I work for a mental health crisis line. We are taught, with extremity, to always go for least intrusive intervention possible. We will only ever call Emergency Services after a literal check list to ensure it’s the last resort possible.
Practically the only times we ever call EMS on someone is if they tell us they are actively dying this very second, due to injury or overdose, etc. Or if they, after all of our attempts to listen, empathize, talk about what’s going on, talk about how they’re feeling tonight, work on what options there might be, who in their lives might be able to help, listing resources, and attempting to safety plan; if after all that, they say “yeah, I’m gonna kill myself specifically in this fashion and I’m gonna do it right now, and I have the means available to me.” Then hang up and don’t answer when we call back. Then we call EMS.
It’s drilled into us that EMS is expensive for the person, and potentially dangerous because police are often not great at responding to Mental Health emergencies. So always the last last last resort.
Emergency services are like the absolute worst dog shit resource for mental health issues. 99% of the time they just make shit worse, I had to learn this the hard way.
It actually makes me mad that so many people suggest it as what you “should” do if someone is in crisis because it’s just not made for that. Do not call 911 if you are having a panic attack or SI or even self harming in a non SI way, they will do nothing to help you and it will just cost a fuck load. Like you said the only time it makes sense is if you are actually dying from an attempt. Even MH practitioners say to call 911 when they should know better. I am glad your place seems to know what’s up because so many people get the wrong advice on this issue and it actively hurts people. Maybe if the healthcare and police system were different going to the emergency room or calling 911 might be a good idea, but how they are now its just not.
The group that handles 988, the suicide line, is called Vibrant and they’re working with 911 dispatchers all over the country to train them to transfer over to 988 if there’s any situation like that instead of handling it themselves.
Firstly, this varies by region. Most people don’t live in the US, including me.
Secondly, you’re right in that it will be an unpleasant experience for most patients, but the vast majority of patients will survive the episode. Which is the point.
This is a really interesting perspective, and obviously you know a lot more about this than the rest of us.
I think you can probably understand that your own training, experience, expertise, and support gives you a range of other options to implement before calling EMS. The rest of us don’t have most of those options.
There’s not much more I can say just because I’m not in the US. Obviously the options will vary by location.
So many people seem to only care about life and not dignity. Locking someone up against their will for being suicidal will always be wrong in my mind. Unless they are threatening harm to someone else, then it might be warranted in order to protect the threatend person.
Locking someone up against their will for being suicidal will always be wrong in my mind.
You’re entitled to that opinion, of course.
Contemporary thinking, including that of the mental health care profession, is that thoughts of suicide are the product of illness, and that treatment options are available. Terminal illness or chronic suffering are an exception. If someone has an illness which causes them to harm themselves, it seems appropriate to intervene when no alternative options are available.
While I am sure that’s true for a lot of cases, I think you have to look at society and the individual as a whole. Lots of people are homeless or struggling to afford food, and they will never break out of poverty completely even if they manage to improve their situation a little. Add on to that the fact we are killing the planet, each other, and nature all at the same time and I don’t think suicide is that unreasonable in some cases. This is especially true for disabled people that can’t get jobs or have much quality of life and live on peanuts from the government if anything.
You’re also entitled to that opinion, but you have to acknowledge that it’s not commonly held, which is why people will prevent others committing suicide.
Few people are required reporters and those will be medical workers, public school employees, and people who work for universities for the most part. Calling 911 will get your friend shot by the police in the worst case, and traumatized and in debt in the best case.
I get that. I never said I intended to harm myself or others to them. In my opinion they overreacted and nothing I said could convince the ambulance not to take me.
This might sound unsympathetic, but it’s easy to put someone else in a situation where they must call the police / ambulance.
It doesn’t really matter how close a friend is. If you say you’re at risk of harming yourself or others, they don’t have a lot of options.
I work for a mental health crisis line. We are taught, with extremity, to always go for least intrusive intervention possible. We will only ever call Emergency Services after a literal check list to ensure it’s the last resort possible.
Practically the only times we ever call EMS on someone is if they tell us they are actively dying this very second, due to injury or overdose, etc. Or if they, after all of our attempts to listen, empathize, talk about what’s going on, talk about how they’re feeling tonight, work on what options there might be, who in their lives might be able to help, listing resources, and attempting to safety plan; if after all that, they say “yeah, I’m gonna kill myself specifically in this fashion and I’m gonna do it right now, and I have the means available to me.” Then hang up and don’t answer when we call back. Then we call EMS.
It’s drilled into us that EMS is expensive for the person, and potentially dangerous because police are often not great at responding to Mental Health emergencies. So always the last last last resort.
This so much…
Emergency services are like the absolute worst dog shit resource for mental health issues. 99% of the time they just make shit worse, I had to learn this the hard way.
It actually makes me mad that so many people suggest it as what you “should” do if someone is in crisis because it’s just not made for that. Do not call 911 if you are having a panic attack or SI or even self harming in a non SI way, they will do nothing to help you and it will just cost a fuck load. Like you said the only time it makes sense is if you are actually dying from an attempt. Even MH practitioners say to call 911 when they should know better. I am glad your place seems to know what’s up because so many people get the wrong advice on this issue and it actively hurts people. Maybe if the healthcare and police system were different going to the emergency room or calling 911 might be a good idea, but how they are now its just not.
The “wellness checks” are way too often murders. I would never call the cops to check in on someone because they’ll likely shoot them
About three weeks ago, my coworker’s brother was shot by police responding to a wellness check. It’s fucked.
The group that handles 988, the suicide line, is called Vibrant and they’re working with 911 dispatchers all over the country to train them to transfer over to 988 if there’s any situation like that instead of handling it themselves.
Firstly, this varies by region. Most people don’t live in the US, including me.
Secondly, you’re right in that it will be an unpleasant experience for most patients, but the vast majority of patients will survive the episode. Which is the point.
In the US, surviving the episode and immediatly going into medical debt is why the second attempt happens with them not reaching out to anyone.
Alright don’t blue ball us, give us the list. I want to know step 1,2,3 on how to handle people like this.
My employer is actually having a “mental health first aid” seminar pretty soon. You should look for things like that.
I’m not sure I understand, you want to know how to deal with mental health workers or with people in crisis?
This is a really interesting perspective, and obviously you know a lot more about this than the rest of us.
I think you can probably understand that your own training, experience, expertise, and support gives you a range of other options to implement before calling EMS. The rest of us don’t have most of those options.
There’s not much more I can say just because I’m not in the US. Obviously the options will vary by location.
That sounds like a good protocol but that was not followed in the incident I was referencing
Yeah, unfortunately not all call centers have the same policies. I can only speak for mine.
So many people seem to only care about life and not dignity. Locking someone up against their will for being suicidal will always be wrong in my mind. Unless they are threatening harm to someone else, then it might be warranted in order to protect the threatend person.
You’re entitled to that opinion, of course.
Contemporary thinking, including that of the mental health care profession, is that thoughts of suicide are the product of illness, and that treatment options are available. Terminal illness or chronic suffering are an exception. If someone has an illness which causes them to harm themselves, it seems appropriate to intervene when no alternative options are available.
While I am sure that’s true for a lot of cases, I think you have to look at society and the individual as a whole. Lots of people are homeless or struggling to afford food, and they will never break out of poverty completely even if they manage to improve their situation a little. Add on to that the fact we are killing the planet, each other, and nature all at the same time and I don’t think suicide is that unreasonable in some cases. This is especially true for disabled people that can’t get jobs or have much quality of life and live on peanuts from the government if anything.
You’re also entitled to that opinion, but you have to acknowledge that it’s not commonly held, which is why people will prevent others committing suicide.
Few people are required reporters and those will be medical workers, public school employees, and people who work for universities for the most part. Calling 911 will get your friend shot by the police in the worst case, and traumatized and in debt in the best case.
So what do you do if a casual acquaintance tells you they’re intending harm to themselves or others ?
Whatever I feel like. If I care for someone you better believe I won’t call authorities and make their life worse while destroying our relationship.
I get that. I never said I intended to harm myself or others to them. In my opinion they overreacted and nothing I said could convince the ambulance not to take me.
Well something doesn’t add up.
Do EMS often abduct people?