this post was submitted on 29 Mar 2024
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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?
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.
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.