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Handling a suicide threat

Posted by Carol Vassar @vassarradio, Nov 25, 2015

Hi everyone:

It’s been awhile since I’ve posted, but a busy period of learning and growing here at Hartford HealthCare.

Recently, we had a real life situation where a follower of one of our Facebook pages threatened suicide on the page. As a result, we’ve developed some guidance in that area. (He’s fine, BTW – ended up getting a social welfare visit from the local police department, thanks to our intervention).

Has anyone else every had to handle this type of situation? I’m posting our current guidance for your comment and feedback based on your experiences in this area. Please feel free to use this guidance (and the comments we get as a result of posting this here) in your daily work.

1. If you know or can determine present location of the person making the threat, please call the nearest police department and ask them to do a safety check on this individual. Be prepared to identify yourself, who you represent, the reason you are calling and the name and present location of the person in question.

2. Whether or not you can determine their location, do the following:

a) Ask the person to call 9-1-1 or go to their nearest emergency room.
b) Ask the person to private message you their contact information, particularly their present location.
c) Report the threat to Facebook at: https://www.facebook.com/help/contact/305410456169423
d) After completing these steps, if someone requests immediate crisis intervention, please contact their nearest crisis intervention team via the website for the Connecticut Department of Mental Health and Addiction Services (DMHAS) website: http://ct.gov/dmhas/cwp/view.asp?a=2902&q=378578
e) As follow-up, please screen shot or print the suicidal post, remove it from social media (if possible) and report the outcome to your supervisor as well as to the HHC Social Media Specialist and/or the HHC Director of Digital Strategy.

Looking forward to hearing from you! And, as always, Thanks!

Carol Vassar
Hartford HealthCare

This is excellent, @vassarradio. So valuable to have in these extremely sensitive situations. Two questions for you:

Who on your team came together to develop the guidance? HR? Legal? CMO?
Do you have any idea what Facebook does with these reports?

Thanks again!

Liked by Susan Woolner

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Hi @vassarradio,

Thanks for sharing!

This is one of my worst nightmares, and I’m grateful (touch wood) I have never come across this in the communities I manage. Great work for dealing with it – I imagine it would not have been smooth sailing.

I too would be interested to hear who helped come up with these guidelines – HR, Legal or both? Do they live somewhere on your page permanently now, or is this an internal piece of info you only distribute if flagged?

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@LianaNeri

Hi @vassarradio,

Thanks for sharing!

This is one of my worst nightmares, and I’m grateful (touch wood) I have never come across this in the communities I manage. Great work for dealing with it – I imagine it would not have been smooth sailing.

I too would be interested to hear who helped come up with these guidelines – HR, Legal or both? Do they live somewhere on your page permanently now, or is this an internal piece of info you only distribute if flagged?

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I developed this guidance as a result of what happened that evening, and at the present moment it stands as draft guidance for HHC marketing staff who monitor and post to our many social media pages. It is currently being vetted by our legal department. This speaks to a larger issue of policy development, but that’s for another post. 🙂

Much of what you see here is based on my experience having come from the marketing department at HHC’s Behavioral Health Network. I’ve had enough exposure to our Mental Health First Aid trainers you’d think I’d have actually taken the course (which I have not, but I intend upon doing so and have recommended it for all of our social media monitors/posters – just in case). I knew that Connecticut (like many states) supports a network of mental health crisis intervention teams that stand ready to intervene whenever help is required.

As for the Facebook portion of this (which I believe Dan asked about), I sent a screen shot of his posts to FB and they responded by saying they’d reach out to him. However, I did not find that to be sufficient or responsive (I wanted to hear back from them that evening – it was the next day before they confirmed they’d contacted this individual), which is why I went to his page, determined the town where he lived (though I knew there was no guarantee he’d even be at home), and was advised by the local crisis intervention team to call the local police. I did. They determined his home address and sent a unit out to check on him.

I have to say, this was quite an emotional and unexpected development, but lessons learned are certainly part of what you see below and will be helpful to my team – and hopefully to all of you.

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So helpful. Thankful for your background @vassarradio that lead to this quick response. So glad the individual is doing well.

Liked by Susan Woolner

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Absolutely great stuff @vassarradio!

Thank-you for sharing.

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I work on a greater than minimal risk research trial, and we get these often from individuals that are very desperate for help. Thanks for making a detailed step/step process.

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Thank you for sharing. I think my heart would have stopped! We are doing a workshop next week to work on updating our social media policy. I plan on bringing this to the table. Best…

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I can only begin to imagine the emotions you and your team must have felt. Thank you so much for sharing the experience and the process/resources.

I also believe this speaks volumes to the level of engagement and trust you are building with the community. Healthcare folks are some of the most trusted professionals…and with that comes responsibility to facilitate connection to- and curation of- evidence based, reputable resources.

What a difference you made in this person’s life. No way to place a dollar value to that ROI!

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Wow, thank you for sharing. This is a horrible scenario. While we haven’t had any suicide threats, we have had people message or comment with alarming physical symptom descriptions, and we advised them to call 911. We have also had threats and concerning posts from mentally ill individuals and reported them to hospital security and local police.

Would you be willing to share exactly what you said to the person? I would be terrified of saying the wrong thing. Did you come up with the wording by yourself or with guidance from someone else?

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We recently faced something very similar. In our case, the patient reached out after a procedure, so in addition to all of the above suggestions, we also enlisted the treating physician. The physician was actually able to reach the person’s emergency contact who went and checked on them, and helped get them to mental health professionals as well as follow up with the original physician. Our response team involved Patient Relations, Behavioral Health, Compliance, the patient’s physicians, as well as the social media team.

If ever a case needed to be made for the important role of social media in healthcare, this is it.

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@ektrenchard

We recently faced something very similar. In our case, the patient reached out after a procedure, so in addition to all of the above suggestions, we also enlisted the treating physician. The physician was actually able to reach the person’s emergency contact who went and checked on them, and helped get them to mental health professionals as well as follow up with the original physician. Our response team involved Patient Relations, Behavioral Health, Compliance, the patient’s physicians, as well as the social media team.

If ever a case needed to be made for the important role of social media in healthcare, this is it.

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Thanks for adding your comments @ektrenchard. Was this situation also a Facebook post? Who discovered the post, and how did he or she know what to do?

Liked by Susan Woolner

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@ektrenchard

We recently faced something very similar. In our case, the patient reached out after a procedure, so in addition to all of the above suggestions, we also enlisted the treating physician. The physician was actually able to reach the person’s emergency contact who went and checked on them, and helped get them to mental health professionals as well as follow up with the original physician. Our response team involved Patient Relations, Behavioral Health, Compliance, the patient’s physicians, as well as the social media team.

If ever a case needed to be made for the important role of social media in healthcare, this is it.

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Interestingly, there might be slightly different protocols for known patients (or those recently released) versus a random threat (as ours was, though he claims he called our behavioral health unit and was turned away). Which reminds me, the person in my instance was posting to a PAID FB ad for said behavioral health unit. What a tangled web the social media world can be!
Carol Vassar, MS
Social Media Specialist
Hartford HealthCare

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Thank you so much for starting this discussion as we faced this a few months back from a patient displeased with their care. I have a workflow I complete whenever I encounter a negative post so I went through that. After reporting the threat on FB I notified the appropriate patient liaison and left it in their hands. I’ll certainly revisit my workflow in those instances and see if anything else needs to be done. Great reminder to be ready for anything.

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Thank you so much for sharing, Carol. One of our Facebook pages is for a drug and alcohol rehabilitation center and, although we’ve yet to come across a situation like this one and I hope we do not, we’ve definitely come across comments from patients or potential patients that are very sensitive. However, your experience definitely makes me want to work some language into our policy about an issue like this, should it arise.

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@megancall

Thank you so much for sharing, Carol. One of our Facebook pages is for a drug and alcohol rehabilitation center and, although we’ve yet to come across a situation like this one and I hope we do not, we’ve definitely come across comments from patients or potential patients that are very sensitive. However, your experience definitely makes me want to work some language into our policy about an issue like this, should it arise.

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Have you developed guidelines for handling these very sensitive posts, @mkutulis? Any pointers you can share here?

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