self-harm or suicide-related posts

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Dear fellow forum members,

I would like to propose a discussion regarding the creation or revision of a policy concerning self-harm or suicide-related posts on our Wrongplanet forum. Our aim is to ensure a safe and supportive environment for everyone within our community.

To guide our conversation, I've referenced guidelines from Samaritans, an organization focused on suicide prevention and support. According to their recommendations, a robust self-harm and suicide content policy should encompass the following aspects:

1. Definitions: Clearly defining what constitutes self-harm or suicide-related content promotes understanding and consistency among our members and moderators.

2. Content Coverage:
Specifying the types of content falling under this policy's scope, such as detailed descriptions of self-harm methods or expressions of suicidal thoughts.

3. Harmfulness Criteria: Establishing criteria for evaluating whether self-harm or suicide content might be harmful to our community. This includes considering potential triggers or normalization of harmful behaviors.

4. Response Mechanisms: Implementing clear and effective mechanisms for addressing content covered by the policy, which may include reporting features, moderation procedures, and access to mental health resources.

5. Policy Updates: Committing to regular policy reviews and updates to reflect evolving best practices and community needs. It's important to note the last update date for transparency.

I invite all members to share their thoughts, insights, and suggestions on this matter. Your contributions are vital as we work towards a policy that prioritizes safety and well-being while fostering open discussions and support.

Thank you for your attention, and I look forward to hearing from you all.

Respectfully,
Fenn


https://www.samaritans.org/about-samari ... nt-policy/

One specific aspect that requires attention is how to respond to urgent situations where a member expresses suicidal thoughts and has a plan in place.

This type of situation requires a structured and compassionate response. Our policy should include guidelines for members and moderators on how to handle such cases promptly and effectively, including:

1. Immediate Intervention: Clear steps for members and moderators to intervene immediately, such as encouraging the individual to seek help, providing crisis hotline numbers, or contacting emergency services if necessary.

2. Support Resources: Information on available mental health resources and support services that can be shared with the individual, emphasizing the importance of seeking professional help.

3. Follow-up Protocol: Establishing a protocol for follow-up actions, such as checking in with the individual to ensure their safety, offering ongoing support, and connecting them with appropriate mental health professionals.

4. Confidentiality and Privacy: Ensuring that responses to such situations prioritize the individual's privacy and confidentiality while also prioritizing their safety and well-being.

I encourage all members to share their input and suggestions on this critical aspect of our policy. Your insights are invaluable as we work towards a comprehensive policy that addresses the complexities of supporting members in distress while upholding our commitment to safety and care.

Thank you for your participation, and I look forward to a constructive discussion.

Respectfully,
Fenn

I think this is an important topic to address. It's been raised a few times over the years. I believe there's a sticky or general help post already put in place, which involves a list of emergency resources including Samaritans.

It's important to remember that WP is doing the best it can to help people in crisis, but none of us are here as mental health support workers, even if that happens to be our day job or vocation.

It's very stressful for me to read posts about suicidal thinking because I take them very seriously and worry about the person so much that it often affects my own life. I feel helpless to do anything but give them emergency information. I'm worried about saying much to counsel them because that's not my field of expertise and I worry about saying the wrong thing. I couldn't live with myself if I had the responsibility of saving the life of a stranger online, and I caused more pain. That's a huge responsibility and it can be emotionally exhausting since we see these comments so frequently. I'm not saying that I don't care, but rather that I care perhaps more than I'm emotionally equipped to do.

Another consideration is that such comments have been levied against members before, as punishment or as threats. I've had a few members tell me that they want to end their lives because of me. It's like an emotional blackmail that if I'm not their friend or I don't write to them when they want, they're going to take their own life and blame me. This happens more than people realize as I know others who've received the same kind of emotional abuse in PM or on the forum. Sometimes we reach out to befriend those people, but they get upset when we can't continue to be there for them at all times. In those cases we get punished for having tried to help in the first place. They sometimes say they will kill themselves because we've hurt them by needing time out to deal with our own mental health instead of theirs.

There has to be a middle ground somewhere. The Haven is set up to be non-judgmental and for people to express themselves when they're in crisis. I think it's fair to say a lot of us don't know how to reply because we don't want to say something wrong or make it worse. We are nervous about becoming emotionally involved. That doesn't mean we don't care. It means we need a protocol which is consistent, and directs people to appropriately-trained mental health professionals.

I can especially relate to this comment. I think that hyper-sensitivity and hypo-sensitivity is essentially linked to autism.

Many emotional situations leave me unable to react without over-reacting or over-whelm.

Which is precisely why I started this conversation. To allow our collective strengths and weaknesses to perhaps come up with a script over a longer period of time to be available to refer to at critical times of crisis. Personally there are emotional situations I can “figure out” over time that I have trouble reacting to in real-time.

One real issue: suicide is real and really does happen. And there really are false threats of suicide. Is is probably impossible to eliminate all false-positives without also missing some true-positives.

My three children have been advised that there is a family history of suicide from both parents and when people talk about suicide and suicide prevention they should pay attention and listen.

Last edited by Fenn on 06 May 2024, 9:00 am, edited 2 times in total.

I can echo the feelings and concerns that both of you have expressed. Being torn between feeling like it's our duty to console and encourage, especially within the autistic community, and being afraid to make a bad situation worse.

Perhaps more of us would speak up, or at least know when action is required, if we had reliable information to guide us.

There's a member who posted over the weekend, that I'm sure we're all thinking of, and it's quite unsettling not knowing if he's ok.

If emergency services need to be contacted on someone's behalf, would any moderators have sufficient information to do so?

Reference material

https://www.vumc.org/health-wellness/re ... ut-suicide

What Do I Say When…?

Someone is Talking about Suicide

Suicide can be an anxiety-provoking topic. Often, the simple act of just seeing or hearing the word spikes personal and societal fears. The idea of a colleague, friend, or loved one talking about killing themselves or “wanting to die” can be even more overwhelming and scary. This article will help to alleviate some of the unknown and answer common questions about how to manage the difficult topic of suicide.

Talking about suicide is not a call for attention, rather a cry for help.

There are two different types of situations you may experience with people having suicidal thoughts – passive and imminent. Both should be taken very seriously, though likely handled a bit differently. In either case, do not be afraid to ask detailed and difficult questions. Asking about suicide does not increase their risk of an attempt. Instead, it decreases the stigma, alleviates feelings of isolation, and increases support – decreasing the likelihood of death by suicide.

Passive:
This situation occurs when someone is speaking more vaguely of wanting to die - maybe they have considered suicide or state that they feel they simply cannot go on like this.

Start with validating that person’s emotions and expressing your own genuine concern. Showing empathy and emphasizing that the person’s feelings matter can go a long way. “It sounds like you are really struggling. Can you tell me more about it? I’d like to listen and help where I can.”
Try your best not to argue with the person’s negative statements, no matter how dire they may sound. You can use positive reinforcement, while still acknowledging that their current emotions are real and fair. “You feel hopeless right now; we will get you the help you need together. You are not alone.”
Encourage the person to seek professional help and offer to help them identify and contact resources (see resource list below).
Safety Plan – Speak with the person about who they will contact if their suicidal thoughts and depressive symptoms begin to escalate. This list will likely include close friends or relatives, a professional, and a 24-hour suicide hotline.
Ask the tough and detailed questions. “Do you have a plan?” “Have you ever attempted before?” “Do you feel as if you could do something to hurt yourself today?” “Are you scared to be alone right now?”
Imminent:
Someone who is expressing a desire to die in the near future is in imminent danger, particularly if they have established a plan, means, or timeline.

Call 9-1-1 or the nearest emergency services unit.
Do not leave the person alone. Make sure they are escorted by a trusted person to the nearest Emergency Department or mental health crisis center.
Ensure that all means are removed from the person’s access. This might include guns, knives, medications, alcohol, and poisons. If this person is not a close friend, be sure to alert someone who will have the ability to remove means.
Work/Life Connections-EAP psychologist Chad Buck created a helpful acronym for keeping some of the tips mentioned above in mind: BELIEVE.

Believe that suicidal comments or gestures are serious
Engage in conversation about thoughts and feelings
Listen without judgment or arguing
Investigate intent and access to lethal means
Express empathy for the person and situation
Validate how difficult and painful this is for them
Encourage them to seek support and escort the person to access help
Supporting those with mental health issues can be incredibly tough, and you should not have to walk through it alone. Vanderbilt’s Work/Life Connections – Employee Assistance Program is a no-cost, confidential benefit for all employees, faculty, physicians, and their spouses. If you are wondering if counseling is for you, I encourage you to call 615-936-1327 and schedule an appointment to speak with one of the licensed clinicians on our team.

If you are a Vanderbilt student, call the Vanderbilt Psychological and Counseling Center at (615) 322-2571.

We are here for you.

Additional Resources:
Crisis Lines:

National Suicide Prevention Lifeline - 1-800-273-8255

Tennessee State-wide Crisis Phone Line - 855-CRISIS-1 (855-274-7471)

Walk-In Crisis Centers:

Mental Health Cooperative
275 Cumberland Bend, Suite 237
Nashville, TN 37228
615-726-0125

Vanderbilt 24/7 Behavioral Health Access
1601 23rd Ave. S.
Nashville, TN 37212
615-327-7000

References

National Alliance on Mental Illness. (2017). Preventing Suicide. Retrieved from: https://www.nami.org/Find-Support/Famil ... rs/Prevent…

National Institute of Mental Health’s Science Writing, Press & Dissemination. (2015). Suicide in America: Frequently asked questions. National Institute of Mental Health. Retrieved from: https://www.nimh.nih.gov/health/publica ... ndex.shtml

Smith, M., Segal, J., & Robinson, L. (2017). Suicide Prevention: How to help someone who is suicidal and save a life. HelpGuide.org in collaboration with Harvard Health Publications. Retrieved from https://www.helpguide.org/articles/suic ... -preventio…

​Maggie Reynolds – Clinical Counselor

Vanderbilt Work/Life Connections - Employee Assistance Program

I will not disagree. I have looked and cannot find it.

Can anyone point me to it?

I feel what you have done Fenn is commendable. There are some posts from the last few days that really bothered me. I didn't know what I should do.

Reference Material:

I know that different areas have different laws.

For reference this is the law where I live:

https://www.legis.state.pa.us/cfdocs/le ... &subsctn=0

Title 18:

§ 2505. Causing or aiding suicide.
(a) Causing suicide as criminal homicide.--A person may be convicted of criminal homicide for causing another to die by suicide only if he intentionally causes such suicide by force, duress or deception.
(b) Aiding or soliciting suicide as an independent offense.--A person who intentionally aids or solicits another to die by suicide is guilty of a felony of the second degree if his conduct causes such suicide or an attempted suicide, and otherwise of a misdemeanor of the second degree.
(c) Sentencing.--
(1) The Pennsylvania Commission on Sentencing, in accordance with 42 Pa.C.S. § 2154 (relating to adoption of guidelines for sentencing), shall provide for a sentence enhancement within its guidelines for an offense under this section when at the time of the offense the person who died by suicide or was aided or solicited to die by suicide is under 18 years of age or has an intellectual disability or autism spectrum disorder.
(2) As used in this subsection, the following words and phrases shall have the meanings given to them in this paragraph unless the context clearly indicates otherwise:
"Autism spectrum disorder." As defined under 42 Pa.C.S. § 5992 (relating to definitions), regardless of the age of the individual.
"Intellectual disability." Regardless of the age of the individual, significantly subaverage general intellectual functioning that is accompanied by significant limitations in adaptive functioning in at least two of the following skill areas:
(i) Communication.
(ii) Self-care.
(iii) Home living.
(iv) Social and interpersonal skills.
(v) Use of community resources.
(vi) Self-direction.
(vii) Functional academic skills.
(viii) Work.
(ix) Health.
(x) Safety.
(Sept. 30, 2021, P.L.400, No.71, eff. 60 days)

Reference material:

https://www.nimh.nih.gov/get-involved/d ... prevention

This has meme-like jpgs like the one below

Top Rated Apps for Suicide Prevention

https://www.suicidepreventionalliance.o ... revention/

The 988 Suicide & Crisis Lifeline
Stories of Hope and Recovery
https://988lifeline.org/stories/

Rudy Caseres shares his story and the importance of speaking up when it comes to suicidal thoughts.

"Suicide is still a topic that is not talked about nearly enough, and it is a detriment to us all because it leaves people living with suicidal feelings and ideation in silence. I’m alive today because there are people around me who I can reach out to when I am suffering."

Twitter has a policy posted.

https://help.twitter.com/en/safety-and- ... nd-suicide

What to do about self-harm and suicide concerns on X

If you or someone you know is struggling or in crisis, you’re not alone. Use the contact info below to get help.

United States: Contact the National Suicide Prevention Lifeline at 988. Crisis workers are available 24 hours a day. Calls are free and confidential.
Other countries & regions: To find a crisis center near you, visit International Association for Suicide Prevention.
If you or someone you know is thinking about engaging in self-harm or suicidal behavior, you should seek help as soon as possible by contacting services with expertise in crisis intervention and suicide prevention. You can also alert the X team focused on handling reports associated with accounts that may be engaging in self-harm or suicidal behavior if you encounter this type of content on X.


X’s approach to content associated self-harm and suicide threats


After receiving a report of someone who may be thinking about self-harm or suicide, X will contact the affected individual to let them know that someone who cares about them identified that they might be at risk of harm. We will also encourage them to seek support, and provide information about dedicated online and hotline resources that can help.


Recognize the signs


Judging behavior based on online posts alone is challenging, but there are potential warning signs or indicators that someone may be thinking about self-harm or suicide. Below are questions that you may ask yourself to help assess if an individual may be experiencing suicidal thoughts:

Does this person frequently post content about depression or feelings of hopelessness?
Is this person posting comments about death or feelings that death is the only option?
Are they posting comments about having attempted suicide in the past?
Are they describing or posting photos of self-harm or identifying themselves as suicidal?
Has their mood and the content of their posts changed recently?

If you are concerned and know the person involved, it can be helpful to contact them personally and encourage them to seek advice from dedicated services who may be able to help. If, on the other hand, you don’t know the person involved, you may still choose to contact them to express concern or refer them to dedicated organizations , a suicide hotline, or someone who might know them personally. If you don’t feel comfortable reaching out to the person on your own or aren’t sure how to reach them, you can also alert X via our dedicated reporting flow.


Managing experiences with self-harm or suicidal thoughts


If you are thinking about engaging in self-harm or suicidal behavior, or are experiencing feelings of depression or anxiety, it may help to talk to people that you trust or to connect with dedicated organizations who can provide support and assistance to help manage these experiences.

Depression has a wide variety of symptoms and affects millions of people every year. Common symptoms include sadness, loss of interest in activities, changes in appetite and sleep patterns, loss of energy, difficulty thinking, and possibly thoughts of suicide. You might exhibit these types of behaviors, or they might be subtler. Either way, don’t ignore them.

ChatGPT:

Let's incorporate Abraham Maslow and Marsha Linehan into the comparison of their approaches to suicide prevention with Carl Jung, Sigmund Freud, and Viktor Frankl.

1. Carl Jung:
- Jung's approach emphasizes individuation, integrating conscious and unconscious elements for psychological wholeness.
- In suicide prevention, Jung explores psychological and spiritual factors like loss of meaning and unresolved conflicts.
- Techniques may include dream analysis and active imagination for personal growth.

2. Sigmund Freud:
- Freud's psychoanalysis delves into unconscious drives and early experiences shaping mental health.
- For suicide prevention, Freud uncovers unresolved conflicts, guilt, and intrapsychic dynamics.
- Techniques like free association and dream interpretation aid insight and coping development.

3. Viktor Frankl:
- Frankl's existential approach, notably logotherapy, centers on finding meaning amid suffering.
- Suicide prevention focuses on addressing existential vacuum and fostering meaning discovery.
- Interventions include helping individuals find purpose and shifting perspectives towards life's possibilities.

4. Abraham Maslow:
- Maslow's humanistic psychology emphasizes self-actualization and hierarchy of needs.
- In suicide prevention, Maslow would address unmet needs like belongingness, esteem, and self-actualization.
- Techniques include fostering a supportive environment, promoting personal growth, and addressing social isolation.

5. Marsha Linehan:
- Linehan's dialectical behavior therapy (DBT) combines cognitive-behavioral techniques with mindfulness and acceptance.
- Suicide prevention through DBT involves emotion regulation, distress tolerance, and interpersonal skills training.
- Interventions aim to reduce suicidal behaviors by enhancing coping skills and addressing emotional dysregulation.

In summary, Carl Jung, Sigmund Freud, Viktor Frankl, Abraham Maslow, and Marsha Linehan offer diverse perspectives and therapeutic approaches to suicide prevention. They all share a common goal of understanding and alleviating human suffering while addressing unique aspects of psychological, existential, social, and behavioral factors contributing to suicidal thoughts and behaviors.

https://www.rcpsych.ac.uk/docs/default-source/improving-care/nccmh/suicide-prevention/workshops-%28wave-4%29/wave-4-workshop-2/suicide-and-autism---slides.pdf?sfvrsn=bf3e0113_2


Suicide and Autism, a National Crisis.
Sue Willgoss, Advisor for Suicide Prevention with Lived Experience, Norfolk and Suffolk NHS Foundation Trust
Founder
#LiftLoudForDanny,
Lived Experience Influencer for National Suicide Prevention Alliance
Daniel Willgoss, 03/10/[19]92 - 17/06/2018
#onetoomany
#LiftLoudForDanny

The statistics that Autistica [a UK nonprofit organization dedicated to funding research] provide are horrific
• Autistic adults with no learning Disability are 9 X more likely to die by suicide than the general population
• It is the second leading cause of death for autistic people. Average life expectancy for autistic people is just 54 years old. (Swedish study of over 27,000 cases)
• Up to 66% of autistic adults have considered suicide
• Adult autistics significantly more likely to die by suicide than the general population.
• Suicide attempts tend to be more aggressive and lethal
• Autistic children are 28 X more likely to think about or try suicide
• One study showed that 15% of autistic children had suicidal thoughts compared to 0.5% of typically developing children
• In the 86 days leading up to the first Lockdown and up to the 56 days after ¼ of young people who died by suicide were autistic or had ADHD.
Autistic people make up approximately 1% of the population but 11% of suicides.
Every suicide is a tragedy but these statistics of the mortality rate for autistic people is a national crisis
Autism Community Priorities for Suicide Prevention, an International Society for Autism Research Policy Brief, April 2021 ‘Suicide in Autism is a hidden crisis…’ … . overlooked by policy makers, clinicians and researchers worldwide.
Population-wide studies in the US, Sweden and Taiwan show that autistic people are up to seven times more likely to die by suicide 1-2 and six times more likely to attempt suicide than the general population.3
The risk of death by suicide is even greater for autistic people without intellectual disability.1
It is also greater among autistic women, who are 13 times more likely than non-autistic women to die by suicide.1

https://988lifeline.org/help-someone-el ... ial-media/

List of social media sites and what plan each has in place for suicide prevention and safety.

The 988lifeline.org people also have a message about being ready to communicate with a social media platform (such as Wrongplanet.net) and help create a plan. And contact info for that purpose.