Crisis policy and crisis page
Hi All,
Today I am writing to follow-up & provide some more context on a topic we all care greatly about - our crisis referral policy.
I would first like to apologize for any confusion you may have experienced regarding the policy. The policy on crisis referral has been the same since 7 Cups was born in 2013 and we will do a better job of communicating this policy across the site to all users so its clear and we are all on the same page.
We have been working hard behind the scenes to figure out the best way to approach this topic. We heard from the community, we researched what other communities like ours do, we researched what the best practices are in the peer community, spoken to licensed psychologists and so much more….
Today, we are going to reveal one piece of the puzzle. We want to emphasize that this will be an ongoing project that we continue to strengthen.
We are excited to announce that we will be adding a Crisis referral page to our site. It will be easily accessible from the site footer and listed under chat drop down. It will be available for members and listeners to utilize. Listeners will be able to refer members to this page easily.
Note on the page contents:
Right now, we are working on creating a training process and protocol that would leverage the QPR (question persuade refer) process. It may take some time to get this guide created. Additionally, we will be making another post on how to manage crimes or other types of crisis. Please stay tuned for that.
In the meantime, we ask that you use this onsite crisis page to help educate one another on how to best support individuals who are in crisis. Please always refer someone who is in crisis. As we do not have training in place to teach you how to differentiate between a passive or actively suicidal individual right now, in both scenarios, we ask you to refer the individuals to crisis hotlines. You may also refer anyone directly to this new crisis page as to ensure they are clear on the policy.
Again, we are working to build out a more comprehensive training program on how to manage a warm hand off to the crisis centers. But this will take some time, we ask you that you are patient and supportive of this process.
Thank you all for being patient so far! We are excited to continue to make this a stronger process.
@Jill7cups Even though this is just one of the many puzzle pieces, this is already a huge help for both members and listeners alike.
The comprehensive doc provides detailed clarification, explanation, procedures and protocols how to handle crisis chats and to put emphasis on what 7cups is for and what 7cups listeners can only do.
I'm hoping to see many changes that will benefit the community! 💜
PS. Who can we contact directly if we'd like to add crisis websites/hotlines/resources onto the doc?
@Erato
thank you so much for the positive reply!
We will keep you posted on the updated referral links
@Jill7cups so, just wanting to clarify something. If someone is experiencing intuitive thoughts about suicide/self harm, do we need to refer them or are we still able to support them (since they wouldn
@MidnightRaven999 Based on my understanding, we still have to refer them. As stated in the doc,
"To ensure everyone is getting the support they need, we will always refer ANY suicidal talk to this page. Please be thoughtful of the language you use."
and I think that crisis situations include suicidal talk but not limited to it. Crisis by definition is "A crisis considered when you feel you may be a harm to yourself or others. If you are thinking about or planning to harm yourself you may be in crisis." so I'm assuming self-harm talk and homicidal are also included.
Edit: I'd also like to add that self harm chat can fall under the grey area and can be tricky. My opinion would be as long as the member isn't in crisis and would like to get support for learning coping mechanisms, venting out their feelings and struggles of self-harming, or focusing on recovery, I think that's some forms of self-harm chat we can entertain. I think reading this post would also help.
@Erato I like that you took up self-harm. I don't think that an urge to self-harm is a crisis situation, as self-harm and suciidal urges are very different from each other. I mean, we have a ton of guides on the site that explain how to handle self-harm chats. If someone is harming themselves during a chat, it might be a different thing though. This is such a grey and tricky area indeed, and I hope we could get some clarification on all that at one point too. And especially a list of resources because suicide helplines don't help with self-harm.
@Erato
I would generally agree with your statements about self-harm. It's much like any harmful behavior we want to change. The framework is a huge factor in determining the right path. It could be very stressful to want to celebrate a small milestone or get a little static out and to get a referral in response.
Of course, there's also the option of saying, here's the resource I've been asked to make sure you have. We can still chat, but please know that this is here, and I have to respond for your safety first. If I tell you to call, know that I'm doing so out of care and concern, not out of rejection.
I think rejection is the top feeling many members seem to feel when I refer them... Having clear guidance is a good foundation; hopefully as these things are developed to a deeper degree, it will help filter some of the issues we have seen over the years.
@MidnightRaven999 we still refer, there are some resources on that page about ideation/thoughts. It will be a little bit of a bumpy road as we all get use to doing this (Listeners and Members alike). We will be updating trainings to reflect this change.
@Jill7cups @Erato thank you for clarifying this for me
@Jill7cups this is very insightful thank you for sharing this.
@Jill7cups
Thank you, thank you, thank you! This is a great resource, so helpful, giving us more tools to help our members and guests and also clearing up an area that has been so vague and for so very long amoungst listeners! So hard for a listener to use their best judgement, to tease it all apart, and try to decifer exactly what this or that meant by the guest/member interaction and then walking away wondering if we had done the right thing or not.
I hope I can add my feedback to this new update. Updates on here are always so eventful and huge since we encourage growth through people and the site platform. I am really excited to see where this takes 7 Cups in the future and hope this is the right decision that was made. However, I do have some questions:
1. This cover page is very long. When should listeners refer members to this? I would imagine that in a crisis, people will not stop to read a very long cover page discussing a lot of different things. Is it possible to have the cover page be shortened to general information as opposed to describing everything? I feel like maybe we could have different clickable sections titled for specific crisis needs in the future so a member can simply click the section they need and read the information pertaining to them there.
2. What other sites were looked into when reviewing best practice? As we all know, 7 Cups is a pretty large site and seems to be a leader for mental health sites as we are doing something right by looking at how far we have come. So, my specific question here is: When using smaller site's policies, were they adapted to 7 Cups and our specific needs? Every site varies, every site has different needs but if there is a best practice amongst all mental health sites, I would be interested in hearing about it!
3. When it comes to active self-harm, when are members welcomed back to use this platform? From my experience in the Group Support Rooms, any member is welcomed back after they aren't harming themselves but what if they have thoughts to self-harm without the intention of suicide? Is this still considered the same as the thought must pass? I feel like this may be a pretty big gray area as we move forward with this policy as we welcome the topic of self-harm but now we are adding exceptions. Additionally, is the Self-Harm guide up to date with all this information?
Thank you for keeping us up to date with this Crisis Policy. I know that updates can be scary and hard to take but I really hope that this new policy does us good and helps people stay safer since we don't have enough adequate training for such thoughts so I appreciate it and hope we learn more along the way to keep being the amazing mental health support site we have been since the beginning.
@Erica
1. Yes when it is a stand alone page the three titles at the top will be clickable to jump to the pertaining section, which will help people navigate.
2. We looked at several mental health sites, chat sites, and crisis sites. A couple that come to mind are Sibly and Trevor project. Then we considered the things that make 7 Cups unique and formulated a plan that we thought was best for how our site works, how our training works, and how we can best support both our Listeners and our Members.
3. We will continue to provide more info on all the gray areas. For now self harm policies remain the same, as in so long as a person is not actively participating in it they can use the platform.
I hope that helps! Appreciate the feedback.
@Jill7cups
I think it is great that you all are looking into and expanding the training, with QPR in mind as well. I went through a QPR course late last year, and it was interesting to see how many people (who were not in any related fields) wanted to learn how to help others in crisis.
I would also be interested in seeing what that training looks like, as I help train people on another online community. Many don't know how restricted the choices can be when operating forums; especially for those who have to enforce the rules, but are not trained/qualified professionals.
Someone has to do the daily grind type jobs, right? Those people aren't always certified to manage more than a simple chat, and it can, at times, be dangerous to do so -- not just for liability, but also safety and community impact. Having experienced that side of it, on non-mental health communities, I know that any sort of quality training is better than nothing.
Also, kudos for everyone who worked on the 7cups support wiki. There's a lot of useful information available. I commend their hard work!
Jill7cups Will that document be moved to the 7cups website?
I think it's not a good idea to put it onto a tracker site like google docs for production.
You could use the article section for it, for example.
@Jill7cups (sorry, messed up the tag)
@cloudySummer I think it'll be transferred! c: Jill said it in her post,
"It will be easily accessible from the site footer and listed under chat drop down. It will be available for members and listeners to utilize."
I hope this answers your question c:
@cloudySummer yes it will be a page on the site and there will be links to it on the footer of every page as well as in the chat drop down at the top of the page (not sure on the app but will share when we know).
So it won't be a google doc, this is just a preview of the content.
@Jill7cups Thanks!
@Jill7cups who works on this guide about difference between passive and active crisis? It would be great if there was a programm which could train listeners to differentiate. We are listeners. We are here to listen. Where is this sensibility we should have towards the members. Some of them, arent even really suicidal, but they just need somebody to listen.
@Jill7cups
so after someone is referred we end the current chat with them and if they message again wanting to continue to talk that is a new chat session with the person correct ? and if in the new chat session they continue to reference suidide we refer again and if they they do not refer to suicide in the new chat session we continue to talk to them ?
@jennysunrise8 Sounds like training people not to speak about their most pressing problem... Not sure how to solve this issue, though. Maybe 7Cups could cooperate with a crisis hotline?
@cloudySummer right eventually people will just learn to not be open about any suicidal or self harm thoughts theyre having and keep it to themselves itll make people afraid to disclose just as much as lack of anonymity would keep people from disclosing info about what theyre dealing with so i dont know what will happen with the depression and self harm communities since this applies to the forums as well as 1-1 chats i guess people can only talk about past experiences and not what theyre currently going through at all it wont be easy for depression or self harm communities and other communities that might have people.who are depressed such as disability subcom and just several others
The crisis text hotline is well managed good resource 741741. They handle suicide and have ways to send help.
@jennysunrise8 what do you currently do if you end a chat due to crisis and they start a new chat with you? Curious how everyone handles that now.
@Jill7cups the few chats ive had where they seem to be suicidal and i refer them i always let them know they can come back as soon as they feel they are no longer suicidal and we can talk again i wouldnt refuse to talk to someone who comes back trying to talk again regardless of how long its been since the last chat that ended with a referral feelings can change quickly and also misunderstandings happen easily with text only communication so listeners should be open to being corrected and be mindful that we do not know how that person is feeling or when their feelings and thoughts change only they know that even if they were not complete strangers we wouldnt know that and even moreso because they are so i would be welcoming and non judgemental with any new chat and i think everyone should be no matter when it happens ( as for your actual question though in my experience only one has come back to talk and that was about a week later ;) but if they came back anytime i wouldve talked to them without any assumptions about how that person who is a stranger and also a unique individual is feeling at that moment )
Here are then other CTL Canada 686868 and UK. 85258@jennysunrise8 hope this helps you all.
