Inability to Discuss Suicide and Get Help Without Serious Risk

[JBG]

A recent article, Teen who jumped to death from Vessel was laughing with sister before leap, guard says (link), discussed a public restaurant that has become a "suicide magnet." Teachers, medical professionals, clergy or just about any helper other than a 14 year old peer is a "mandated reporter" who has no choice but to take draconian and often counterproductive restrictive measures.

This horrible tragedy brought to mind a serious dilemma that many people experiencing depression, momentary or regularly finds themselves. A little personal disclosure because a long time ago I was there for an interval.

During academic year 1976-7 I was a sophomore at an Ivy League school with deep, scenic gorges. The combination of an undiagnosed dust allergy and the cough medicine (Codeine and Tylenol) I used to combat the allergy caused me some rather severe depression, albeit for a few months. Accentuating this was difficulties in completing my foreign language requirements. One night, in early April, I basically "had enough" and started walking back and forth over one of the bridges over one of the gorges. Before I made any attempt to take a leap, I was stopped and questioned by campus police. My first mistake was saying anything about being despondent.

I was held overnight in the campus infirmary. I was evaluated by a psychiatrist engaged by the infirmary, one "Dr. Bull" (his actual name, no joke). I told him I felt better and wanted to finish some homework. He said I didn't get "the big picture", whatever that was.

The next day I was picked up by my mother and stepfather. Both were needed because I had a car on campus. Fortunately, and this is one thing I give my mother a lot of credit for, she took me to a family friend who happened to be a psychologist. He evaluated me and penned me a note that enabled me to return to finish my classes for the semester. I returned the following fall, graduating on schedule.

Mentioning that you are in severe personal distress is most counterproductive. People are not there to help. They are there for a bureaucratic, not personal solution. Now that teen on the Vessel; he probably knew the score, and that if he told anyone how he was feeling he'd be living in a world of hurt, not of therapy and help. Psychologists and psychiatrists are mandated reporters. If someone says they are thinking of suicide in a private session they may have to call 911 or a reporting agency, even if they are well capable of handling or treating the problem. I think the evaporation of confidentiality, which did not officially exist in 1977, is just horrendous.

 

[Neomalthusian]

I’m a little confused by this. It’s kind of like complaining that someone who pried a gun from your hand that you were on the brink of using to kill yourself didn’t respect your second amendment or property rights. Yeah, maybe so, but look, you’re still alive to have those rights and complain, so that’s still a victory, from the POV of the person that intervened.

Therapists et al. shouldn’t initiate civil commitment just because someone admits to having (had) suicidal thoughts. They’re ethically obligated to intervene when there’s probable cause to believe it’s life or death.

 

[AmNat]

A recent article, Teen who jumped to death from Vessel was laughing with sister before leap, guard says (link), discussed a public restaurant that has become a "suicide magnet." Teachers, medical professionals, clergy or just about any helper other than a 14 year old peer is a "mandated reporter" who has no choice but to take draconian and often counterproductive restrictive measures.

This horrible tragedy brought to mind a serious dilemma that many people experiencing depression, momentary or regularly finds themselves. A little personal disclosure because a long time ago I was there for an interval.

During academic year 1976-7 I was a sophomore at an Ivy League school with deep, scenic gorges. The combination of an undiagnosed dust allergy and the cough medicine (Codeine and Tylenol) I used to combat the allergy caused me some rather severe depression, albeit for a few months. Accentuating this was difficulties in completing my foreign language requirements. One night, in early April, I basically "had enough" and started walking back and forth over one of the bridges over one of the gorges. Before I made any attempt to take a leap, I was stopped and questioned by campus police. My first mistake was saying anything about being despondent.

I was held overnight in the campus infirmary. I was evaluated by a psychiatrist engaged by the infirmary, one "Dr. Bull" (his actual name, no joke). I told him I felt better and wanted to finish some homework. He said I didn't get "the big picture", whatever that was.

The next day I was picked up by my mother and stepfather. Both were needed because I had a car on campus. Fortunately, and this is one thing I give my mother a lot of credit for, she took me to a family friend who happened to be a psychologist. He evaluated me and penned me a note that enabled me to return to finish my classes for the semester. I returned the following fall, graduating on schedule.

Mentioning that you are in severe personal distress is most counterproductive. People are not there to help. They are there for a bureaucratic, not personal solution. Now that teen on the Vessel; he probably knew the score, and that if he told anyone how he was feeling he'd be living in a world of hurt, not of therapy and help. Psychologists and psychiatrists are mandated reporters. If someone says they are thinking of suicide in a private session they may have to call 911 or a reporting agency, even if they are well capable of handling or treating the problem. I think the evaporation of confidentiality, which did not officially exist in 1977, is just horrendous.

I agree that violation of professional confidentiality should only be allowed if a person is expressly threatening to cause serious harm. For the reason you give, people in distress (who aren't definitely intending to do something wrong) have the right to seek help without fear of betrayal.

Your statement about clergy is incorrect though. At least with Catholic priests, anything said under the seal of confession is subject to absolute confidentiality. He can neither directly reveal the information confided nor use it indirectly to the injury of the penitent (e.g. by giving someone in authority a general warning concerning the person) for any reason.

 

[Lursa]

A recent article, Teen who jumped to death from Vessel was laughing with sister before leap, guard says (link), discussed a public restaurant that has become a "suicide magnet." Teachers, medical professionals, clergy or just about any helper other than a 14 year old peer is a "mandated reporter" who has no choice but to take draconian and often counterproductive restrictive measures.

This horrible tragedy brought to mind a serious dilemma that many people experiencing depression, momentary or regularly finds themselves. A little personal disclosure because a long time ago I was there for an interval.

During academic year 1976-7 I was a sophomore at an Ivy League school with deep, scenic gorges. The combination of an undiagnosed dust allergy and the cough medicine (Codeine and Tylenol) I used to combat the allergy caused me some rather severe depression, albeit for a few months. Accentuating this was difficulties in completing my foreign language requirements. One night, in early April, I basically "had enough" and started walking back and forth over one of the bridges over one of the gorges. Before I made any attempt to take a leap, I was stopped and questioned by campus police. My first mistake was saying anything about being despondent.

I was held overnight in the campus infirmary. I was evaluated by a psychiatrist engaged by the infirmary, one "Dr. Bull" (his actual name, no joke). I told him I felt better and wanted to finish some homework. He said I didn't get "the big picture", whatever that was.

The next day I was picked up by my mother and stepfather. Both were needed because I had a car on campus. Fortunately, and this is one thing I give my mother a lot of credit for, she took me to a family friend who happened to be a psychologist. He evaluated me and penned me a note that enabled me to return to finish my classes for the semester. I returned the following fall, graduating on schedule.

Mentioning that you are in severe personal distress is most counterproductive. People are not there to help. They are there for a bureaucratic, not personal solution. Now that teen on the Vessel; he probably knew the score, and that if he told anyone how he was feeling he'd be living in a world of hurt, not of therapy and help. Psychologists and psychiatrists are mandated reporters. If someone says they are thinking of suicide in a private session they may have to call 911 or a reporting agency, even if they are well capable of handling or treating the problem. I think the evaporation of confidentiality, which did not officially exist in 1977, is just horrendous.

This is many decades in the past and still truly affects you. Was there stigma attached to this that has followed you to this day? Or for many years, into your ability to enter a profession, to succeed, to gain opportunities, etc?

Please dont feel that you should divulge more personal information but I'm struck by the timeframe and curious about the intent of your post.

 

[JBG]

I’m a little confused by this. It’s kind of like complaining that someone who pried a gun from your hand that you were on the brink of using to kill yourself didn’t respect your second amendment or property rights. Yeah, maybe so, but look, you’re still alive to have those rights and complain, so that’s still a victory, from the POV of the person that intervened.

Therapists et al. shouldn’t initiate civil commitment just because someone admits to having (had) suicidal thoughts. They’re ethically obligated to intervene when there’s probable cause to believe it’s life or death.

There needs to be a balance between intervening in an immediate crisis and punishing someone for having "bad thoughts."

 

[JBG]

This is many decades in the past and still truly affects you. Was there stigma attached to this that has followed you to this day? Or for many years, into your ability to enter a profession, to succeed, to gain opportunities, etc?

Please dont feel that you should divulge more personal information but I'm struck by the timeframe and curious about the intent of your post.

I am quite successful as a lawyer. When I hear of this is the news, I wonder if, had people been able to discuss their feelings without risking what amounts to arrest, people wouldn't get to the point of acting on their thoughts.

 

[HonestJoe]

Teachers, medical professionals, clergy or just about any helper other than a 14 year old peer is a "mandated reporter" who has no choice but to take draconian and often counterproductive restrictive measures.

"Mandated Reporter" typically refers to suspected abused rather than general mental health concerns so I'm not sure that's directly relevant. I suspect the bigger issue here is that most people in positions of responsibility for others have few is any resources to support them when presented with potential mental health issues.

A little personal disclosure because a long time ago I was there for an interval.

What exactly do you think was done wrongly in your situation? It seems to me that you were dealt with entirely correctly (and better than I would have generally expected, especially in the 70s).

Mentioning that you are in severe personal distress is most counterproductive. People are not there to help.

I know this is wrong and, ironically, counterproductive. I think most people would seek to help. The problem will typically be in their ability to help rather than any lack of desire or good intention.

Psychologists and psychiatrists are mandated reporters. If someone says they are thinking of suicide in a private session they may have to call 911 or a reporting agency, even if they are well capable of handling or treating the problem.

That is simply not true, exactly the opposite is the case. A mental health professional is not going to involve the police or inpatient care if they're confident they can resolve the situation themselves. Note that someone talking about suicidal thoughts to a therapist is entirely different to someone taking actual steps towards harming themselves.

 

[JBG]

That is simply not true, exactly the opposite is the case. A mental health professional is not going to involve the police or inpatient care if they're confident they can resolve the situation themselves. Note that someone talking about suicidal thoughts to a therapist is entirely different to someone taking actual steps towards harming themselves.

Mentioning that you are in severe personal distress is most counterproductive. People are not there to help. They are there for a bureaucratic, not personal solution. Now that teen on the Vessel; he probably knew the score, and that if he told anyone how he was feeling he'd be living in a world of hurt, not of therapy and help. Psychologists and psychiatrists are mandated reporters. If someone says they are thinking of suicide in a private session they may have to call 911 or a reporting agency, even if they are well capable of handling or treating the problem. I think the evaporation of confidentiality, which did not officially exist in 1977, is just horrendous.

I know I butchered the use of multi-quote. I need a tutorial. I am responding to part of "HonestJoe's" response to part of my quote. I have spoken with a psychologist recently to consult on some office/industrial issues and my senior Rabbi. When we were not talking about myself we were talking about situations involving suicidal thoughts of others. Both expressed frustration that when someone mentions possible suicide, even indirectly, they have to steer the discussion to ensure that they are speaking about a hypothetical, much as I sometimes need to do in my profession. They consider themselves mandated reporters. This is a corollary to the so-called "Tarasoff Rule.." The Tarasoff Rule arose from a California case where the facts, assumed for litigation purposes to be true, were that a patient of a psychiatrist hinted that he was going to kill someone. That person was in fact killed by the patient. The way it's a corollary was the Tarasoff case created a "duty to report" that has since grown.

 

[Lursa]

I am quite successful as a lawyer. When I hear of this is the news, I wonder if, had people been able to discuss their feelings without risking what amounts to arrest, people wouldn't get to the point of acting on their thoughts.

That is a big issue, the stigma surrounding mental illness, and it does prevent some people from seeking help, or waiting too long.

There are more and more conversations on it tho, so IMO our society is going in the right direction. Are you involved in any mental illness charities or participate in suicide hotlines, etc? More involvement could help you and others.

 

[JBG]

That is a big issue, the stigma surrounding mental illness, and it does prevent some people from seeking help, or waiting too long.

There are more and more conversations on it tho, so IMO our society is going in the right direction. Are you involved in any mental illness charities or participate in suicide hotlines, etc? More involvement could help you and others.

Stigma wasn't really the problem, at least for me. I'm not afraid to discuss something with someone or tell them it's none of their business. The problem was the knee-jerk to conduct what amounted to an arrest, and being handcuffed to the bed at the infirmary. Basically when I asked about arrangements to complete a course assignment Dr. Bull said that was "very strange." At that point I thought of it as having been a bad evening when I felt down and out. From the university's perspective it was anything but routine.

The only thing missing from treatment as a criminal was not being read my Miranda rights. Please note, everyone, I did graduate quite successfully two years and one month later, the Thursday before Memorial Day weekend 1979 if my memory serves. There was no reason for some very rough handling.

 

[Neomalthusian]

There needs to be a balance between intervening in an immediate crisis and punishing someone for having "bad thoughts."

I don’t think there needs to be a balance between those things. No one should be punished for having bad thoughts at all.

 

[JBG]

I don’t think there needs to be a balance between those things. No one should be punished for having bad thoughts at all.

A 911 call by a mandated reporter is not meant as punishment but it does work out that way.

 

[Neomalthusian]

A 911 call by a mandated reporter is not meant as punishment but it does work out that way.

Being treated in a hospital that serves dry bread rolls and liquidy jello could be construed as punishment.

To someone who is intending and attempting to kill themselves, intervening at all, causing the person to continue living, could be construed as punishment.