Radically Genuine Podcast with Dr. Roger McFillin

Roger K. McFillin, Psy.D., ABPP (00:01.591)
Welcome to the Radically Genuine Podcast. I am Dr. Roger McFillin. In July 2022, the United States launched the 9 -8 -8 suicide and crisis lifeline, hailed as a compassionate step forward in mental health crisis response. But beneath this veneer of progress lies a disturbing reality that few are willing to confront. As calls to 9 -8 -8 surge

So do reports of privacy violations and forced psychiatric detentions. What was meant to be a lifeline for those in distress has become a dragnet funneling vulnerable individuals into a system that may do more harm than good. Today's guest's research reveals a troubling trend. Psychiatric hospitalizations, often traumatic in themselves, are on the rise. Here's the

These interventions far from preventing suicides might actually be increasing them. Patients report leaving these facilities more distressed than when they enter and feel deeply violated by the process. Many are prescribed medications with black box warnings known to increase suicidal thoughts and behaviors. In a cruel irony, the very system designed to prevent self harm

maybe pushing more people to the brink. As we dive into this explosive topic, we're forced to ask, in our rush to do something about the mental health crisis, have we created a monster? Are we sacrificing our civil liberties, privacy, and even lives on the altar of good intentions? I want to welcome back to the show Rob Wipond, who is a freelance journalist who writes frequently about the interfaces between psychiatry, civil rights, community issues, policing.

surveillance and privacy, and social change. His articles have been nominated for 17 magazine and journalism awards. He is the author of Your Consent Is Not Required, The Rise in Psychiatric Detentions, Forced Treatment, and Abusive Guardianships. Regarding the 988 suicide and crisis lifeline, Rob has been writing extensively on this subject with Mad in America and really is going to be the focus of

Roger K. McFillin, Psy.D., ABPP (02:24.151)
program this afternoon with interesting, I think, side discussions about, how do we compassionately, scientifically and ethically respond to people who are in crisis situations and might be experiencing suicidal thinking and emotions. Rob Wipond, welcome back to the Radically Genuine Podcast.

Rob Wipond (02:46.528)
All right, thank you for having me. Yeah, I felt like the last time we talked, we still had hours more to talk about. So it's exciting for me to get a chance to sit down with you again and explore these issues some

Roger K. McFillin, Psy.D., ABPP (02:59.191)
Yeah, let's start with updating our listeners on the 988 suicide crisis lifeline. Like what is it? How is it marketed to the general public and those who choose to use it generally, what are they expecting?

Rob Wipond (03:14.244)
So 988 was adapted now from the National Suicide Prevention Lifeline. They basically took it over. It's an affiliation of about 200 semi -independent call centers around the country that are now part of this. If you call 988, you'll be directed, excuse me, based on your area code right now, largely you'll be directed to one of those call centers and talk to somebody.

could be a volunteer, could be a professional of some kind, trained to just talk with you about whatever you're going through and hopefully provide you some positive feedback or help or just a sense of connection for five, 10, 15 minutes is the length of an average call. And then you'll go on with your day. That's sort of the main service that they're ostensibly providing to people. However, they

get engaged in all these other things that I've been researching and writing about, which are these enormous privacy invasions, which are growing. So yeah, it's a very, a lot of money has gone into it. The Biden administration has put $1 .5 billion over the last couple of years. It was actually brought in during the Trump administration. So both left and right governments tend to be supporting it. It gets a lot of positive publicity.

Right now we're on the sort of anniversary of it. And so there's been a ton of media coverage over the last couple of days, all very celebratory, just talking about this dramatically increasing number of people calling, up to five million a year now, and the faster response rates, just covering these really basic things that they're doing and celebrating that. And so far I have not found a single other news outlet or journalist that's been talking about what I write about in the research.

behind it, which itself is distressing and maybe we could explore at some point what's really going on

Roger K. McFillin, Psy.D., ABPP (05:13.783)
So on the surface, sounds very positive. It's an outlet for people who might be really struggling. Someone who's a lifeline maybe can help ground them in that particular moment. Another human being so they don't feel so alone. When you do dig into the research on completed suicides, that feeling of emptiness, loneliness, and hopelessness tends to predict suicide. This idea that you are really

disconnected from your community and other people. So you would think on the surface that this is a very positive response where someone who has some training and can be a compassionate ear can help somebody get through a maybe real difficult time where otherwise they might have been impulsive. But what is it in reality

Rob Wipond (05:59.374)
Yeah.

Well, yeah, I mean, it is that, right? We need to acknowledge that. think there's lots of people who say, you know, I called the line and I had a nice chat and I felt a little better in my day. And that's great, you know, that's what they're doing. But they advertise themselves as absolutely private and confidential and life saving.

We might hypothesize that some people feel as if the contribution it makes to their lives, that 15 -minute call is quote unquote life -saving. that's not usually what we think of when we say something's literally life -saving. And they promote it as that all the time. But we don't actually have any evidence of that. There's no study out there that shows, oh, if people call the lifeline, we literally saved their lives. And in fact, there's mounting evidence of the opposite happening for this huge percentage of these calls.

callers, huge and growing. And when I say callers, I just want to emphasize that also mean people who are texting and chatting as well, just for the sake of ease, you know, I refer to them all collectively as callers, but more and more people obviously do use their computer in some way or a smartphone to access these lines. So one of my main problems, and there's multiple problems, one of the biggest ones that I have is

that they engage in call tracing. Now, they still don't have the power to do that directly themselves. What they typically would do is if they have some concern that a caller may be at risk in the relatively near future hours, days, it's really unclear in the policy how long ahead they're trying to predict. But I think if you might be at risk in some way of harming yourself or something, then they will.

Rob Wipond (07:44.42)
Contact 911 and 911 has this power to ping people's mobile devices or look up your location through other means. One way or another, it's a pretty high rate at which they can find you, your exact location, where you are, down to about three meters on an XYZ axis. So it's a pretty effective tracking tool. And then police will come to your door.

Sometimes it's depending on who's available, it could be another first responder like an ambulance or a fire department. And they will usually talk with you a bit and then take you to a psychiatric hospital or crisis stabilization center of some kind where you can then be forcibly subjected to psychiatric evaluation of some kind, detained for anywhere from hours to days to weeks in some cases.

People find this very distressing and shocking. The whole process can out them publicly because the ambulance and or the police may have shown up at their workplace or their home, wherever they were when they made this call. And suddenly if they were talking about something that they thought was private and confidential, well guess what? Now your whole family knows that you were contacting 9 -8 -8 while about what? What's going on? They're talking with police too, right? All of it, it can be very distressing. It's happened for children at school.

that are calling this line, having this kind of stuff happen. So it's an enormously privacy invasive process, deep sense of portrayal that people experience. And then whatever happens in these psychiatric facilities plays out. You could be literally forcibly detained for weeks on end as a result of this and potentially forcibly drugged and all the other things that happen, restrained and these.

psychiatric hospital, especially when you're being forcibly detained there, is not a pleasant place for a lot of people to be. And I've just talked with a lot of people who've just had some of the most traumatizing experiences of their lives going through

Roger K. McFillin, Psy.D., ABPP (09:47.349)
Yeah, before we get to those details, let's take it a step back here. And I want to understand what private and confidential actually means, because this is quite nebulous. You know, for me as a, as a clinical psychologist, privacy and confidentiality are the bedrock of my profession. So most of my clients that I work with have to have the freedom to talk about their inner world and their experience, right? Which often includes I consider

you know, what it would be like to not live anymore or the steps I could take to escape this pain. That's in itself is not enough for me in any way to violate that privacy and confidentiality and take steps for hospitalization. There would have to be pretty imminent risk to their lives. And, and, what I mean by that is they have to be pretty definitive that they're going to end their life.

And this is the last time I'm going to see them. And there's nothing that I can do. And then I'm kind of, you know, in many ways handcuffed, but the overwhelming majority of situations are people that are sitting there in front of me because they want to feel better. And I would imagine the same thing is occurring if somebody is calling one of these hotlines, they don't really want to die. They're actually reaching out for a lifeline. They're reaching out. So, you know,

they can take a step back from what they're going through. But I've been looking, you know, into some of your work and in your article that you posted on Madden America, apparently the data shows that police and EMS interventions on 988 calls quadrupled in the first year. And so that's like contrary to the promises of getting police out of crisis care. So there's a couple things that I want to explore is where is the line with this privacy and confidentiality?

are those who call, are they really told upfront about what the implications are based on what they reveal? And what's driving this dramatic increase?

Rob Wipond (12:03.278)
Yeah, all great questions. And let's be super clear about this. People are not only uninformed about this, they're being misled.

It's very clear if you try to look at these privacy policies that these call centers have, there's really no cohesiveness to you. There's no formal kind of clear national policy for 9 -8 -8 right now. Every call center has its own sort of policy, but a lot of them have none whatsoever. You go to their website, you search around. When you go through the process, there are some sort of terms of service you click on. It won't really clarify this. And if you see anything about this specifically, it will be

Well, if your life is just as you worded it, they'll claim that they're doing what you say you're doing, but they clearly aren't. And that is they'll say, if your life is an immediate, clear danger, we may call 911, you know. But that's not the policy. If you look at the policy, it's much broader, much vaguer. And it's not a may, it's a will. And all that's happening here is it becomes highly subjective when they're going to call.

why they're going to call and it often has to do with just the level of sort of anxiety that the volunteer, the call attendant, whoever's on the other end of the line may have about you. And that's why it's so important that relationship you're talking about. If you've got a client, well, you're developing a relationship over time. You have a sense of them. You know, if you're, if you're dealing with me, you know,

Rob, when he gets upset, maybe he gets really animated and talks dramatically. And you'll get used to me going, for God's sakes, I'm going to go out and kill myself right now. And then you might even get to point of laughing because you know that I'm just upset in the moment. You Rob, Rob, sit back down here. And yeah, yeah, you know. You can develop a relationship with someone over time. And you get a sense of really where they're coming from and how serious that is. And if you start feeling that it is serious.

Rob Wipond (13:58.454)
you can explore that with them and feel confident because you again, you've developed that relationship and you know they feel comfortable with you. Right. And that's key. Right. And that can take a long time to build those kinds of relationships. And this isn't what's happening on nine eight eight. It's random. I'm calling up.

I don't know who I'm talking to. They don't know who they're talking to. This is the first time we've ever spoken. You know, if I just say what I just said to you, it's completely out of context now. They think I'm serious. Something very serious can happen as a result, right? And this is what happened. And I use that example precisely because I talk with people who've literally called the line kind of to troll it and make jokes and things like that. And then that ended up with the police coming to their door because

the person at the other end of the line didn't realize. They were just kind of making a joke. that's an extreme case. I don't think that's happening a lot, but it's indicative of the level of misunderstanding and confusion and vagueness that can kind of drive these sorts of interventions. And you talk about the increase. That's exactly what many of us predicted. The moment we said, create this line, you get more and more people calling.

You're going to have, you have to hire more and more staff, you know, and there's, you're not boosting up mental health services in communities. It's not like you have a ton of places you can refer these people to. Well, all that's going to happen is you're to have more people who are going to call up with these feelings, because lots of people have them and you're going to, the call attendant's going to feel afraid. Well, what can I do for this person? They only have one option of something they can do. And that is call 911.

Roger K. McFillin, Psy.D., ABPP (15:37.493)
Yeah, I mean, it's interesting that we do use police in these situations. So what are people going to experience when an officer comes to their home?

Rob Wipond (15:46.702)
Well, this is what's so concerning because particularly anybody that's from a kind of marginalized community of any kind, racialized community, immigrants, people with difficulty speaking English, lower income, people who for whatever reason may be living in neighborhoods or communities where

There's already more tension with police in that area. It's very, very risky when this starts playing out for them. And this is one of the ways that it most commonly plays out too, is that a call attendant may say to you, well, listen, you either tell us exactly where you are and we're going to send the police around, or if you don't, we're going to send the police around anyway. And the average person figures out pretty quick, gee, think I'd rather the police come.

thinking that I'm compliant rather than that I'm non -compliant in this situation for safety purposes. And so they agree to give over their name and name and location. And that becomes now a consenting agreement. And in the data and the statistics now, these are people who supposedly consented to this kind of intervention. wasn't against their will. So even the data is vastly undercounting. How many people are being pressured?

coerced and threatened into these kinds of interventions. So yeah, it's very risky, particularly in racialized communities in America today. And those are the people often who are speaking out against this. And so it's highly distressing that we have those voices not being lifted in the public dialogue right now. I'd say that it is very racist what's happening with 9 -8 -8, that they're promoting it so heavily without at

cautioning and warning people at all times. as I said, it's not in these privacy policies very clear and it's not in news media articles about it either. There's this general attitude out there, know, paternalism in the mental health system. I think that's behind that. Well, we don't want to frighten people from calling, but as a result, people then have these experiences and they're extremely shocked and betrayed.

Roger K. McFillin, Psy.D., ABPP (17:59.287)
So it starts with law enforcement, and then they're taken to a psychiatric hospital for an evaluation or a hospital setting for an evaluation, usually with a social worker. And that's accompanied by a police officer or potentially maybe in an ambulance. And what are they going to experience when they arrive at a hospital?

Rob Wipond (18:21.528)
Most people, of course, experience already, even before they get there, they're starting to, it's heightening their anxiety and fear, because they had no idea this could happen. Or if they've ever been in a psychiatric hospital before, they know what can happen there. And so that's heightening their fear as well. And when they get there, essentially it's a highly coercive environment. They're told right away, you cannot leave. You're here for an evaluation now.

often something is conveyed about what happened in the conversation. So already again, your privacy is being breached. You'll find out that, the social worker, the nurse, the doctor, all these people have heard what you supposedly said on that call and what precipitated the worry and the intervention. and often people report that that's not accurate as far as they're concerned, what's been relayed. And so they're already feeling like kind of

Distress like are these people really looking out for me? Do they they're because they're not even believing you when you say well I know I didn't say that you know and maybe somebody's recollection is wrong, but you know these things they're not Clearly sharing the recordings they won't share them with you all this is sort of being relayed in the moment So there's just a sense of kind of heightened anxiety in this situation Really for you and for the people who are supposedly trying to help you so you'll be detained you'll be held you'll be put through some sort of usually it's a 10 -minute sort

conversation with a psychiatrist who may come in much later depending on what time of day it is or evening or the weekend. A lot of times the psychiatrists aren't even there so you'll be held for the entire weekend before you even talk to the psychiatrist and get a formal evaluation. And then at that point if they evaluate that you are in some way potentially a risk to yourself and they want to hold you for a longer period they can and do. And this varies from state to state for how long and what the process is.

but it can be anywhere from another couple days before you actually get a hearing in front of a judge, or even weeks in some states where you can be held before you even get a hearing in front of a judge. And in that time, they can also do emergency interventions of different kinds. So if you're completely compliant and calm at all times, that's unlikely to happen. But if you start getting upset, if you really want to leave, if you physically resist,

Rob Wipond (20:37.62)
in any way, if you're offered drugs and refuse them, then the kind of tension between you and the staff can escalate and they can forcibly intervene with injections of powerful anti -psychotic tranquilizing drugs, concoctions of sedatives and anti -psychotics and so on and restrain you. They have the legal ability to do any of this if they believe it's for your own good quote unquote.

Roger K. McFillin, Psy.D., ABPP (21:04.001)
You have some, you have a powerful story on that article on Matt in America, but I want to share a recent experience with me as I had a client who was provided a non psychiatric drug in a medical setting that had adverse psychiatric consequences to it, worsening mood, sleep problems, and suicidal increased in suicidal thinking. I was aware of those adverse reactions to the drug when my client was experiencing it. I know

She was acting outside of what was typical for her. And I was concerned and she was calling me and she was at home and I didn't observe her. And I did encourage her to go to get evaluated for the toxicity of the drug called the physician who prescribed it and was very clear that this isn't a psychiatric evaluation. This is potential drug toxicity or an adverse reaction to a drug. They still.

treated her almost like she was a prisoner. I asked her to keep her phone with me and her phone with her to text me or call me if I need to intervene anywhere. They took her phone away. This is a person with a trauma history. This is a person who was stalked previously. Very, not that dissimilar to the individual that you interviewed and you used in your article. So maybe you can share a little bit about

complexity of some of these experiences for someone who is struggling because in a lot of ways, you're not, if you don't have intent to kill yourself going into this situation, going through this in itself might increase your willingness to want to end your life because again, you're just, you're treated almost like you're subhuman. You're treated like you're a threat. And a lot of what people's experiences are, are described as traumatic.

Rob Wipond (22:53.956)
Yeah, and thank you for sharing that story. I'll just emphasize, yeah, I've heard similar stories a lot. It's not uncommon. People having physical responses or adverse drug effect responses or a psychological response to a physical illness. And it all gets misdiagnosed and mistreated in these medical settings. And there's studies showing that it's extremely common. And yeah, I interviewed a woman who had no intention of killing herself.

was totally not on her mind. She was calling because she was just going through some flashbacks as a result of a history of sexual assault in her life. And she just wanted to feel grounded. Her boyfriend wasn't home at the time, and she was on her own. And she just wanted to kind of feel grounded with someone else there. So she called and was talking. And they interpreted this as certain.

Who knows? We don't really even know, Because we can't get the record. She can't get the recording of the call. She's wanted to get it and they won't release it to her. So she's just going on her memory of what she said. But she said, certainly I wasn't feeling suicidal. I might've said this or that, you know, that got misinterpreted in that particular way, you know, this kind of thing. In any case, she got, you know, this kind of intervention threatened essentially, we're going to send the police out or you drive yourself to the hospital right

And so she decided rather than having the police come that she would go and as you're describing all these other things can happen along the way so People were you know can be you know all her belongings were taken away She was required to remove her clothing You know in the setting that's feeling very physically threatening so for her She's immediately being really triggered. She was already in this deep state of having flashbacks about being

Howard and assaulted. And now here are those same things playing out for her in that moment, these same feelings being heightened by these people who were supposed to be helping her. So, so it, it, just kind of really, really worsened her state. And then she was detained.

Rob Wipond (25:00.356)
through this whole period in a hospital setting. And this is, again, very typical, that they're kind of unregulated overall in the sense that, there's a lot of patients in a lot of different kinds of states. And it so happened that you're all kind of forced to be in these lobby areas and settings. You can't close your doors. You can't lock your doors. None of this stuff. So she's basically found that there were several men on the ward who

really into sexually harassing the women on the ward and it was out of control. And she just felt constantly under threat from them. again, just deepening the trauma that she's going through in this setting to the point she was also afraid to say anything because she asked herself if she could be transferred to another hospital. They said, no. And so then she realized, well, if I can't be transferred.

he's not going to be transferred even if I complain about him. So what am I going to do here? And yeah, so she felt very trapped in this situation and then everything else is happening with the staff themselves are doing. And this is just from the other patients. So it's just out of control. mean, that's something so basic to you kind of go, yeah, whoever thought of this idea that we're going to put a whole bunch of people with completely different kinds of emotional, psychological problems.

together in a giant dormitory setting. And this is going to be a helpful setting for them. It's really kind of so illogical. And yet again, it's the foundation of how we treat mental health problems in our mainstream system right

Roger K. McFillin, Psy.D., ABPP (26:32.003)
It is so appalling to me how the psychiatric community, the system in which I work in, doesn't rely on really good data and compassionate care. mean, in fact, we do things repeatedly over and over again that are clearly going to worsen outcomes. And then the resistance to change in this field is

really infuriating. You know, in my experience and understanding the research around psychiatric hospitalizations, ultimately, they do not actually prevent suicide. And some of the some of the papers that I've read, it's it's opposite. It's like what we call a negative intervention that you're more likely to have a worse outcome by entering it. But my experience in the field is that we're in like this fear based culture, even, you know, move away from 988.

just the therapies that are provided, the therapists are like so scared of a client dying by suicide who's under their care, that they are hyper -vigilant to any sign and they're pushing people into psychiatric hospitalizations as if it's an effective intervention. And I wanna get your thoughts on what you really know about kind of the science around this. I mean, are you seeing the same things that these exact interventions are actually

worsening outcomes?

Rob Wipond (27:56.14)
yeah, yeah. You know, we've seen these studies and it's consistent. It's not like we're seeing anything else. Every study that's looked at this is finding that somebody who's put into a psychiatric hospital, and I want to emphasize, it could be voluntary or involuntary. They're not separating in most of these studies. So even people who go there willingly say, hey, I really want help and end up there, end up after their experience of hospitalization hundreds of times more suicidal than they were before they went in. And

groups of people who weren't suicidal at all. That wasn't the reason that they went to the hospital, come out 100 times more suicidal. And this is consistent in these studies. Now, this is co -relation, not causation. We don't really know what's going on there. But then you can look at how dose response it is. It's kind of like we can see these trails where, the longer you were in the hospital, the more likely you are to be suicidal. You see all these relationships. And yeah, it's

really indicative of what's probably going on. And then you talk to people, right? Like you and I have. You talk to people who've been in this situation, and you go, well, makes a lot of sense that this is happening. The data is actually quite explicable based on how people describe what it's like to be in a hospital. It's a very depressing setting. If you're kind of there because you're feeling at the end of your own capacity to help yourself and you're reaching out, it's

doubly depressing because now you go, well, now I've even tried this and that failed. It's made me worse, not better. So you become way more negative than you were because you're being told by the culture like this is going to help you. And it's so bad. I just saw today the government accountability office got asked by a senator to investigate the veterans crisis line because they had a case of one guy who did call. And based on what they're quoting, sounded

He was pretty suicidal, and they didn't intervene in this case. And he did die. He did kill himself. And so obviously, that's super unfortunate. But at the same time, now you know where that's going, right? The push is you've got to be more aggressive on everybody who so much as hints that they're feeling suicidal and intervene, intervene. But no part of that discussion is, but will that

Rob Wipond (30:17.432)
Will that, you that'll stop that person in that immediate moment, yes, from potentially killing themselves in that immediate moment. But do we have any evidence that this particular action of sending the police around, dragging that person up to a hospital, locking them up there for a period of time, that this is ultimately going to have a positive effect? No. We have no science to show that. So all that's happening here is, as you described, it's a very fear -based.

gut reaction kind of approach to preventing suicide. If anyone so much as hints it, let's stop it. Let's use as much force as possible to prevent it in that moment. And even if we have ever mounting evidence that that's actually dramatically worsening the problem, we're just going to ignore it. We're not going to talk about it. And that's that resistance to change you're talking about too. I don't understand. Really, you know, I'm a journalist here. I'm looking at that system from the outside. going,

How can any, how could you work in a hospital setting? How could you be a psychologist, a psychiatrist, a nurse, a social worker, anybody working in that setting and not be worried about this and not be speaking out about it and not saying, we need a different approach with things like 9 -8 -8. We need a different approach with involuntary commitment. This seems to be not working and it actually seems to be backfiring.

miserably. Why is it only people like you and I that are talking about this? This should be mainstream discussion. I'm aghast. I invite you to comment on why you think that resistance is so, so huge. I have lots of theories and ideas too, but I think it's just something that needs to be more talked about and we need to get underneath it.

Roger K. McFillin, Psy.D., ABPP (32:01.163)
Yeah, I think it's multifaceted. I think there's always a financial component. When you start talking about this, like for example, I run a program here, it's dialectical behavior therapy. We were doing one for both adults and adolescents and those who enter into dbt programs are experiencing generally chronic suicidality or self injury amongst maybe some other potential struggles. And the effectiveness of dbt is it prevents hospitalization. So that in itself presents

traumatic experiences, unnecessary pharmaceutical interventions, and a number of things. And when I work with parents, I work with parents on the adolescent end, and I provide coaching on how to deal with a suicidal teen or a teen who is self -injuring or so forth. And it's important to note that non -suicidal self -injury, like cutting, doesn't necessarily mean that it's an imminent danger or risk, and that psychiatric hospitalization should be the,

frontline intervention. In fact, there's really no evidence that's going to be helpful at all. Non suicidal self injury, right? So it's better to be within a system and a therapy that's going to be able to help someone overcome self injury. But what happens you go there and if you cut yourself, you're automatically going to go into the psychiatric hospital. And what is a psychiatric hospital? They're going to prescribe you one or likely multiple mood and mind altering psychiatric drugs that haven't been evaluated long

that haven't been evaluated in interaction with themselves. And even the evaluations that we do have the clinical trials, it's very clear that there is a myriad of adverse consequences, including worsening mood and increased suicidal or even homicidal ideation. So that's what happens when you go into a hospital and imagine being under the age of 25 and you're an adolescent and you still have a developing brain and so forth. No one really understands the context that led them

cut themselves or be suicidal in the first place. And so now I'm providing a lot of this education to parents, but a school system might still want to force hospitalization. And so at least the parents know at this point about the science and safety around these psychiatric drugs. So they'll be the first ones to say, we're not consenting to any psychiatric drugs. And then the psychiatrist will say, well, what do want us to do then? Really? Like our only option is to force drug?

Roger K. McFillin, Psy.D., ABPP (34:25.589)
an adolescent, like you have no other tools to be able to work with someone in that moment. How about just compassionate ear and some time? Because those are some of the things that we see that suicidal experiences tend to be episodic in high emotional states related to something that provoked it, right? So there was something in their environment or within them that provoked it and put them into that state. And so we just know them being in a safe place.

with a compassionate ear and maybe improving their ability to cope with the situation, that's gonna provide the positive outcome, right? Well, that's certainly, you know, in a lot of situations like that, it's not really lucrative from a pharmaceutical perspective. And we know how intertwined they are into the hospital -based systems and the medical authority. They're trying to get more and more drugs prescribed, and this is how they're training physicians. So we know that's a piece of it. I also think there's just a marginalization.

of people who are struggling with their mental health. And there are a lot of people who working in these facilities or doing this work who aren't highly trained and aren't the most compassionate or people oriented person that should be in in that really critical and important position when you're working with somebody vulnerable because it takes a lot of patience. It takes a lot of compassion. I think a lot

training on how to respond to a person like that. And you see these overworked healthcare workers or social workers who just appear to be emotionally detached from the emotional suffering of others, or just desensitized to it or in burnout. So like all these things are part of it. You add in law enforcement to this, this is not what they're trained to do generally. Law enforcement is, you know, working, you know, on the front lines of danger and threat.

And so they're approaching everyone as if it's a dangerous and threatening situation. So all this like heightens these negative reactions and response. And it's a systemic problem that is so multifaceted. And then you can go into the training of mental health clinicians and how poorly we are trained to intervene with someone who's suicidal and how poorly we predict whether someone's going to engage in suicidal behavior. I mean, the entire thing is a mess and we require more education.

Roger K. McFillin, Psy.D., ABPP (36:49.643)
We require more rigorous training for those who are going to be involved. again, I mean, if you're going to put people in social services who make low wages, low income and are poorly trained, then you're gonna have poorly outcomes. And then if you're going to have psychiatry being trained in the way that it currently is, whether they're just forcing drugs, they don't really know what else to do.

I mean, you can understand it's just combustible. Like it's an interaction of all these factors.

Rob Wipond (37:21.144)
Yeah, and I want to emphasize to clarify what we're really talking about here, what the numbers are right now, like how much we're not doing what you and I know would be the proper approach, like how much we're doing these kinds of interventions right now that are very aggressive and very counterproductive. And that is that I found that typically for years now,

the folks running 9 -8 -8 have said, oh, it's about 1 to 2 % of the total calls where we do these kinds of non -consensual call tracing and interventions. Well, now a national survey was done by NRI, which is the research arm of the National Association of State Mental Health Program Directors. So very much an organization that's involved in helping create 9 -8 -8.

So we can certainly rely on these numbers a lot. And they actually allowed anonymity, ironically. All the states demanded anonymity to supply this data to NRI. But from this national survey, we now know that in the first year of 9 -8 -8 in 2022, the numbers of these interventions quadrupled up to almost 8 % of all calls. And that's huge.

Like you need to even at one in 2%, I mean, that's one in every 50 callers that have having this happen, right? But now we're up to almost 10%. This is a lot of people having this happen. Doing the numbers, it's almost 400 ,000 people in a year who are having these kinds of experiences. So it's huge. And then I got

more detailed data from a call center in New Mexico because the government in New Mexico required the call center there to actually collect and publicly release data. So this is really rare because it's very hard to get this data. They've been hiding it a lot. And it's really, really interesting. And one of the things you see there is that the intervention specifically on suicidal callers, because only one in five callers is actually suicidal to these lines, people call for many other reasons just to discuss

Rob Wipond (39:32.58)
problems in their lives or get referrals to local services and so on and so forth. But one in five callers are calling to talk about suicidal feelings. And with them, was passing 20 % of those people were getting these kinds of interventions implemented on them. So now your odds, if you're calling these lines, your odds of having this kind of intervention are one in five or potentially higher because that's an average.

get into other states. And we can see some data there where a huge percentage, even higher percentages of the overall calls were getting these kinds of interventions. There were lower states and higher states. And that's part of the story here, is just the crazy levels of vulnerability. Sorry, variability. The crazy levels of variability, which is in some cases up to 80 or 90 % of callers were

The call was not resolved. So some form of other kind of intervention happened by the end of that call, whereas in other states, it's much lower. And we don't know which states those are. So it's really, really concerning what's going on. And I'll just add one other thing. Certainly, there is a movement on politically to get mobile crisis teams, mobile mental health crisis teams to respond to these calls more than police. And of course, that's a good thing in the sense that

fewer people are likely to be shot and these kinds of really bad things that can happen when police respond. And I'm sure that police would rather not have to deal with these kind of calls themselves. So that's good that there's more of a movement on to do this. But the data shows that you're just as likely to end up forcibly hospitalized after these mobile crisis teams visit as in these other situations. So it's not like

really successfully deescalating all these situations or whatever it is they're supposed to be doing, you know, and taking a different approach and connecting people with services. Yes, they're doing all that, but not at such a rate that it's dramatically different than what police are able to do and can do and often do do in these kinds of situations. And in fact, in some cases, it looks like in certain states, it's worse that they're just more likely as mental health professionals to be worried, to be concerned about liability and to kind of go, well, whatever, we're just going to take you to the psychiatric

Rob Wipond (41:53.828)
So yeah, it's really impacting a lot of people and we're really just seeing the tip of the iceberg right

Roger K. McFillin, Psy.D., ABPP (42:00.673)
So from what I understand, there's this company Vibrant and they've partnered with SAMHSA and they've been reluctant to release a lot of this data. Why do you think there is a lack of transparency?

Rob Wipond (42:13.604)
Yeah, and I want to emphasize how reluctant. So Vibrant Emotional Health is a nonprofit that was given the contract by SAMHSA, the Substance Abuse and Mental Health Services Administration, to administer 988. So the two of them together essentially run this line. I submitted both of them 16 questions about two pieces of this, this thing we've been talking about up till now, the forced interventions, but also my other discovery around

how they're also recording these calls and sharing them with corporations for AI development and things like that. So I was interested in both of these privacy invasive elements going on. So I submitted 16 very clear, simple, straightforward questions, questions like, for example, where is your privacy policy that addresses the recorded conversations and what you're doing with them? That's a very logical question to ask. What are you doing with the recorded conversations?

Who are you selling them to? Are you selling? Because on one website, I found them claiming they didn't sell it. So I simply asked them. It says on this little website here that you don't sell the data. Is that true? Is that accurate? Because I found other things that are not accurate. So I just want to know, can you confirm? They would not answer a single one of these questions. They gave me a generic, generalized,

blurb about, do our best to protect people's privacy, blah, blah. But they didn't address any of questions. I wrote back and said, you notice you didn't actually answer any of my questions, right? Like I was that emphatic about it. And that's where we end up. So yeah, they really don't want this information out there. They don't want to engage in public dialogue about it. It's just completely suppressed. And I find that very, very concerning. And I can only assume.

because they won't talk about it. can only assume the reason is because it makes them look bad. And what it does show is that the system is backfiring because as you said earlier, one of the things they pledged, the main thing they pledged with 9 8 8 is we're going to reduce police interventions because these calls won't be going to 9 1 1 more and more will come to us. And because they come to us and we're mental health professionals, blah, blah, we are going to deal with them appropriately and police interventions will go down. And instead what we're finding

Rob Wipond (44:30.222)
police interventions and first responder interventions have increased fourfold. So that should be part of the public dialogue and it's not, it makes them look really bad. makes it look like it's backfiring and then connected to, they also promised more and more privacy and confidentiality. Anybody be able to call any time of day and feel really comfortable. And what I showed, what we can see is that in fact,

There's less privacy and confidentiality on these lines than there ever has been. That data is becoming an increasingly lucrative -looking pool for a lot of different companies and organizations and researchers. And they want to get at it. And other people are seeing that there's money to be made from it. And they are making money from it. And all of this is not being disclosed publicly at

Roger K. McFillin, Psy.D., ABPP (45:22.519)
scary. I have a well founded distrust for government and positions of authority. think history suggests that we should all be very skeptical and concerned about, you know, the role of authority and government in our own personal and private lives. And that's the thing that I'm really concerned. I think what's important for all our listeners to understand is that you can go through a vulnerable period in your life. And that can stay with

the label that's attached to it without your privacy, without your rights being protected, that can now affect you on so many different levels down the line. Some of the things that I've observed and witnessed throughout my career is like, for example, during a divorce proceedings where a woman's mental health history or a diagnosis that was provided by a psychiatrist is part of a court record that's used to restrict her access to her own children. Other things are around

life obtaining life insurance, example. And then there's the biases that exist like when you go into the hospital systems, because with the sharing of electronic records, physicians, medical professionals have access to those records. So if there is a psychiatric label that's attached to it, now your symptoms, whatever you're going in to see the medical professional for, are being now viewed through this lens of you are mentally ill,

has proven to misrepresent or mislabel a lot of legitimate medical conditions as if they're psychiatric. And so these have lasting consequences. And that's without even going down the rabbit hole about what government can do. If any way you're a dissenter or something is happening in your life, maybe it's your use of the internet or use of your social media. And now they have this data on

you know, and how that can be used against you. These things have critical implications, don't

Rob Wipond (47:23.182)
Yeah, exactly. Affirming everything you just said, the implications of simply having a psychiatric diagnosis on your medical record can be huge, and let alone also if there was ever a police intervention involved.

may have just called 911, thought they were helping you. was the police that came. Now there's a police record as well of a mental health intervention in your name. And we have lots of examples of that having huge consequences, hugely negative consequences in people's lives in ways that they just never imagined. One of

ones I talk about in the book is crossing the Canadian US border. So it was revealed that, guess what? And this was people in their 50s who, when they were 15 years old, somebody called in a wellness check because they were feeling a bit suicidal as a teen. Now they're in their 50s. It's all along in the history. But guess what? Oh, that electronic record surfaced at the border because

Police are sharing these kinds of records and people were being blocked from crossing the border because they had this quote, you're a dangerous mental patient implication on their record. And it ended up getting investigated by the privacy commissioner in Ontario and Canada and kind of created a bit of a hullabaloo, but it's not clear that it stopped. In one province, it seems to have been kind of controlled. But yeah, that's just one example of many that we can talk about that are very, very serious.

Yeah, so I forgot what else I was going to say in response to what you were just talking about. But I absolutely agree on the consequences here can be huge.

Roger K. McFillin, Psy.D., ABPP (49:01.803)
Now my mind is go my my god sorry.

Rob Wipond (49:04.74)
Oh, I was just going to talk a bit about how this connects up with what I was talking about earlier now. I recall it was this issue of these recorded conversations. And so we can already see there are dashboards being developed for answering the 988 call. So the call attendants will have these computerized software dashboards that they're working on where the calls are coming in and they're creating records of who the callers were and so on and so forth. And already people are working on linking these

people's health records. And so you hope that's going to be an opt -in option where you will tell them what your name is and your phone number or something gets linked to your medical record. is it going to be? And already, lawyers had asked me, well, what's going on at 9 -8 -8 right now

people say who might be calling to talk about that they're seeking an abortion. Because now that's basically illegal in many states. And you don't know which call center you're getting when you call 988. You might get routed to one in the state you're in or nearby, or if you're traveling and you don't know the laws in the state where you're traveling, you know which call center you're going to get. And now basically the call attendant

Is the call attended a mandatory reporter? If you say, yeah, I'm thinking of going to get an abortion, are they required in fact, to contact police at that point, regardless of what they personally might feel? Because in that state, this is an illegal act you could be undertaking. So I asked that question of vibrant emotional health and SAMHSA as well. They didn't answer. So this is really concerning. If you're a pregnant person out there, I'd say be very, very careful about calling 9 -8 -8.

person who identifies as trans in any way, particularly if you're a child or youth, be very, careful because in certain states, say, confessing that your parents are supporting you in that could be something that triggers police intervention on you if you've called 988. I asked about that as well. They refused to answer. So we have some major privacy and confidentiality problems. And as you were talking about,

Rob Wipond (51:16.9)
potential consequences that can be severe for people that are hovering out there around the use of 9 -8 -8 right now, to which we have no answers.

Roger K. McFillin, Psy.D., ABPP (51:27.351)
So you got me thinking about the use of AI technology. Are they gathering this data as a way of like informing decisions, like how to intervene? I mean, there can be widespread ethical implications here when you start using these technologies in crisis response.

Rob Wipond (51:44.792)
Yeah, it's doubly scary. So as near as we can tell based on the ones we've been able to dig up and get some details on, they're doing both. So they're mining all of these recorded conversations to develop artificial intelligence, language learning systems that supposedly are going to be better at predicting suicide, even though humans are terrible at predicting suicide.

supposedly, we'll be able to train a computer to do it better. It's sort of this weird Aurelian ironic nonsensical thought, right? That somehow, what will it be? A computer will see patterns that we can't. Yeah, but how are we even going to validate this thing? And so on and so forth. just all sorts of questions get raised there, let alone the fact that your privacy has been breached. Nobody's authorizing their recordings to be used for this purpose.

And then researchers are just using it where they're actually literally going in and listening to them personally. So there's cases where people are actually listening, it's not just machinery. And then yes, one of the tools they're developing is a tool that will listen to these calls as they're coming in, as they're happening in real time and flag for the call attendant, hey, you know, the AI system thinks

thinks this person is acutely suicidal. The AI system thinks this person needs a policing intervention. And then you can imagine what happens there. Supposedly, it's just quote unquote advice. But of course, if this is happening, if the AI system is flagging it, it's probably going to put actual pressure on the human call attendant because the AI system is supposedly better than you. And so we're going to see an upsurge. And so that may indeed be already happening.

Canada in the Canadian 988 system, they've admitted that some of the call centers are already using tools like this to actually monitor calls and flag callers for emergency interventions. So they're already using it. I haven't found anyone ready to admit it in America, but we can presume if they're using it in Canada, they're probably using it here as well. And this may be one of the drivers, one of the reasons that these interventions that we've been talking about have been increasing so dramatically.

Rob Wipond (54:04.12)
because I don't know about you, but even though I'm resistant to this, I think if I'm a volunteer on a crisis line and suddenly the language learning system that I'm supposed to be paying attention to because I just got brought in to do it is telling me to do something, I'm going to feel more pressure to do it than if that wasn't

Roger K. McFillin, Psy.D., ABPP (54:24.289)
Yeah, I mean, this ultimately just creates more distrust in the entire system and is going to have the opposite of effect of what our tax dollars are designed or supposedly supposed to do, which is to, you know, improve our communities and improve our responses in the best interest and welfare of people. And so this is going to just create more of a distrust of government and authorities in our communities. It becomes like this big brother

dystopian nightmare that gets ushered in using all the available technologies at the arm of the state. And it's been a slippery slope, you know, over decades.

Rob Wipond (55:05.252)
Yeah, I mean, I find it really distressing, particularly this sort of acute polarization that occurs now, where it's just not allowed into the public dialogue that this happens. Like, we're still dealing with apparently a larger percentage of people are having an OK experience calling 9 -8 -8. OK, sure, we can acknowledge that. There's some evidence to support it. You can find people who say that. OK, great.

But there's also this rising number of people who are having these really, really horrifying experiences. And so if we're going to talk about it publicly, both voices should be allowed. Multiple voices should be allowed. And we're just not seeing that. I've been so upset by the mainstream media coverage. Well, not even just the mainstream, but really across the board. Left, right, center, investigative, sensationalist, whatever kind of publication you want.

They're just sort of putting forth this kind of very propagandistic, positive message about call 9 -1 -1 -8, 9 -8 -8. A lot of them even begin with that message. Hey, if you're in any way feeling distress reading this article, call 9 -8 -8 with no caveat, no warning. But be aware that they may trace your call, right? Which would seem like that's an easy, just added line you could add there to a little more information about that piece of it. But they don't. And I just find that so

concerning that so many people and professionals have bought into this as a, let's just lie. Let's just completely lie to the public about it. And one of the reasons I know they know is because I was on the national press call in the day of the announcement two days ago that HHS held. And so I made a point. I got in the queue to ask a question. And I just made a point of very simply and politely asking, saying, hey, you

policing interventions have increased fourfold. What's your comment on that? Only because I didn't really think I'd get a great answer from them, but I wanted all the other media on the line to hear that fact. And I cited the study so that they could go find it really easily. And so I hope that maybe some of them would cover it. But so far, I haven't seen any of

Rob Wipond (57:23.502)
that have. And so that's what we're up against. That's the real dystopian aspect of this, right? That it's happening and that we're not able to kind of publicly really talk about it honestly.

Roger K. McFillin, Psy.D., ABPP (57:36.457)
Yeah, and don't think there's a lot of trust for the corporate media right now and who they're representing. And so I don't know where the incentive is for a lot of working in in in corporate media. I mean, that's why these these podcasts are so critical. Why someone like you as an independent journalist is so important. Because I think there is an awakening that's happening throughout throughout the United States, you know, around the veil that kind of has existed that

protected these large institutions and you know, the American people are exposed to one narrative and a lot of this important information is just not, it's just restricted from us. And so we have to ask these critical questions. This has been an incredible conversation, Rob, and I really, really do appreciate you coming on. I really think it's important that those who are listening to this podcast are exposed to your work. So maybe you can just let

the audience know what kind of work you're doing right now, where they can read your stuff, even if anything's on the horizon, because I love how you think. And I love the work that you're doing, because it's a lot of critical thinking, you're asking the challenging and difficult questions. And it's around protection of civil liberties and our rights, which is even more and more important as time goes on now with what we're facing in Western societies.

Rob Wipond (59:02.404)
Well, thank you. Yeah. thank you for your voice, too. We need more. We need more of them. Absolutely, I agree. And just more honesty around all of this stuff and more avenues, more access for more people to kind of see different points of view on all of this. And I want to, because we've talked a lot about 9 .8 .8 and the problems there, I want to emphasize for some people that there are some other lines out there that don't do this kind of call tracing.

though a few of them I know, you can research and find out. And I encourage people, like call your local line and ask, do you do this? And under what circumstances do you do it? See what kind of answer you get. Because it just at least flags that people are concerned about it. But we know that Wildflower Alliance runs a hotline that doesn't do this. Samaritans, New York City still

do call tracing. There are some in California. you search for them, sorry, I've forgotten their names right now. But if you search around, you can sometimes find these other help lines, hotlines are available. Trans Lifeline is available. They're actually on a campaign to try to stop this altogether. So you can count on them not doing it for sure. So yeah, there some out there and it's worth looking for. Unfortunately,

There aren't a lot of them, so you may end up in a queue more likely than you will with 988, but they do exist. As for me, yeah, you can find me through my website, which is my name, robwypont .com, my book, Your Consent Is Not Required, is available anywhere, books are sold. I find on Twitter, X, most often, because I get a lot of engagement there compared to some of the other social media platforms. So yeah, connect with me there.

or, and I'm always available through my website. There's a contact form and an email address for anyone wants to reach out and share anything. And yeah, I'm also on Facebook and Instagram, a couple other places, but as I said, yeah, most active on Twitter X.

Roger K. McFillin, Psy.D., ABPP (01:01:02.487)
And if you haven't heard our previous conversation with Rob, it was episode 80 of the radically genuine podcast. was released on April 13th, 2023. And the title of that was, Your Consent Is Not Required, where we did review the book. I read the book. It's excellent. I really suggest that everyone go out and read it if you're interested in this topic and get a better understanding of what mental health really does look like in the United States. There's so much that's pushed by,

The Biden administration for one about pumping more and more money into mental health, pumping more money into mental health doesn't mean we're improving our mental health response. So keep that in mind. I've really been trying to sound the alarm bells on like school -based mental health clinics and so forth.

Rob Wipond (01:01:48.154)
yeah, and that reminds me, asked as well what's on the horizon. One of the things I'm actively working on, if there's any listeners that work in this field or have experience with it in one way or another, I'm really interested in community -based coercion and the increasing of front of that. I do cover it in my book, of course, the different ways that mental health thoughts are being used in different institutions.

But there's this huge world out there of people living in group homes, assisted living, other kinds of sort of small kind of institution -like facilities who are subject to enormous amounts of coercion. And it's very hidden. It's even more hidden than what's behind hospitals, because it's even more poorly regulated and controlled. And it's becoming clear to me that the numbers are astronomical.

how many people are really out there. And so yeah, I'm trying to learn more about that and write about it in future.

Roger K. McFillin, Psy.D., ABPP (01:02:41.796)
Great. Well, Rob, I want to thank you so much today. It's been enlightening and it's certainly been a radically genuine conversation.

Rob Wipond (01:02:51.083)
It does indeed. Thank