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I am not a mental health expert. I am not qualified to diagnose people. If I was, I would never do it based on a short piece of text on a web-site.

But, because I am not, I can freely say: We occasionally get some posts here by people who appear to be mentally unwell. They need more than an empirical answer to their irrational question; they need proper help that we cannot provide.

In particular, I think, by the nature of this site, we attract people suffering (clinical) paranoia. (My inexpert guess is we get a disproportionate number of people on the spectrum too, but I suspect that leads to misunderstandings in comments, rather than a risk of self-harm.)

I think our responses are, sometimes, inappropriate for that situation. I think we, as a community, tend to treat others as rational human beings who are merely sorely misguided, and would happily change their ignorant minds if only we could get them to understand these! simple! facts! Such robust replies may not be appropriate ways of addressing, for example, delusions.

I wonder if we need a better understanding and practice for identifying, and responding, to potential mental health sufferers, in a way that is not destructive or risky, but at the same time, is not condescending, doesn't invoke stigma, doesn't harm robust discussion and doesn't get abused as an ad hominem attack to dismiss genuine claims.

We also need to understand that, neither the mods nor the general community are trained for this. We don't have a duty of care (IANAL, either!) and we cannot offer to help people through troubling times, but it seem unethical to simply ignore danger signals, and snub them.

That said, I feel rather ill-prepared to propose such a policy. Any suggestions?

I asked around, and here are some similar questions on other sites, that we can crib from:

  • Programmers.SE, with an answer from Stack Exchange's @Shog9.

  • Christianity.SE - likely to need some work to match our secular audience, but still useful.

  • Reddit Suicide Watch has some resources. In particular, their talking tips have some advice on what not to do that I may have been getting wrong until now - e.g. I have suggested they "should" consult a GP, rather than offering it as an option.

    Heading


Some clarifications:

  • I am not proposing we try to diagnose people, especially from their writing styles. I am not proposing to reject questions from people who are handling their illness.
  • I am not proposing we "engage" with people - e.g. invite them into chat rooms to discuss their problems.
  • I am not even proposing we take an heroic measures - e.g. trying to discover their identity, and report them to medical authorities.
  • I understand the way we respond could possibly make things worse. But we already do respond. This post is about trying to make that response thoughtful rather than ill-considered.
  • I anticipate this will be limited to having a template we use when closing the question, and a policy to delete certain types of comments and answers in those situations.
  • We have never, to my knowledge, received a post that has suggested direct, imminent danger. However, a few times per year, we get people talking about having problems with their thoughts, and seeking advice. I don't want to get into specifics but some examples include: a someone with (self-described) depression worried about having a breakdown and asking whether particular self-treatment might work; someone with delusions about a celebrity supernaturally communicating with them who posted that they were desperate for an answer when their question was closed. These people are looking in the wrong place for help.
  • I think my answer on Christianity is less appropriate for this site than Caleb's answer. Short version: a reasonable person might come to a site named after a major religion seeking spiritual guidance. Leaving a comment is intended to correct the misconception. I don't think a reasonable person could come to Skeptics with the expectation that they will get personal advice. – Jon Ericson Jan 15 '14 at 17:09
  • @JonEricson: Agreed it would need customising, but it demonstrates the type of message we could be sending. Unfortunately, we do get unreasonable people coming to Skeptics looking for personal advice. – Oddthinking Jan 15 '14 at 22:59
  • Can't you already leave a message along with the closure, and delete any comments that are "too chatty", "rude", or "offensive"? – user5582 Jan 16 '14 at 5:57
  • @Articuno: Yep. What should the message be? Anything in particular that we should look out for in comments? – Oddthinking Jan 16 '14 at 6:32
  • @Oddthinking I don't have much insight into this other than what the answers say. In short, my opinion is just stay professional and friendly. – user5582 Jan 16 '14 at 6:57
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    @Oddthinking I have updated my answer. – called2voyage Jan 16 '14 at 14:39
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I think it's safe to assume that the vast majority of participants here lead relatively functional and productive lives, and are not a danger to themselves or anyone else. The topic of this site is going to draw people that have varying levels of paranoia, and some that also suffer from the effects of severe paranoia, schizophrenia and a variety of other illnesses.

They've probably been coping with it for quite a while, and chances are that they are or have been under the care of a medical professional. There's also perfectly healthy people that are just plain weird, and in this space where we don't benefit from gate, diction, voice inflection of facial expression - it can be quite difficult to know the difference.

Don't take it upon yourself to see to the well being of someone that you feel might be unstable; if you're convinced that someone is in some kind of eminent danger, reach out to the community team and let us know what's going on.

If you feel that the matter is urgent, also flag the post that concerned you for moderator attention, and ask the moderators to escalate the matter to us - they have a hotline that reaches us very quickly, and can always find one of us lurking in chat.

You can unwittingly do active harm by trying to engage people that suffer from certain conditions at the wrong time with the wrong words, so please, don't try to engage with someone that you feel might not be stable. Just bring it to our attention and let us take it from there.

  • Tim, I have made some clarifications to the question, which I hope address some of your points. – Oddthinking Jan 15 '14 at 22:59
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Does it seem like the user might endanger their life or others? Then I think it might be appropriate to follow Shog9's advice on Programmers that you linked to.

For questions that specifically request advice that we cannot give, you are correct that a clear comment is in order when we close the posts. Perhaps something like this:

Thank you for contributing to the Skeptics Stack Exchange. We appreciate your search for knowledge and/or advice in this area, but unfortunately this is something that we are not adequately equipped to handle on this site. If you need help in XYZ areas, here are XYZ resources that we can direct you too.

Otherwise, I don't feel like it would be appropriate to take any action. We should respect their privacy and treat the question or answer like we would any other post.

  • I have posted some clarifications, so you can see that these aren't like any other post. They are off-topic and quickly closed. The action I am proposing is probably limited to redirecting them to better resources which we often do for off-topic questions. – Oddthinking Jan 15 '14 at 23:02
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    @Oddthinking Thanks for the clarifications. I will try to incorporate that in my answer. – called2voyage Jan 16 '14 at 14:35

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