[tptacek]

It is extraordinarily unhelpful to suggest that people who are endangered by mental health problems should avoid the mental health system.

There is a lot not to like about emergency mental health care. The experience is indeed akin to that of criminal justice, and can at times verge on dehumanizing. Our handling of these issues must improve.

But the alternative to being locked in a room with police officers watching the door is something far worse than that.

People with suicidal depression, severe anxiety disorders, or post-traumatic stress disorders can endure episodes where they almost completely lose judgement, or experience dissociation and derealization. You can't simply gut these things out: you need to be in a safe space, ideally attended to by professionals who can intervene medically during the worst of it.

If you are feeling suicidal, or that you're not in control of your own actions and concerned about harming yourself or others, you should call 9-1-1 or go to a hospital ER. It won't be pleasant, but it will be safer than the alternatives.

[0xcde4c3db]

This post comes off as pretty dismissive. For me, the experience did not verge on dehumanizing, it was dehumanizing. "Our handling of these issues must improve" doesn't even come close to acknowledging the severity, depth, or difficulty of the problems I encountered.

[tptacek]

I'm doing my best to capture how bad the experience is and I don't object at all to anyone suggesting that it's worse than I described. I think it's a very bad system.

[chris_wot]

There's a reason I said it doesn't have to be a medical person. I'm in the same boat - I had the worst experience of my life when I spoke to authorities about a suicidal episode. It was degrading and dehumanising. I will never make that mistake again, if I'm feeling suicidal I will never tell authorities, a doctor or anyone who might put me in that situation again.

[tptacek]

That sucks, and, having some little bit of knowledge about the process you went through, I absolutely believe you.

Having said that: if you were my friend, and you told me you felt like you weren't in control of your thoughts and were concerned you might harm yourself, and you had no better options lined up (a long term mental health expert you'd built a relationship with, for instance), I'd help coerce you into the emergency mental health care system before I allowed you to become a victim of a controllable illness.

[teslabox]

Psychiatry is an officially-sanctioned pseudoscience. People who get stuck in the system tend to never get better.

[tptacek]

The former sentence is more a statement of religious belief than an argument. The latter is demonstrably untrue. Either way: the point of my comments isn't to take the side of the mental health care system and argue with all comers. In particular, there's a reason I keep using the term emergency mental health care.

[throwaway1]

Preface: Please, no advice. Please!

You may think that this is coldly logical. It's not. I have dealt with OCD and depression-like systems for a long time now. 90%+ of the time I'm "fine" to "great." Another 9.9% I feel like scum for no good reason. That last 0.1% is what sucks -- that's the suicidal thoughts.

Holidays that are the worst, when everybody seems to be paying each other extra attentions and I find myself feeling lonely/forgotten. Last night, I had raging suicidal thoughts for a few hours (about the length of the usual bout). These thoughts are not directed or particularly purposeful.

When I have these thoughts, I badly want to talk to somebody about them. It's like the monster in your closet -- in the light of day it's less scary. But I can't, and it sucks! If I go to a shrink about this, I would likely be involuntarily committed and be greatly impacted in my professional life, etc.

Suicide is a taboo topic and it's too bad for those who struggle with suicidal thoughts, because they have to keep them inside. I've brought them up to some "friends" before and the reaction is that I must be crumbling, etc. There's almost a sense of shame from these people, like they've accidentally seen you naked.

I keep this to myself, but the most productive thing is to confront the issue. The best way I've been able to do that is by reading things written by/about suicide not from the perspective of "gotta save you!" This might sound odd, but places like /r/SanctionedSuicide (which isn't really what it sounds like, if you recoiled) actually makes me feel respected and not ashamed. Looking through a different lens, I see that my life is pretty good and I have many things to live for! When I feel this way I read the generally "gotta save you!" stuff too because hey, it's nice and positive, but in isolation it's quite patronizing.

Mentally sound people seem to immediately equate suicidal thoughts with an imminent life-and-death struggle and have the accompanying "EMERGENCY!!" reaction, and that is simply not how this works.

[nyan4]

You are (incorrectly) implying that the only choices are calling 911 or "being locked in a room with police officers".

[jMyles]

> But the alternative to being locked in a room with police officers watching the door is something far worse than that.

This seems like a false dichotomy to me.