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Open thread: Interventions? No trolls, no MRAs.

This is for a continuation of the discussion about the ethics of calling the police when a friend is suicidal that started here.

No trolls, no MRAs, etc etc.  Trigger Warnings for discussion of suicide.

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Robert
Robert
6 years ago

We respect our son’s autonomy enough that, when he asked us/his therapist/ his psychiatrist to allow him to stop taking his meds (fluoxetine, guanfacine) because he found their effects disagreeable, we agreed. This was a while ago.

We did speak with him in a private setting at the facility, and he assured us that he was being treated well. My husband is going back to see him on Tuesday.

I greatly appreciate the support I’ve been shown. As someone who took it for granted most of my life that marriage and parenthood would never happen, I truly cherish my family and am glad that it shows.

hellkell
hellkell
6 years ago

Brookside sounds a lot like One Tree Hill in terms of ridiculousness.

kittehserf
6 years ago

Leum, I’m so sorry you and your friend are going through this. I hope she’ll be okay.

steampunked (@steampunked)

I think most people are talking specifically calling emergency services – I didn’t talk about committing myself. I’m not sure how committing works here, really – like a lot of Western countries, the government hugely de-funded most institutions here.

hellkell
hellkell
6 years ago

Robert, I’m glad your son is being treated well.

Leum
Leum
6 years ago

Thanks kittehserf (and everyone else). I hope she will be too. If/when I find out I’ll either post about it here or email David for a thread if this one has died.

kittehserf
6 years ago

I certainly don’t think institutionalisation would be a given here, especially since most of our mental hospitals were closed decades ago. Care in the community aka leave people in need of help with nowhere to go.

scott1139
scott1139
6 years ago

And tbh, not much to say, other than I’m totally disgusted with the number of people here going ‘oh yeah, take away their autonomy’

Yeah, except in Leum’s case the only options seemed to be: “call police, friend’s autonomy taken” and “risk friend killing self”. And Leum said she had plans, means, and intent.

cassandrakitty
cassandrakitty
6 years ago

@ kittehserf

I can’t remember what year that plot aired, but I think it predated the West case, which is extra creepy.

And yeah, not every case in which the police are called when someone is trying to commit suicide results in involuntary incarceration. Most don’t. What Marie and Fade’s parents did was shitty, but a. that doesn’t mean that every other situation will go the same way, particularly when it involves adults whose parents are not the ones calling in the authorities and b. it doesn’t make it OK to keep lashing out at other people who’re trying to figure out what the hell they can do to help a loved one who’s in a crisis situation.

Also, if you call the emergency phone line isn’t it the dispatchers who ultimately decide who to send out? If you called the local police station that would be different, but if you call the emergency line I’m pretty sure that they’re not going to allow you to tell them “cops only, no ambulance needed” or whatever, they’re going to ask you what the situation is and then dispatch whoever they think is best suited to handle it accordingly.

katz
6 years ago

Leum: Feel free to revive the thread for updates. It’s not a necro if it’s relevant new information that we want to hear, all of which is true.

cassandrakitty
cassandrakitty
6 years ago

@ Robert

I’m glad things are going relatively well so far. Please feel free to keep us posted/ask for support, if that’s something you want/need. The fact that you really love your kids is obvious every time that you talk about them, so don’t think for even a second that most people reading your words here don’t know that you’re a good father.

Dawn Incognito
Dawn Incognito
6 years ago

Leum, I just wanted to say that I think you did the right thing. I say this as a survivor of one failed suicide attempt and several planned-but-not-attempted ones.

My sister is a nurse, and she told me about the horrible deaths she’s seen of people who’ve attempted suicide. She’s had people tell her that they didn’t mean it, but unfortunately they did too much damage. Every time I think about taking a header off the balcony or in front of the subway I remember that.

It sounds to me like your friend was in medical danger. Calling the authorities may have saved their life. I don’t see how that can be wrong.

I hope you and your friend are okay.

steampunked (@steampunked)

kittehserf – Yes, that was my impression. Leading to the situation that is (for Australians) more common: Someone who is suicidal and you are the carer and the only resource you realistically have is the police and ambulance.

Given the way ambulance times are ramping up more and more, I’d probably call the police as well, as they would get where I am faster. After all, they’re trying to defund the bloody ambulances as well.

cassandrakitty – I thiiiink so, but here you get asked ‘Fire, Police, Ambulance’, you say one word, and you get directed IMMEDIATELY through to the one you choose. It gets hinky around some of it, as the Firies are volunteers, so channels can get weird. A lot of our Emergency Service personnel in the rescue area are also volunteers. You might have to call back more than once to get more than one group, but just getting a single group is pretty easy.

It should be efficient, and it would be if we’d pay our ambos a decent wage and maybe provide our fire folks with decent support.

mildlymagnificent
6 years ago

I suspect that a lot of the reason behind emergency contacts often sending police first, or only, is what the financial arrangements are with ambulances. Police don’t charge for callouts. Most ambulance services do. So if they’re not sure whether a person needs ER attention, they’ll send the cops first and let them call an ambulance if they see the need.

And then there’s always the access issue. If a door needs breaking, they have to be there even if it’s the ambulance that’s the real need.

Alex
6 years ago

Well, this is just my experience, but suicide dominated my thoughts on and off throughout my entire adolescence. And no one, not a single person knew. Oh, I’m sure several people knew I was depressed at times, but they never knew the extent. See, I’d set myself up as the listener, and often felt that other people didn’t need to be burdened with my baggage. I don’t blame people for not knowing; I must have hid it pretty well, and I really should open up more to people who are close to me. But it would have been nice if *someone* had seen and tried to intervene.

I mean it hurts to know that if I ever got into a really, really bad space and got as far as an attempt, it’s possible nobody would have any clue and I wouldn’t get any help. That knowledge has forced me to be my own person who talks me down when things get really bad. I guess what I’m saying is, however stressful being put into an institution or having the cops called on me might be, when it comes to a life or death situation, for me it would be nice to know that someone gave a shit enough to try to do *something* for me.

My nana went into hospital for liver cancer while I was visiting my mom and sister 8 hours away. When I returned, I had to stay with my grandparents, and my grandfather was pretty anal about bedtimes and lights out. Problem was I couldn’t sleep. Without the light I had nothing to distract me, so I started scratching my thighs, and of course he had no idea.

My last boyfriend had seen me almost faint after a hot shower once. Some months later I was in a hot tub, and I’d gone down to my neck to stay warm. Well, he couldn’t see me from the pool and immediately thought the worst and rushed over. Later he tearfully told me he’d been really afraid and said “You can’t”. I burst into tears. Logically I know there are many people who’d be devastated if I died, but sometimes I have a hard time believing it, so hearing it said in so many words really moved me, and quite unexpectedly.

But again, that’s just me. Leum, I hope your friend’s doing okay. And also it’d be nice if people stopped jumping on each other. Jumping on trolls is cool. Not so much when it’s people I like and respect doing it to each other. :/

kittehserf
6 years ago

I can’t remember what year that plot aired, but I think it predated the West case, which is extra creepy.

I suppose that’s marginally better than if they’d done it afterward. But ewww, anyway.

When you ring emergency in the US, do they ask first off whether you want police, ambulance or fire brigade? That’s how it goes here, and I suspect I’d default to “police” for something like this, if it was someone far away.

cassandrakitty
cassandrakitty
6 years ago

Where I live I’d prefer to call the ambulance people first in an emergency, since the station is close and they have medical training, but in an emergency where you think someone is about to try something, but hasn’t actually done it yet, it’s pretty much a case of whoever can get there quickest.

kittehserf
6 years ago

ninjaed by steampunked!

Which state are you in? Here in Vic the ambos have been fighting for better pay and conditions for years.

Alex, hugs if you want them.

contrapangloss
6 years ago

@Kittehs,

Generally dispatch says: “You’ve reached 911, what is the emergency”

Then, they dispatch any available resources that they can, or could be required.

Generally, a fire engine (for door breaking, extra bodies to manage heavy patients down flights of stairs, so on), and ambulance (for the patient).

The troopers (police) will also get called in if the call has any potential to be hazardous to rescuers or there is any chance of the patient dying, be it heart attack, severe trauma, or suicidal thoughts.

kittehserf
6 years ago

contrapangloss, that sounds more helpful for when you don’t know exactly who you need, doesn’t it? At least as long as the distpatcher’s on the ball.

cassandrakitty
cassandrakitty
6 years ago

@ Alex

Agreed on all of that. I haven’t been in that mindset since high school, but if I ever was again I’d really like to hope that anyone who cared about me would intervene first and worry about what was going to happen next later.

Auntie Alias
Auntie Alias
6 years ago

In my city, fire department personnel are trained as first responders since they can usually arrive at a scene before an ambulance. A couple years ago I was having stroke symptoms, called 911, and the fire dept. arrived first. There I was sitting on my porch, surrounded by a half dozen hunky firemen asking me questions and taking care of me. Ooo la la! 😉 They were excellent from a medical standpoint, too.

hellkell
hellkell
6 years ago

Alex: All the hugs.

I’d prefer if arguments like this didn’t happen at all, but saying nothing this time was not an option.

weirwoodtreehugger
6 years ago

I did some Googling. As I suspected, it is in fact rare for any adult to be involuntarily committed past a 72 hour old. Inpatient care is expensive, even if the patient has insurance and since the 80’s the US has been steadily moving away from institutionalization.

Here’s a state by state breakdown if anyone is curious.
http://mentalillnesspolicy.org/studies/state-standards-involuntary-treatment.html

In Minnesota where I live it is a last resort.

MINN. STAT. ANN. § 253B.09(1) “If the court finds by clear and convincing evidence that the proposed patient is a person who is mentally ill, developmentally disabled, or chemically dependent and after careful consideration of reasonable alternative dispositions . . . it finds that there is no suitable alternative to judicial commitment, the court shall commit the patient to the least restrictive treatment program or alternative programs which can meet the patient’s treatment needs . . . .”

Even for the state to intervene and force outpatient care the standards are pretty high. A person must be proven unable to make responsible decisions themselves.

Given the laws in my state I feel fairly certain that a person in a crisis is highly unlikely to be held for an unreasonable period of time and feel OK calling emergency services if there is no other option.

Alex
6 years ago

kittehserf, hugs are accepted. 🙂

Auntie Alias
Auntie Alias
6 years ago

Here they answer, “911, what is your emergency?”

kittehserf
6 years ago

Hunky firemen, Auntie Alias? You mean they really do exist outside calendars? :O

katz
6 years ago

Auntie Alias: Bow chicka bow wow. And they’re likely volunteers so they probably all have hearts of gold.

weirwoodtreehugger
6 years ago

I’m glad things are going relatively well so far. Please feel free to keep us posted/ask for support, if that’s something you want/need. The fact that you really love your kids is obvious every time that you talk about them, so don’t think for even a second that most people reading your words here don’t know that you’re a good father.

Seconded.

Bee
Bee
6 years ago

Hey, so, I was once institutionalized against my will for being suicidal (I signed papers that said I was self-admitting, but if I hadn’t, my therapist said he would have me admitted). It was awful in a lot of ways, and also possibly unnecessary (was I really going to kill myself? probably not), but also kind of useful in that it interrupted my previously kind of out-of-control thoughts/actions. Which was useful because those thoughts/actions were largely pretty destructive.

On the other hand, the friend who called my parents and told her I was acting self-destructively, which was one of the things that kind of sent me down the road to suicidal ideation? I never really trusted her after that, and we stopped talking not too long after. That was probably me being an immature brat, but after 22 years we still haven’t reconciled so, probably not gonna happen.

Now, having recently lived in a city where cops were called on — and shot to death — suicidal people at least three times in the last few years, I would carefully consider my options before calling the cops on a suicidal friend. At least in that city, and especially on a non-white person in a non-white neighborhood.

Alex
6 years ago

Hugs accepted, hellkell, and yeah, I know. I can understand both perspectives on this, and don’t want to tone-police, and also don’t like seeing people get piled on when they’re asking for support, or when comments have made someone seriously uncomfortable, and blah.

steampunked (@steampunked)

kittehserf – I’m in Victoria! In fact, I’m in the bush (was at the Festival of Lights last Sunday), so we are surrounded by hunky firepeople of all stripes.

I have a possibly weird view on the whole institutionalising things as I was diagnosed with a form of anxiety-induced psychosis and they asked me if I wanted to live in an institution for a while. I thought about it and said ‘Let’s see if the drugs work’. The drugs worked, but I really, REALLY got the vibe that the professionals would prefer me not to be there.

It seemed odd to me then and now, a little, because I was a danger to myself and others (suicidal ideation and violence as well as voices), but apparently I was too calm and their resources were stretched too thin so someone who was fine with medication would have been taking up a valuable bed, I guess.

I’m still not sure how I feel about it all – possibly good because nothing DID happen, but I don’t know, it still feels like someone gambled and I was lucky it paid off.

Auntie Alias
Auntie Alias
6 years ago

@kitteh, they really do! That comparison wasn’t lost on me at the time, in spite of my situation. 🙂

@katz, they were the real deal (in more ways than one).

kittehserf
6 years ago

Hey, fellow Victorian! ::waves from Melbourne:: Enjoying the chilly chill chill this wintry day?

Did your drugs/institutionalised situation happen recently? I’m amazed there are any places left where that’d be an option, after our hospital system was Jeffed.

kittehserf
6 years ago

@kitteh, they really do! That comparison wasn’t lost on me at the time, in spite of my situation. 🙂

Now I’m thinking of probably unsuitable “Have I gone to heaven?” lines.

cassandrakitty
cassandrakitty
6 years ago

I guess that’s the one disadvantage of the skinny pretty boys I tend to favor, they wouldn’t be much use in a situation where hefting heavy things around was required.

Auntie Alias
Auntie Alias
6 years ago

@kitteh, I didn’t want to say it in this particular thread but, yeah, that’s exactly what I was thinking.

kittehserf
6 years ago

Auntie Alias, I’m not surprised!

zoon echon logon
zoon echon logon
6 years ago

No.

When I was suicidal, one of the main reasons that I (almost) never talked to anyone about it was because I did not want someone calling the police/emergency services on me. If I’m ever suicidal again, I will not talk about it with anyone who thinks that would be a good idea.

@Weirdwoodtreehugger

I guess I just find the notion that calling emergency services is a violation of autonomy very strange. If you saw someone get hit by a car would you stop and ask them first if they’d mind you calling 911? Or would you just call?

An unconscious injured person is not analogous to a suicidal person in terms of autonomy. One is unconscious, the other is not. It is a reasonable assumption that the unconscious injured person would want assistance if they were aware. Involuntarily committing someone to psychiatric care is involuntary.

A better analogue would be someone with a serious, very painful illness. It may be curable, it may not be. If someone in such a condition makes the decision that they’d rather be dead than continue in pain in the hope of it maybe, someday, getting better, I might try very hard to talk them out of it, but I think it’s ultimately their decision.

A question: Intervention in the sense under discussion (I think) pretty clearly involves violation of autonomy. Someone has made a decision, you disagree with that decision, so you forcibly override what they’ve decided to do. To people who think this is justified, what justifies it? (Real question, not rhetorical)

steampunked (@steampunked)

@kittehserf – About two years ago. We do have places left, but the ‘bar’ for involuntary commitment here is much higher than in the states, I get the impression. Though I was asked voluntarially and kind of informed they’d prefer I didn’t if I could just keep it together.

People here have to be assessed by a psychiatrist within a set time, and some states have a tribunal the person involved can request to challenge this. There are also protective measures in place to stop people getting other people committed by making up crap (particularly around violence).

Some treatments require further tribunals and procedures as they are deemed possibly risky to the patient, so it looks (I may be wrong? I don’t know the US laws) as if we have a more graduated system.

In Victoria, the mental health act states you can only commit someone if the person cannot receive adequate treatment for the mental illness in a manner less restrictive of that person’s freedom of decision and action.

cassandrakitty
cassandrakitty
6 years ago

Why do people keep acting as if calling the cops/emergency services when someone is suicidal will always automatically result in their being involuntarily committed? It doesn’t.

pallygirl
pallygirl
6 years ago

The couple of times I tried to kill myself I told no-one and attempted at such a time that there would be no interference – it was luck rather than anything else that I am still here. (I haven’t tried for…21 years, I’m over it just in case anyone is wondering.)

I’ve also had a few people I know commit suicide successfully – the worst day was when two people – one acquaintance and one friend/ex-boss killed themselves separately on the same day (different places, different methods, and they didn’t know each other).

My ex-boss was sitting next to me one day at work, and when we were alone, they told me they were really depressed (and the reasons for it) and that they were going to kill themselves and told me the method they were going to use. I tried to change their mind about their reasons at the time, and kept their confidence so that nobody would think anything worse about them. Then about a month later, after I had to finish work for health reasons, they did it.

The fucking guilt I went through was incredible. I blamed myself, I told myself it was all my fault they were dead and went through all the “if onlys” I could think of. They were a super nice person, possibly too nice for this world, and they were dead. It took counselling sessions, while I was getting treated for sexual abuse, no less, to get over this. Plus, they left family behind (no children, thank goodness, but an ageing single parent was among the grieving).

Also not helped by the other person coming to the safe house where I was the night beforehand and being extremely upset (I’ve never heard a guy cry like that before). And then he killed himself too, so I had two flatmates who also had this type of shit on them, at the same time I did.

Where I live, police do not routinely carry guns. Suicide attempters are not shot.

Anyways, that’s my short story such as it is.

Auntie Alias
Auntie Alias
6 years ago

Why do people keep acting as if calling the cops/emergency services when someone is suicidal will always automatically result in their being involuntarily committed? It doesn’t.

Seconded.

mildlymagnificent
6 years ago

“Enjoying the chilly chill chill this wintry day?”

Just you wait till tomorrow if you’re thinking you’re cold right now. Here, I just checked BOM’s reading for this area. The temperature has rocketed up to a balmy 11 degrees. But the wind has also picked up a bit – the “apparent” temperature, what it feels like regardless of what the thermometer reads – that’s down to 1. One whole degree. Courtesy of South Australia, you lot over there can have this as soon as possible so that we’ll be rid of it.

I’m thinking that I should pick up the needles and knit a few draft stoppers. Right now I can feel every one of the tiniest minusculest gaps at every door and window.

cassandrakitty
cassandrakitty
6 years ago

My landlord had to cut down the edges of my door a bit because it was getting jammed, and now every time it’s windy I can feel a draft coming through underneath. I wish they sold those snake things that you can get to cover that part of a door here, but they don’t seem to exist since everyone I try to explain them to just looks at me funny.

steampunked (@steampunked)

A question: Intervention in the sense under discussion (I think) pretty clearly involves violation of autonomy. Someone has made a decision, you disagree with that decision, so you forcibly override what they’ve decided to do. To people who think this is justified, what justifies it? (Real question, not rhetorical)

It’s really tricky. The one I end up wrestling with came out of autonomy over children – as a first-aider, the one time you aren’t allowed to treat someone unconscious is if a parent objects – even if you are convinced the child will die. So I can be told by a parent ‘No, don’t do that, we don’t believe in XYZ medical treatment in our religion’ and I am legally bound to obey this.

Except the fact is I _know_ I wouldn’t obey when it concerned a minor. I’d override the parent here and do everything I could, and I know I’d be jailed for the offence. I am okay with that (not really happy about it, but it’s the price I pay).

The problem is that the ‘intervention’ I am considering in a suicide case is ‘Calling an ambulance’. So the decision they made was suicide, and the decision I have made is to override their decision.

I feel justified in calling an ambulance whenever I think there is a reasonable chance someone is going to need hospital treatment (caveat, I’ve had some training so I’m okay at assessing this unless I’m panicky). I’ve called ambulances quite a few times in my life as a result of being a responder, so it’s pretty normalised for me. If I thought someone had swallowed pills, cut themselves, thought they seemed dizzy, had sharp stomach pains, were, confused, etc, I would call an ambulance.

A lot of those symptoms are also identical to heart attack or stroke symptoms, which I also automatically dial an ambulance for.

If I was near my house, I would call the police as the station is much, MUCH closer than the hospital, and all police stations have a defibrilator, and I can use those suckers.

Leum
Leum
6 years ago

A question: Intervention in the sense under discussion (I think) pretty clearly involves violation of autonomy. Someone has made a decision, you disagree with that decision, so you forcibly override what they’ve decided to do. To people who think this is justified, what justifies it? (Real question, not rhetorical)

I overrode my friend’s decision because she was sick. Her brain had had its normal desire for self-preservation overridden by her illness. This has happened to me. My experience, and that of several other friends who also exprience depression, is that I am glad I was prevented from killing or hurting myself when my depression was that acute.

In the end, it boils down to this: I experience suicidal depression. I know what affect suicidal depression has on my ability to think and act rationally. Given this, I feel I can safely say that my friend was not in a position to think and act rationally, so I stopped her. To me, this is no different in kind (though very different in degree) from stopping someone from stepping into traffic because they aren’t paying attention.

Or, more simply, personal autonomy is not my highest moral value.

fruitloopsie
fruitloopsie
6 years ago

Zoon, Bee and steampunked

Sending the internet hugs

Pallygirl

Hugs if you need them and I wasn’t there you are the only person who knew about what was going on but please don’t blame yourself.

you said that they were very nice people so I bet that they don’t want you to blame yourself.

steampunked (@steampunked)

Hmm, that is a more succinct way to frame it:

I value life over most other objects. There are limits to this (I’m not anti-euthanasia, having watched several loved people die from cancer). But in general I value life more highly than almost anything else.

There aren’t absolutes, it’s just if I have to make a snap decision, I snap to ‘life and the chance to fix whatever happened here’ rather than ‘respect for autonomy unto death’.

It ain’t that I hate autonomy. It’s that if I have to weigh two things of such high merit, the ‘life’ side has more for me.

And now my lunch is over an’ I really gotta work.

cassandrakitty
cassandrakitty
6 years ago

Part of what’s being left out of this conversation is that a very high percentage of people who attempt suicide and end up surviving are very glad that they did. People change their minds. There’s no way to know for sure who will and who won’t, obviously, but it’s weird to be acting as if that’s not a thing that happens.

And I know for sure that it does because I tried myself when I was 17. Like a lot of people who attempt suicide, I didn’t really want to die (although I thought I did at the time), I just needed help and didn’t know what else to do and was stuck in a negative mental feedback loop. Once the people closest to me realized what had happened and made me actually talk about what was going on, I got the help I needed, and the urge went away. So can we please not ignore that part of this conversation?