How should we respond to questions where the OP needs professional help?

Question

Some of the questions that have been asked here show that the OP would benefit from professional help. In some cases the questions are unspecific while in others, it's clear from reading the question that it is a cry for help.

Both of these question types have attracted answers from well-intentioned amateurs. Some of this advice has been worded in ways that could be read as hurtful or at least overly blunt:

If you have written 6 pages then it is likely not an apology it is grasping for control over the narrative.

But what really makes me uncomfortable is that any advice other than "see a professional" was given at all. Nobody on this site is a professional. If you are a professional, then because this is an anonymous Q&A site we have no way of identifying that. And without professional expertise, it's impossible to know whether your well-meaning advice is helpful. Perhaps it is helpful in 99.99% of cases. But for the remaining 0.01%, someone may suffer serious harm.

It's also important to recognise that because this is the internet, it's easy for someone to conceal the true extent of their problems. We have no way of knowing whether someone who tells us they are depressed is also suicidal. Your well meaning advice may be tailored to one situation when in fact the OP is in a worse situation, leading again to the risk that our advice may be harmful.

So, how should we respond to these questions? I think it's crucial that for a problem where the solution is for the OP to get professional help, that the only advice we give the OP is for them to receive professional help, and that this advice be communicated in a calm, respectful, empathetic manner.

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Here are some examples of questions that call for professional help, not internet advice:

• How am I supposed to talk about my inability to talk? (since deleted by CMs)

• Looking for help regarding feelings of worthlessness and suicide (since deleted by CMs)

• Apology to ex-boss (migrated here from The Workplace, since rejected)

• Is it rude to drive at the speed limit on dangerous roads when another driver wants to go faster? (multiple answers consisted solely of safe-driving advice and were removed; those that remain are often little better)

• Childhood Parental Influence on my self esteem

And here are examples where questions mention topics such as depression, but do not constitute a call for professional help.

• How to talk to a dean about depression

Answer 1

We need to take this seriously.

We're dealing with people's lives. Frustrated, upset, depressed, suicidal even - we have no business dealing with that. I think Shog9 put it best when he said

I hate to sound callous about this, but... This isn't a support group; y'all probably aren't trained to deal with the outpouring of grief and despair of someone you've never met and may have absolutely nothing in common with. I'm certainly not. Indeed, there's a decent chance that leaving a post like this around could end up just making things worse.

And it's true. Please realize - one angry word, a harsh response, or well-intentioned but unfortunate advice could lead to drastic consequences. We're not professionals, and we're dealing with people who are in a dark place (often of no fault of their own; but it's the truth). We don't want to say something or do something that leads to bad things for the OP. That being said, that doesn't mean we callously downvote into oblivion and close without a comment. As SQB said in chat

While we may not be equipped to give these users the help they need, I fear that closing the question, even with encouraging words, may be yet another rejection.

And I understand that. So please, don't vote - and if you see a downvote, upvote to keep the question at zero. There's no need for these people to feel any unnecessary further pain. You can also write a kind comment.

There's no harm in making them know that you care. Just avoid any other advice other than contacting a professional.

I know it has been said before, but read this answer!

Guidelines on determining if the OP needs professional help

Please note that many of the guidelines here are subjective, and may not even be good ones. I will be editing as I think more on the issue.

If yes to multiple of these points, follow the guidelines below.

1. Perhaps the most obvious one - are there any explicit mentions of planned suicide, self-harm, or other such matters?
2. Is the OP extremely self-deprecating, perhaps calling themselves names a lot?
3. Is the OP's language full of extreme sadness, hopelessness, etc?
4. Is the OP asking about a very difficult situation that they are having trouble dealing with (this especially should be along with the others; i.e., hints of something in response to a terrible situation)?
5. Is the OP asking about dealing directly with depression and/or suicidal thoughts?
6. Are there any hints or explicit questions about dealing with PTSD/remembering a terrible incident over and over?

What to do if OP needs professional help

1. Comment
2. Vote to close
3. Flag for mods so they can lock, alert CMs, and eventually delete
4. Vote to keep the question's score at zero

Above all, take it seriously. A person's life could be on the line.

Ready to use comment - general

Hi there! It sounds like you've been through a rough time. I'd love to help right now, but many of us here just aren't very skilled at providing assistance in situations like these. I just want to let you know that many of us who see this all care for you, and we all wish you all the best! Your best option is to try and find a psychiatrist or a social worker in your community. Thanks, and I really wish you the best :)

(Thanks to Zizouz212 for posting this great comment.)

Ready to use comments - depression, suicide, and/or self harm

Ready-to-use (international)

It sounds like you’re going through a hard time. I’d really like to help you, but unfortunately, we’re not well equipped to do so here. Your best option is probably to call [a suicide hotline](//suicide.org/international-suicide-hotlines.html). People are on call there to talk to people struggling with the same kind of issues you are, regardless of location. If calling is not good, you can [chat with them live online](//suicidepreventionlifeline.org/GetHelp/LifelineChat.aspx). It might not help, but what’s the harm?

Ready-to-use (US)

It sounds like you’re going through a really hard time. I’d really like to help you, but unfortunately, we’re not well-equipped to do so here. Your best option is probably to call the [National Suicide Prevention Lifeline](//suicidepreventionlifeline.org/). People are on call there to talk to people struggling with the same kind of issues you are, regardless of location. US: +1-800-273-8255. If calling is not good, they can [chat with you live online](http://suicidepreventionlifeline.org/GetHelp/LifelineChat.aspx). It might not help, but what’s the harm?

Close reason

I'm voting to close this question as off-topic because questions asking for psychological help are outside our scope. We care about you and want you to get the best possible help you can - from someone professionally trained to help you. We are not able to do this for you here.

(Thanks to Catija for the text of the reason.)

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Any edits, comments, etc are welcome. I am also open to discussion in chat. I will be editing this as I continue to think about it.

Answer 2

One could easily argue that everyone needs professional help...

Kidding aside, I think the more obvious cries for help should be flagged for moderator attention. They have a procedure in place to handle extreme cases.

In some cases both voting to close and flagging would be appropriate...

I'm cautious to say that we should close all mental health related questions because many if not most of our questions will contain lesser elements like self-esteem, emotional dependence, boundaries and so on.

The emergency cases are just that. Emergency cases. As you mentioned we're not in the position to help in these cases, but we can still avoid doing harm by directing these questions to the Stack Exchange Staff through our moderation team.

But keep in mind that these are rare exceptions. We shouldn't be trying to handle them the same way we would with regular off-topic or poor quality content. Closing alone isn't appropriate, these should be flagged for moderator attention.