sure; a ladder-up risk assessment is basically the person you're talking to is going to (in my experience) explicitly ask, "are you feeling suicidal? do you feel like you have a plan to act on this? do you intend to do this tonight?" sorts of questions. you say Yes to all of those (i.e. you go up the "ladder" of the risk to a "high" risk case) then you qualify as an imminent risk. But in my experience you can be quite nuanced/honest--yes, I have a plan, but I don't want to do it tonight--and they will cope. They may request that you put lethal means in another room or out of sight or that sort of thing.
Safety planning is simply "what can you do tonight to make yourself feel safe or feel better?" This is brainstorming. Sometimes it's sharing skills, sometimes it's asking about things the caller has enjoyed in their life and seeing if they can do that, sometimes it's inquiring if someone they know can come be with them. It's a set of specific resources that the caller can do to improve their safety in the moment, essentially. My sense is (since I believe it is true, certainly for me, that a true suicide attempt is FREQUENTLY a result of IMPULSIVITY on some level) that simply talking through options and being more logically minded often helps.
988 says: "The 988 Lifeline does not currently have the capability to directly “trace” callers, chat, or text users in the same way that 911 providers do."... . "In the atypical situations where emergency services must be contacted to prevent persons from seriously or fatally harming themselves, and the person is unwilling or unable to share their location information, 988 Lifeline crisis counselors must provide what information they have to 911 operators–the caller’s/text user’s phone number or the chat user’s IP address–to enable them to do whatever they can to locate the individual." (https://988lifeline.org/faq/about-us/faq-does-the-988-lifeline-trace-callers-texters-or-chatters/) "Geolocation, or receiving pinpoint information for dispatch during an emergency, is not currently enabled for 988 and is not under active consideration." (https://www.samhsa.gov/mental-health/988/faqs#about-call-routing-privacy-network-functioning)
My experience is that this referral to 911 is used QUITE rarely and judiciously and transparently. I've never had them do it for me. I think they conceptualize their role as being a human being extending empathy, offering some basic problem solving expertise, offering a referral to a mental health organization, etc, and not (for the most part) rescuers. It's the suicide AND crisis lifeline; they focus on getting people through the worst emotions of the crisis, whether suicidal or not. You can just call them if you're super upset and are worth their time. And they can tolerate ambiguity well. I do not believe they collect information over time, either, as if building a profile of you.
They would be less helpful over time if they came to be known as the people who simply send emergency services to your home. They want as few barriers to being contacted as possible.
(Just to assert experience, I have attempted suicide 5 times depending on who's counting but woke up in the ED twice and once needed intensive care; at one point I called 988 daily.) It is remarkably easy to NOT have the police or EMS called on you. They will do a ladder-up assessment. And they are transparent in my experience. They tend to look for safety planning instead. They arrange callbacks at other days. Heck, when I was concerned, I believe I even declined to give my name or address and we still were able to talk. They don't want to discourage people calling by making it seem they're just a pipeline to the issues you suggest.
The carceral treatment of mental illness, and the suicidal, has pretty serious problems, which are structural because of society's inability to self-critique social conditions are causing mental illness, but also sensational. I was once locked up without seeing a psychiatrist, given food I was allergic to, and kept longer than I needed to be in order to scam medicaid by charging my presence (a known thing in the industry an investigative journalist for the Nytimes established iirc).
As a factual matter, 988 has an empirical basis.
"Researchers from SAMHSA also examined caller feedback to better understand the effectiveness of the 988 services. They spoke with 437 adults who used the Lifeline; approximately 98% of those surveyed reported that contacting 988 was helpful, while 88% said that the call stopped them from engaging in suicidal behavior." (https://www.pew.org/en/research-and-analysis/articles/2026/07/24/4-years-later-988-suicide-and-crisis-lifeline-shows-successes-and-opportunities-for-improvement)
("Jack Lewars is the founder of Ultra Philanthropy, an independent advisory that helps major donors give for maximum impact, and is the fund manager of its Mid-Stage Global Health Fund. He advises donors giving up to nine figures a year, and is Chair of Trustees at High Impact Athletes.") vs. ("aconcretemoth is unemployed, disgraced, disabled, has been nearly homeless, though has 8 years of college education, and has tried to be the best person he could on EA grounds, a more than reasonable amount of the time.")
(I'm sure this will be called virtue signaling but I really don't care actually; sometimes there are meanings in expressivism. I believe this post is on theme with the Mr. Lewars's sentiments. I am researching AI in general for literacy reasons--I was reading the Pope's encyclical and thought of you--so am probably just visiting).
I am a senior member of the effective altruist community, though new to the forum. I was exposed to EA ideas in 2012 and structured my life around them.
I gave a kidney to a stranger in 2014 and saved the lives of 8 people through the Mayo Clinic.
I aspired to give a portion of my liver but it is unlikely given a mental illness background which came upon me in my 20s.
I donated enough money--mostly gained as a working class or sub-working class individual, who has never made over 60k per year--to be invited as a major donor to TheLifeYouCanSave large donor events.
I studied Derek Parfit and other principles of utilitarianism on my own. I felt that was sufficient to get a move on.
I took in 3 homeless men off the street at various times.
I went off after undergrad into the world informed by but not determined by 80k hours (whose worldview I feel is incomplete) with the goal of becoming a nurse anesthetist. I did the corporal works of mercy.
That career collapsed, due to extreme systemic racism (I could tell you stories) and mental illness.
My sense has been that I may no longer be seen as successful or representative of this community, not being a philosopher, board member, finance type, or AI researcher, that I have nothing to offer it intellectually or in spirit, because I have no access to money or power or prestige or a subtle background in utilitarian problems, nor am I interested (or qualified) in giving out advice or proving the feasibility of a take or idea, and I have no substack to advertise.
I no longer have the power or money to embody EA principles.
But I have lived my life according to some of EA's precepts as a donor and recommender of a certain kind of life, at least to a reasonable extent (less, now). And I think about utilitarianism from time to time. In fact, at the moment, my income is $0 and I have a Class 1 Disability (though I do not qualify for government assistance of any kind nationally or through my state because of how it is designed), and the world has treated me like a dog, in general. I am that race and class of person now whom ordinary people photograph with flash in stores to upload to neighborhood watch sites while I am shopping or getting a coffee. (I am in fact stably housed but certainly downwardly mobile.)
I fell in love with the idea of EA because of a dream of a life lived heroically, frankly-- I see a suffering person and THAT PERSON, RIGHT THERE, is a lens to ANOTHER, SINGLE, INDIVIDUAL person, like myself -- and wanting to help that OTHER person, because I could not help the person in front of me, though I tried to in my career. I knew that person had a name, and I didn't understand their life, so I tried (and it took me too long) to learn a bit about what it might be like, from a radical humility stance. EA seemed to me to be a way to humanize those far away, to be less insular, as a powerful lens on the world, and to redeem something about the world, to enrich my own life spiritually.
It did not seem to be about numbers or computers or philosophical problems. It seemed like a way of empathizing, combined with radical optimism that impressive things could be accomplished, even in a single person's life.
I believe it was an orientation toward power, money, prestige, that make me no longer representative of EA (which would also decline to fund the interventions that saved my life, which is a hard thing to think about); but I recall EA being about a child drowning, once. You should do everything you can to avoid looking like a stooge of the rich and powerful to launder their reputations with charity-washing, and maintain a laser focus that you do what you do because you care about individuals, not numbers or theory.
I mean, a co-temporaneous post is a guy complaining that he should make at least as much as 250k a year for working in AI safety. Well... ok. That seems like a lot of money. I've never had any savings, personally.
Evening. I'm expecting to donate 30k to charity this year. I enjoy the resource on TheLifeYouCanSave.org that calculates your impact in terms of outcomes--8 people saved if money given to the Against Malaria Foundation, etc--but I was wondering if there's a calculator that estimates in terms of Disability-Adjusted Life-Years (DALYs) in a similar way?
sure; a ladder-up risk assessment is basically the person you're talking to is going to (in my experience) explicitly ask, "are you feeling suicidal? do you feel like you have a plan to act on this? do you intend to do this tonight?" sorts of questions. you say Yes to all of those (i.e. you go up the "ladder" of the risk to a "high" risk case) then you qualify as an imminent risk. But in my experience you can be quite nuanced/honest--yes, I have a plan, but I don't want to do it tonight--and they will cope. They may request that you put lethal means in another room or out of sight or that sort of thing.
Safety planning is simply "what can you do tonight to make yourself feel safe or feel better?" This is brainstorming. Sometimes it's sharing skills, sometimes it's asking about things the caller has enjoyed in their life and seeing if they can do that, sometimes it's inquiring if someone they know can come be with them. It's a set of specific resources that the caller can do to improve their safety in the moment, essentially. My sense is (since I believe it is true, certainly for me, that a true suicide attempt is FREQUENTLY a result of IMPULSIVITY on some level) that simply talking through options and being more logically minded often helps.
988 says: "The 988 Lifeline does not currently have the capability to directly “trace” callers, chat, or text users in the same way that 911 providers do."... . "In the atypical situations where emergency services must be contacted to prevent persons from seriously or fatally harming themselves, and the person is unwilling or unable to share their location information, 988 Lifeline crisis counselors must provide what information they have to 911 operators–the caller’s/text user’s phone number or the chat user’s IP address–to enable them to do whatever they can to locate the individual." (https://988lifeline.org/faq/about-us/faq-does-the-988-lifeline-trace-callers-texters-or-chatters/) "Geolocation, or receiving pinpoint information for dispatch during an emergency, is not currently enabled for 988 and is not under active consideration." (https://www.samhsa.gov/mental-health/988/faqs#about-call-routing-privacy-network-functioning)
My experience is that this referral to 911 is used QUITE rarely and judiciously and transparently. I've never had them do it for me. I think they conceptualize their role as being a human being extending empathy, offering some basic problem solving expertise, offering a referral to a mental health organization, etc, and not (for the most part) rescuers. It's the suicide AND crisis lifeline; they focus on getting people through the worst emotions of the crisis, whether suicidal or not. You can just call them if you're super upset and are worth their time. And they can tolerate ambiguity well. I do not believe they collect information over time, either, as if building a profile of you.
They would be less helpful over time if they came to be known as the people who simply send emergency services to your home. They want as few barriers to being contacted as possible.
(Just to assert experience, I have attempted suicide 5 times depending on who's counting but woke up in the ED twice and once needed intensive care; at one point I called 988 daily.) It is remarkably easy to NOT have the police or EMS called on you. They will do a ladder-up assessment. And they are transparent in my experience. They tend to look for safety planning instead. They arrange callbacks at other days. Heck, when I was concerned, I believe I even declined to give my name or address and we still were able to talk. They don't want to discourage people calling by making it seem they're just a pipeline to the issues you suggest.
The carceral treatment of mental illness, and the suicidal, has pretty serious problems, which are structural because of society's inability to self-critique social conditions are causing mental illness, but also sensational. I was once locked up without seeing a psychiatrist, given food I was allergic to, and kept longer than I needed to be in order to scam medicaid by charging my presence (a known thing in the industry an investigative journalist for the Nytimes established iirc).
As a factual matter, 988 has an empirical basis.
"Researchers from SAMHSA also examined caller feedback to better understand the effectiveness of the 988 services. They spoke with 437 adults who used the Lifeline; approximately 98% of those surveyed reported that contacting 988 was helpful, while 88% said that the call stopped them from engaging in suicidal behavior." (https://www.pew.org/en/research-and-analysis/articles/2026/07/24/4-years-later-988-suicide-and-crisis-lifeline-shows-successes-and-opportunities-for-improvement)
("Jack Lewars is the founder of Ultra Philanthropy, an independent advisory that helps major donors give for maximum impact, and is the fund manager of its Mid-Stage Global Health Fund. He advises donors giving up to nine figures a year, and is Chair of Trustees at High Impact Athletes.")
vs.
("aconcretemoth is unemployed, disgraced, disabled, has been nearly homeless, though has 8 years of college education, and has tried to be the best person he could on EA grounds, a more than reasonable amount of the time.")
(I'm sure this will be called virtue signaling but I really don't care actually; sometimes there are meanings in expressivism. I believe this post is on theme with the Mr. Lewars's sentiments. I am researching AI in general for literacy reasons--I was reading the Pope's encyclical and thought of you--so am probably just visiting).
I am a senior member of the effective altruist community, though new to the forum. I was exposed to EA ideas in 2012 and structured my life around them.
I gave a kidney to a stranger in 2014 and saved the lives of 8 people through the Mayo Clinic.
I aspired to give a portion of my liver but it is unlikely given a mental illness background which came upon me in my 20s.
I donated enough money--mostly gained as a working class or sub-working class individual, who has never made over 60k per year--to be invited as a major donor to TheLifeYouCanSave large donor events.
I studied Derek Parfit and other principles of utilitarianism on my own. I felt that was sufficient to get a move on.
I took in 3 homeless men off the street at various times.
I went off after undergrad into the world informed by but not determined by 80k hours (whose worldview I feel is incomplete) with the goal of becoming a nurse anesthetist. I did the corporal works of mercy.
That career collapsed, due to extreme systemic racism (I could tell you stories) and mental illness.
My sense has been that I may no longer be seen as successful or representative of this community, not being a philosopher, board member, finance type, or AI researcher, that I have nothing to offer it intellectually or in spirit, because I have no access to money or power or prestige or a subtle background in utilitarian problems, nor am I interested (or qualified) in giving out advice or proving the feasibility of a take or idea, and I have no substack to advertise.
I no longer have the power or money to embody EA principles.
But I have lived my life according to some of EA's precepts as a donor and recommender of a certain kind of life, at least to a reasonable extent (less, now). And I think about utilitarianism from time to time. In fact, at the moment, my income is $0 and I have a Class 1 Disability (though I do not qualify for government assistance of any kind nationally or through my state because of how it is designed), and the world has treated me like a dog, in general. I am that race and class of person now whom ordinary people photograph with flash in stores to upload to neighborhood watch sites while I am shopping or getting a coffee. (I am in fact stably housed but certainly downwardly mobile.)
I fell in love with the idea of EA because of a dream of a life lived heroically, frankly-- I see a suffering person and THAT PERSON, RIGHT THERE, is a lens to ANOTHER, SINGLE, INDIVIDUAL person, like myself -- and wanting to help that OTHER person, because I could not help the person in front of me, though I tried to in my career. I knew that person had a name, and I didn't understand their life, so I tried (and it took me too long) to learn a bit about what it might be like, from a radical humility stance. EA seemed to me to be a way to humanize those far away, to be less insular, as a powerful lens on the world, and to redeem something about the world, to enrich my own life spiritually.
It did not seem to be about numbers or computers or philosophical problems. It seemed like a way of empathizing, combined with radical optimism that impressive things could be accomplished, even in a single person's life.
I believe it was an orientation toward power, money, prestige, that make me no longer representative of EA (which would also decline to fund the interventions that saved my life, which is a hard thing to think about); but I recall EA being about a child drowning, once. You should do everything you can to avoid looking like a stooge of the rich and powerful to launder their reputations with charity-washing, and maintain a laser focus that you do what you do because you care about individuals, not numbers or theory.
I mean, a co-temporaneous post is a guy complaining that he should make at least as much as 250k a year for working in AI safety. Well... ok. That seems like a lot of money. I've never had any savings, personally.
Evening. I'm expecting to donate 30k to charity this year. I enjoy the resource on TheLifeYouCanSave.org that calculates your impact in terms of outcomes--8 people saved if money given to the Against Malaria Foundation, etc--but I was wondering if there's a calculator that estimates in terms of Disability-Adjusted Life-Years (DALYs) in a similar way?