Policing is in such a horrible state in America that an emergency number that excludes police involvement seems increasingly necessary. I wonder if you can get paramedics through this route or if it just rings and you eventually get a counsellor.
Many, if not most, of these places give the operator full access to your phone number and whatever geolocation data they can get based on that. They also have policies where the operator is allowed/encouraged to call emergency services on you without your ongoing consent, or even without telling you. In my experience talking with others who have been affected by those kinds of policies, this can lead to police breaking down your door while you're naked and crying, or worse. A person in deep crisis is not likely to respond well to armed officers showing up, as the police are more likely to come into the situation looking for conflict.
Sometimes, you can call a local dispatch and just get medical services, or maybe a fire department sent first. But that's entirely up to the discretion of the dispatcher and local protocol.
There's also a relatively common experience I've heard where people who aren't actively suicidal call these lines, and the operator (I won't say counselor) is completely dismissive: "if you're not going to hurt yourself, what do you want me to do?"
Not to mention the stories I've heard where call centers just have passwords for their internal systems on sticky notes laying around on monitors...
The general field is so bleak that some other folks with peer support experience and I have started a nonprofit where one of the things we're doing is building open-source software that will let anyone create their own support line. Security and privacy are our primary concerns, ensuring that operators and callers never see each other's numbers or any kind of information.
[0] non-consensual active rescue is the practice of calling emergency services on someone without their OK
[1] The line was Trans Lifeline, which I cannot recommend supporting for other reasons at this point
- A culture of internal anti-Blackness. During the uprising of 2020, staff and volunteers wanted the leadership team to address real issues with race inside the organization. As a member of the leadership team at the Director level, I pushed for many of the staff-led changes, but most of the team wanted to just talk about things instead of implementing policies.
- I had a bug in some software I wrote - applications for a service were supposed to be distributed based on race. A few more white people than they wanted got through. I fixed the bug immediately (it was a concurrency issue), explained it, and was met with absolute hostility - shouted at in meetings, labeled a white supremacist and removed from leadership. A plan was developed to have mediation, but after months nothing happened.
- From what I understand, they have basically gotten rid of their QA program that would review calls to make sure operators are properly trained and handling calls appropriately.
- A former staff member went missing during a mental health crisis. They said they were going to provide FMLA but fired her instead, leaving her partner and children without any financial support.
- Piss-poor answer rate. After they fired their Hotline Program Director last year, basically no one stepped up to run the hotline. Folks I've heard from have reported that many volunteers (the backbone of the hotline department) left, new volunteers weren't being processed properly.
https://twitter.com/covertactionmag?s=21&t=zbpg0lQWdYJ70Gbhq...
cmg is directly involved in pushing disgusting lies like “Is Russia’s Bombing of the Mall in Kremanchuk Another False Atrocity Story Being Used to Justify Ongoing Military Intervention in Ukraine?” (https://covertactionmagazine.com/2022/07/01/is-russias-bombi...)
As a member of the EB, cmg apparently approves of interesting stories like “ Calls By Western Socialists For A Russian Retreat From Ukraine Amount To De Facto Support For NATO Aggression” (https://covertactionmagazine.com/2022/05/22/calls-by-western...)
cmg has also been involved in stories such as “Remember the Maine: The Alleged Russian Atrocity at Bucha Looks Like Another in a Long Line of False Pretexts for War” (https://covertactionmagazine.com/2022/05/13/remember-the-mai...)
From reading these articles, it is difficult to come to any other conclusion than that cmg is actively working to support the genocide in Ukraine. Perhaps you should treat his words like as if they were coming from William Joyce.
Covert action magazine.
I don’t believe I’m on a side other than that of democracy?
Is that controversial?
> UPON DISCOVERY OF UNAUTHORIZED PURCHASES TOTALING $353,703 BY TWO OFFICERS OF THE ORGANIZATION THAT OCCURRED IN 2017, ON OR AROUND JANUARY 21, 2018, TRANS LIFELINE REMOVED THESE OFFICERS FROM HAVING ACCESS TO THE ORGANIZATION'S BANK ACCOUNTS AND ASSETS AND TERMINATED THEIR EMPLOYMENT AND THEIR POSITIONS AS OFFICERS AFTER COMPLETING ITS INITIAL INVESTIGATION OF THE DIVERSION. ...
It goes on to say that they didn't file a lawsuit, and criminal charges don't appear to have been pursued. What the heck happened?
[0] - PDF: http://web.archive.org/web/20190221114026/http://rct.doj.ca....
I wasn't there, don't know all the details, but this sounds like a classic case of Woke Monster eating itself.
My brother is going through some stuff and got this exact response in the UK.
If you aren’t immediately about to harm yourself there’s basically no state provided resources.
"We don't have time for this" [0] comes to mind.
[0] https://www.insider.com/cop-said-i-dont-have-time-shooting-k...
That would get you dismissed from any reasonably-run suicide hotline program ASAP.
I have a friend who volunteers for a suicide hotline program here in the US. He says it's actually well run and they keep close tabs on the volunteers. Everyone who volunteers is doing it because they care. It wouldn't make sense for someone to volunteer for such a program just to be dismissive and rude to people who call in. However, I could see this happening at poorly-managed programs that use low-paid employees without proper training and supervision.
Hi, CTL volunteer here. I have some gripes with a few of your assertions.
It's true that CTL was caught sharing data. They have retracted that policy, and it remains unclear to me how much of the data was being shared to which level of granularity. Since then, data can be manually deleted after a conversation is concluded. I have seen this happen, and I welcome you to try again if you would like to test the system. That is welcomed.
Each counselor is required to treat each texter with empathy and the gravity that a mental health crisis requires. I do not know of anyone on the platform who would disparage a texter because his/her/their crisis isn't significant enough. If you text CTL, it is for a reason, and we want to help you through that moment no matter your background.
Another important distinction is that we are trained to risk assess each and every texter, irrespective of our intuition about their mental state. That means I treat someone testing the system like I would someone who has been flagged as an imminent suicide risk.
Supervisors monitor this evolution of the conversation closely.
The assessment is important because ultimately the decision to call emergency services comes after that rigorous assessment of the person's suicidal ideation, followed by their plan and access to means, as well as their timeline. If all those criteria are met, I contact my supervisor, and then we work on separation from means. If those criteria are not met, we continue the conversation accordingly.
I have personally walked numerous people back from the edge simply by talking to them and hearing them out; often times, texters deemed imminent risks are capable of staying safe that night after we have come up with a safety plan for them together. Calling EMS is truly a last resort and not an attempt to cast off responsibility.
In the cases when we do call emergency services, it is after we have exhausted all other options. It should be noted that access to geolocation is strictly limited to these supervisors, and in all likelihood is limited to a texter's phone number alone. It's not like they have a backdoor into AT&T, and the supervisor must make a call to emergency services directly. From what I can tell, very little information is given back to CTL. On occasion, I can see a timeline that EMS was dispatched but rarely do I ever learn about the outcome.
The success of the platform is that we can work with people to find them their own solutions. CTL was not a viable intermediary for calling 911.
All in all, I recommend other readers to treat the post above with a grain of salt. Please be aware that platforms such as CTL are frequently volunteer-staffed, and, while we all do receive 20 hours of mandatory training, we aren't psychologists and we are not allowed to act in a medical capacity in the slightest. Each counselor is expected to work within a strict purview with clear objectives. Lots of well-intentioned people are there for whoever needs support. As far as volunteering goes, this is some of the most emotionally-involved I've ever had to do, and it pains me to read reviews of CTL that paint it is a data profiteering lab of pseudo-psychologists and dismissive blowhards.
Lastly, should data privacy be a cornerstone to these services? Yes, I wholeheartedly agree. But I am glad that this service exists, and we should not miss the forest for the trees. Many of our colleagues, friends, relatives, and countrywomen are suffering right now more than ever. We should not profit on their misery, but we have an opportunity to connect with them and change their lives. To my mind, that is worth every byte of data.
My post was general, not specific to CTL.
Assholes like yourself are why I need to bring a gun to my doctor visits. I might need to murder the doctor in self defense. Way easier to get out of a hold if you do that first.
You’re out of line.
Some of the worst people I've met are the EMTs who do these calls. Some believe they are doing no harm. They are worth killing, and I am not sure whether I could avoid doing that if someone exposed themselves like that to me.
edit: why am I being downvoted?
people already avoid a call to 911 because the subsequent ambulance service is unaffordable and can land you in collections. they avoid the ER for the same reason. 988 assumes anyone who needs crisis care will be able to get it, or even afford it and the ecosystem of services and medications that may ensue.
988 gives, as amber alert did, a can for politicians to kick down the road and cheerlead.
In Ontario an ambulance trip is about $40. But in the US it can be crippling.
btw many is cities can barely keep their dispatch for 911 staffed.
One of these things is not like the others.
There's no need for gun control once a society has implemented the other three; violence and suidice (with or without access to firearms) is a direct function of socioeconomic inequality - and I'm uncomfortable (to say the least) with disarming the very working class most impacted by said socioeconomic inequality at all, let alone before actually addressing that socioeconomic inequality.
Does that imply you'd support an armed insurrection? That seems pretty extreme! And if not, then why exactly do these people need guns?
It implies that I support the right to self defense - including against an oppressive regime and the enforcers thereof. Specifically, it implies that I support the exercise of that right among the class of people typically excluded from it. Violence is the last resort, but it is a resort nonetheless.
"Under no pretext should arms and ammunition be surrendered; any attempt to disarm the workers must be frustrated, by force if necessary" -- Karl Marx
"That rifle on the wall of the labourer's cottage or working class flat is the symbol of democracy. It is our job to see that it stays there." -- George Orwell
"A man's rights rest in three boxes. The ballot box, jury box and the cartridge box." -- Frederick Douglass
> And if not, then why exactly do these people need guns?
Because even when a government is not actively oppressing its people, it is demonstrably (with considerable regularity) incapable of protecting each and every one of its citizens from one another. Like the saying goes: when seconds count, the police are an hour away. Every person has the right to ensure one's own safety and security, even if their government can't or won't ensure it for them.
And that's entirely ignoring things like non-combative use of firearms, like hunting or pest control or defense against predators or marksmanship or what have you. Quite frankly: the purpose for one's ownership of a firearm is the business of none but oneself.
I can potentially see this in rural areas. Not so much in urban areas, where the police are much nearer and it seems that the guns are the main conveyer of harm.
I don't think you can ignore that they are also used in offence, not just defence. I live in the UK and I don't need a gun to defend myself, because any attacker is extremely unlikely to have one either (because the penalty for even being found carrying one is so severe that it's not worth the risk for them). One of the best ways in which a government can protect its' citizens from each other is removing dangerous weapons from their possession!
I guess my question is: what are you scared of? To my mind the most likely thing to be a victim of is burglary, in which case isn't it much better to just let the robbery take place (and then claim on insurance) while being safe and unharmed than to risk being shot in an armed conflict? Seems to me you make yourself less safe not safer by bringing guns into the equation.
Unless you have a cop on every street corner (and even then), you wouldn't have enough coverage for cop intervention to be something upon which you can rely for your own safety. At best, they might catch your assailant after you're already dead.
> I live in the UK and I don't need a gun to defend myself, because any attacker is extremely unlikely to have one either
You're ignoring the vast differences in available socioeconomic safety nets between the US and the UK. The UK's still pretty shitty on those metrics (which is why there's no shortage of violent crime), but it's certainly better than here in the US.
> I guess my question is: what are you scared of?
I'm scared of my government deciding that it's time to round up everyone of $ETHNICITY or $RELIGION or $IDEOLOGY or $SEXUALITY or what have you and send them off to internment camps. I'm scared of white supremacists deciding it's time to bring lynch mobs back into fashion. I'm scared of the ownership class using the state to coerce (with increasing severity) the working class into continuing to work despite continuing to get the increasingly short end of the stick. I'm scared of theocrats deciding that "separation of church and state" is no longer necessary and therefore empowering themselves to impose their own religion (or more precisely: a very twisted and corrupted version of it) on every other American. I'm scared of GSRMs losing the rights we had just so recently won.
> isn't it much better to just let the robbery take place (and then claim on insurance)
It would be much better to deter the robbery in the first place. It would be much better than that to give people a safety net such that they don't have to resort to robbery in the first place.
Suicide is a direct function of depressive issues and circumstances that peaks on you at the same time you get that one too many "it's gonna be a bad day" piece of news. I'm a suicide survivor (I say survivor because I didn't attempt anything. I succeeded.) whose only alive because my bulldog lead my youngest brother to where I was outside as he had dropped by to see me. A lethal dose of methadone is 50mg. I took 500mg and washed it down with Jim Beam. I was legally dead three times (once in the ambulance and twice in the ICU). I'm not going to say it doesn't happen....giving someone with depression all kinds government reform will do exactly nothing to cure that depression. More affordable opportunity to seek mental health, sure...I'm with you. But even that is maybe 10% chance to prevent if they're down on a day when something happens. I had divorced as well as having my middle brother pass away within weeks of each other.
As far as violence? If you made everyone a millionaire today, there'd still be violence crime, hence violence to retaliate to that, tomorrow. Because people are never satisfied. And unless every physical asset was a cookie cutter model of every other item like it, people are going to be jealous of what someone else has. The best way to cure a lot of the violence is for people to leave each other alone and show some decency to each other.
Because people generally don't kill themselves or others for shits and giggles.
> Suicide is a direct function of depressive issues
Which largely go unnoticed, undiagnosed, and untreated until it's too late, in no small part due to the absolute shitshow that is mental healthcare access here in the US.
> and circumstances that peaks on you at the same time you get that one too many "it's gonna be a bad day" piece of news.
For large swaths of the American population, those pieces of bad news skew heavily toward socioeconomic circumstances. Job loss, debt (incl. medical debt), homelessness, being convicted of crimes because you couldn't afford any better than an already-far-overworked public defender... the list goes on. Even for the things outside that list, they become a lot easier to bear when you can actually afford some degree of treatment.
> giving someone with depression all kinds government reform will do exactly nothing to cure that depression
It will do everything to solve it in the vast majority of cases, and in the remainder of cases will at least prevent "I can't afford it" from being an excuse to get help.
> If you made everyone a millionaire today, there'd still be violence crime
There would be a hell of a lot less of it.
> The best way to cure a lot of the violence is for people to leave each other alone and show some decency to each other.
Which is a lot easier to do when you don't have to resort to crime for basic survival.
Assuming that was under the deductible, so the ambulance provider did not get paid anything else, and $500 was the negotiated pricing for members of your insurance plan.
Or are you at some point willing to admit that not everything should be a private, purely for profit/shareholder value, venture?
The fact that the insurance company can negotiate the bill to $500 indicates what the real price is. The $12k number is just fantasy numbers that healthcare providers throw out to start the negotiation.
That really depends on your definition of "real price", particularly considering how in a lot of developed countries that'd still be considered a pretty outrageous price to pay for such a situation, particularly while even having insurance.
It does not depend on who pays for it.
I did not intend to comment on who should or should not be liable for paying this price, simply that $500 seems like a reasonable price for an ambulance service.
I would have made the same statement if the government had paid the ambulance company $500, or if the government’s cost for providing that instance of ambulance service was $500.
Obviously, the $12k is ludicrous, proven by them being willing to accept $500 for people who belong to an insurance plan.
Health insurance in the US is not just insurance against a one time high cost event. One aspect of it is paying a business to gain access to lower pricing due to volume that you would be unable to get as an individual, which seemingly this person’s insurance plan did.
It only makes sense to talk about volume discounts when there is actual savings from providing volume (for example, less packaging). Many different instances of individual care do not create such savings, for anything but handling the make-work billing paperwork that this system itself generates.
This idea that individuals shouldn't be market participants is a broken assertion that underlies much of our healthcare dysfunction. In the situation you're describing, the "insurance" company has zero market leverage over the ambulance provider, and so you're championing a specious "negotiation". Meanwhile individuals that need a ride to the hospital avoid calling 911 since they have no idea what it will cost, and instead look to markets with price transparency to fill in (ie markets where they're welcome).
A straightforward healthcare reform would be to eliminate this cartel dynamic of providers having a different price for each "insurance" company, and mandate that they charge the same published prices regardless of who is paying. At that point, insurance companies would financially provide real insurance rather than their current function of bundling and obfuscating price signals. There would no longer be this "out of network" nonsense, but rather insurance coverage would be based on percentages of market prices. Insurance companies could then recommend providers that charge lower prices to save money for themselves and their customers, while still allowing their customers to be market participants when their preferences differ.
I do not assert this. I would much prefer transparent pricing and people being able to shop around.
> In the situation you're describing, the "insurance" company has zero market leverage over the ambulance provider, and so you're championing a specious "negotiation".
If this was true, then the ambulance company would not have accepted $500, and would instead demand the $12k they billed. It may be that the leverage is simply political or PR, but it must exist in order for them to come down from their fantasy list price.
I agree with your last paragraph, and that is the situation as of recent due to new laws passed about surprise billing and out of network restrictions for emergencies. As well as publicly listed prices.
Source: https://www.census.gov/library/publications/2021/demo/p60-27...
Again, I cannot stress enough how insane this sounds to someone from most other first-world countries.
Hm? The insurer would've paid the difference (minus some additional discounts depending on the size of the insurer and its bargaining power). That the patient paid $500 does not in the slightest bit indicate that the insurer negotiated the rate down to that pricepoint.
Even at $500 (and let's assume that was an hour-long ride, for easy math that's maximally generous to your argument), EMTs on average make around $20/hour at best, and maybe double that for a nurse - so a fully staffed ambulance would run around $80/hour for labor. Round it up to $100 to be generous and that still leaves $400 for the ambulance itself. Ambulance itself costs up to $150,000, so earmarking another $100 would pay it off after 1,500 hours of service - so less than a year, even if it's only running for 40 hours a week. Maybe it's really fuel-inefficient and breaks down frequently, so we'll say another $100 for fuel and maintenance. Throw in another $100 to pay off $150,000 worth of equipment and medical supplies.
So of that $500 price the patient pays, we're left with $100. At the price billed to the insurer, that's an eye-watering $11,600 of what appears to be pure profit. Maybe there's some excuse for that, but to me it's pretty obvious that something's way out of whack. $500 or even a bit more than that would be reasonable if EMTs and nurses were being paid better, but they largely ain't.
I have no idea how much ambulances and personnel cost, but I do know that whatever the costs are, they have to be distributed amongst the emergency events.
An ambulance and redundant staffing is paid to be available 24/7, but there might only be 3 or 4 or 10 trips per day.
I assume there are also considerable liabilities and hence insurance costs.
That doesn't make the fact that they bill such a ridiculous amount in the first place any less unacceptable.
And if you're uninsured? Or your insurance refuses to cover it? Or it does, but with a high deductible?
My point is that the "well established practice" in question is useless at best and outright detrimental (to say the least) on society. Why even bother throwing out that number unless there's an expectation that someone would pay it?
Those workers are paid ~minimum wage, and the amortized cost of the vehicle and its equipment is not $500/ride.
The reason they charge $500, $800, or $12,000 is because ambulance firms have monopoly licenses, because you're not going to haggle over the price when one arrives, and because they can charge you whatever the hell they want, and when the dust settles, some people might even pay it.
Related to the rest of this thread, a family member was hurt at work about six months ago and needed a 12-mile ambulance ride. The ambulance company billed the company's insurance $1,400. The company's insurance actually paid a little over $300.
However, they're usually managed by air/rescue and therefor part of the fire department or equivalent.
It's not that it's a shit job, it's that it's a job that requires you to commit reprehensible acts, so good people can't join in good conscience. If our laws, law enforcement methods and justice system weren't horrifying, cops would be better, no matter how shit the pay or demanding the expectations.
It absolutely does not require that.
> If our laws, law enforcement methods...weren't horrifying
Give some examples and provide some practical solutions.
Are you actually required to do that as a police officer? Would it not be up to the discretion of the officer as to whether it was in the public interest to make an arrest or not? Here in the UK it would be pretty unusual for someone to be arrested for getting high unless they were causing a public nuisance, property damage, or similar.
Forty percent of Uvalde's budget was going to the police - $4.3M for 15,000 residents, or $2900/person. That doesn't include the half a million dollars for their school police force.
New York City has a budget of about $100BN, and $11BN goes to NYPD - $1300 for every single person in the city.
https://substackcdn.com/image/fetch/f_auto,q_auto:good,fl_pr...
Second, spending on police has actually been trending down for quite some time:
https://fred.stlouisfed.org/graph/?g=Q7WX
And the number of officers per capita has remained remarkably stable over time (contra suggestions that the number of police has risen dramatically). See Table 1 in this PDF:
https://bjs.ojp.gov/content/pub/pdf/nsleed.pdf
Third, we spend much more on schools than on police:
https://substackcdn.com/image/fetch/f_auto,q_auto:good,fl_pr...
Despite the prevalence of memes to the contrary:
https://twitter.com/RCAFDM/status/1532739121562656770?s=20&t...
https://twitter.com/CharlesFLehman/status/153270044228675993...
Fourth, because spending in the U.S. is split amongst federal, state, and local governments, looking purely at local budgets is often more obfuscatory than explanatory. If we look at combined state and local spending, the picture looks quite a bit more reasonable:
https://www.urban.org/sites/default/files/2020-06/state_loca...
That graph in words:
> Overall, police spending was 4 percent of state and local direct general expenditures in 2017. (This data included federal transfers; if we look at just own-source funds, police spending was 5 percent of state and local expenditures.)
> This is far less than what state and local governments spent on public welfare (mostly Medicaid in the Census accounting) and K–12 education, but more than many other services, including housing and community development (and others not listed on the chart).
Source: https://www.urban.org/urban-wire/what-police-spending-data-c...
Obviously people can disagree about how much we should spend and on what, but, generally, the U.S. spends a pretty typical amount on police, that amount is significantly less than on various other social services, and the amount has largely not been growing.
E: hard to even imagine what kind of an utterly horrible person would downvote this
https://www.ksl.com/article/46295693/when-swat-teams-are-use...
This 2015 article claims 80k deployments per year
And I guess it makes little difference whether it’s the SWAT team that shoots you or just regular cops.
In 2021 there were ~1,000 police shootings. 85% of shot suspects were armed with a deadly weapon. That's in a nation with a population of 334,000,000 people.
edit: and I'm even accidentally being deceptive. There were over 1000 people shot dead by police. There were more people killed by police.
There are 1,136 total killed by police in 2021. 1,055 of them were shot.
There is a rough estimate that there were about 800 non-deadly police shootings, but that's a rough guess without much data.
That percentage is artificially inflated due to LEOs having a very broad definition of "deadly weapon".
Side note....did you read about those 150 Americans they chose randomly, and then stripped them of their right to vote as well as their right to firearms? It's funny how I could spread that fake story and people would lose their minds talking about a government not long to stand. Yet, if I say that 150 unarmed Americans were murdered by agents of the state who were violating their civil liberties under color of authority you'll cite the national population and say that shows great professionalism. Oh....the FBI is about to stop tracking those stats since only 57% of total LEO reported to them for the 2021 numbers. Just 44% reported the year prior.
This entire bizzaro world of where it's patriotic to support a group of revenue generators for the state being able to murder someone because, "Well....he took a breath faster then the previous one and I was sure he had a SAW system in your pocket....so me and Fred shot him 37 times. Well....we shot at him 37 times. But a few hit him. Some random house of someone in that area luckily took all the wayward rounds for us!", meaning it takes a true patriot to understand that our rights are all based on supporting someone who will allow you to die or end you themselves if they even see a shadow that makes them think that you mean him harm and are planning his demise.
Which might not seem like a lot, but this scales up quickly considering there are more than 17,000 swat units in the US [0].
If we average the callouts to 12 per yer, per units, that's still 204.000 callouts per year on a nation-wide scale. A number that does not seem too unrealistic judging from past data I could find [1].
[0] https://www.theiacp.org/resources/document/national-special-...
[1] https://theweek.com/articles/531458/troubling-rise-swat-team...
Now go outside and start pointing firearms at people or taking hostages and you will probably be getting some SWAT attention.
The article from The Week has a WaPo source that has more detailed data on SWAT deployments in Maryland [0];
"Since the law passed in 2009, the data have consistently shown that on average there are about 4.5 SWAT raids each day in Maryland."
"• Prince George’s County alone averaged well over one SWAT raid each day in 2012 (510 in total)."
"In 2012, nearly 90 percent of the SWAT raids in Maryland were to serve search warrants."
"• Half the SWAT deployments in 2012 were for “Part II” crimes, the nonviolent class of crimes. The vast majority of those raids were to serve search warrants on people suspected of drug offenses."
So not really a lot of "pointing firearms at people" but apparently a lot of war on drugs.
Also; Around 51 deployments in Maryland didn't serve search warrants, tho it doesn't detail it further what they instead did.
[0] https://www.washingtonpost.com/news/the-watch/wp/2014/02/17/...