Should this really have gone through?

February 12, 2009 9:14 AM

This makes me very uncomfortable.

This anon question is from a person who describes hard-drinking - mixed with pills - and cutting who (a) wants some advice about how to have a conversation with a friend and (b) pooh-poohs getting any help beyond that.

Having suffered from depression (though thankfully nothing like that) I know how hard it is to take the first step, but this isn't written like someone taking the first strokes up towards the surface, this is someone looking for ways to continue with very self-destructive and dangerous behavior.

This really screams out at me like a question asking for tips on playing russian roulette. Is there a line that shouldn't be crossed on questions about self-destructive behavior? Or is it a matter of "people are going to do it anyway, maybe this way they might get some help."

Maybe it should stand, but if I was the admin who received this question I'd have been seriously tempted to contact the person's school rather than approve the question.

posted by phearlez to etiquette/policy at 9:14 AM (19 comments total)

if I was the admin who received this question I'd have been seriously tempted to contact the person's school rather than approve the question.

We don't do this. Our basic options are...

- not approving the question
- contacting the person directly to rewrite their question because self-harm descriptions tend to make people uncomfortable and seeing if we can get the gist of their question without the shocking parts.
- contact the person directly, using what we know about their location and recommending good resources for them in their area
- in the rare cases [I've seen this once or twice] contacting someone who knows the person and telling them we think that person might be a danger to themselves.

The line we have set up is that if we think someone is suicidal or doesn't have the wherewithall to know if they're suicidal, we don't approve the question and we contact the person directly. It's a messy judgement call because once someone has reached out, even as an anonymous asker on the website, it feels a little like closing the door on their face to just not respond in some way. More responses from concerned users, esp in a situation like this, seemed to me to be the best approach but I'm not totally comfotable with that either.
posted by jessamyn at 9:23 AM on February 12 [2 favorites]

Calling someone's school is a very bad idea, in my opinion, and could have terrible unintended consequences.

Cutting is a pretty common coping mechanism for people the (apparent) age of the poster, and does not equal suicidal.

People with MH stuff in college tend to be really syptomatic -- they haven't yet figured out how to live with their conditions or to find the treatment that works for them or to ride the waves of mood swings, or any of the other stuff the older folks have figured out. And student MH care is pretty bad, often. This person has identified issues, met with therapists, created support systems, etc., all imperfect but signs of slowly figuring out one's path in the world as a person with MH symptoms.
posted by ClaudiaCenter at 9:50 AM on February 12 [4 favorites]

phearlez, I really disagree with this callout, although I understand why you might be disturbed by the question.

Adding more pressure is exactly what this poster does not need right now.

The poster has a good insight about the bad coping mechanisms and I feel the response should be to keep encouraging therapy, talking, reaching out. But that's just my personal opinion having received the kind of therapy and used the kind of coping strategies the poster uses.

Might I suggest some non-judgemental, supportive words to the throwaway e-mail cited in the original post?
posted by Wilder at 9:52 AM on February 12

I think at the bottom of it all you have to look at whether your actions would cause more harm than benefit, right. Schools, in my experience, don't have the resources or infrastructure in place to provide the degree of in-depth support that a depressed person needs. In many cases, they freak out, contact the parents, and it ends up being a giant mess.

The OP is not suicidal, or at least openly so, and recognizes the need to stay in touch with the real world. That's a pretty good first step, I would say. Having a bunch of people who are supposedly in authority mishandle their case and perhaps shut down in face of their problems is the opposite of supportive. At that age, peer support matters far more. It's an iffy question, but I feel like getting response from the Green would put them on the path to reaching out.

Ultimately it's none of our business what they do, we can simply offer them the best advice we can come up with and hope they take it. They trusted AskMe in posting these intimate details, and breaching that trust and "tattling" to the school doesn't really seem like a constructive way of helping them through their depression.
posted by Phire at 10:21 AM on February 12

Having suffered from depression (though thankfully nothing like that) I know how hard it is to take the first step, but this isn't written like someone taking the first strokes up towards the surface, this is someone looking for ways to continue with very self-destructive and dangerous behavior.

I've been through the same kind of stuff as the anonymous poster of the question, including the alcohol, painkillers and cutting. Back then getting better wasn't my priority; being able to keep myself safe in spite of the self-destructive behaviours was. That seems to be what anonymous is trying to do.

There's a wide gulf between being in need of immediate help and your comparatively less severe episode(s) of depression. Not everyone is able to set off on the road to recovery by taking that first step. Formulating strategies to manage and cope with long-term problems is a good thing. People freaking out about this stuff isn't helpful and doesn't make life any easier.
posted by xchmp at 10:39 AM on February 12

This is pretty creepy, but that is what really makes my skin crawl. Actually, pronouns in general make me uncomfortable. Mods, make it stop. Augh!
posted by carsonb at 10:48 AM on February 12 [2 favorites]

Telling the school will result in him getting expelled ("put on medical leave"). Don't do that!
posted by Electrius at 10:49 AM on February 12

Formulating strategies to manage and cope with long-term problems is a good thing.

I certainly concur, but does having a friend "check in with" someone who is mixing large quantities of booze with painkillers really qualify as a strategy to manage and cope? It might qualify as triage, but I have a hard time seeing it as more than that.

ClaudiaCenter says that school mental health care is bad. I wouldn't say that. I'd say mental health care in the US is flat-out atrocious across the board. But this seems like worrying about the color of a parachute once you're already plummeting out of a plane.

I'm not trying to encourage the admins to contact his school, I was just expressing my reaction to the question. I appreciate the clarification, Jessamyn, and I don't envy y'all having to walk that line. I appreciate that this person may not necessarily meet the criteria to call them "suicidal" but I also feel like there's sort of an irrelevant distinction between someone making an overt attempt to kill themselves and someone repeatedly engaging in terribly risky behavior.

*sigh* I'm sorry if my posting bugged any of you. This just really got to me somehow and I was looking for some understanding.
posted by phearlez at 11:15 AM on February 12

Something to think about is that the OP's situation may be an improvement over what they've had before. If this level can be maintained, then when they've gotten out of that spell, it's not as high a hill to climb to get to the next step.
posted by lysdexic at 3:04 PM on February 12

This callout makes me very uncomfortable. You should have contacted an admin directly. I'm sure the OP feels shitty enough without having to read on Metatalk that s/he's made you uncomfortable. I hope s/he feels okay to keep posting anonymously here.
posted by meerkatty at 3:20 PM on February 12 [2 favorites]

Yeah sorry but this callout is fucking balls.
posted by turgid dahlia at 3:27 PM on February 12

Or, less harshly: I appreciate that the AskMe might have upset or worried you, but there's a time and a place.
posted by turgid dahlia at 3:28 PM on February 12

We often see ourselves in AskMe questions, it seems. This makes things a lot stickier. What's often needed is sympathy. What's much more rarely needed is empathy.

It seems difficult to understand a familiar situation in which the other person's fundemental beliefs differ from our own. "When I was in that position, the last thing I needed was what you're clinging to. You're wrong to ask that question and more importantly, people are wrong for answering it as it was asked. What you really should be asking is this, and the answer to the question you should be asking is this."

That sounds like utter and ridiculous hubris on the surface, but how many times have I, stubby phillips, erased a similar tirade in the AskMe or MeTalk text entry field? Lots. I sympathize with your feelings.

I empathize too.
posted by stubby phillips at 3:53 PM on February 12

I appreciate that this person may not necessarily meet the criteria to call them "suicidal" but I also feel like there's sort of an irrelevant distinction between someone making an overt attempt to kill themselves and someone repeatedly engaging in terribly risky behavior.

If I thought this kind of substance abuse was as terribly risky as you do, I might agree that anonymous was in need of immediate help. I don't think that mixing booze and painkillers is a good idea by any standard, but it's not all that unusual for people with mental health issues to engage in substance and alcohol abuse. And it's certainly not something that mental health services are going to see as requiring their urgent intervention.

I also think you have rather high expectations of mental health services. Immediate and urgent intervention really only takes place when people are in imminent danger of seriously hurting themselves or others. Merely being suicidal, without active intent doesn't usually qualify.

The rest of your position on this seems pretty much reasonable, but your assumptions - that anonymous is in immediate and serious danger and immediate help would be available if only the right people knew about it - are wrong.
posted by xchmp at 4:16 PM on February 12

Actually, I feel like this callout is "working as intended."

This leaves the green alone and doesn't derail that conversation with a discussion of the asker's (presumed or projected) intent - while offering a forum for people to discuss the larger implications of such a question.

Like phearlez, parts of the question made me particularly uncomfortable, mostly because of my experiences with my brother's own repeated suicide attempts.

I just want to be able to get in touch with someone, and feel like it's OK to do this

Statements like the above jump out at me and say, "This person is in trouble." That's where my discomfort comes from. The OP isn't asking for therapy. The OP is asking for a pass on life. And that is problematic.
posted by greekphilosophy at 8:57 PM on February 12

a friend of mine's ex-wife liked to mix pain-killers and booze - a couple of months ago, she took a mixture of a few different prescriptions - i'm guessing not that much and i have no idea if she drank anything

i do know that she went to bed not "feeling well"

i do know that she never woke up

she was around 45 and had been doing this kind of thing for decades - this year, it got her

well, i guess it doesn't answer the question so i won't post it there, but what the op is doing is self-destructive behavior, and yes, it can kill, and yes, there's a reason to be concerned about this

sooner or later it WILL get you if you do it, one way or another
posted by pyramid termite at 9:07 PM on February 12

I'm sure the OP feels shitty enough without having to read on Metatalk that s/he's made you uncomfortable.

I'm with greekphilosophy, and dislike the sentiment above. Seems to me this is what MeTa is for - raising issues related to the day-to-day running of the site. Even though I couldn't disagree more with phearlez' take on this question, telling folks they shouldn't use MeTa because it's more important to protect the feelings of anonymous AskMe posters is worse.
posted by mediareport at 5:12 AM on February 13

This makes me very uncomfortable.

I thought this was going to be about pictures of taters.
posted by various at 6:08 PM on February 13

I guess some of you can't see a metatalk posting as anything other than a criticism of the Asker - thus your beating the drum to the tune of the word "callout" - but I worked very hard in my wording to not give any impression of criticism of Anonymous. S/he clearly is in a bad place and needs something, I merely questioned whether Ask was going to be the place to get it and if running this kind of question will likely do more harm than good.

As far as mixing booze, pills, and cutting and whether or not it's cause for immediate concern, xchmp, we're going to have to agree to disagree. If self-medication is what it takes for Anon to get through the day at the moment then that's the way it is. But any one of those things alone has the potential to be immediately or long-term fatal under extreme circumstances. The mix and match of booze and downers notably raises the potential for an accidental overdose.

Can it be done and get away with it? Sure, maybe even most of the time. It's the unpredictability that's the problem, as well as the fact that it is partially dependent on making good - or at least less bad - decisions while impaired. Long term it's a recipe for tragedy, and we don't do anyone any favors, no matter their circumstance, if we send the message that it isn't something that should be avoided.

This is getting far afield of why I posted this question, so with that I'll drop it.
posted by phearlez at 8:07 AM on February 14