I interviewed 60 people less than 24 hours after they attempted suicide. AMA | Hacker News Reader

I interviewed 60 people less than 24 hours after they attempted suicide. AMA

anyasq.com

58 pointsRoboTeddy36 comments

I stopped reading after the first question, where the interviewee states that people are "rarely" forced into inpatient treatment against their will. Maybe it's an insurance thing and they kick out the indigents by rationalizing their "commitment to outpatient treatment", but I have multiple friends who sought psychiatric help proactively, got talked into conceding suicidal ideation, and ended up stuck in worthless inpatient prisons for days and days.

This is real, serious problem with how we handle mental illness; anybody savvy enough to know what emergency help is available should unfortunately be savvy enough to know to avoid showing up anywhere in person.

I think there's a more practical reason behind it. In the United States, it's actually pretty hard to get someone committed against their will, and plenty of psychiatrists have argued that it should be easier to do so (and not completely without merit). I mean, how many people on the streets are there because they're incapable of taking care of themselves? How many people have committed crimes that could have been prevented with a mental hospital stay?

>>> How many people have committed crimes that could have been prevented with a mental hospital stay? <<<

Isn't this essentially equivalent to pre-emptive punishment? If you abstract it you could say, how many murders will stop if we lock up anyone who has ever been in a violent altercation? It is compelling in some ways, but this list also includes anyone in a very stupid bar fight. The real problem isn't even the haziness of the line, it's where do you draw the line.

Is being gay evil? Not too long ago it was viewed as that, and feminine boys were quite often put through hell. I really don't want to live in a world like that. This led to atrocities like these; http://en.wikipedia.org/wiki/Aversion_therapy#In_homosexuali...

The problem with a lot of psychiatry is the game of vested interests. For example, people making the DSM have a vested interest to categorise deviations from the social norm into disorders which require their own unique brand of "therapy". If you add in the fact that most of psychology research lacks proper scientific methodology, and its often used as a platform to prove a point, which somehow always agrees with the researchers prejudices, you get people juggling grenades on a glass slop, while balancing on a wet soap bar.

Also, it is far from a given that a mentally ill person is especially inclined towards crime. My mother worked as a psychiatric social worker for an extended period and her opinion was that schizophrenics were less dangerous than just average people.

Certainly, many mentally ill people could use some help and will engage in behaviors "disturbing to the public" (talking loudly to themselves etc). But it seems to me that serious criminality requires a certain confidence and competence maybe not a lot but more than, say

Actually, it has been shown that in the absence of substance abuse, schizophrenics are no more violent than the general population.

I have a family member with mental health problems. It annoys me to know end when I see yet another episode of Criminal Minds where the killer has paranoid schizophrenia. People with mental health issues need support not alienation from society.

How is it in the interest of the person concerned to be in prison rather than undergoing psychiatric care though?

We can take an extreme view of personal liberty, but in the UK at least a significantly higher percentage of those entering prison are suffering from mental health problems than in the rest of society. Prison is a suboptimal way of treating them; the level of disconnect with the normal world that it forces is unhelpful enough to healthy inmates, let alone those already in a fragile state of mind. My understanding is that the bulk of individuals with severe mental health problems are more likely to be a danger to themselves than others in any case.

Your argument seems to presuppose that authorities are inherently evil and trying to inflict harm on the individual. One could certainly make the case for that in some totalitarian regimes, but in a healthy democracy I don't believe that's a sustainable view. If you genuinely believe that, make your case and run for office.

Yes, it has to be carefully used and overseen and yes, there have to be limits on its use (UK law explicitly requires that treatment to the individual's benefit must be undertaken during their time in hospital) but in balance and in a carefully controlled and properly publicly accountable system, I'm comfortable with the detention of individuals with mental health problems for treatment.

I think that you're confusing 2 issues;

Issue 1 : A large amount of criminals have mental health issues.

Issue 2 : We don't like people with mental health issues and we tend to characterise them as "dangerous".

The people in Issue 1 are a small subset of people in Issue 2. How you treat people in Issue 1 is a completely different matter than locking up people in Issue 2. It's like saying since 80-90% of rapists are males, we should pre-emptively employ measures such as imprisonment, tracking, banishment and castration for all males (these are measures currently undertaken for certain classes of sex criminals)

Clearly a subset is not representative of the entire set.

>>> Your argument seems to presuppose that authorities are inherently evil and trying to inflict harm on the individual. One could certainly make the case for that in some totalitarian regimes, but in a healthy democracy I don't believe that's a sustainable view. If you genuinely believe that, make your case and run for office. <<<

Alan Turing.

Well, introducing rape in that way is a bit of a straw man I'd say.

As I said, the bulk of individuals suffering from mental health issues severe enough to provoke possible medical incarceration are primarily dangerous to themselves, not others; their restriction is in their own clear long-term best interests.

Nonetheless, for the few who are more likely to be dangerous to others or who, as a result or side-effect of their difficulties either have committed crime or are demonstrably threatening to do so, it is in no-one's best interests for them to be treated as if they are either a rational individual at liberty or a prisoner with no particular needs (depending on the stage). We have laws against conspiring or attempting to commit crime - how is it different to incarcerate (for purposes of treatment) the disturbed individual who makes a clear and credible threat of criminal behaviour for purposes of treatment? Or to link an individual's release from criminal incarceration to a treatment program for the condition that contributed to their offending behaviour?

The example of Alan Turing might be valid had his prosection not happened 59 years ago and the offence for which he was prosecuted repealed 44 years ago. If there's a comparable contemporary offence and case of the state so demonstrably working against the interests of its citizens, let's have it out - otherwise, I don't see the case has been made.

Actually there are provisions for insanity in the law. So, that's taken care of.

>>> Well, introducing rape in that way is a bit of a straw man I'd say. <<<

How so? It's devastating for the victim and ruins thousands upon thousands of lives everyday. It's not a straw man. It's just a natural extension of your suggestion. Who draws the line and where do you draw it? This is a very, very slippery slope and it's best that you tread carefully.

>>> their own clear long-term best interests. <<<

Their best interests as defined by you? Isn't that a wee bit arrogant?

Their best interests are in letting them be. Their best interests are in letting them breathe. Their best interests are in helping them live, instead of locking them away where they can't make people feel uncomfortable.

>>> We have laws against conspiring or attempting to commit crime - how is it different to incarcerate (for purposes of treatment) the disturbed individual who makes a clear and credible threat of criminal behaviour for purposes of treatment? <<<

Because,

a) Over there they committed the action.

b) Over here someone is just talking about it.

a and b are quite different you know.

>>> not happened 59 years ago and the offence for which he was prosecuted repealed 44 years ago <<<

It still happens today. It's just that humans have this weird penchant of abusing power, and that simply won't change for a long, long time.

http://www.unhcr.org/refworld/topic/4565c22532/4565c25f3f5.h...

Anyone interested in that topic (Aversion therapy for homosexuals) should read http://www.boxturtlebulletin.com/what-are-little-boys-made-o...

It's a very well researched piece on the impact it had on one boy's life - very moving, very well written, very fascinating.

No, it's hard to keep someone locked up, but it is surprisingly easy to have them locked up in the first place. It takes days to resolve this.

Should read the rest, too. I'm European, but I understand US is pretty federal at its core - i.e. customs in one corner can be completely different to customs in another. And her CV mentions Massachusetts, which AFAIK is one of the saner corners.

I attempted to sign in to ask a question, and got the following message:

This application will be able to:

    Read Tweets from your timeline.
    See who you follow, and follow new people.
    Update your profile.
    Post Tweets for you.
    Access your direct messages until June 30th, 2011.

Who the in their right mind would sign into this ???

I couldn't find a way to ask for fewer permissions. All we need is ability to post tweets since there's a checkbox to post to your followers when you ask a question or start an AMA.

We don't use any of the other permissions and won't do anything unexpected.

For what it's worth, we've run the Graffiti app on Facebook since the launch of the platform, and have never spammed anyone or their friends, or misused any data or permissions.

Why don't you let them tweet with a simple "tweet this" button instead? Why can't you just put in a tweet this button in a notice that appears after they post?

Hi Tim

I wasn't actually expecting a personalised response from the AnyAsq creator.

It was more a general comment, and the question still stands I think - read my DM's?, no frickin' way!! - that's a serious invasion of privacy ...

I understand that you have to do what you can to spread your product, but there's a trade-off between being able to tweet, and asking someone to basically give up their twitter accounts to you ... you're going to lose more potential customers than gain with this method IMHO ...

How about: asking someone to sign in twitter, and asking their permission to just tweet their questions? - could you limit it to that ?

I appreciate the feedback, and we're still thinking about how best to do it. I'm hoping at some point twitter will implement a more granular way to ask for permissions.

As for direct messages, I believe twitter will stop asking for that either today or tomorrow.

I'm super surprised they haven't implemented it already, i mean, it's not that difficult to build a granular permission system, what they have in place right now is a disaster ...

I'm wondering if they might be planning to transition to a more granular permission system like Facebook, since they recently started displaying the permissions more granularly and it would make a lot of sense.

I was looking for the transcripts of the interviews she did with the suicide victims. I was a bit disappointed.

If you're curious, could probably ask her a question about the type of things people said

She wouldn't be able to release those without consent or major editing / censorship due to patient privacy laws.

"Rarely do people without a serious mental illness attempt to take their own lives."

I wonder if she considers voluntary euthanasia to be a form of suicide, or whether these simply were not part of her study (maybe due to their success).

Check out her blog, interesting stuff there, too: http://taradeliberto.blogspot.com/

Where I am from when someone says I am tired, I am going to commit suicide (and they could sound a bit serious), the most likely answer you get is Sure. Go ahead. We'll only cry for one day and eat well at your funerals. I have never known anyone who went through with it.

The problem is that you never know when someone is just talking, just seeking attention, or is serious. Often, the most serious don't talk about it. They just do it. But even attempting it is bad enough and while many might make light of someone's threats about it as nothing more than lame attempts at milking attention, that alone denotes a fairly serious concern. There are several levels before the point of actually attempting or committing the act which are deserving of serious notice.

I haven't known anyone who went through with it, either (though I know many who know those who have). I'll tell you, however, that I'd sure rather know someone that made threats that I took serious and tried to get help for than know someone I didn't take serious and will regret not taking serious for the rest of my life.

Maybe you also come from someplace where friends and families keep suicides of friends and relatives secret whenever possible, due to stigma.

I personally know two completions.

From the site: Where interesting people say: "Ask me anything."

You know the author is interesting, because there's a giant photo of them in a dress cut down to their navel, right above the questions about interviewing dozens of attempted suicides.

Please do enlighten us: what is the correct clothing to wear on a website when you discuss attempted suicides? Should we make sure to stick to earth tones so that we respect the solemnity of the topic, or do we want to add some bright colors in to make sure no gets even sadder? This is one area where I sure wouldn't want to make a misstep. What's your opinion vis a vis a pipe for added gravitas? I think it might go too far. Maybe when you're done with suicide-related topics, you could compose a manual for other scenarios, so that we can be sure to never again offend your sense of fashion.

tl;dr, cut the fucking body policing, jackass.

Maybe he was just making a joke/being funny? If indeed then probably should make that clear since we all come from different cultures and sometimes jokes are misunderstood.

I think the "serious answer" would be "you don't put a photo of yourself, or, in fact, anything related to yourself that could be misconstrued as egocentric or status-serving, in an article related to suicide; you just let it speak for itself." However, that sort of goes against the whole point of the site's format, which is, basically, to status-affiliate [through social learning] with people who have done things that have made them high-status in one way or another.

I think the "serious answer" to that would be "then they shouldn't have done the interview" (or "they should have made some special exception to their normal site formatting," which through interview prioritization basically amounts to the same thing) which has interesting implications for the ethics of free speech.

I could understand if it were just a little user icon off in the corner, but to have a huge 200x300 photo in the article is a little obnoxious, though probably not intentionally crude. If it's an automated function of the site that puts it there for, then maybe a more tasteful choice of photo is called for when one posts several articles about working with suicide patients.

I should edit this to add that the author being an attractive young women is irrelevant and that a similar photo with a male author would be as unfortunately distasteful. And as the other poster mentioned, they thoughtfully changed their photo. Maybe it's just a cruddy way the site automates the use of people's photos in a sort of template?

I have to admit when I clicked on the page I thought about it, but I was a nice surprise. Btw she changed the picture.

  > what is the correct clothing to wear on a
  > website when you discuss attempted suicides?

You're missing the point: What value does the photo even add to the focus of the discussion? There's already a icon/avatar photo of her in the top right corner with her twitter account. Why are we blasted with a huge photo of her (regardless of what she's wearing)? Personally, I would find a huge photo of a guy with a beard toting a sweater vest and smoking a pipe just as jarring.

We ask for a relevant photo when you create an AMA. I think a photo of the person answering questions is more relevant than some sort of suicide-related stock photo.

You're misunderstanding. I'm advocating no photo.

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