured by the average number of years someone survives after diagnosis, regardless of the rate of remission. How many years of life does treatment buy a patient, given the kind of cancer and the stage at which it is discovered?

Your argument is "more people who are suicidal enough to warrant involuntary commitment end up killing themselves than people who don't reach that point, therefore commitment causes (or at least does nothing to prevent) suicide," which is absolutely illogical.

This is beyond "I don't understand 'correlation != causation,'" and is into either "willful ignorance" or "I enjoy hearing myself talk" territory.

Prove what?

So uh...you made one call to a suicide hotline, admitted that you were not suicidal, and you think that experience is enough to assert that the service is completely useless for those that are suicidal?

A suicide hotline is not a general mental health therapy. It was one function -- to prevent the caller from committing suicide in the immediate future. It was successful.

You can't test the effectiveness of a suicide prevention with a dry run. Fire drills don't put out fires either.

Also, you essentially admityed that you were making a false call. That's not going to get a great reply. You shouldn't call 911 to test response time either.

Exactly, and I'm sure they want to keep their lines open for the real emergencies.

My point is that it can be hard to tell a real emergency from a non-real one. Not everyone is going to be sobbing and shouting. Some may sound calm and alright. If you've known someone who committed suicide, you probably know that there isn't always a flashing warning sign the day of. There is sometimes, but it's not reliable. I think it's important for a hotline to treat all calls equally.

My impression differs.

The caller left the experience feeling more disheartened and unsupported. Logically that seems like they were at an _increased risk of suicide_ relative to when they called.

He literally answered "no, I am not suicidal" to the "are you suicidal" question. And in fact, he did not became suicidal after.

This was not failure of suicide hotline. This was them recognizing he is misusing the service.

If you answer yes they are liable to send someone to kidnap you, so people are trained to not answer yes.

Expectation for suicide hotline is not "make whoever is sad and calls happy". It is to prevent suicides. He called suicide horline. He was not suicidal at all, he said it to then and to us.

He was not trained away from saying it. The question did not even came straight away. If he is afraid to admit suicidal thought for rational reasons, as you say, rational act is to not call at all.

Way more likely explanation is that they realized he is not suicidal, then asked to confirm and end ended that all.

It's heartbreaking our social institutions failed you so badly that you needed to call a suicide hotline to connect with someone, even though you weren't suicidal. However that's not a test call. In telecom people who install phone systems are legally required to call 911 just to make sure it works. It usually takes five seconds and then they hang up, because they know emergency hotlines might be understaffed and they need to be available for people in emergencies. One thing you might consider is calling your bank or some commercial call center where company policy prevents representatives from hanging up on customers. There's so many people who are lonely and have no one else to call, so they turn to these hotlines. It's still not great, because it contributes to hold times and makes it harder for the person who picks up to meet their quotas, but you'd at least be freeing up resources for the people who at risk.

Is your advice based on this single interaction?

Well, I have two options going forward:

1. Despite my bad experience, recommend suicide hotlines in the hopes that they work even though they didn't for me.

2. Recommend against suicide hotlines while explaining why and cautioning that my experience may or may not be representative of the norm.

I'm going with #2 for the time being, yes.

You really can't think of any other options?

Why do you feel recommending anything at all is required?

3. Share my experience, acknowledge this is a single data point, and withhold recommendation.

This is a good point, and phrased better and more openly than the other replies.

Recommending against anything because it didn't work for you isn't good, even with the disclaimer. Antidotal evidence is the worst.

3. Not post about something you have scant evidence one way or another about.

3. Collect more meaningful data before offering recommendations?

Called an emergency line after hallucination episode. Woman meant well but was very limited in her suggestions and empathy.

I don't blame them though. That said whether or not they're optimal.. it's often a good last resort option. Many people might have avoided tragedy through some mild listening. I've seen it happen on other venues.

[0] To be fair.. most psychology professional I ran into were far from perfect.

It's not a hotline for free therapy, and they only have the script/training for one circumstance. You don't blame your hammer if it doesn't saw very well.