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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 7 to 31 of 67. Go back in thread:
Posted by alexandra_k on March 5, 2005, at 15:12:10
In reply to Re: possibly being able to do more to help, posted by Dr. Bob on March 5, 2005, at 9:28:17
http://www.dr-bob.org/babble/admin/20050219/msgs/465833.html
Just in case you missed it...
:-)
Posted by just so sad on March 5, 2005, at 16:58:22
In reply to Re: PS » Dr. Bob, posted by alexandra_k on March 5, 2005, at 15:12:10
How about allowing each poster to elect in or out for themselves, indicating whether or not they want other posters to alert you or the ISP if they appear to be suicidal?
Posted by Phillipa on March 5, 2005, at 16:59:01
In reply to Re: PS » Dr. Bob, posted by alexandra_k on March 5, 2005, at 15:12:10
I think it deserves some serious thought. Some people [it seems especially young posters] don't really know who they can call,and act out without thinking the consequences through. I maintain some sort of crisis intervention. Maybe a Board that lists what a person can do for help if they are suicidal. For example, Look up a crisis line in your area, even call AA they can link you up, call an ER, your Doctor. Some people when that upset just act. They trust this Board enough to Post here. Okay maybe some are looking for attention, but we are not qualified to make that call. I'd rather be wrong, than sorry. I like your idea Dr. Bob. Fondly, Phillipa
Posted by Dr. Bob on March 5, 2005, at 20:30:35
In reply to Re: PS, posted by Phillipa on March 5, 2005, at 16:59:01
> could there be a separtate email account for this sort of thing that you check?
>
> rainbowbriteThere could be, but sometimes I don't have Internet access at all...
--
> How about allowing each poster to elect in or out for themselves, indicating whether or not they want other posters to alert you or the ISP if they appear to be suicidal?
>
> just so sadI like the idea of giving people control, but what if someone who opted out were suicidal?
--
> I wouldn't be prepared to deal with the consequences for making a bad call either way. Even the consequences of making a good call.
>
> alexandra_kI'm not sure what you mean, the consequences of making a good call, what might they be?
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> Maybe a Board that lists what a person can do for help if they are suicidal.
It's not a board, but there's already Coping With Crisis:
http://groups.yahoo.com/group/psycho-babble-tips/links/Coping_with_crisis_001012507973
> I'd rather be wrong, than sorry. I like your idea Dr. Bob.
>
> PhillipaThanks, but I think usually people think of it as *safe* rather than sorry. :-)
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> I'm immediately concerned about the potential for misusing this potential feature.
>
> Lar> Not to mention the difficulty in assessing the difference between ideation and intent.
>
> I think *I* would find it a bit overwhelming.
>
> Dinah> Yeah, I agree with Larry that I don't think you want everyone to be able to do that.
>
> alexandra_kI agree, the potential for misuse and the difficulty of assessing posters are definitely serious issues. Are there ways they could be addressed? For example, what if it took more than one person?
Bob
Posted by Dinah on March 5, 2005, at 20:31:55
In reply to Re: possibly being able to do more to help » Dr. Bob, posted by alexandra_k on March 5, 2005, at 15:02:51
I just don't understand the anger towards people in such acute distress that they want to kill themselves. While I know it's distressing to watch, I imagine, no I KNOW, it's a whole lot more distressing to experience.
We want Babble to be a community, a family away from family, yet we also want to send the message that if posters are feeling so bad they want to end their life they should go away and do it elsewhere because it makes us uncomfortable? I hope Dr. Bob never follows the example of the other community and implements such a policy.
We've lost at least one Babbler over the years I've been here. And I have to say that it isn't at all preferable for someone to be clearly increasingly distressed and then disappear. Moreover, if even one Babbler is helped through a suicidal crisis by other posters or by intervention here, well, thank God and Dr. Bob.
Babble is a big board. It's perfectly ok for posters not to feel up to coping with a thread like that and to skip it.
I'm sorry if I sound a bit strident. But I remember the message I got as a teen. Nobody cares if you're desperately unhappy. Nobody cares if you feel like killing yourself. But for heavens sake don't make a scene.
Posted by Dinah on March 5, 2005, at 20:37:43
In reply to Re: immediate concerns, posted by Dr. Bob on March 5, 2005, at 20:30:35
> I agree, the potential for misuse and the difficulty of assessing posters are definitely serious issues. Are there ways they could be addressed? For example, what if it took more than one person?
>
> BobThat would help a lot.
Another thing that might help is very clear guidelines very prominently postes. Something along the lines of "if you express clear suicidal intent, your ISP will likely be contacted, but do not rely on that and please seek help in real life". That way if people get upset that the police came to their door, they can't claim ignorance.
Posted by Phillipa on March 5, 2005, at 20:38:47
In reply to Re: immediate concerns, posted by Dr. Bob on March 5, 2005, at 20:30:35
May be farfetched but how about our own crisis center. I used to have to take crisis calls and refer them when I worked psych. It's hard but rewarding. They have volunteers that work these lines in my area I believe. And you're right Dr. Bob it's safe not sorry. Fondly, Phillipa
Posted by Dinah on March 5, 2005, at 20:39:32
In reply to Re: immediate concerns, posted by Dr. Bob on March 5, 2005, at 20:30:35
Is there some person, group of persons, or organization with experience in assessing intent that would be willing to review posts that were sent to their attention?
Posted by Dinah on March 5, 2005, at 20:42:31
In reply to Re: immediate concerns, posted by Phillipa on March 5, 2005, at 20:38:47
That's a great idea, if you could scare up volunteers. That way the people who were doing it would have volunteered for the duty.
Posted by Phillipa on March 5, 2005, at 20:42:37
In reply to Re: immediate concerns » Dr. Bob, posted by Dinah on March 5, 2005, at 20:39:32
It would take too long, by then what was intent could be reality. Fondly, Phillipa
Posted by Dinah on March 5, 2005, at 20:44:12
In reply to Re: immediate concerns » Dinah, posted by Phillipa on March 5, 2005, at 20:42:37
It's what Dr. Bob does now. And I trust him more to do it than I would trust untrained posters. I wouldn't want the police showing up at the door too easily.
Posted by Phillipa on March 5, 2005, at 20:46:00
In reply to Re: immediate concerns » Phillipa, posted by Dinah on March 5, 2005, at 20:42:31
I'll volunteer. I have an active RN license. I was also Nationally Certified in Psychiatric Nursing. Unfortunately I no longer have it as I haven't worked in 7years. Fondly, Phillipa
Posted by Dinah on March 5, 2005, at 20:51:32
In reply to Re: immediate concerns » Dinah, posted by Phillipa on March 5, 2005, at 20:46:00
That's great. I think it's a good idea if Dr. Bob can get volunteers. I just would hate to see it be something that people felt like it was their responsibility to decide, especially if they had no training. If Dr. Bob gets one or many volunteers, that's a different thing altogether.
But I've got a therapist, ok? I'm in close contact with him. And several people can reach me off board, or even reach my therapist if necessary. Just opting out now. :)
Posted by alexandra_k on March 5, 2005, at 23:30:08
In reply to Re: possibly being able to do more to help, posted by Dr. Bob on March 5, 2005, at 9:28:17
>Would that be overwhelming?
I think I would prefer not to have it.
>I think *I* would find it a bit overwhelming. Feeling like if I had done something, someone might not have died. Or taking the chance of causing problems in a person's life by pressing the button too easily.
I agree with that.
The consequences of making a good call…
Even if a life is saved as a result I worry that a poster won’t be happy that another poster called the police on them.But why do people post that kind of stuff on the boards?
I guess it is a plea for help.
I am not angry that some people post that kind of stuff. But I do think it is inappropriate to post that kind of stuff on the boards. That is largely because (currently) when it comes down to it THERE IS NOTHING WE CAN DO. Aside from inform Dr Bob and he can’t be expected to be online 24/7. That is not the message that it is inappropriate to express what one is feeling. Or that it is inappropriate to express suicidal urges. Just the message that it is inappropriate to talk about suicidal urges on the boards (or via babblemail) because THERE IS NOTHING WE CAN DO. There are alternative places to request help from.But would it be overwhelming to change it so that there is something we can do?
If we have the choice to be able to do this (or have some say in whether it happens)
Then to ‘opt out’ is (to me anyway) the same as doing nothing.
And a consequence is that I would feel partly responsible if they were not okay.
I could have done something and I did not.So I guess it is up to you…
I don’t think I would find it overwhelming. But I would find it hard. It might seem overwhelming if one found one made a bad call…
On a slightly different note I wonder if letting people do this would escalate or reduce those kinds of posts on the board.
Posted by Phillipa on March 5, 2005, at 23:49:44
In reply to Re: immediate concerns » Dinah, posted by Phillipa on March 5, 2005, at 20:46:00
To work a crisis intervention service on this Board you would have to know all Posters Dx, Their pdoc or doc, past hx of suicide attempts or threats, where they lived, and someone to contact in case of emergency. That's a lot I have to admit. Fondly, Phillipa
Posted by Dinah on March 6, 2005, at 0:37:51
In reply to Re: immediate concerns, posted by Phillipa on March 5, 2005, at 23:49:44
All Dr. Bob does is contact their ISP. Even that is loaded with trouble. People can and do get very angry with him for doing it. But doing it may save someone's life.
That's a heck of a lot of responsibility to bear.
Posted by alexandra_k on March 6, 2005, at 1:10:17
In reply to Re: immediate concerns » Phillipa, posted by Dinah on March 6, 2005, at 0:37:51
I agree Dinah, it is.
One I think I would prefer not to have.
But if it becomes an option I would feel obliged to volounteer. Because if I didn't volounteer and I saw someone in distress I would have to live with having volounterily chosen to be powerless in such a situation.Yuk.
Posted by cubic_me on March 6, 2005, at 5:58:22
In reply to Re: immediate concerns » Dinah, posted by alexandra_k on March 6, 2005, at 1:10:17
I think that if the system of people being able to notify ISP providers was in place, I would hardly talk at all on these boards for fear of the police knocking on my door.
I don't post suicidal intent on these boards, however I can completely understand why people do. Many people have few people IRL who know them as well emotionally or who they trust as much as babblers. It is not true that we can do nothing to help - sometimes words alone can be enough for people to hang on a few more days until things seem bit brighter. Of course we want to stop people killing themselves, but in the end it is THEIR choice, it will not be our fault if they kill themselves. If this system was opperating I think that it may stop people posting who could have truely been helped by some support from babblers.
I don't think that babble has ever explicitly stopped me from attempting suicided (however even recently I can think of one person it has), however it has made me feel less alone at those times. I would not have posted, and therefore felt less alone if I'd have thought that the police may come knocking. I am a very private person, and people knowing about my depression would have severe concequences for me. Also, I ofen post from the university computers - would the police be able to find me there?
I'm sorry for the length of this post, I just feel strongly about this. I think that the idea of some kind of crisis centre is good, but may be impractical (but I don't know). Perhaps more prominant links to the crisis pages would be good, as I didn't even know there were any unitil I read about them on Admin a few weeks ago.
Posted by Dinah on March 6, 2005, at 9:08:16
In reply to Re: immediate concerns, posted by cubic_me on March 6, 2005, at 5:58:22
I agree with everything you say. I would hate for people to lose Babble at the point they most needed it. Perhaps it's a situation where trigger warnings would be a polite gesture. But I don't think it would be right for Dr. Bob to shush people for expressing the ultimate of despair.
I know there are times when people feign suicidal intent, for various reasons. I try to be understanding of the fact that I have no way of knowing if that's true in any particular case, and that whatever reason they have is vital to them. I sometimes fail to keep that in mind.
Oh, this brings back so many old feelings.
Right now, Dr. Bob does contact the ISP if he feels there is an immediate threat, and if he is available. But he's conservative, and he has experience in determining whether a situation calls for that drastic intervention. In fact I contacted him once about a situation that I thought fell into that category, and he disagreed. I trust him in that position.
I'm also not sure it's a burden Dr. Bob should place on the Babble population at large. If he's willing to accept volunteers and give them some rudimentary training, that might be different. Or accept volunteers who already are credentialed in some way.
Posted by Phillipa on March 6, 2005, at 9:27:11
In reply to Re: immediate concerns, posted by cubic_me on March 6, 2005, at 5:58:22
Maybe our crisis center could offer the services of fellow Babblers trained to "know what to say". Then if it was in agreement with the potential suicidal person, a list of places or people they could call for help in their area. Asking them if there was a loved one whom we could help them contact to go to their location. With their permission of course. Sometimes you just have to talk someone through the necessary steps to available help, as they are so stressed at the time that they can't do it by their self. Fondly, Phillipa
Posted by Dr. Bob on March 6, 2005, at 14:49:36
In reply to Re: immediate concerns, posted by Phillipa on March 6, 2005, at 9:27:11
> Another thing that might help is very clear guidelines very prominently postes. Something along the lines of "if you express clear suicidal intent, your ISP will likely be contacted, but do not rely on that and please seek help in real life".
>
> DinahI'm not sure how prominent I'd consider it, but the FAQ does already say:
> I ask for email addresses (and the server logs IP addresses) so that if there is any abuse or serious danger, I can notify the person's Internet service provider (or other authorities).
http://www.dr-bob.org/babble/faq.html#privacy
--
> May be farfetched but how about our own crisis center.
>
> Phillipa> Is there some person, group of persons, or organization with experience in assessing intent that would be willing to review posts that were sent to their attention?
>
> Dinah> Maybe our crisis center could offer the services of fellow Babblers trained to "know what to say".
>
> PhillipaWhat if Babblers who were interested obtained training from the Samaritans or someone?
--
> The consequences of making a good call…
> Even if a life is saved as a result I worry that a poster won’t be happy that another poster called the police on them.OK, thanks, I see.
> On a slightly different note I wonder if letting people do this would escalate or reduce those kinds of posts on the board.
>
> alexandra_k> I think that if the system of people being able to notify ISP providers was in place, I would hardly talk at all on these boards for fear of the police knocking on my door.
>
> cubic_meWhat about me already being able to notify your ISP?
If you aren't really suicidal, you can just say so, and that would be nice for everyone to know...
Thanks for thinking this through with me,
Bob
Posted by alexandra_k on March 6, 2005, at 15:01:59
In reply to Re: immediate concerns, posted by cubic_me on March 6, 2005, at 5:58:22
I think that there is a difference between posting suicidal ideation and suicidal urges. Well, the border can be fuzzy at times to be sure, but my understanding is that it would be clear cases of the latter that would warrant someones internet provider being contacted.
I post ideation quite a bit. I also say that I will be okay. I don't want to worry people but I do want to vent what is going on for me. Nobody has had a problem with that (that I am aware of) but people did express concern and I got some supportive posts which helped me.
But when someone posts something saying that they are going to do something or they have just done something or saying goodbye to everyone then that is when something needs to be done. It is that kind of stuff that I wish people wouldn't post here because a) It is a gamble as to whether Dr Bob can do something so they receive intervention in time and b) The rest of us have to deal with being very concerned (possibly triggered) and helpless and powerless to do anything. I don't think it is fair to the posters here. We are not trained to deal with suicide intervention. With respect to getting supportive posts you don't need to post the latter kind of claims to get support. The rest of it is unnecessary and there are much more appropriate alternative places with trained staff that people can turn to.
If we can get someones ISP provider to contact the police then Babble becomes something of an emergency service. If that is acceptable then I would request that the latter kinds of urges be prefaced with a special trigger warning. In fact, why not just hook it up to 911 directly ???
> I think that if the system of people being able to notify ISP providers was in place, I would hardly talk at all on these boards for fear of the police knocking on my door.
Yes. I can see it now. Police phone the manager at the hostel: some of the residential assistants are informed etc etc. Then they want to know whether I post on this board and what I post and why someone called the cops on me etc etc. Humiliating. But I do think that there could be measures around this. We would need to know what kinds of things warrant a call to the ISP provider (to make sure we don't say them) and that calls are made only on the basis of our having posted such things.
I apprecite that I will probably get jumped on again... But I do think that it is possible to express yourself in a way that is true to your experience AND considerate of posters and their position here at the same time.
Posted by alexandra_k on March 6, 2005, at 15:14:49
In reply to Re: immediate concerns, posted by Dr. Bob on March 6, 2005, at 14:49:36
> > On a slightly different note I wonder if letting people do this would escalate or reduce those kinds of posts on the board.
> What about me already being able to notify your ISP?
But that is fairly inconspicuous...
(Though not anymore not anymore)
Also it is a great gamble.
Who knows when you will be able to do that.
And how long the ISP will take to notify the cops.
And how long the cops will take to find someone.
If posters can do this too then there is much faster intervention.I guess my experience with suicidal peoples is the people I knew in DBT group. That is probably impacting on my thoughts about this quite a lot.
One expresses urges or has an attempt and then by next week almost everyone has expressed urges or had an attempt. Catchy. For people who have a tough time dealing with crisis services the police being called by a third party might be what it takes for them to be taken seriously. But then Babble becomes a routine way of getting services they need in their area.
So be it I suppose.
It is not that I am so very cold and heartless.
But their has been something of a spate of this on the boards recently...
Also people saying they need to reduce their emotional involvement with Babble...
Catchy?
I worry that it will significantly change the tone of the boards...But all that being said...
I would prefer to interveane rather than be powerless.
And people do insist on expressing their urges.Sorry.
I have felt quite affected by some of the posts here recently. I don't think I am the only one. I'll just try to think of it as a 'bad patch'.
Posted by Tabitha on March 6, 2005, at 17:47:41
In reply to Re: immediate concerns, posted by alexandra_k on March 6, 2005, at 15:14:49
From a technical perspective I don't think Dr Bob can necessarily trace each poster's location. He probably won't want to share specifics, but I suspect his ability to locate a poster isn't fool-proof. So even if he extends this "notify the ISP" power to us posters, it still might fail to provide that person's physical location to the police. This makes us uniquely helpless here in cyberspace.
If I tell my therapist or pdoc I'm going to kill myself, they can take action to get me hospitalized. If I call a crisis hotline or 911, they can trace my call and locate me. This forum might be the only place I can announce my intent to kill myself without any consequence. I don't think such a situation is healthy for the suidical person or for the other members.
I also question whether allowing group members to provide suicide intervention makes any sense. Would any real life support group have its members able to or responsible for intervening in other members' suicide attempts? Just does not seem like good boundaries to me. In fact it seems really messed up. I think Dr Bob should discuss this idea with some other psychiatrists or mental health professionals and get their input.
Posted by Phillipa on March 6, 2005, at 19:22:34
In reply to Re: immediate concerns, posted by Tabitha on March 6, 2005, at 17:47:41
Good Idea. Fondly, Phillipa
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