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Suicide Prevention Hotline Number Should Be 3 Digits, 988, Agency Says (nytimes.com)
183 points by pseudolus 60 days ago | hide | past | web | favorite | 110 comments



For a satirical look at why brief emergency service numbers are essential, there’s always this gem: https://youtu.be/ab8GtuPdrUQ

In all seriousness, there is possibly no better domain where reducing friction leads to lives saved. I applaud this decision and hope it comes with sufficient funding to handle increased call volume.


I think this move is a no-brainer. But I'm also curious just how effective these hotlines are. Feels like something that's quite difficult to measure.


Having worked on a crisis hotline I agree that it's difficult to measure but it felt like we were helping enough of the people we spoke to.

The calls from someone who's just swallowed a bottle of pills are harrowing and thankfully I never got one of those myself.


Look at the ratio of calls they get vs. suicides? Seems pretty easy to measure to me.


What does that tell you?

A suicide hotline might be called only by people who have no intent to die. If we measure how many people die it's not going to be many, but that doesn't mean the hotline works.


As a side note, in Italy (and in some other countries) the "emergency" numbers have historically been 112 and 113 for two reasons:

1) you could dial them also on old rotary phones with a lock on the dial disc (the lock was put on the "three finger hole") but of course now it makes no sense anymore

2) they were easier to "dial" without dialing but tapping on the "hang" buttons

Nowadays 112 is the "unique" emergency number across all EU and many nearby countries:

https://en.wikipedia.org/wiki/List_of_emergency_telephone_nu...


There is another part to the story, to why low-number number are betters. They were faster to dial on rotary phones but also faster for the machine on the other end of the line. As the rotary dial on your phone was turning, so too was a device at the phone company. The smaller the total number, the faster that machine could had your call off and start on the next. That's why the most populated areas, places like New York City (212) Chicago (312) or LA (213) have low-number area codes. And it is why "1" is often the number used to designate a long distance call.

Anchorage Alaska: 907 (2x as long as NYC) All of Idaho: Either 208 (2x) or 986 (4x).


I always thought 1 for long distance was because that's the country code for the US, or maybe those two things are related?


Country codes came much later.

The current system was introduced in the CCITT Blue Book in 1964, it looks like. Area codes were in the 40s.


> but just tapping on the “hang” button

That looks like a hack. I understood it at 7 years old, but it is typically the kind of hack I’m told other adults wouldn’t understand. Do you think it was much used beyond technical-minded people who always wondered how things worked?


People who needed to make a lot of phone calls would often do this because it was faster than waiting for the rotary wheel to return to the start

You sometimes see it in old movies


>People who needed to make a lot of phone calls would often do this because it was faster than waiting for the rotary wheel to return to the start

Allow me to doubt that, the time the rotary dial goes back is exactly the time needed for making the pulses at the correct interval/rate, typically 10 pulses per second:

https://en.wikipedia.org/wiki/Pulse_dialing

https://en.wikipedia.org/wiki/Pulse_dialing#Pulse_rate_and_c...

Even if the switch allowed usually (and in theory) 7 to 12 most phones dials were set for exactly 10 and I doubt that anyone could get relably 12 pulses per second by tapping, in any case, a 999-999999 would have taken some 9-10 seconds by dialing and no less than 7 seconds by tapping or anyway at the most you would have been able to shave off at the most some 20% of the dialing time, introducing a high risk of getting "another" number.


As I recall, there was a movie where someone was in jail, the CO dialed the phone number for their free phone call, and then when the CO locked the number pad and left, the "hacker" immediately hung up and redialed a different number by tapping on the cradle switch.

They might have just tapped 10 times (dial rotary-0) to get an operator and then requested manual completion of the call. I don't remember, exactly.

I don't even know if you can still also do pulse dialing instead of solely DTMF dialing now.



If I recall correctly we guessed this as children because the sound made by the rotary thing let go at "N" was the same as pressing the "hang" button N times

I mean it was an easy association to make, so at least a couple of friends guessed it. I can't remember if I was told or if I figured it out myself, but at least the explanation I was given involved this empirical observation


There was a downside to using the lower numbers: rotary phones worked by repeatedly shorting the connection to indicate to the switch which number it was, so one "click" would be one, two clicks "two", etc. This led to many phones accidentally dealing "1" if they did not have their wires properly connected. It's the reason the emergency number is not 111 (They still received quite a few fake calls until newer switches came into use that only allow to tone dailing).


In France the historical emergency numbers are also still in use in addition to 112 and are just two digits. 17 for police, 18 for fire department, 15 for emergencies.


The EU has designated six-digit numbers starting with 116 as "harmonised services of social value"[0] which are reserved for a specific purpose.

For example:

116 000 is for missing children;

116 006 is for victims of crime;

116 111 is a child helpline;

116 117 is for non-emergency medical assistance; and

116 123 is for people in emotional distress.

[0] https://en.wikipedia.org/wiki/Harmonised_service_of_social_v...


Too bad in the USA's FCC 70 page report there are 0 mentions of the number 116 123.

(https://docs.fcc.gov/public/attachments/DOC-359095A1.pdf)

116 123 is the new standard for emotional support helplines in the 28 EU countries and has already been implemented by France, Germany, Ireland and United Kingdom.

You would've thought 116 123 at least deserves consideration by the USA, even if they didn't adopt it?

Also, while they are at it, it's a shame the USA don't fully implement 112 alongside 911 as their emergency number, because Americans are starting to look like the odd ones out - see this world map https://en.wikipedia.org/wiki/112_(emergency_telephone_numbe...

I heard, these days, people go on holidays & vacations abroad, and emergencies & illness don't care about national boundaries.

On a positive note, it's nice to hear about Americans caring for sick people.


I think GSM has some kind of mapping for emergency numbers internationally, so it should work if people dial either 112 or 911 on a GSM phone. (Of course, this wouldn't work on a land line.)


That strategy seems silly at first glance. All of these are so fact-specific and infrequent that the victim will not have committed them to memory and would be better served with a 116 + dispatcher to triage?


Yup. The only short numbers of this form I have memorized are 311 and 911. Both use human operator dispatch. I'm not going to memorize and successfully recall a much larger number of these phone numbers, especially given that I probably won't even use a single one of them anytime in my life.


I've been confused about how Brazil has more than a dozen of these

https://en.wikipedia.org/wiki/Telephone_numbers_in_Brazil#Pu...

(I don't think this list is complete!). It's hard for me to think that many Brazilians remember all of these -- the Wikipedia article suggests that most don't -- and it's also unclear to me, for example, how one should choose which police force to call when needing police assistance.

On the other hand, perhaps several of these were created in order to provide a free call option for accessing public services, and in some cases one that would be usable by functionally illiterate citizens.


Wow, that's way too many. Unless each number is going to be targeted with a long-term awareness campaign (as 311 and 911 are, and as the suicide hotline number is likely to be), it's hard to justify them. No one's gonna remember them.


I saw a printed chart of them in a payphone in Brazil (which seems genuinely useful if the reader knows how to distinguish, for example, which police force to contact in an emergency), but payphones are also becoming rarer in Brazil and I'm not sure that the list of these numbers is ubiquitous.


Great idea. B-number routing changes are straight forward. Some questions they would need to figure out is:

- Where are we routing this

- When the target is full, which hotlines do we route to and in what order (load balancing)

- Will this use e911 coordinate forwarding? i.e. what privacy controls will be in place

- Will this get priority override on cell networks? i.e. bump non 988 calls when cell site is full, but not bump 911 or first responders. (GSM capability)

There are probably a few other details that would need to be sorted, but it should be easy from a technical stand-point.


Please don't use code formatting for things that aren't code. The side scrolling makes it annoying to read on desktop, and borderline impossible to read on mobile.

List above with line breaks:

- Where are we routing this

- When the target is full, which hotlines do we route to and in what order (load balancing)

- Will this use e911 coordinate forwarding? i.e. what privacy controls will be in place

- Will this get priority override on cell networks? i.e. bump non 988 calls when cell site is full, but not bump 911 or first responders. (GSM capability)


Updated. I've never owned a smart phone, so I suppose I've never taken that into consideration.


I've heard that calling the Suicide Prevention Hotline can cause some pretty terrible unintended results (like cops showing up at your home and being placed in a mandatory medical hold) if called. Especially if one is not actually contemplating suicide but rather needs to talk.

Does anyone have anything that backs this up?


So, I volunteer for one of the centers that answers calls to the National Suicide Prevention Line (NSPL).

The training that we get involves risk assessing the caller by asking them questions. I won't go into details, but it's very rare that we would call emergency services without the caller's consent, and it would require the caller to tell us that they're in imminent risk of taking their life, and also that they aren't willing to work with us on finding a means of staying safe.

The training that we get puts a lot of emphasis on protecting the dignity and autonomy and privacy of the caller.

There's no one national center, calls to NSPL get routed to the center that's closest to you geographically (I believe that's based on area code). Different centers may have different training and policies, etc.


>There's no one national center, calls to NSPL get routed to the center that's closest to you geographically (I believe that's based on area code). Different centers may have different training and policies, etc.

I would definitely argue that this is the case. Like you, I also volunteer for one of the NSPL crisis centers, and we don't generally call emergency services unless it's absolutely necessary, but there are definitely stories out there where they were called when (in my personal opinion as a volunteer) it was not required. I seem to remember a story about a veteran getting an unwelcomed visit from law enforcement simply because they owned guns and had suicidal thoughts with no intent to harm themselves. If I can find the story again I will link it.


Somebody once called the suicide hotline at my dorm and the cops showed up. This lead to everyone in the dorm knowing she called the hotline, probably not the outcome she intended at all.


There really should be an offering for people who just need to honestly talk to someone without consequence or follow up (barring cases involving harm to others).

I think a big reason so many people deal with depression in silence and end up committing suicide is because they don't want the attention or being put into the mental health system. They need someone who'll listen to them be completely honest about all the problems that they can't be open about with friends and get it all out without the whole neighborhood knowing or being fucking detained.

Plenty of people are going through temporary troubles and don't want "depressed/suicidal/a risk to themselves and others" tacked onto their name forever. But as it is, a lot of our mental health frameworks are set up that way and it leads to people choosing a quieter way out.

I know loads of people will defend wellness checks or putting people in a hospital for a while. For some people going through extreme crises, it is good. But we need a very clear and obvious option for people who aren't a danger to others and just need an anonymous chat once in a while and want to be left alone the minute they hang up the phone. I think men in particular, especially since a large number have nobody who they can honestly vent about their problems with, are in need of something like this. They don't want to be seen as weak, they don't want to be thrown into the system, they just need someone to talk to.


In men’s issues (where I volunteer), the reason they don’t generally call the police or subscribe to a psychologist is because of incels who commit terrorist attacks. Who would want to call the police and say they’re upset with the system, knowing the first thing the police may do to remove the risk is to remove... you? Sometimes they go to a psy, under a false name.

A men are the first suiciders, so it’s worth weighing this is. Once we find a group for them where they can share the problems they have with women, they’re generally defused and talk about their thoughts years later. It’s living in the omerta and denial of women’s issues that multiplies anger.


> There really should be an offering for people who just need to honestly talk to someone without consequence or follow up.

The vast majority of people who call suicide hotlines do it for this purpose.


I know people who called and got a 1 week trip.

A problem is there's a "risk" in calling. There's no 100% guarantee that you won't get a knock on your door 30 minutes later.

I know people will say that suicide has a clear and obvious risk, too. The problem is that people fear the embarrassment of being paid a visit or people knowing about their troubles more than they do death.


Better than the alternative.


You know the reputation that US cops have earned themselves for violence? It has gotten so bad that some police forces will not do welfare checks any longer because they are tired of the bad press that follows when they kill yet another suicidal person.


>It has gotten so bad that some police forces will not do welfare checks any longer because they are tired of the bad press that follows when they kill yet another suicidal person.

Maybe I have low expectations but stopping doing something because they're killing too many people unnecessarily seems like a big and uncommon step in the right direction for most law enforcement agencies. Usually they just deny, deny, deny.


Have they tried not killing people?


“Death by cop” is a form of suicide. Some will try to create a situation where the cop has no choice but to kill or be killed.


Cops will regularly escalate a volatile situation because they have no incentives not to. Come on, about 1000 people are shot dead by police every year, that's an outlier in the civilized world. Firearms are rarer outside the US, but anyone can pick up a kitchen knife, which is just as deadly. Strangely enough, outside the US, deadly shootings involving the cops are actually news.


I wish we would put more effort into policing the police, but for some reason, cops seem to stick up for each other even when a crime may have been committed.

I believe that most cops are good, but the position definitely attracts people who like violence/power. I don't know the solution here, but there has to be a way to help good cops get the recognition they deserve without forcing them to betray their fellow officers to eliminate the bad.


Earlier this year, a video of the NYPD impounding a dirtbike made the rounds: https://nypost.com/2019/04/08/nypd-officer-wipes-out-on-dirt...

There was a large group of arsehole youth tearing through the area on their dirtbikes, and some fellow came off his bike, he escaped by hopping on his friend's bike, but the bike was left behind, and the police had to remove it.

In the video we are treated to a group of officers egging on a colleague to get on the bike and take it to the precinct. The victim had clearly never ridden motorbike before, and it ends up as expected, the guy tears across a busy intersection through a red light, wipes out, nearly hitting two cars. And then he picks himself up from the ground and none of his "friends" assists him. Oh, and no helmet, no protective clothing, presumably no license, but open weapons. The guy did something wrong and was made fun of in public.

Unit discipline in the leading city in the US is bad beyond all description. There is no good cop in all of that video, not a single one. They all deserve to have serious discipline imposed, but that will never happen.


Some cities have dedicated mental health crisis units that are trained to deal with such situations, and some cities do not. In most of these cases, emergency services are only called if the situation escalates out of the control of the person on the phone or therapist. E.g.:

Situation 1:

Therapist/volunteer: "Are you planning to kill yourself right now?"

Client/Hotline caller: "No, I just can't stop thinking about it and I don't see any other way out."

Therapist/volunteer: Gives resources, talks "Do you think you will be safe until you can make it to counseling/crisis center/other help?"

Client/Hotline caller: "Yes."

no emergency services are called

Situation 2:

Therapist/volunteer: "Are you planning to kill yourself right now?"

Client/Hotline caller: "Yes, I have this bottle of pills/knife/rope and I'm doing it tonight."

Therapist/volunteer: tries to talk them out of it, and get positive affirmation that they will be safe, but fails

emergency services are called

Situation 3:

Therapist/volunteer: "Are you planning to kill yourself right now?"

Client/Hotline caller: "Yes, I have a gun and I'm going to kill someone else too"

cops are called immediately

Those are extremely contrived examples and I'm not a therapist/volunteer myself (I just know a few), but that's generally how it goes. Emergency services are called only when the caller has a concrete plan, the means, and refuses alternatives or represents a danger to others. In some places with poor services (read: places that probably need them the most, unfortunately) this just winds up being poorly trained cops and people get shot sometimes because the cop "felt threatened". Bear this in mind in how you communicate such an emergency, if you ever face it with a loved one. Know your resources.


Without evidence, this seems like a pretty irresponsible thing to suggest.


"Will the Police Get Called If I'm Suicidal and Call a Suicide Hotline?

This is a tricky question and the answer is neither "yes" nor "no." In the vast majority of cases, no police (or other authority) involvement is required and in the cases where emergency help is needed, suicide hotline staff will make every attempt to gain permission to send them. The goal of a suicide hotline is to help you with your personal crisis and no one-size-fits-all solution is possible.

That being said, if you are actively suicidal and threatening to imminently hurt yourself, it is possible that emergency personnel may be called without your permission. While no one likes that scenario, it truly is the best, lifesaving thing an operator can do in a small number of cases."

From: https://www.healthyplace.com/suicide/suicide-hotline-what-ha...


Without evidence, any comment you make is uninformed, so maybe spend a few seconds with your favorite search engine before commenting.

There are numerous reports of police showing up to suicide calls and shooting someone.[1][2][3][4][5] There's certainly a discussion to be had here about whether the shootings are self defense, but Taylor_OD's speculation is certainly not "without evidence".

[1] https://www.blacknews.com/news/matthew-tucker-fatally-shot-p...

[2] https://www.twincities.com/2018/04/12/sheriffs-deputy-fatall...

[3] https://www.nwahomepage.com/news/knwa/police-investigate-dep...

[4] https://www.azcentral.com/story/news/local/southwest-valley/...

[5] https://www.ajc.com/news/crime--law/breaking-officer-involve...


Did you actually bother reading your articles?

The person was shot after attacking the cops. You make it sound like they just shot these people for fun.


> The person was shot after attacking the cops.

The person? There's five different articles with five different people.

> You make it sound like they just shot these people for fun.

Did you actually bother reading my post? I brought up the possibility that the shootings were self-defense--nowhere did I blame the cops.


If things go south, in the US, yes, you can be sectioned. That probably shouldn't be seen as a negative, though. You'd typically be taken to an ER where a qualified medical professional would talk to you and decide whether you're likely to need assistance from a hospital. If you are, you're sectioned, which means you're placed under observation for three business days. During that time, they would typically provide a wealth of medical and mental services to you; full check-ups, access to therapists, etc. You're also given free access to a lawyer, if you so choose.

If, after three days, they determine that you're not a danger to yourself or anyone else, out the door you go. If they determine that you're in harm's way, they talk to you and make recommendations. You don't have to agree to any of them. Typically they involve plans for moving forward, like making arrangements to see appropriate medical professionals on a regular basis, finding housing (if you're homeless), enrolling in rehab... whatever is relevant to your case.

If they decide you need to stay, but you say you want to leave, they can either take the matter to court, or they can let you walk out the door. I've only ever talked to one person who landed in that situation; it doesn't seem to happen to most people who get sectioned.

Obviously, some areas of the US have worse medical and mental care than others. If you're in a part of the US that's lacking in that regard, it could be more like a jail sentence than assistance.


Remember that in the end they will send you a bill for this entire circus, so unless it's an acute emergency you do not actually want any of this.


That depends very much on the circumstances. With decent insurance, they'll pay for almost all of it. Depending on your location, the state, federal government, or hospital may be required to foot the bill.

If the alternative is being dead, well... but yes, you don't want it unless it's a serious emergency. Chances are a welfare check isn't going to result in sectioning anyway, though.


There's a more fundamental issue - a mental health crisis is a medical emergency, not a crime. Police officers are rarely trained in mental health first aid and are not appropriate first responders. The default should be to dispatch an ambulance, with police support if specifically required.


I recently heard a segment on the radio which discussed suicide, and it ended with the host giving the common "If you are in crisis, then resources are available..." statement.

The contact details were a 10-digit phone number which wasn't easy to remember, or to text a 5-digit number to a different 5-digit number. The specifics went in one ear and out the other. I was driving at the time, but I would have struggled to remember them long enough to find a pen if I was at home!

If instead, it was to call or text 988, then that would have been much more memorable! I hope this saves lives!


There are real stories of cops doing "welfare checks" on people and ending up killing them. More often, all they know is escalation of force and the person ends up roughed up and in some facility.

I don't trust authorities so much that I worry people in need of help are dissuaded from calling them.


Maybe in the US, but in parts of europe de-escalation is an important part of their 4+ year education


I believe the average US police program is under 6 months, so probably not a lot of time to learn things like how to de-escalate.


These stories are few and far between. Well-being checks happen routinely here in Massachusetts--it's a big part of a police officer's job. If you listen to a police scanner for an hour or two here, you'll probably hear several.

I had a series of medical issues when I was in high school. On more than one occasion, police came to do a well-being check because I wasn't at school--they knew why, but they were still required to check. One time I did need immediate help and was taken by ambulance to a local hospital. These efforts do save a lot of lives--easily more than they take.


I think more dire is staffing the hotline appropriately. Routinely people have to wait upwards of an hour to connect with anyone.


You make a good point, but I wouldn't frame these two ideas as dependent upon each other.


truth.


This is a great idea. I'm happy to see the FCC proposing something good for once.


If you think this is the only good thing the FCC has done, you're probably getting your news from the front page of Reddit.


I'm not in the US, and I don't follow the FCC's news briefs. What I do tend to hear (yes, from Reddit, and also other tech news) tends to be the more controversial things.

Perhaps you could enlighten us with examples?


Recent highlights sourced from https://www.fcc.gov/news-events/headlines

* FCC Improves Access to 911 and Timely Assistance from First Responders - This is more-or-less explicitly requiring that phones in hotels, campuses, office buildings, etc be able to directly dial 911 without having to do any sort of prefix, that could be unknown or confusing in an emergency.

* FCC Bans Malicious Spoofing of Text Messages & Foreign Robocalls - This makes it easier for the FCC to pursue action against scammers who spoof caller ID (previously there were loopholes so that they couldn't take action if it was a text, or if the call originated from outside the US, or if it's a one-way VOIP call.

* FCC Authorizes $121 Million In Rural Broadband Funding In 16 States - Pretty self-explanatory

* FCC Reaches $550,000 Cramming Settlement with CenturyLink - This was in response to CenturyLink placing "unauthorized third-party charges and fees onto consumers' bills"

* Chairman Pai Recommends Approving T-Mobile/Sprint Merger - This one's more controversial, but you can make a strong case that allowing T-Mobile/Sprint (two relatively small providers) to merge would allow for them to compete at a higher level against Verizon and AT&T, increasing consumer choice and competition for most Americans. It also requires for them to sell off Boost Mobile to address competition concerns at the lower level, and to also invest a lot into pushing 5G technology.

So, in short, the FCC has been focusing on the following to improve the consumer experience with communications in the US:

* Pushing 5G tech

* Fighting back against robocalling and scams

* Increasing access to broadband in rural areas


I don't really understand why they're trying to push 5g. 4g is pretty fast, and it's still not available everywhere. I'd much rather have more 4g than start another arms race for faster cell towers.

If the FCC pushes anything for wider access to fast internet, I think it should be in low orbit satellites, which offer alternatives for everyone instead of just people who live in cities (5g) or people who live in rural areas ($121M investment you talk about).

Are they doing anything related to satellite internet? I know SpaceX and OneWeb are developing tech in this space, and I would absolutely love an alternative to cellular networks for internet outside my house, and I think it's reasonable to invest in it in exchange for allowing ISP competition with a shared set of satellites.


At least you are aware that your news source choices bias you toward only hearing about bad things.


They'd probably get a LOT of misdials. Especially on phone systems (like mine) where you dial 9 to get out, and 888 is a common toll-free prefix. So if I'm dialing on a phone that's not on my phone system, I'll accidentally get the suicide hotline.


The EU has standardised the 116 prefix for helpline services - 116 000 for missing children, 116 111 for child helplines and 116 123 for emotional support/suicide prevention.

https://ec.europa.eu/digital-single-market/en/content/eu-rul...


Suicide is a profound issue so in that sense I support this.

But how many short codes can we have before we can't remember what they stand for? IN this sense 988 is a better choice than one of the unused [2-9]11 numbers -- I can only remember one of them.


e-numbers cross-dispatch so it’s not really an issue. You can call 911 in case of fire, it’ll be relayed.


Huh? 911 is the number for emergency services (police, fire and paramedics), not just the police. There's no relaying involved, 911 is who you're supposed to call to get the fire department.


There are various non-emergency assignments to other [1-8]11 numbers but though I have read the announcements over the years I still have no idea what they are.


I agree with the sentiment of the article. I think the suicide hotline should also include a mental health hotline, or make a mental health hotline a separate number. I think that would help prevent some of these mass shootings. Perhaps a potential shooter, between planning and action, might have a moment of clarity where they know what they are doing is wrong and could call the number. The result could be a simple conversation along with a notification to local or federal authorities.

Here is an interesting take on the profiles of mass shooters. The part that jumped out at me is we need to be profiling these people as serial killers rather than domestic terrorists. He is basing his opinion on a study of mass shooters from today back to 1966.

https://www.youtube.com/watch?v=Ht5ldqQdioM


> along with a notification to local or federal authorities

I think that might dissuade a lot of them, but one of the biggest problems I see with some of the red flag laws that have been implemented is the mental health professionals who have been involved are the only people who aren't allowed to report you to the cops. Anyone else can, with impunity, but not them.


Yes, I agree. It would have to come with the contention that there wouldn't be an arrest, punishment, etc, or that any confiscation would have a limited term. Perhaps someone, in their moment of clarity, would understand that confiscation is the best solution at the time. I think it's at least worth a trial run.

Also, I believe mental health professionals are allowed to report incidents where the patient has indicated they plan on committing a violent crime.


This seems like a no-brainer and something I thought already existed.


I think this is a great idea as someone who should probably have called a few times. Silly Q though:

Are all numbers starting with 9 reserved or will we need some people to give up their numbers?


988 appears to be the area code for Saginaw, MI. I assume anyone who has a number in that area code would have to change.


To determine if this meets the target market or is just virtue signalling, it would be interesting to rub the stats together to see if there's any positive correlation.

If there's any use at all, thats nice, but higher use rate strategies should have money spent on them first. For example if tumblr use or reddit use or instagram use correlated higher, which seems likely, then spend the outreach money there first to save the most people.


I have never even considered this. This seems to be a good idea with little downside.


Cleaning the national number plan of 911 took a lot of work and time.

Right off the top of my head the 513 NPA (Ohio-ish) has a 988 NXX so there's a thousand potential phone numbers that have to change. There's going to be a ton of incoming traffic from people trying to call a dominos pizza in ohio who manage to get themselves routed to the hotline because they dialed 988 as part of the number.

Some people program some PBX dialplans such that pretty much any stream including the regex 911 goes to 911 (dial 9 for outside line and 911, dial 911 without a leading 9, etc) and they're going to try that with 988 with predictable results (try to call your buddy who used to be extension 9889 and you're mysteriously connected to a hotline).

The international phone dialing country code for Bangladesh is 880, that country code will have to change because some fraction of PBX programmers and users are going to F it up (as usual) and route all "9 for outside line 880 for Bangladesh then 123456 for the lnum" calls to the hotline.

The massive incoming call volume will require laws to reduce the massive volume involving expensive fines and fees. That'll scare people away from calling. Well, they say fake or repeatedly incorrectly routed calls will result in a $1000 fine, so if someone's feeling down, they're not going to be into a $1000 fine...

In the end it seems like it would be ridiculously cheaper, simpler, more reliable, and safer to simply have people dial 911, and the 911 ops can read a sticker stuck on their phone with the transfer number on it.

Overall the idea adds complication to a dangerous situation which is never advisable. Only someone very sarcastic could say, I know what stressed people need, is a larger more complicated decision tree when they urgently need help... Not exactly aerospace engineering going on here. We already have a "I need help" phone number, 911...


> Right off the top of my head the 513 NPA (Ohio-ish) has a 988 NXX so there's a thousand potential phone numbers that have to change.

They can just require 10 digit dialing for that area code. It's already been required on may others.

> Some people program some PBX dialplans such that pretty much any stream including the regex 911 goes to 911 (dial 9 for outside line and 911, dial 911 without a leading 9, etc) and they're going to try that with 988 with predictable results (try to call your buddy who used to be extension 9889 and you're mysteriously connected to a hotline).

That would break so many things if they did that today. Numbers can contain "911" within them and have nothing to do with 911. If they've made it this long with a broken dial plan, adding another broken match for 988 won't change much as they're already used to not being able to dial thousands upon thousands of numbers.

> The international phone dialing country code for Bangladesh is 880, that country code will have to change because some fraction of PBX programmers and users are going to F it up (as usual) and route all "9 for outside line 880 for Bangladesh then 123456 for the lnum" calls to the hotline.

Generally you have to dial an international call prefix before the country code, so this is a non issue. Without it, the phone system won't know if you're trying to reach country code 44 for the UK, or area code 440, 441, 442, 443, or 445 in the US.


> Generally you have to dial an international call prefix before the country code, so this is a non issue. Without it, the phone system won't know if you're trying to reach country code 44 for the UK, or area code 440, 441, 442, 443, or 445 in the US.

...are you in the US? That isn't true at all. You start with the country code. You can't reach any of the area codes you mentioned by dialing a number starting with the area code, because you have to start with 1, the US country code.

Outside the US, you can use the more unambiguous country code 001 to reach the US. (e.g. I had difficulty calling the US from China because normal American 11-digit numbers starting with 1 are processed by Chinese carriers as 11-digit Chinese cell phone numbers. But there, like here, there was no "international call prefix". You just start right off with the country code.)


> You can't reach any of the area codes you mentioned by dialing a number starting with the area code, because you have to start with 1, the US country code.

You absolutely can. 443, and 445 allow for 10 digit dialing. 442 requires a 1 prefix.

https://nationalnanpa.com/enas/npasRequiring10DigitReport.do

In the USA you need to dial 011 (the exit code) before dialing a country code. You can't just pickup the phone and dial any countries country code and expect it to work. If you're on a phone system that supports it, you can dial +[country code] where the phone system will translate + into your countries exit code.

> Outside the US, you can use the more unambiguous country code 001 to reach the US. (e.g. I had difficulty calling the US from China because normal American 11-digit numbers starting with 1 are processed by Chinese carriers as 11-digit Chinese cell phone numbers. But there, like here, there was no "international call prefix". You just start right off with the country code.)

Only in countries where the exit code is 00. The Country Code for the USA is 1, so in a country where the exit code is 00 that would translate to 001.

In Hong Kong, the exit code is 001, so if you wanted to reach the US you would dial 001 1 then the US area code and number.


> ...are you in the US? That isn't true at all. You start with the country code.

With limited exceptions (e.g. on cell phones or VoIP that automatically corrects you), to dial a domestic long distance call, you actually begin with the domestic long distance prefix, which just happens to be 1 in the US. This is entirely separate from the NANPA country code, which also just happens to be 1.


Yes I agree completely with your calm and rational analysis. Technically completely correct.

The problem is the whole point of the system is its for users who are not calm and rational.

I've never seen a scenario in the real world where making a system more complicated helped users who were not calm and rational.


911 doesn’t have the resources or training to deal with suicidal people. The purpose of 911 is to get first responders to your physical location. The purpose of suicide hotlines is to get help on the phone.


The 911 dispatchers shouldn't be dealing with suicidal people, they should be forwarding calls from suicidal people to the correct place. I would hope they already do this. What happens if you call 911 and tell them you're suicidal today?


I don’t know, but I’d expect them to send the police if it’s an emergency (you’re in imminent danger of going through with it) and to tell you to stop tying up the line and seek help yourself otherwise.

This would be just like calling them for any other medical problem. If you’re in imminent danger they’ll send help. Otherwise they’ll tell you to get off the line. They won’t forward you to a doctor.


(Agreeing with you), i don't see how they could have decided that clearing out one of the less used N11 codes was too hard, but clearing out a prefix across all area codes would be tenable.


The downside is that with a mass of publicity around promoting it, some people (such as children) will get it mixed up with 911 and in an emergency there will be a delay in getting the proper help.

Edit: I'm not necessarily against this idea, I'm merely trying to participate in due diligence.


They should just be able to forward you to 911.

And, also, is there an major epidemic of emergency calls being placed to 311 or similar?


The Suicide Prevention Hotline may go to a national center and forwarding to local 911 may be complicated.


If cell phones can figure out how to call local 911 from wherever they are I'm sure this can be done.


Cellphone locating for 911 is a whole mess and sometimes doesn't work anywhere near as well as you'd like it to and requires the police to drive around block sized areas trying to find whoever needs help.

Add in the complexity of transferring calls (how many times has your call been dropped when a support agent transfers you?) and this is a bucket of trouble.


That’s probably a bigger problem of 911 being hard to enter compared to, say, 999


Wasn’t 911 chosen to be hard to dial by accident?


That's why I like 999, despite the risk of it being entered accidentally (this isn't as common as Americans seem to imagine). Same goes for 112, which is just as likely to be input by accident.

In placing an emergency call, sometimes milliseconds count.


In the UK, in 2008, there were several million silent 999 calls. http://news.bbc.co.uk/1/hi/magazine/7748046.stm

It's harder now, because smart phones have made it harder, but it still happens.


Do you have an example of milliseconds counting?

I’m not doubting you - just can’t think of one and would like to know.


[flagged]


I've spent more than 200 hours volunteering on a suicide hotline.

I've called the cops once, on a woman who had taken two bottles of NyQuil and was losing consciousness with the phone on speaker begging me to stay on the line until she died because she didn't want to die alone.

I've talked a dozen people out of nooses, helped teenagers get through the night with out cutting themselves, helped women who were being beaten by the spouse find a women's shelter. I've talked to the same depressed and lonely old women in a California nursing home almost every week. I spent two hours on the phone with a man who was driving because he kept threatening to crash into on coming traffic.


Morally, you should've let all of these people die, except the last one.


Under what moral code or axioms??

From what I can assume, your difference is on whether they’d harm others. I’ll assume your creed is libertarian, though there are multiple essays where respected libertarian philosophers have argued that libertarianism doesn’t allow you to give up your liberties (e.g. suicide and indentured servitude)

The fact that these people could be talked out of their suicides (and in fact that some wanted someone to talk to lest they hurt themselves) shows they clearly were having a temporary lapse in judgement. If we accept utilitarianism as the basis of libertarianism, living another day with a clearer state of mind increases utility.


The moral code of "living fucking sucks". If somebody makes the choice to stop living, they should be allowed to fulfil thart choice instead of being stopped, forcibly or otherwise.

The last one is bad because those people unfortunately chose to live that day.


People who've made a firm decision that dying is the best thing for them to do don't call hotlines to get talked out of it. Nothing stopped any of those people from trying again later, either, if they decided that holding off had been the wrong decision. There's plenty of stories from people who e.g. jumped off a bridge but survived, who were filled with regret as soon as their feet left the platform. The fact is that suicidal impulses are often acute and transitory.

People should have the right to die, but you're basically saying that people shouldn't be allowed the option of talking things over with a sympathetic listener before making a final decision.


They called a suicide hotline. They did not want to die.

Edit: I have attempted suicide before and self harmed many times. I dated a woman who attempted 12 times.

It turns out life can get much much better. I haven't self harmed in years, she's very happy and hasn't either.

It's very hard to know what living well feels like until you've done it. It took years but I like waking up in the morning.


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