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Comment by nyanmatt | Hacker News Reader

I don’t see how. Have you ever tried calling one of these lines in a suicide emergency? Things I’ve learned in California:

- an ambulance will not be dispatched unless you physically witness someone trying to kill themselves

- otherwise, they send the police

- the police arrive without training and severely escalate the situation

- the person having an emergency will be taken into custody and stripped of rights until being medically evaluated (not arrested)

This is the program of an allegedly progressive state. After 2 experiences like this, adding trauma to already traumatic situations, I would never recommend these hotlines.

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Very much disagree and I am in California.

I have called this line in particular during a sever major depression episode. I tried calling my fraternities mental wellness hotline first but it went unanswered which I thought was quite funny at the time.

The rep was able to talk me down through my spiraling thoughts. Told me that "no your therapist was not egging you on when he said well why don't you commit suicide what's holding you back". He was instead trying to figure out my reasons for living.

They do not automatically call the police and telling people they do is harmful. My anecdotal evidence has been a much better experience, and others I know who have called have said the same.

I'm not sure what would cause them to send the police but having a safe line to call when you have nothing else is important. Maybe the change that should happen here is having social workers or other mental health representatives respond, not getting rid of the phoneline.

I have a loved one who used the 988 hotline several times.

None of them resulted in police intervention. Our county has a mobile crisis team of social workers who show up and get you connected to services.

... services that use force against individuals. Never ever, ever tell a social worker of any kind that you think of suicide, or that anyone else does. ESPECIALLY not if you're young. Help, or social worker's kind of help, does not help. And getting rid of social workers ... I almost killed one before that happened.

All the lip service they make to that force is not the answer. It's lies, cheats and deception on their part, nothing more. Once on a forced youth services vacation I locked, with an entire group, a social services worker into a room. She became instantly educated why locking the rooms was a bad idea, why not even having a lock on the inside was an incredible mistake, and why youth workers ignoring screaming in the facility was an incredibly bad idea. All these people want is to be the big man (yes, including the 19 year old women who join), and you cannot explain it to them. After she eventually got out, we never saw her again, and the others were a LOT more flexible.

And that wasn't even close to the worst that happened.

These things is what social services calls "protection". They purposefully create situations where Gandhi would eventually beat up his own mother, and call it protection. Don't do this to people.

Consider the possibility that both your experience and those you worked with are not universal. The experience our family had was night and day different from yours.

I suspect this varies enormously from country to country, state to state, county to county, and per provider.

edit: OP changed their post substantially, and I'm now not quite sure what it's asserting at all.

I don't claim they are. And even if my experience is a 1% case, you still need to make people aware they're a possibility.

And it's far more than 1%.

You didn't say possibility, though. You said things like "Never ever, ever" and "It's lies, cheats and deception on their part, nothing more".

I have no doubt that forcible confinement is unfun. I also have no doubt that it's sometimes warranted and the best thing for someone to be able to heal. That you once menaced a social worker into quitting is not, I think, evidence against that.

The social worker in question forced confinement on children, when I was one, and got to experience her own tactics firsthand. Her reaction to her own tactics was indeed to quit the job entirely, the second she got loose. Of course, the same courtesy was NOT afforded to the children there. They got locked up, yelled and screamed for hours, then were simply locked up again. There was no exit, other than violence. Which, of course, led to extreme violence and constant escalation.

These assholes and idiots that call themselves social workers themselves can't themselves deal with the tactics they use on children. In fact they can't deal with 1% of the intensity of the tactics they use on children, because I assure you not having an exit for weeks after a few hours screaming out your lungs in a small room really 10x the stress. Then, 5 minutes later, seeing one kid using a knife on another, again just to get out of there, ANOTHER good way to 10x the stress.

As for "the best thing for someone to be able to heal", you mean forcing kids into an environment with constant violence? Both among kids, a bunch of adults using violence against kids, occasionally extreme violence from kids against those adults, and violence from the situation/facility itself? (or how else would you describe confinement?)

That's some social workers' way to deal with psychic vulnerability, and the potential consequence of asking for help with your vulnerability as a child, or, as in my case, a teacher "getting help" for a vulnerable child. Is that "the best thing for someone to be able to heal"? It certainly didn't prevent suicide or suicidal thoughts, and had the complete opposite of the "intended" effect when it was used on drug addicts, and anorexic patients.

(oh and extreme violence WAS the way out. Once these social workers really did totally lose control, they'd "solve" the problem by sending the kid home. In fact, some they literally shoved onto the sidewalk. And of course, the second advantage of going out that way was that you would never be "asked" to return)

> The social worker in question forced confinement on children…

Sure. Because they needed it. (And there are a lot of social workers at much lower acuities than forensic psych wards for violent kids.)

Kids don't like getting vaccinations, either, but stabbing the pediatrician in revenge is clearly not the solution to that. The pediatrician doesn't need a polio booster.

This is not a forensic psych ward. The only way to get into those is to commit an actual serious crime, which is pretty hard to do before you're 18 years old.

This environment is referred to as "closed", sometimes even "semi-closed". There's also "open" and "semi-open", but almost everyone runs away. You see, social workers' theories ... don't work. Don't help. And kids realize this pretty quickly. The only kids you see there are the ones they've suddenly kidnapped for 2 weeks to "closed", scared into behaving for a while. This works the first time, and kids that have nowhere to go at all (whom they kick to the sidewalk on their 18th birthday. Best hope you don't have your final school exams after your birthday ... because how will you ever do that?). The vast majority of kids are there (in open or closed) because they refuse social worker's help. This can mean getting placed by a judge in foster care and running away. This can mean systematically not turning up for "help sessions" at school (that was my "crime"). This can mean avoiding "in-house" help. In general kids get locked up because they make a social workers' job impossible. Which is ironic, because that is also the only way out.

And social workers lie. They are judged by how many kids they "helped" and so if the situation becomes truly untenable they send you home. You see, they lie you're cured. The advantage is that it's pretty hard to get punished for doing things wrong there. So you eventually realize that making the situation totally untenable is the way to get out. First thing I tried was to simply fight directly. I started fighting sports at age 3, and they tried to attack. I knocked 3 of them out and they decided to wait me out, which succeeded after more than a day. Next I decided the best tactic is to simply wait for a situation to turn violent. You won't have to wait long. And then figure out how to prevent social workers from helping each other, from fixing the situation, making everything go as bad as possible, without being even remotely responsible. Stand in the way. Make them trip. Close the right door at exactly the wrong time. For that they started to try to bribe me (e.g. a key, access to the "library" (a few dozen comicbooks and one programming book I brought. Of course no computer. I still know that book by hard) including at night, access to the kitchen). Then I figured out how to disappear, with a girl, for a few days. Just because these buildings are closed doesn't mean there are no places to hide. Social workers are total morons. We came back when we ran out of food. I was home before dinner.

The only case I heard of where a kid was sent to forensic psych from this was one that put a plastic utensil (he broke it in two and used the sharp edge) through the throat of a fresh intern. She lived, btw. For that, he was sent there for 2 weeks. They made some excuse for sending him home after 2 weeks, something to the tune of "it's not meants as a punishment and should not be used like that".

All social workers' help is a punishment.

Oh, and that's not because they don't want to keep kids in forensic psych. But the whole point of social workers' infrastructure is to provide maximum comfortable jobs for social workers. The whole system doesn't work. I've never met anyone who was actually helped (of course everyone lies to get out, or even to get back in as a social worker themselves). Forensic psych is ridiculously expensive per kid (> 200k per kid per year), and so kills jobs for social workers. Oh, and because you can imagine how violent that is, nobody wants to work in a place with kids that were probably pretty bad before social workers inflicted their torture on them (sorry "help them"). Even in "closed", kids learn to attack, first psychologically, then physically social workers literally before they've said a word to them. Because otherwise ...

I'm pretty used to "opinions" like yours. People have no idea how social workers actually do things, and they don't want to. If you have a discussion like this, nearly always people don't even realize this even exists.

> I started fighting sports at age 3

You’re on the very high acuity end of things. I’m not sure you even realize it.

> I'm pretty used to "opinions" like yours. People have no idea how social workers actually do things, and they don't want to.

There’s a whole world of social work that isn’t desperately trying to regulate people who were in Toddler Fight Club out there.

> There’s a whole world of social work that isn’t desperately trying to regulate people who were in Toddler Fight Club out there.

1) You have a very weird idea of fighting sports. Fight club is just drunkards hitting each other like girls. Real fighting is an art.

2) No there isn't. There's just social workers who desperately try to tell themselves they're not part of this.

Or if you prefer the academic approach, here is the biggest study ever of social work: https://mitsloan.mit.edu/shared/ods/documents?PublicationDoc...

TLDR: kids do better abused at home than well taken care of in the best youth help has to offer: foster care by family. Every other form of help is worse than that. And the more "help" children receive from social workers, the more crimes they commit later, the more they commit suicide, the less they read, ... etc.

That's a study of foster care. Frequently performed by non-social-workers.

If you want an ambulance dial 911.

These hotlines are for providing support. They are trained not to escalate to sending someone unless they absolutely deem it necessary (and the caller agrees). My wife has been working the hotline as a volunteer for 6 years and has not once escalated to sending someone.

As others noted, my California county has a dedicated team to respond to this.

Well that's just not true. You're supposed to call 911 if you witness someone else in crisis, not the crisis hotline. The police will be sent because they have baseline training in de-escalation, and they have officers with specialized training in crisis negotiation. An ambulance is relevant only if someone is already hurt. They're medical professionals. Even in that situation, police officers are usually dispatched to investigate and to keep the ambulance personnel safe in a potentially unpredictable environment. And you're correct, protective custody exists and it's there to keep the person in crisis safe.

>The police will be sent because they have baseline training in de-escalation

There are something like 30,000+ police agencies across the United States, and a proportional number within California (if we're talking about that place in particular and not more generally). To say "they have baseline training in de-escalation" is, at best, wishful thinking. While no doubt some departments make that a part of their training and within those departments most patrol officers will have undergone the training (enough that your statement wouldn't be especially incorrect if you were to specify one of those departments), it is beyond fallacious to assume that this holds true for all of them in general.

Even when the training does exist and the officer has completed it, it consists of a one or two day seminar. They are not evaluated in a way that some pass and some fail. We do not know who took it seriously, and who thought it was some jackass bleeding-heart bullshit that they could ignore. We do not know if those anyone gains by it... if some are good at it afterward and others are bad at de-escalation afterward, has that percentage shifted upwards compared to whatever their pre-training scores would suggest?

I do not believe you when you fallaciously assert "they have baseline training". No one else should believe you either, if the answer actually matters to them. I do not know why you assert this, and the speculation ranges from "not a good reason" to "even worse reasons".

They're crisis services, not emergency services. Anyone who is an immediate danger to themselves or others needs to be attended to by the first available emergency services. The attending services should be trained to deescalate, definitely, but I don't think this is an indictment of the crisis lines themselves. Less than 1% of calls to the crisis line result in any sort of emergency service dispatch.

I find something darkly depressing and comedic about how we try to prevent people from shooting themselves by sending people with guns to help them.

> how we try to prevent people from shooting themselves by sending people with guns to help them

People with guns are still people. Having anyone there will reduce harm in more cases than it escalates. Suicide is usually an impulse a lonely person who is otherwise perfectly sane carries out in the absence of intervention.

Replace the phrase "people with guns" with "institutional violence" because that's what the police are. When police are called to the scene, the intention of the caller is violence, not to help. If the intention was help, then actual helpers would be called instead.

> the intention of the caller is violence, not to help

This is mostly nonsense. Most cases where wellness checks result in a tragic outcome did not stem from the caller having violent intentions.

> If the intention was help, then actual helpers would be called instead

I believe clinician-led wellness checks are more effective than police-led ones [1]. But it’s untrue that police-led interventions are unhelpful. Not every person or community has a healthcare contact who will personally conduct a check. If the choice is between no check and a cop, you’ll save lives with the latter.

[1] https://www.proquest.com/openview/5504a2f3d69ee782daddda0ce1...

>This is mostly nonsense. Most cases where wellness checks result in a tragic outcome did not stem from the caller having violent intentions.

No, it's not. What's the point of the police? They bark orders that are backed by violence.

The caller doesn't "mean" to add violence to a situation in the same way my racist grandma doesn't "mean" to be racist simply through her choice of vocabulary.

This is completely tangential to suicide by cop. Even if the cops themselves smart enough not to escalate straight to a shootout they will apply increasing violence until you comply or die. It's literally their job.

The degree to which police led interventions are helpful is mostly a reflection of officers and departments understanding that they need to behave like EMTs on those calls rather than cops and the people who they are being called on being compliant.

If you watched random police encounters for 6 hours a day (pretty much everything is bodycam'ed nowadays), every day for the rest of your life, you would see about 1 police killing video per decade, and probably never see a police murder.

Don't let headlines and internet rage detach you from reality.

Not all police abuse results in murder, but that still doesn't make it okay just because it could be worse.

> People with guns are still people

No one is questioning that police are people.

> Having anyone there will reduce harm in more cases than it escalates

That was never the point I was arguing against. I was arguing against which people are there.

> Suicide is usually an impulse a lonely person who is otherwise perfectly sane carries out in the absence of intervention.

I do not believe that in the slightest. There is an array of causes from physical illnesses, mental illnesses, spiritual beliefs, political beliefs, to even cultural beliefs. Sure, loneliness can contribute in some cases, but it does not hold a candle to conditions like mood disorders, psychotic disorders, substance abuse, etc..

> There is an array of causes from physical illnesses, mental illnesses, spiritual beliefs, political beliefs, to even cultural beliefs. Sure, loneliness can contribute in some cases

Sorry, I was unclear. I meant that loneliness is often a major proximate cause of suicide. An interruption–even something as jarring as the cops at the door–can snap someone out of a pattern which, if left alone, can end in tragedy.

A mental-health professional, or friend or family member, checking in would be ideal. But that isn't always possible. In the absence of better options, a cop checking in is better than nothing.

What does loneliness have to do with being physically close to a person? Lonely people walk among other people all the time.

Someone asking if they would like a receipt, and “have a good day”, ought to snap someone out of it just the same with this logic.

Armed cops actively escalating the situation will help someone suicidal?

The cops in my country do work that is not about catching criminals, like leading search and rescure operations. Apparently not a problem. Apparently now these particular police have started carrying weapons as a matter of course. So that’s a bad development for a regular, peaceful presence. But overall we seem okay with the regime.

So I don’t have some personal feeling that violence is about to erupt because the police are nearby.

But I don’t see how this helps for those particular locales where the population (or segments of it) only associate active police involvement with escalation.

A fact I've noticed is that suicide rates are higher in areas with lower population density. For example, Alaska's suicide rate is 4x what New York's rate is.

Perhaps just human connection, even momentarily, is enough to break the pattern of behavior that has lead to the ideation.

Also worth noting that suicide rates among the elderly are higher than they are for anyone other than teens. If you have someone you love that doesn't get out much, make sure you give them a call now and again.

An alternative explanation is that cold places with long winters are depressing, and because they are depressing fewer people want to live there.

Alaskan winters are hard regardless of how many friends you have.

If you take a chart of population density, and overlay the chart of suicide rate, you'll see an exceedingly strong correlation. It does not follow weather patterns. Utah has 3x the problem relative to California, for example.

Yeah if you go to CDC WISQARS you can do fatal injury reports filtered by intent (suicide) and aggregated by urban/non urban geography. These differences are not small, they vary by factors or orders of magnitude in every state. It's not the weather.

The more likely explanation is guns. Gun ownership tends to be higher in rural areas because of a mixture of culture, politics, utility and laws. Only 14% of adults in New York State have guns compared to 59% in Alaska. Having a quick, easy and painless way to end your life right on your nightstand makes it a lot more likely that a bolt of suicidal urges turn into action.

https://www.rand.org/research/gun-policy/gun-ownership.html

Then overlay a map of gun ownership rates over the suicide rates and see if you see the same correlation.

This isn't an intuitive point. There's actual data showing the correlation I've described.

Something you'll also want to explain is why the suicide rate for teens is 3x higher than for adults and why elderly is 2x higher than adults. Or why more than 1/3 of suicides don't involve a gun at all. Or why Japan's suicide rate is so much higher despite having no gun ownership rights.

And yet the data shows that they did decline. I'm sure they could be much better, and the response will vary from state to state.

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