Where do we draw a line for 'needs professional help'?

Question

So, in the past, we voted to close How to help my girlfriend get her confidence back? as 'needing professional help'.

My stance on that question was that it needed to be closed as 'needs professional help' because:

• The OP and the girlfriend were already receiving professional help. As random internet people, we don't know the details of their case, so why should we be better at giving advice than their professional?
• Although it was suggested that they may get advice here that wouldn't be thought of by their professional, we are a Q&A site (not a fellow-sufferers group) and we can't guarantee that the advice given is not dangerous/that it won't do more damage than good.
• The OP in this question initially stated that 'they would run the advice by their professional'. But these questions are here for posterity, they may be viewed by other people that aren't receiving professional help/don't ask a professional first if this is a good thing to do. Even the OP realised that, later:

  @Tinkeringbell I think it might be important to note that people in a similar position might read those topics. While in my case i was seeking for ways to help her in addition to a therapist, there might be people taking one the proposed solution instead of a therapist, so I think we should consider that too – user3399 Sep 19 at 15:33

Another question was closed as a duplicate of this question (while this was still closed): How to help my girlfriend with her lack of self-confidence?. It didn't spark the discussion that was mentioned in the comments to that question though, so I'm hoping to start one here.

While I was sleeping, this question got posted: In an early relationship, how can I handle my partner's deep depression and not be an enabler? In my opinion, it shows a lot of similarities with the confidence questions: The partner is receiving professional help for serious mental health issues (deep depression), the OP wants us to present him with ways that he can deal with their partner's issues.

Do we close questions where the OP (or the person the OP is asking about) is already receiving professional help as 'needs more professional help', or do we allow these questions, with a risk that future users who are not receiving professional help stumble upon solutions that present a risk of being hurtful to them?

Answer 1

I see two slightly different reasons for a "needs professional help" closure. The first would be in a case where an OP's own personal problems are beyond the scope of the site; the obvious case would be one where the OP is actively suicidal. These should be closed immediately, perhaps eventually with a link to some further resources.

Your examples all fall into a slightly different category, though, where the OP is dealing with a third party who needs and/or is seeking professional help. There may be overlap (the OP may be in need of professional help to deal with the relationship), but it's primarily an issue of the third party.

In cases where a third party is involved, I think we could potentially answer some questions. For example, questions like

• My friend just told me they're being treated for a significant mental illness; how can I react without causing offense?

or

• I have a sibling with a life-threatening illness; how can I talk to my parents about my emotional needs, without sounding like I'm equating the two?

would be pretty solidly focused on non-clinical, IP-related issues. The hypothetical OP is not trying to solve the third party's problem, and is not asking us to tell them how to do that. Rather, this kind of question asks a regular IP question, with a particular kind of complicating factor. I think we can probably answer many of those.

On the other hand, I think any question that looks like

• *How can I act as a therapist for my deeply disturbed acquaintance/friend/loved one?

is very far beyond our scope, and should be closed ASAP.

The two closed questions you linked both sound very much like "help me counsel this person" questions, and were appropriately closed. The newer question is more of an edge case; the title sounds like it might be leaning toward "help me counsel my girlfriend" but most of the body questions are a little more solidly on the "how do I handle specific IP issues, with the complication that they involve someone with depression". The answers might well include "talk to a therapist" but I don't think that's the only possible solution. In this case there isn't any indication from the OP that there is a physical danger to either party, and they aren't asking for help in that light. All of this leads me to believe that it is probably on this side of the line, but I think it is certainly worth discussing (and possibly putting on hold during the discussion).

Answer 2

This we might need to decide on a question by question basis.

For example the In an early relationship, how can I handle my partner's deep depression and not be an enabler? question is giving me a hard time about whether it should have been closed. The OP's girlfriend is receiving professional help and it's clear that the OP needs counseling but

The OP asked how to not be an enabler, (a saying-no question).

The issue is that, while being kind and accepting, I do not want to be an enabler by allowing her to cancel things that are important or helpful especially looking at the long term.

...asking for money from me, to buy more marijuana

The OP has every right to not want to continue enabling some of his girlfriend's behaviors which might be self-destructive in the long run (make her apathetic), e.g. paying for his girlfriend's marijuana and how to say no to that, in my opinion, is answerable, whether the girlfriend is depressed or not.

Let's look at the OP's question again:

How do I gently but confidently say "no" to her behavior in a healthy manner, without her viewing it as an attack on her or her condition?

which has two parts,

Part 1 : How do I gently but confidently say "no" to her behavior in a healthy manner

though "healthy manner" might need clarification

and

Part 2 : without her viewing it as an attack on her or her condition

Part 1 is answerable. The OP has every right to stop enabling a self-destructive behavior whether the girlfriend has depression or not and he's asking for a gentle but confident way to do that.

I would not answer the question at all if the girlfriend has attempted suicide, is suicidal, or is a threat to the OP.

Part 2 might not be so answerable. We can't guarantee that the girlfriend will not take the OP's "No" as an attack on her and this is best worked with a professional (nor can we predict how well she can take "No" for an answer).

Since this site doesn't need a disclaimer, and unless the OP mentioned (or did he forget in which case this should be clarified by the OP) that suicide or self-harm was involved, the part about how to say no, how to not enable, is answerable.

The OP isn't at fault and neither are we, if his girlfriend responds by threatening him with suicide when the OP stops allowing certain behaviors to continue, and if this happens the OP needs to seek professional advice.

Answer 3

with a risk that future users who are not receiving professional help stumble upon solutions that present a risk of being hurtful to them?

Honestly this is slightly hyperbolic. Not to say that there isn't any risk, but any information shared on any website runs a tiny risk of being misunderstood or misused by someone.

Erring on the side of caution makes sense in a lot of cases, but I think there's also a distinct possibility that being too cautious can become an error.

If we become too cautious we may be starting down the slippery slope of censoring any post that could be misunderstood or misused, which could easily become nearly all more meaningful questions.

What's left after the more meaningful questions are all too dangerous? The light/simple etiquette questions that tend to be resolved by a dozen answers applying roughly the same "common sense". Basically we're left with a site that isn't particularly useful for anyone.

Answer 4

I agree that this should be decided on a question-by-question basis.

As someone currently receiving professional help, I'd still like to be able to ask questions here :) Therapy can be expensive so I save the biggest problems for that hour, and the rest of the time I'm on my own! So as @AnneDaunted suggested in a comment, I've tried to either steer clear of the major problem areas or distill it into a smaller, focused issue. This seems to have worked reasonably well so far (that is, none of my questions were closed, and I got some great answers, so it seems the community was okay with them).

Take social anxiety as an example. I might talk to the therapist about "how do I make friends, omg everyone thinks I'm terrible don't they, how do I stop hating myself and wanting to crawl into a hole every time I text someone". That would be way off topic here! But things like appropriate responses in a specific social interaction are less complicated and self-contained enough for a layman's Q&A.

Depression can be considered similarly. For instance, these questions are asking for professional-grade treatment plans (besides being too broad, pretend they're just the titles):

• How do I stop feeling worthless and tired all the time?
• How can I make my partner less depressed?

But these questions are more focused, and don't require professional training to answer:

• How do I explain to my friends that I'm not being as sociable because I'm depressed?
• How do I suggest to my potentially depressed partner that they consider therapy?

The problem being asked about is what should matter. If the problem requires a professional, close the question, but don't close because OP is seeing a professional.

I think 1006a and Tycho's Nose address your specific examples nicely. The first two questions are essentially asking how to help third parties as a substitute for professional help, which should make it off topic. The third example has elements of "How can I handle this interpersonal issue, when that person has depression?". Since OP has clarified the girlfriend is not actively suicidal, I think that part of the question is on topic here just like questions of similar form have been, e.g.

• How can I handle this interpersonal issue, when they have autism?
• How can I handle this interpersonal issue, when they are developmentally disabled?

(I hesitate to say the entire question is ok as is, because there's a lot going on - but I don't think it should be closed because the partner is seeing a professional for depression.)

Answer 5

While I agree with Tycho's answer: we need to decide this by each question, I'm mainly concerned in answering questions how to deal with person with severe depression.

Let me share a bit from HDE's answer in Should we allow questions on dealing with depressed/suicidal friends/colleagues?

My main reluctance about these questions is the consequences for when folks get answers wrong. I think this point has been briefly bounced around in chat in general cases, but it's especially relevant here. When a person - preferably with the help of others - is trying to help someone who may be suicidal, mistakes cannot happen. A person's life may rest on whether or not those who care about them can help.

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Well, users expect that our advice is good, and they'll often take it. And that can go very, very wrong.

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I think we should make individual requests for dealing with these situations off-topic.

I believe the correct way to deal with potentially "needing professional help" question is to put them on-hold immediately, while we review whether it is safe to reopen it. That is better than reviewing first before putting it on-hold, which will take time. Meanwhile, an answer can be posted and who knows if the OP then decide to follow that answer?

As soon as community see these kind of questions, put it on hold immediately, while we discuss how to proceed; whether to keep it closed and points to a generic, canonical How-to-deal-with-a-suicidal-close-friend/relative post, or reopen it and approach carefully.

It may help to put a custom notice to suggest users to answer this question very carefully, because it deals with people that needs professional help.