With the state collecting that data, your phone company collecting that data, your cell phone OS collecting that data, random apps collecting that data, and who knows who is on the other end of that call and what they're doing with your data.
Will you be turned down for jobs because when a company has a choice between two equal job candidates and one of them has shown suicidal tendencies at any point why should they risk that their employee will kill himself and lose money on re-hiring/re-training?
Will your health insurance company buy that data? Your life insurance company?
Could you lose your right to own a firearm?
Can it cost you custody of your children?
Will it end up leaked or "lost" on a USB drive and find itself on the internet?
This is actually one of the big hurdles to getting some people into therapy/treatment/medication that they need: They imagine a lot of catastrophic scenarios about what could possibly happen if they get the help they need, which creates a gridlock that traps them in their situation.
From a pure risk management perspective, the highest risk by far in these scenarios is failing to accept help that could improve the underlying problems. If someone reaches the point of considering suicide, it doesn't make sense to refuse help due to hypothetical fears about some future job obtaining phone records and declining someone for a job (which isn't a thing that happens, BTW).
Don't let fear of far-reaching hypotheticals get in the way of making progress on mental health.
Practically speaking, these kinds of things are happening every day. I would agree that it might be better to take the help and live accepting the lifelong consequences of your actions in seeking that help. A life where you lose your children, lose job offers, or have your deepest troubles exposed to the world might easily still be a life worth living.
The reality is that we've created and enabled a system that hurts people. Our communications are logged forever and we have no power to limit the ways that data can be used against us. It's only natural for people to take that into account before doing something that makes them so very vulnerable.
How would you lose a job? Your would-be employer faced with two otherwise equally qualified candidates pays a third party to run a background check that includes information lifted from your social media sites (https://www.careerbuilder.com/advice/social-media-survey-201...) and collected from data brokers.
> Data brokers will often combine all the information outlined in these two lists to build complex profiles about each of us. These profiles are used for an increasing number of purposes, from serving targeted advertising to crafting insurance policies to providing background checks for employers. (source: https://www.digitaltrends.com/web/its-a-data-brokers-world-a...).
The FTC has warned about this kind of thing (https://www.nydailynews.com/sdut-ftc-puts-background-check-s...) but it still happens.
Maybe you called the suicide hotline using your cell phone and some sketchy app (like a call blocking app or facebook: https://www.theverge.com/2018/3/25/17160944/facebook-call-hi... or even a stalker app: https://news.softpedia.com/news/stalker-android-apps-with-th...) sold your contacts/call history or maybe your phone company did it. See this example from the article here: https://arstechnica.com/tech-policy/2013/12/att-accused-of-v...
> "[T]he sale of CPNI to the government isn’t our only concern—when we did a little more poking around, we found that all four major mobile carriers (AT&T, Sprint, T-Mobile, and Verizon) have privacy policies that indicate they believe it is OK to sell or share similar records to anyone,"
It's not really a question of "how is anyone going to know?". Every communication you make is logged forever and shared (read: sold) with "partners" and turned over to the state. Someone, somewhere, will absolutely have that data. You aren't allowed to know who has it, where they got it, how accurate it is, what they are doing with it, or how/if it's being secured, but it is out there and it will follow you for the rest of your life.
https://news.ycombinator.com/item?id=32122139
I've heard over and over horror stories along those lines. Someone having a mental health crisis calls emergency services for help (and absolute best case scenario they get a very expensive taxi ride to the ER) or goes to the ER themselves. The ER pumps them full of drugs or just locks them in what amounts to a prison, does nothing to treat people or connect them with services but charge tens of thousands of dollars, leaving people in the same spot they were in before but with mountains of medical debt.
Or, someone is honest with their therapist, the therapist prioritizes not getting hit with a malpractice lawsuit so they report their patient to the police, and...see above, except worse, because the patient isn't expecting it nor did they consent to such a sudden and drastic intervention.
If we want people to get help we need to think very carefully about what getting help will cost them, because the higher that cost is the more people there will be who are unable or unwilling to afford it.
For example, imagine if an airplane pilot or anyone in a position of being responsible for a mass number of lives has previously called into suicide hotlines.
Would you feel secure knowing the pilot of your plane once exhibited suicidal tendencies? I doubt it.
Any bits of data we can collect to make accurate assessments should be collected.
This is the kind of thinking that got us into this mess. The data being collected may not be accurate, may not be interpreted correctly, and may not even be useful, but fearful people like you will happily use it for a tiny sliver of peace of mind.
Lets say the pilot on your next flight did call the suicide hotline 15 years ago after his wife and child were killed in a car wreak. Would that make him more likely to be a danger for you today than the pilot on your last flight who was currently suicidal but never called the hotline?
Lets say the pilot on your flight wasn't just going through a rough time 15 years ago, but was actively feeling suicidal on the day of your flight. Is it more likely that he would also be a mass murder who wanted to kill everyone on the plane, or is is more likely that he would kill himself later that day while alone in a hotel room at your destination city?
Thoughtcrime is a dangerous thing and our algorithms aren't so good at predicting human behavior that we should support handing out extrajudicial punishments to people based on what they might do. Those are things you should fear far more than what the mental health history of your pilot might suggest.
I really don't care, to be honest. As long as the problem has been fixed through major changes to lifestyle and/or medication, plus enough time has passed to ensure that the person is stable, the fact that they once called a hotline is irrelevant.
I might not be as vehemently against the collection of this data if there were a strict retention limit written into law, perhaps 3-5 years, alongside a solid plan to properly enforce that limit and to keep records confidential.
As written, your comment implies that people can never change and situations can never improve. People regularly change their lives drastically, especially young adults whose brains are not even fully done developing.
> Any bits of data we can collect to make accurate assessments should be collected.
I doubt that the fact that someone called into a hotline twenty years ago would allow anyone to make an accurate assessment as to their fitness to fly today. It would likely be used as a tool of oppression, and it would make people think twice before choosing to risk their future career prospects by calling into the hotline in the first place.
Permanently barring hotline callers from becoming pilots makes about the same amount of sense as permanently barring people who have ever had a broken arm from becoming pilots.
Better bar me from becoming a pilot, quick.
For example, resident physicians are known for being pushed to work 80+ hour weeks. Would any of them ever officially admit to having mental health issues? Hell no, and that's a problem from an ethics perspective and a declining level of healthcare, not to mention tragically ironic to boot.
Would they feel secure knowing their call will create a permanent record of suicidal tendencies, limiting their career for years to come? I doubt it.
Any bits of data we collect to make accurate assessments will encourage suffering people to withdraw further and remain silent instead of getting help.
"...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."
I've volunteered nearly 300 hours, most of those were dead of night EST. I've spoken to several hundred people, and maybe a couple dozen have been flagged as imminent risk. Of those flags, I can count on one hand those who have required a call to EMS. Mostly, I'm able to come up with a safety plan with them and get them through the night.
No counselor on CTL will say it's wrong to end his/her life. That's because one of the core values is to treat each person without judgement (on any issue they bring up, from abuse, to self-image, to drama with parents, to rape).
For example, if someone says "I am having thoughts about suicide." No counselor would respond, "Oh that's awful, you shouldn't be having those. What's wrong with you?"
Or if someone says, "I just don't see the point in life anymore." No counselor would respond with, "Oh well life is sacrosanct and you're lucky to be here, so how could you possibly think about killing yourself? Your pain can't be that bad -- just think about your family who will be so sad."
These tropes are obviously harmful in a therapeutic setting, and the judgement is so counterproductive to keeping people engaged and finding solutions within themselves, which is key because we are not authorized to act in a medical capacity or advise people on what to do.
I have had many conversations with people who are clearly in lasting and profound pain and who just don't want to continue. Chats such as these are probably the hardest to endure because some people are just so resigned to their misery, and major depression just can't be treated by text. I'd give them a hug, but well...
I just want to end on a bitter note that while it seems like a lot of growth has happened in treating mental health, unfortunately many services have gotten a bad rap or are viewed suspiciously for the fact that previous generations of healthcare workers and society writ large did not give credit to the pain and difficulty in surmounting these conditions. It is a very dark morning in America, and we must be willing to listen to and validate each other's pain. CTL is one such location where that is possible.
A close friend struggled with bipolar. She was uninsured and making close to minimum wage…calls to suicide prevention hotlines resulted in thousands of dollars in new bills from ER visits and even involuntary psychiatric care.
She was struggling to pay rent. Being discharged in effectively the same condition as before but with new debt she wouldn’t be able to pay off for years…the medical bills for involuntary psychiatric care were their own special sort of crazy.
See https://ajp.psychiatryonline.org/doi/10.1176/appi.ajp.2020.2...
Will 988 calls be referred to 911?
Currently, a small percentage of Lifeline calls require activation of the 911 system when there is imminent risk to someone’s life that cannot be reduced during the Lifeline call. In these cases, the crisis counselor shares information with 911 that is crucial to saving the caller’s life.
So it does sound like that can happen. Though I don't know what else they could reasonably do if it sounds like the caller is imminently going to do serious self-harm.
Having some counselors stop by or something, might be cool, but the police are basically the opposite of that, at least today, at least in most places. I can't imagine a worse sequence of events to kick off.
The first person I know who committed suicide, did so after being arrested for something that shouldn't have even been illegal. But the ordeal into which he was plunged by law enforcement was too much to handle. He was very stressed out by the shame of being in the newspaper and such, but nobody realized the degree until it was too late.
The second, too. Different details but overall similar scenario; he wrote of the feeling of being ground up by this massive machine.
Want to make someone feel hopeless, start by sending police in place of counselors.
I only know two people who've committed suicide. So that's not a great track record for police making things better.
There is a difference. Actively preventing someone from committing suicide, taking them from the absolute brink of destruction, is the first step towards recovery. Intervention works.
> The first person I know who committed suicide, did so after being arrested for something that shouldn't have even been illegal. But the ordeal into which he was plunged by law enforcement was too much to handle. He was very stressed out by the shame of being in the newspaper and such, but nobody realized the degree until it was too late.
I'm sorry to hear that, but that's entirely non sequitur to my point.
> Want to make someone feel hopeless, start by sending police in place of counselors.
Intervention by police to prevent someone actively trying to kill himself results in better outcomes for the person than the person actually killing himself. Or it could be firefighters. Or a random passerby. Police are sent because they are what is available.
I asked a friend who volunteers for one of these hotlines. He says it's actually rare and the guidelines are more about people are in imminent danger to themselves or others (e.g. threatening suicide by a method that would endanger other people in the process, or worse, implying threats of hurting other people or inducing suicide by cop).
Definitely not the common or standard outcome, though.
"What's this? The caller intends to commit suicide by cop? Surely sending cops to kick down his door will put a stop to that!"
Fortunately, I only had to walk out into the middle of my street in my PJs. Sadly, my biggest concern was some trigger happy lunatic would kill my new dog, imaging a hyperactive doodle puppy as a vicious cop killing hellhound.
I'm still a little fuzzy on why a health check requires a paramilitary response. Wouldn't it be safer and cheaper to have some sweet little old lady with a clip board knock on my door?