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Comment by Gimpei | Hacker News Reader

I don’t see what the problem is. If someone has just taken pills and is close to dying on the other end of the line, do you really think the optimal course of action is to just sit there and listen to them fade away?

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That's almost never the case. And how can some stranger at a call center know this? Mentally ill people are unreliable narrators of their own circumstances. They're prone to exaggerations, delusion, rants, lies, subterfuge, concealment, verbal abuse.

If someone called 998, then yes, please listen to them. Listen attentively, validate their feelings, but soothe and comfort and reassure them. There are systematic ways to do this and they can get results.

But never ever call 998. Beware if someone offers to do so. Your hospital incarceration will be more traumatic, damaging, and expensive than any other alternative.

Get help before it gets to that point. Seek out good therapists and support groups when you're sane and calm, and stick to your treatment. Do it in-person, face-to-face. There is no substitute.

988 is not 911. Authorities are only called in extreme circumstances. Please do call if you feel the need.

You called 998, you called the "authorities" already. Cat's out of the bag. Van's engine is running. They know where you live and they know how fast you're moving. They can't know how many doses you took or how many rounds are left. You'll wake up chained to a bed with screams and moaning in the hallway. Nurse Ratched is here with your pills.

Your attitude actively harms people with mental illness. Well done.

But doesn't the attitude that one should trust the 998 system also actively harm people with mental illness?

Your attitude of dismissal over why a suicidal person would prefer to avoid calling 988 is disingenuous and perpetuates real harm while it serves as a wolf in sheep's clothing.

The whole point of the article was that there's no transparency. Nobody knows how many calls gets passed along to 911 and there's no way for an end user to know if they are getting pinged/traced. It is a fraud and a violation of trust for 988 to bill itself as confidential under these circumstances.

When I was sick with a condition whose symptoms precluded me from being aware that I was sick, I yet had a vague awareness that something was wrong. I ended up talking to an academic adviser at my university, who had the insight to transfer me to the university's general practitioner, who had the insight to transfer me to an excellent specialized treatment program. I am now fully recovered. I was very lucky: if I had called 911, I would likely have been placed on a railroad to a much worse place.

The condition, according to the article, was not having taken pills and being dying, but "if a call-attendant believed a person might be at “imminent risk” of taking their own life in the next few hours, days, or week".

This is weak enough that it will happen many times for people who are not in a significant risk, but for whom such an intervention can be seriously detrimental to their life. Note that suicidal thoughts are most of the time just thoughts and not acted upon.

If nothing else, it should be made clear to the person calling what risks they are taking. Many people might believe that they have confidentiality and that they can talk freely without risk of consequence.

So, if they didn't intervene, and the caller did indeed commit suicide the next day, you're all good with that lack of intervention?

On the other hand, there are people who need this service are not using it because of fear of getting hospitalised involuntarily.

Yeah, their fear is largely unfounded. Sadly, we've swung too far to the other extreme on involuntary treatment.

"Largely" unfounded doesn't make it unfounded. It's founded, and relevant, and either will be addressed by people acknowledging its genuine existential nature as a threat or, following your baseless dismissal, people will die.

Yes. IMO, we have to be willing to accept errors of both types (under-intervention and over-intervention) in order to design a system that is the most helpful overall.

Some people who call a suicide prevention hotline will go on to kill themself. That by itself is not evidence of a flaw in the hotline or its policies.

Yes, I was expecting this hotline to do more harm than good. It's not just for people who have problems themselves, it's also a hotline to report those who they care about. It's basically snitching on people because of their thoughts. It's a further entrenchment of our "police state".

Many times ordinary people have suicidal thoughts and don't carry out it at all. Subjecting those people to coercive treatments would be extremely harmful as doing so will further traumatize them. And it's also an affront to individual liberty, including the freedom to have negative thoughts. Sometimes such thoughts, if not interfered with by a meddling "nanny state", are an opportunity for growth and recovery.

And this hotline can also be used as yet another means of coercive control by a partner with Narcissistic Personality Disorder, or other personality disorders. Where the partner can threaten to report the victim as suicidal or mentally unstable. Yes that happens, and it's surprisingly common. That's why here in the UK we passed laws against coercive control.

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