When I started Tweeting, I anticipated dialogue with all manner of service-users, professionals and carers concerning incidents where the police had become involved in mental health issues of all kinds. I predicted that this engagement may be valuable, not just in terms of being able to explain police processes and law to people who wanted it, but in my continuing to understand from those who use the police service how we could do it better and to share knowledge and practice issues.
If I’m honest, what I did not predict was being contacted in relation to ‘LIVE’ suicide incidents by people on twitter who are concerned for others making specific or generalised threats of suicidal ideation on their timelines. In hindsight, that was quite naive of me. There have been five such examples in the nine months or so I have been on here that I’ve been brought into by concerned tweeters.
I’ll be honest – each one immediately fills me with a sense of dread: Twitter accounts are often anonymous, people are ‘looking at me’ (virtually) as the police officer to ‘do something’ and yet obviously, I’ve often got no more information than anyone else about where in the UK or the World the account owner may be.
One of the incidents a few months ago, involved someone in Australia, but more than that was not immediately clear and only only one of them has come in whilst I’ve been ‘at work’! Another came in when I was up to my eyes at the time with my son’s U7 rugby team playing a series of matches at a kids’ rugby tournament – I could do little more than give two tweets of general advice to the person who alerted me. Ironically, that person was then traced by the police to a location about 10 miles from where the kids were playing rugby.
Sometimes engagement of local services has come around as a result of me getting into a dialogue with the individual and eliciting enough information to make my own phone call to mental health or police services. More often, it involves advising those who have raised the alarm – who actually are linked to that person on Twitter and have a level of engagement already established with them – to offer help and support. In two cases, it involved a few hours of tweets or DMs to get the person to focus on something other than their suicidal thoughts and agree to disclose enough information to get the support to them.
This post attempts to briefly show the power of social media and online ‘communities’ in pointing out that in all five cases so far, it has been possible to establish sufficient information to contact appropriate health or police services to begin ‘safe and well’ processes. Local professionals could then decide what necessary further action to take, once they achieved contact with the individual.
It is now entirely obvious that such cases would come to my attention given the subject issue I tweet and blog about – social media is yet another mechanism by which people secure networks of all kinds, for a variety of different reasons. Why would crisis support in mental health crisis be excluded from the other kinds of help and support that social media offers to people may otherwise believe they are alone?
This is why when I heard about the Sunday Times writing an article about tweeting police officers (in my force area, actually – Solihull) wasting their time on Twitter, I wanted to push back with examples from my own experience. I don’t know whether those (para-)suicidal thoughts were expressions of serious intent, a cry for help or even (potentially) an attempt to gain attention or manipulate … in a sense it doesn’t matter one jot whether they were. They created a condition in which we would all expect to see public services acting to ensure that those at risk were identified, found and that their safety was ensured – all the other considerations of motive and intent are secondary.
Eventually, if not already, one of these incidents will lead to the identification of someone whose life is at serious risk from their own mental health problems and where a response initiated via Twitter or other social media leads to them being saved from an attempt on their life. We can then legitimately ask again whether some journalists still thinking policing and social media is a waste of time?
If it is, it’s a waste of my own time – this is not my job: it’s just something I do because it’s right.
Winner of the President’s Medal,
the Royal College of Psychiatrists.
Winner of the Mind Digital Media Award
All views expressed are my own – they do not represent the views of any organisation.
(c) Michael Brown, 2012
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Mental Health Cop 
The worrying aspect is also how involved twitter becomes in such timelines, witness yesterdays issues with the RT’s for a certain user who was tweeting their alleged live overdosing together with instructions on what to look for after their death and who to blame. The RT’s at a click of a button were spread without thought for how this might affect the person themselves but the conciousness of other vulnerable individuals who might see twitter as a stage for their own issues. You are right to fear the ‘go to’ label, another layer of responsibility by profession heaped upon the shoulders easily vilified if it doesn’t work out but hidden from praise if it does. In this age of blurred worlds, twitter users have in the main, yet to accept that social media is just that, and society in all it’s shades easily visible on their phone may not always be pretty.
I’ll apologise first, in case I’ve misunderstood you. But I found this remark a little odd… “The RT’s at a click of a button were spread without thought for how this might affect the person themselves…”
Surely they were spread very much with the thought that the person in question might be in immediate danger at their own hand and *something* ought to be done to try to help..?
Few people are trained in best practice approaches to such situations. But better something is done than nothing. Surely?
This blog and these events are going to cause me to put together a further blog on suggested responses and I’m going to get advice from MH professinoals and police crisis negotiators. Standby … not sure how long it will take.
There’s a decent ethical debate on Twitter about this right now following some views, I’ve expressed.
I have had some experience of this as well. I would urge people to undertake the ASIST training. Invaluable in this environment
I’ve become involved in a few cases like this involving Twitter and Facebook since I started blogging. As you point out, there are some simple steps you can take to engage the person and keep them distracted and safe until enough info can be extracted to call the appropriate authorities – but not enough people know what to do.
Added to that are the people who think social media is the root of all evil and is “causing” problems. It’s a godsend, quite frankly – speaking for experience, when you’re feeling suicidal you are often socially isolated and without the instant opportunity of outreach that social media provides, we might never know that people are at risk.
Thanks for this post.
Second that social media can be a godsend when suicidal!
The only thing that concerns me is the public seem to think once someone has been located and taken to relevent services, then all is well.
They don’t see the person being kicked out of hopsital after 2 days, or more likely not getting admitted at all, or being forced to wait in a crowded A&E for seven hours before being belittled and sent away by a scathing ‘crisis’ team.
Then it is all the more awful for the person who felt so very desperate. The people who were so quick to call the ambulance aren’t so quick to help when the magic hospital doesn’t fix you, or even try.
Sorry to be so bleak but the gap between expected help and what’s actually offered is a cause of much anguish for myself and many others. So many people have lost patience – “why don’t you try and get some help?!” and are shocked and sadly disbelieving when you try to explain. I am blamed for my problems, blamed for the failures of the health service, blamed for the traumatic things that have happened, oh and it must be my fault because we all know anyone can ‘voluntarily’ go into psych hospital. Yeh right!
betty is right about the kind of emergency care on offer. A few months ago I sought help in A & E as a result of bipolar episode, waited 7 hours to be assessed only to be seen eventually by one sole CPN. Not a psychiatrist in sight, nor a social worker, nor any follow up. Despite being on CPA and Enhanced Care Programme, I was quite cursorily disposed of. A very unsatisfactory state of affairs.
Agree completely. Mental health services are useless and especially bad out of hours. Like you, I’ve faced aggressive mental health staff who seem to think they can reprimand someone out of suicide and are letting all suicidal people down.
It is disgusting and sickening that mentally ill people are treated like this.
I know this probably isn’t going to be popular but I think such actions on twitter etc are selfish. People naturally care and it is unfair to say you are in danger of doing something or have done something then fail to communicate further with people who have been trying to support you. It is manipulative and from what I have witnessed, reappear on twitter within a day or 2 seemingly unashamed of the psychological and emotional pressures they have put people under.
In addition on a protective point for myself, I am trying to recover from mh problems and have attempted sui etc on countless occasions and am careful to associate on twitter with only those of a recovery mindset so as not to trigger me. However, RTs of ‘please help this person’ etc are reminders, triggering and distressing and I wish people would not do this.
failtoreover – when someone is genuinely ill/suicidal, ‘selfishness’ is not a quality they are able to experience or consider.
There are too many professionals out there and others ready to condemn. Many people who are driven to suicidal actions need compassion not judgement. Often it is that lack of compassion that has resulted in their tendency to harm themselves, therefore in general it is better to seek to understand and support.
A person who is drowning, flailing about in the water, doesn’t utter a polite ‘please’. They shout and scream and grasp and struggle. Unfortunate thought that may be, and uncomfortable for the rest of us who at that time may be ok.
Why is it when I have been desperate and attempted suicide, I have been able to consider the impact and have not been selfish and manipulative towards complete strangers. I believe it is an excuse for inexcusable behaviour. I have been in services for several yrs etc and experienced said lack of compassion by professionals but not found it necessary to emotionally and psychologically hurt strangers on social media sites.
Tricky subject! Some valid points mentioned. I know I have removed some people from my twitter feed & personal facebook because of their daily talk of suicidal ideation. I do sometimes feel that social networking reinforces negative behaviours – people say they are suicidal & seem to get the reassurance from others that they seek which reinforces these dialogues. I myself suffer from suicidal ideation and have lived through 2 suicide attempts, I understand the desperation for understanding & help that people may feel. I don’t however feel it is the responsibility of my twitter followers to manage my mental health. Perhaps tweeting with mental health crisis supports would be viable, I don’t know the answer. I do however want to encourage people to seek help of local crisis teams/professionals. I call the crisis team or present to ED if I have suicidal ideation and this has worked for me time & time again. I also take comfort in the fact that these people are trained to manage (and emotionally cope with) my situation. I know here in Australia, if “Suicide” is searched in Google, the number for Lifeline Australia appears at the top of the search results. Perhaps implementing these kinds of informationals in social networking may help, or having some kind of crisis service/hotlines that can quickly trace users with credible threats – some type of formal protocols to deal with these issues. I guess there are many aspects of social networking that weren’t foreseen as becoming issues, but this one is something that needs to be addressed.
I think people can be so let down by the system, so alone, that they are desperate and just reaching out in the hope that someone, somewhere can help them. I agree some of these things seem attention seeking or manipulative but then you don’t know what other avenues the person may have tried to get help – and if they are doing these things for attention there is clearly something wrong in any case.
I’m just a bit wary of calling anyone manipulative, as people have done this to me even though I have NEVER threatened suicide. I have only ever told people I feel there is no other way and I am trying to get help, so obviously would be receptive to that help. I have felt so low I refused to go to hospital with the cops, and been told I’m not trying to help myself, but the reason I don’t go is beacuse I want HELP, not to sit in A&E for hours and be sent away which makes things much worse. This is why I am very wary of judging or labelling people who are hurting as you can’t see what’s in their mind, and you don’t know how many times they might have tried the ‘appropriate’ channels and got nowhere.
And speaking as someone who regularly struggles not to harm myself, it is very embarassing when someone has caught a glimpse of you not coping, not making rational decisions or being ‘yourself’. As soon as you possibly can you want to sweep it all under the carpet and pretend everythings fine because you cannot bear to be such a failure. So I can see why people don’t want to refer to it afterwards.
I really think a huge part of the problem is that people aren’t able to access proper follow-up care/treatment, so although they may be temporarily soothed and encoraged by support in the hours after a suicide attempt/ high suicide risk, they are back where they started a couple of days later.
Without ‘proper’ ways to get help and services for desperate people (and despite all the official claptrap people are fobbed off and refused help regularly, esp. hospital admission!) then people will keep being desperate enough to post for help on social media, and we cannot say who is serious or not.
Isn’t it sad that these people can’t say ‘please will you help me?’
Would anyone help if they did?
Betty, I think yours is very intelligent and insightful comment.
I’ve a lot I want to say on this, but not sure what yet. Everything’s hectic right now, so providing some kind of comment in case I forget to come back to it, which hopefully I won’t.
Wanted to say firstly that I have a hell of a lot of respect for you.
Also, I have been involved in two cases online (through a facebook group I admin and through a mental health forum) where I have rung the police and got help for someone. In both cases I was able to track down the full name and town of the person, and in one their date of birth. In one, the person had told me they had taken a serious overdose but wouldn’t get help, so I sent the police there who took them to hospital. They thanked me for it later.
There is a lot of aspects to this, but I don’t regret getting the person help in either case.
I’ve a lot of thoughts on this, but head is quite muddled tonight, but wanted to say that I think this is an increasingly relevant issue given the continual increase of social networks and online communities, and something which definitely needs addressing.
I understand this from your point of view. As someone that works with people who have mental health issues, we want to help people but we state from the start that we are a 24/7 service but what we do is provide information on service that cover out of hours support and we work in partnership with these organizatons. Luckly we have had no issues with twitter and sucide
Sorry we are not a 24/7 service.typo
When a person feels suicidal, the most problematical issue is that although there are various support groups out there, they all approach the care in different ways. It can be very frustrating and not at all helpful to find complicated protocols in different organisations. The Samaritans may or may not be helpful for example, depending on who you get to speak to,and there is of course no continuity, or referring on, or communication with those already perhaps involved professionally. Sometimes I have really needed that connecting-up to make me feel put back together. In my experience, there is very little out there of real help, most people simply not having real understanding of what it means to be so desperate. They may be trained to say the right words, but when you have heard those ‘right’ words so many times, they are no longer so effective in helping you to move out of a destructive mood. In the end, if you are able or willing – whichever point of view/bias you might hold about this – you start to realise you really are ‘on your own’, and paradoxically, that is the beginning of the route to a healthy mental state….You are, ON YOUR OWN – however anyone else seeks to dress this up. That is my conclusion..Extremely hard though that may be to digest.
If there was more love and compassion in the world we wouldnt need suicide services at all. Sometimes I think the increasing professionalisation of compassion for those suffering in this way, makes the vast majority think they have no responsibility for their fellow humans.
Often those who feel suicidal in the way that has been described are simply a reflection of how harsh our society has become.
The politics we are suffering under this administration are creating exactly the type of culture that exacerbates the struggles of the vulnerable amongst us.
IN the end however, we are all victims of this increasingly cold and unfeeling world.
We need to return – from our heads to our hearts. All of us.
Very well put.
I have recently had one such approach from someone I thought was suicidal on Facebook. Using suicide prevention techniques I had learned on ASIST (applied suicide intervention skills training) I decided the person involved was at serious risk. I tried incredibly hard over a number of days to get help from the appropriate professionals – but was not successful – they intervened, but not in a way that was sensitive, effective or appropriate for the person concerned and none of it, in my view, lessened the risk.
During what was quite a stressful period for me I worried about all the things you mention: was I being manipulated; were they really at risk; was I making things worse? Like you, it came at some personal cost to me as much of this was out of hours and, although like you I tried to pass this on to the people who should have been dealing with it, that didn’t work so I was left holding the parcel – or what sometimes felt like a ticking bomb.
I continued to support the person & some weeks later they shared with me that I had saved their life and explained how.
To me this shows how social media can be used for enormous good & can be incredibly efficient & effective. In fact I’m going to suggest to our local crisis services that they consider using it as a method of supporting people in crisis. All of us that use twitter regularly know that there are informal networks of ‘buddies’ who support each other through some quite major crises – including when people are in acute wards. They are also great for engaging with young people who might not find it easy to engage in more traditional ways. There is also a written record of the conversation, which can seem threatening, but if you are acting as a responsible professional should protect both you & the person at risk.
However, there are obviously some downsides. For example it’s not appropriate for this sort of conversation to happen in a public forum – you need to be able to take it on to DMs or private messages.
It all needs thinking through very carefully to keep everyone safe & protected. But I honestly believe that social media can be used for enormous good & not only that but can go a long way to giving support to the many, many people who currently get none (or at least very little & what they get doesn’t help at all). They could be a much more efficient use of the very scarce human resources we have in social services, health & the emergency services, especially ‘out of hours’ which is, let’s faci it, when people most need support.
I would love to be involved in any discussions about how these ideas could be put into practice.
Great insight – there’s loads there to think about and I’m really grateful that you shared it on here. Thanks!!
One of the very many, and most important uses of social media, whose power and reach we have not yet even begun to untap.
Great post.