I am a Crisis Text Line volunteer. So the short answer is yes we do call EMS when we have to. I posted this longer answer in a different parent on this thread, but I'll re-post it since it directly speaks to your question and sheds some light on the criteria we use to determine if someone might harm themselves.
"...We are trained to risk assess each and every texter, irrespective of our intuition about their mental state. That means I treat someone testing the system like I would someone who has been flagged as an imminent suicide risk.
Supervisors monitor this evolution of the conversation closely.
The assessment is important because ultimately the decision to call emergency services comes after that rigorous assessment of the person's suicidal ideation, followed by their plan and access to means, as well as their timeline. If all those criteria are met, I contact my supervisor, and then we work on separation from means. If those criteria are not met, we continue the conversation accordingly.
I have personally walked numerous people back from the edge simply by talking to them and hearing them out; often times, texters deemed imminent risks are capable of staying safe that night after we have come up with a safety plan for them together. Calling EMS is truly a last resort and not an attempt to cast off responsibility.
In the cases when we do call emergency services, it is after we have exhausted all other options. It should be noted that access to geolocation is strictly limited to these supervisors, and in all likelihood is limited to a texter's phone number alone. It's not like they have a backdoor into AT&T, and the supervisor must make a call to emergency services directly. From what I can tell, very little information is given back to CTL. On occasion, I can see a timeline that EMS was dispatched but rarely do I ever learn about the outcome.
The success of the platform is that we can work with people to find them their own solutions. CTL was not a viable intermediary for calling 911."
I've volunteered nearly 300 hours, most of those were dead of night EST. I've spoken to several hundred people, and maybe a couple dozen have been flagged as imminent risk. Of those flags, I can count on one hand those who have required a call to EMS. Mostly, I'm able to come up with a safety plan with them and get them through the night.
Calling the authorities under _any_ circumstances where the person is not planning to harm anyone else is unacceptable. The way you talk seems to presume that all suicidal people are out of their mind and irrational and need to be protected from themselves, which allows you to rationalize neglecting respect for their bodily autonomy. My body, my choice. It’s a person’s goddamn right to make the choice whether it’s better for them to continue living or not. How can we call ourselves free persons if we’re not even in control of our own body?
You're viewing this rather myopically. If someone texts us, we're operating under a valid presumption that they value their life, otherwise why text for help? We can't call EMS on someone we're unaware even exists.
My views are based on personal experience, so they may be biased, but they’re not ignorant. Years ago I was at the height of a decade of misery and spent months convincing myself that God and hell did not exist so that I would have the option of killing myself. I then spent months when I would decide every day whether I wanted to keep living. My life is top 1% awesome now, but if I had to go back knowing what I know now I don’t know that I would endure that suffering again to get where I am. Nor would I force anyone else to. Regular people can’t imagine the level of suffering someone contemplating suicide is experiencing. I’ve talked to a number of acquaintances contemplating suicide since then and I’ve made a point of never telling them it’s wrong. I offer my friendship and support to make sure their feelings are not from lack of that, but I also give them advice on what to do instead if what they’re planning is unnecessarily painful. To my knowledge they’re all still alive and don’t think I’m a jerk for not telling them it’s wrong to do it.
I respect your position on autonomy and letting people control their bodies. However, I am not sure if I personally am prepared to take it to this extreme. It's not how I was raised, and something is deeply unsettling to me to be a part of such a destructive action. I need to think on it some more.
No counselor on CTL will say it's wrong to end his/her life. That's because one of the core values is to treat each person without judgement (on any issue they bring up, from abuse, to self-image, to drama with parents, to rape).
For example, if someone says "I am having thoughts about suicide." No counselor would respond, "Oh that's awful, you shouldn't be having those. What's wrong with you?"
Or if someone says, "I just don't see the point in life anymore." No counselor would respond with, "Oh well life is sacrosanct and you're lucky to be here, so how could you possibly think about killing yourself? Your pain can't be that bad -- just think about your family who will be so sad."
These tropes are obviously harmful in a therapeutic setting, and the judgement is so counterproductive to keeping people engaged and finding solutions within themselves, which is key because we are not authorized to act in a medical capacity or advise people on what to do.
I have had many conversations with people who are clearly in lasting and profound pain and who just don't want to continue. Chats such as these are probably the hardest to endure because some people are just so resigned to their misery, and major depression just can't be treated by text. I'd give them a hug, but well...
I just want to end on a bitter note that while it seems like a lot of growth has happened in treating mental health, unfortunately many services have gotten a bad rap or are viewed suspiciously for the fact that previous generations of healthcare workers and society writ large did not give credit to the pain and difficulty in surmounting these conditions. It is a very dark morning in America, and we must be willing to listen to and validate each other's pain. CTL is one such location where that is possible.
Thank you for the thoughtful reply, I see what you’re aiming for is admirable and something a lot of thought was put into. I think where you might be kidding yourselves is on the passing judgment aspect. You may not verbally express judgment, but what is calling the police without someone’s consent other than passing judgment on what they’re doing?
"...We are trained to risk assess each and every texter, irrespective of our intuition about their mental state. That means I treat someone testing the system like I would someone who has been flagged as an imminent suicide risk.
Supervisors monitor this evolution of the conversation closely.
The assessment is important because ultimately the decision to call emergency services comes after that rigorous assessment of the person's suicidal ideation, followed by their plan and access to means, as well as their timeline. If all those criteria are met, I contact my supervisor, and then we work on separation from means. If those criteria are not met, we continue the conversation accordingly.
I have personally walked numerous people back from the edge simply by talking to them and hearing them out; often times, texters deemed imminent risks are capable of staying safe that night after we have come up with a safety plan for them together. Calling EMS is truly a last resort and not an attempt to cast off responsibility.
In the cases when we do call emergency services, it is after we have exhausted all other options. It should be noted that access to geolocation is strictly limited to these supervisors, and in all likelihood is limited to a texter's phone number alone. It's not like they have a backdoor into AT&T, and the supervisor must make a call to emergency services directly. From what I can tell, very little information is given back to CTL. On occasion, I can see a timeline that EMS was dispatched but rarely do I ever learn about the outcome.
The success of the platform is that we can work with people to find them their own solutions. CTL was not a viable intermediary for calling 911."
I've volunteered nearly 300 hours, most of those were dead of night EST. I've spoken to several hundred people, and maybe a couple dozen have been flagged as imminent risk. Of those flags, I can count on one hand those who have required a call to EMS. Mostly, I'm able to come up with a safety plan with them and get them through the night.