Suicidal Ideation in Virtual Support Groups
by Storm A.King
May, 1995
Cite as:
King, S. A. (1995). Suicidal ideation in virtual support groups. Retrieved [fill in todays date here] from the World Wide Web: http://www.concentric.net/~Astorm/suicide.html
Abstract
This paper is an overview of the occurrence of expressions suicidal ideation in cyberspace communication. The construct of Virtual Support Groups is defined and proposed as the context in which most cyberspace suicidal ideation occurs. The areas of national and world wide communication networks with the highest expected frequency of occurrence of this phenomena are reviewed. A case study from my participant observations is presented, in which the positive outcome resolution is know. Specific occurrences of electronically communicated suicidal intentions and the context in which they occurred are analyzed. The ethical considerations and moral dilemmas faced by the viewers of cyberspace suicide notes are discussed. Selected recent cyberspace discussions amoung professionals likely to encounter, or be called on to deal with, such notes are included. An attempt is made to clarify the possible qualitative differences between expressions of virtual psychopathology of this kind and that encountered in traditional settings.
Introduction
A new form of group support is rapidly growing in popularity. The
information superhighway now makes it possible for people to share ideas and feelings across vast distances and with enormous numbers of other people. Many forms of virtual communities have grown within the tangled web of
cyberspace communication (Rheingold 92). The ease with which special interest virtual community groups form is astonishing. It is a reflection of the nature of the information highway itself, where geographic distance is reduced to an illusion. The ability to find ones peers, no matter how esoteric ones interests are, is a phenomena that heralds great social change
.
An increasing number of these new virtual communities are Virtual Support Groups (VSG). These groups are focused on a mutually recognized need for emotional support and feedback. Members offer each other encouragement in dealing with a medical or mental affliction that they share in common with other members of the group.A seminal study of the psychological elements in virtual networks correctly concluded that the communication of intimacy was problematic in this medium (Kiesler 1984). The subsequent formation and growth of VSGs requires a revaluation of this, for the context in which these text-based communications occur is qualitatively different than the groups existent in that study. Members join these groups today for the express purpose of
gaining access to others insight, experience and emotional support. A large number of VSG are populated by members who participate in real life support groups, especially 12 step based ones. They bring to the VSG an expectation of finding a mutually caring and supportive environment, similar to that in live groups. This bias makes the interpretation of text more personable. The social norms of a genuine and an emphatic communication style carry over into virtual group sharing.Many people facing chronic medical problems avail themselves of this ability to connect through cyberspace to others that have the exact same condition. VSGs exist for conditions that range from commonly occurring disabilities to rare, infrequent diagnosis. There are VSGs for cancer, and for tinnitus (ringing in the ears). Members share their successes and their disappointments that come from dealing with their affliction. The
level of concern for each other shown by participants who have never seen or heard each other in person is a phenomenon that begs future study. The therapy inherent in the exchange of experience, strength and hope on these VSGs seems to be real, valuable, and, in many ways, unique to this format (King 1994).Some VSGs are devoted to topics more commonly associated with psychopathology. People with depression, victims of abuse and people in recovery from addiction all have many forums in which to share. The interactions and replies are generally of a benign nature. The notes that get the most attention are the ones that speak loudly of angst. VSGs with titles like alt.psychology.help exist, for the sole purpose of allowing users a place to express needs and feelings. Much of the writing on these groups reflects a disturbed or distressed state of mind. Pleas for help and assistance occur on a regular basis.
Suicide is the eighth leading cause of death in the United States
(Winokur, 1992). With the phenomenal growth in cyberspace participants in recent years, it is to be expected that some percentage of on-line people will be suicidal at any given time. There are a few forums in cyberspace that are specifically set up as being focused on suicide ideation. The IRC channel #suicide is an active, long-standing forum that attracts depressed individual wanting to share in real time. The UseNet group alt.suicide. holiday is possibly the forum with the highest frequency of suicidal ideation. The extent to which these few groups specifically devoted to suicide function as complete VSGs is unknown at this time, but my review did show that many of the suicidal posters were being replied to in a supportive manner by others not currently suicidal.Case Study
I am a participant/observer in a VSG that is devoted to the support of recovery from addiction. In September 1994, one of our members got drunk after 4 years of continuos sobriety. Within a week, he became suicidal. This is a very cohesive VSG. It has been in existence for nearly a year at the time of this incident, and had well over 100 members. This list is closed, only people in recovery can join. A person must request to be added to the list, and then they are asked, in a polite manner, to write an introduction to the group mentioning their affiliation with a recovery organization prior to being added to the list. There is even a separate business list for members to discuss the workings of the group. The messaging rate runs between 5 an 15 notes posted a day. There were several occasions when the supporting software responsible for distributing group notes went down for a few days, precipitating a flurry of notes that indicated the daily messages were dearly missed by some group members. Several of the factors that help define the construct of VSGs are reviled in this case study. There is a core group of about 20 members that are on-line frequently and always respond to pleas for emotional support. The positive transformational power of participation is frequently remarked upon in the notes posted. The exchange of notes that occurred between "Ray" (not his real name) and the other members of the group demonstrates the depth to which members of this group view it as a source of emotional support. Ray reported his relapse to the groups as follows;
"It's happened and I drank at home last night. I have always been honest .. ...as you all know my attitude sucked...I let a lot of resentments build up and simply came home from work yesterday and proceded to get drunk."
Over the next few days, many notes were posted with comments such as "Thanks for your sharing. I want you in the program. Please stay." and this one;
"Hey (Ray), thanks for sharing. I was just getting ready to call it a day and you certainly made my day. I hate the slow days, when there isn't very much posting and to hear someone having a tough time, that is all I need to make me grateful and for me to hang in there and give what support I can. That is what it is all about. You helped everyone of us. Just keep on keeping on."
Ray then choose to go visit a member of this on-line meeting, in an attempt to get help. He posted in from the house of this member the following; "This is me (Ray) It took everything I had to get to (name of town deleted) to see Peggy (not her real name). Got booted off a plane for intoxication. I need to talk to Debbie (not her real name) when I get home. I'm dying a slow death from this disease. This is Ray talking from Peg's house..."This reference to dying was the first clue that the group had as to the desperate state of mind that Ray was in. It must be evaluated with the understanding that the majority of members perceive their condition to be life threatening if untreated, and that it is commonly assumed in this kind of group that to drink again is to risk death. No reaction to this reference to death in this context was forthcoming. The next note posted to the group from Ray that day showed the existence of a suicide plan.
"I had a twenty gauge shotgun in my mouth and it was either fly out and connect with my friend Peg, or pull the trigger. I am trying the best I can to stay sober and to stay alive."The next day, the actual suicide note came in.
"yI am hhome with my 12 gauge.......Iamvery sorry for my ----typos. Therev comes a time in all of our lives when kicking that one final drunk becomes intolable......I can not go on. Seeing-double at my keyboard .... I have lost everything I choose to live for, My trip to Peg's wascfine. ICONLY HOPE SOME DA Y YOU WILL br privvliged enough to meet Peggy. I am just one of the" hopeless thank you (Peggy)................good-bye (name of on-line group).....Ray."
The "I can not go on" and the mention of the 12 gauge were an obvious references to intentions to suicide. The emotional impact of viewing this kind of note can not be overstated. Ray was not some stranger, he is known to this VSG, having posted to it regally for some time prior to this. The approximate 100 people in this group knew of his depression and had witnessed the progression of it. There could be no doubt of the seriousness of this situation. The feelings of helplessness generated in the viewers are noteworthy, for the possibility of direct intervention by members is precluded by the nature of the medium. The notes that followed clearly point out this frustrating dilemma.
"Would someone like to respond to the fact that we received what amounts to a suicide note from Ray? Would someone who knows him please call this in?"
"Yes, his note really freaked me out. Ray, please write back and let us know you're OK..."
"You don't have the right to do this, Ray. You don't have the right to decide that the world doesn't need you, that your family doesn't need you, that we in (name of group) don't need you. And you certainly don';t have the right to scare the shit out of us with the suicide note. All we ever are is the sum of all the feelings, thoughts, and attitudes of each of us. You count, you matter, and you can't decide that you don't."
"I'm scared to death---and Ray, I'm scared to death for you. I don't want you to die"The name of the town where Ray lived was part of the signature file at the end of the note. This information was used by a member of the group from a different part of the country to contact the local police. "This is a suicide note, folks. Is anyone close enough to (name of town) to check on Ray in person? Peg or anybody else, do you have his street address. I called him as soon as I saw his message, but got his machine. I also phoned the (name of town) police and asked them to check on him, but his address isn't listed in their reverse directory."
As other members logged on the next day to check their mail from the group, more replies came in that demonstrated the shock and distress caused by the suicide note.
"Please, somebody, let me know what is going on. I hope (and pray) that this is the booze talking. But my tummy is lurching just the same. I HATE being powerless! My first husband stood in front of me and shot himself in the head with my handgun. What can I do??? I am responsible when anyone anywhere reaches out to AA....come on God!!! Ray? Are you there?"
Finally, a note of explanation was offered from Peg, that informed the group as to Rays current status, as best as could be determined at that time
.
"I heard this morning from Ray's sponsor, Jack, that he is in custody somewhere -- someone called the police and they went to his house and took him away. So, for now, he's ok. Or rather, he's not dead. I think they took him to detox, but I'm not sure as Jack called me very early and I was alittle out of it. Anyway, thanks to whoever responded to his suicide note, I think it might have been someone from this group because Jack said that
the call to the police came from ..(ten states away). I have to go to work. Pray for him"
"First - thanks to Peg for letting us know that Ray is somewhere where he can't hurt himself for now. I felt shocked, and saddened when I read his message, and then reassured when I read the subsequent messages. I'd say this group apparently showed solid action in responding to his message."
"Thanks, Peg, for the update on Ray. My heart froze when I read his note, followed by (name of person who called police)' quick response. What an unfortunate/fortunate reminder for me."Finally a note came in from Ray;
"Just got home from the nut - house on 5 day hold.....I want to check my (name of group) mail...........I love you guys....I AM SOBER TODAY. GOD what a nightmare.......still pretty shakey........I am alive and willing. Who called the paramedics and saved my life.... ..? I have to clean my house and then read my mail.......I AM SOBER (name of group)....((( ))) Ray.
For the next several weeks, communication in this group was dominated by discussion of this event. Many members posted in to share their feelings and to offer Ray encouragement.The dynamics of this case represent a new, qualitatively different kind of suicidal ideation expression. Ray was at home, alone. Due to the interactive nature of email messaging, he was able to broadcast his intentions to a large group. The only factors in the reception of that communication are the size of the group and the frequency with which other members check their mail. In this case, there is a substantially large number of group members that read their mail regularly, and someone was sure
to see it quickly.Other Cases
The most common act in a suicide case is the communication, somehow, of intent (Shneidman 1986). The frequency of these electronic kinds of suicide notes will rise as these types of and numbers of VSGs proliferate. The ability to find special interest groups on-line allows people with current psycho pathological and medical conditions to find others that share their state of mind, as well as people who will be supportive. In this overview, I examined Internet UseNet groups, Prodigy bulletin boards, and some IRC channels in an effort to determine which of the thousands of forums available on-line could be expected to have the highest occurrences of suicidal ideation. There seems to be two classes of VSGs that are at most risk of having suicidal members.
One is a VSG devoted to a serious, life threatening medical condition. Aids and cancer are examples, and the VSGs for these conditions are very active. Since Aids and cancer victims are the highest group to request assistance with a suicide (Breitbart 1993), it is reasonable to expect that they are also likely to express this intention to members of their on-line community. Groups devoted to recovery from this kind of debilitating condition tend to be very supportive of each other and have members that post with great regularity. The case study described above, though not devoted to a medical condition in the strict sense of the word, is from this
class of VSG.The other groups that would be expected to attract suicidal members are ones with names that describe a type of psycho pathology. Prodigy has bulletin boards for depression, and obsessive compulsive disorder sufferers. The Internet has bulletin boards with names like alt.support and alt. support.depression. People who are looking for a forum to share their suicidal intention may seek this kind of group, knowing from just the title of it that they are not out of place there.
In the course of doing an overview of these forums, I found the following note;
"I've lurked here for a long time, I have something to say that is important. If you are a lurker who hasn't spoken out, for whatever reason, you need to think again. I've had it. My life sucks big time and I'm going to finish it. But you may have a chance. Don't do what I'm going to do, it will hurt everyone who is close to you. Only if you don't speak out, will it be too much. I should've, but didn't. In the ever immortal words of someone stupid, goodbye cruel world."I noticed that the time of posting was only 10 minutes prior to my seeing it. I experience an emotional reaction, thinking that I was likely in the position to be the first to have seen this. The dilemma of what to do with this information was most easily resolved by deciding to reply, by private email. Here is my reply;
"I saw you recent post to alt.depression. How can I help? I am on-line here a lot, and would be glad to talk to you about anything you wish too. I have been down a few times, it sucks, but it does help to talk about it."
I never got an answer. This incident points out the difficulty in evaluating lethality in VSG suicidal ideation's. There are two factors that are most important in analyzing notes of this kind. One is the level of anonymity of the poster. In this case, the poster was not known to me at all, and claimed to not be known to the group either. This does not mean that the truth of his stated intentions can be completely discounted. This
situation is much more questionable than one like my case study, where the poster is well known. The other factor is the location the note. If this note had appeared on a group not devoted to depression, or in some other way appeared completely out of context to the topic under discussion, I would have been more likely to discount it as a possible hoax.In such forums as the IRC channel #suicide, the interactions are brief and the expectation of "seeing" that person again in cyberspace are minimal. A check of this channel on a late Saturday night, presumably the most active period for this channel, showed 7 people logged on. There was some talk
about how to die in a painless way. One participant asked the others present for suggestions on how to end their life with dignity, without a fire arm. They received several suggestions in reply.The next recent incident shows the possible negative results to the poster of a suicide note. I will start with the conversation after the resolution of the suicide ideation. The following is from alt.society.mental-health, a VSG on the Internet that has numerous depressed people posting notes. It also gets notes from members of the healing professions, such as psychologists and psychiatrists.
"Boy do I hate mental health workers (read fascists). I got committed by Cornell University because I falsely "threatened" to commit suicide on the internet. (Anyone remember the mega-thread "I was kidnaped the by the State ?)"
In reply to this, one member said; "Hmmn, so you threatened suicide in public and are angry that other people responded to help you? Is this not the type of attention you were after? Or more precisely, how would you expect someone to react if you threatened to harm yourself?"This was followed by a long debate that entered into the right to die subject, as well as suggestions on how to handle cyberspace suicide notes. Towards the end of this thread, the original poster replied to a question about his state of mind when he posted the suicidal note.
"Actually, I was neither ill or rational at the time.. I was, however, fairly drunk and missing the woman I was involved with (of course, I suppose someone out there is going to classify loneliness as an illness). I did not consider the consequences of posting the article because, at that time, I felt like I had complete anonymity and freedom on the net. My mistake."Dr. Stevens Report
The next example is a post to a psychiatry email list from a member that has had experience dealing with on-line suicidal posters. I received permission from Dr. Stevens to include his remarks here.
"Through my residency I was very active on the Mental Health section of the GOODHEALTH forum on CompuServe. Towards the end of my training I was the official psychiatric consultant and assistant section coordinator. The topic of suicidality on the part of forum participants arose many times. I also saw, that suicidality in email messages was much more overt than in publicly posted messages. Currently I am director of the Psychiatric Emergency Service at UTMB, and view the messaging of many of the people with whom I interacted as very similar to what is seen in a psychiatric ER. It is especially similar to the phone calls we get, many from callers who will not give their identities. We had one member from Belgium who clearly stated his plan of killing himself with a canister of carbon monoxide gas he had obtained in the course of his work. This was done in the context of begging other members to tell him why he should go on living, then viciously attacking any who attempted to offer help or advice. Nevertheless, many other forum members continued to offer support and good wishes in the face of his abuse. After a time, his threat escalated - he reported having bought a Belgian shotgun, which he described in loving detail. He described in similar detail how he intended to use it on his head. In email he was vicious towards any who offered help and threatened to kill himself immediately if anyone attempted to notify authorities in Brussels. We tried anyway, but none of us was able to provide enough information to the correct authorities to allow any intervention. He has since stopped his threats and his participation on that forum, although he has been "seen" participating elsewhere on the service, apparently doing well. One time, while playing an interactive game on a MUD (multi-user domain) one weekend a young woman participant told me she intended to "try to" kill herself. She described her plans (which surely would have been fatal if acted upon), and her belief that she was in fact a 700 year-old vampire and thus immune to suicide attempts, in some detail. I revealed to her that I was a psychiatrist and asked her to clarify whether she was kidding around or acting "in character" but she assured me she was in earnest. She went on to claim that "everyone" including her parents knew about these thoughts and beliefs but didn't care. She offered her father's phone number and dared me to call him to confirm this. I did call him and he did essentially confirm what she had told me, but did not think her thoughts were cause for concern. I notified the student health center at her university. For a short while thereafter the woman complained to other participants about my "mean" behavior, but has stopped reporting suicidality. Nearly a year later we continue to "meet" online, fairly cordially. I report these cases (out of quite a few) to illustrate the many opportunities the virtual community offers for maladaptive behaviors. These include splitting (treaters vs. virtual community, virtual community members among themselves, etc.), acting out (threats and intrusiveness towards other virtual community members), manipulativeness, and inappropriate venting of anger, frustration, and aggression. There are online equivalents of frotteurs, voyeurs, and exhibitionists. Many count on their anonymity and the impotence of others online to intervene. I think the additional "impersonal-ness" of typing versus telephonic speaking makes the online experience seem even more anonymous to some users. Some seem to use the technology as a buffer between them and their emotions or against seeing the others involved as "real" (thus "justifying" otherwise outrageous behavior). Others appear to view the technology as a barrier to be overcome by zealous and inappropriate attempts to "get close" to essential strangers. Don't get me wrong - I view online services (such as CompuServe, or innumerable resources on the internet) as being of potentially incalculable value to millions of people. The vast possibilities have just barely been tapped. I am concerned, though, about the potential for serious problems
within a huge virtual community of anonymous participants. Cyberspace is an anarchy which for the most part works extremely well, but which contains the seeds of disaster as well. It may be wise for us as mental health professionals to keep these issues in mind when surfing the net. As suicide is of such importance, it may eventually be necessary to develop some consistent strategies for addressing such threats (or ignoring them, if that appears to be indicated)." Mark A. Stevens, M.D, Assistant Professor of Psychiatry, UTMB. (1)Dr. Stevens addresses some of the issues that are critical in understanding the difference between expressions of psychopathology in VSG's and that found in traditional support groups. The seeming anonymity of cyberspace communications that causes people to post without due consideration for
others can be blatant. This occurs most often in groups that do not have a cohesive core of regular posters, or where the distressed person is new to the group.There is a FAQ (frequently asked questions) on how to commit suicide that is posted regularly to several Internet groups. This FAQ is not a joke, it has serious suggestions for how to kill ones self, and is a long document. It's existence and perpetuation is an example of the anarchy in cyberspace mentioned by Dr. Stevens. The introduction reads as follows;
"Hello, folks. This is the semi-famous alt.suicide.holiday MethodsFile. It contains information on many different ways to take your own life. Some of them are serious, some of them are not. Hopefully, you can see which is which by yourself, but I'll try to mark them anyway."
Detailed instructions are given as to the types of drugs and commonly available substances, how to administer them, what to expect, and the amounts needed to be lethal. Descriptions of mechanical techniques, with materials needed, are offered. Some of these methods are described as having the "advantages of being 'accidental', and your family/friends do not have the additional pain and guilt associated with suicides."
There are efforts underway to assist the suicidal cyberspace poster. One is a FAQ, from Australia, that is widely and regularly distributed among Internet groups. It describes prevention and detection measures, and how to best help a suicidal person. A more recent effort has been launched by the Samaritans, an organization in England that works with suicidal people. They have put together a program to receive anonymous emailings from depressed, suicidal people. This is part of the "press" release from that group;Suicide Counseling by E-mail.
When the power and reach of the Internet joins with the caring and compassion of a friend, a new and valuable asset is created. Suicide Counseling by E-mail was launched on July 14, 1994 and proved so successful that an Internet domain was opened. The Samaritans, a non-religious charity in Cheltenham, England, now offers emotional support to the suicidal and despairing via the Internet. At the launch of their new Internet domain, Mike Haines, Director of the Samaritans, said: "During the test month we received over 200 messages. Many were from well- wishers, journalists and academics but there were around 15 very desperate people as well. The need for a full launch of our service with an easier address was amply
demonstrated." In the first 2 months of operation, 48 people in at least 4 countries have contacted the Samaritans, demonstrating the need for the service. Since then, the number of E-mail users has increased to 3 per day and the numbers continue increasing as the resource becomes better known. E-mail's anonymity has helped in the success of the pilot project. Statistically, the suicide rate among males is four times that of females but females are more likely to contact a Suicide Counseling group for help. E-mail has changed the contact statistics and it appears that equal numbers of men and women are contacting the Samaritans. The Samaritans have offered support to the suicidal and despairing for over 40 years by phone, visit and letter and E-mail expands their services to a wider area. Callers are guaranteed confidentiality and retain the right to make their own decisions including the decision to end their life.Is working over the Net good "treatment"? Steve 305 at the Samaritans' help -line says: "What we see is raw emotion and openness from our callers. Some of them would be unable to express their feelings in any other way. It also provides access and privacy for the disabled and geographically isolated. Our confidentiality rules prevent me from quoting what callers have written to us but it would be very familiar to people in the Usenet groups alt.suicide.holiday, alt.sexual.abuse.recovery, etc." (2)
The reference to how e-mail anonymity has helped the Samaritans efforts is indicative of the differences between cyberspace suicidal ideation's and that of more traditional settings. In cyberspace, the exact location of the poster is not known to the receiver. A suicidal member of a VSG can state their intentions to kill themselves and be assured that it would take a considerate effort on the part of the readers of that note to intervene. This could make such declarations of intent much more likely to occur.
Conclusion
There are areas of cyberspace that are more likely than others to be the recipient of a suicide note. These areas constitute Virtual Support Groups, where the members are participating with the expectation of exchanging emotional encouragement with the other members. UseNet groups on the Internet with names like alt.support.dissociation (for people with multiple personality disorder) are frequented by people at the highest risk for suicidal ideation. Support groups for depression, addiction, cancer are existent on all national interactive service providers, as well as local networks. The formation of self identify and social companions in a medium devoid of tactual clues is amazing in itself. The fact that participants in theses forums have such deep feelings of concern for other members is phenomenal. "Today the technology of cyberspace is creating the social situation for the formation of a new understanding of community." (Cutler, 1994) Within these communities are the occasional despondent member for whom life no longer seems worth living. The tendency to share these feelings of hopelessness by means of a written communication to a group of people is a qualitatively different kind of suicidal communication than that studied previously.
There are many issues here that beg for future study. Both VSGs and the occasional suicidal member are understudied at the present time. What are the specific factors that make participating in a VSG more attractive to some and not others? How does the seeming anonymity of cyberspace affect a suicidal note posters willingness to share? Does this anonymity contribute to the amount and quality of shared feelings?
As the participation in support forums continues to grow, so will the occurrences of suicidal ideation and other expressions of psychopathology. The question of how to best meet the rise of such broadcast pleas for help are unanswered at this time.
References
W. Breitbart, ( 1993). "Suicide Risk and Pain in Cancer and AIDS Patients," in Current and Emerging Issues in Cancer Pain: Research and Practice, ed. C. R. Chapman and K. M. Foley. New York: Raven Press, 49-65.
Cutler, R. (1994, Nov.) "Self & Community in Cyberspace" Presented in panel at the 1994 Speech Communication Association, New Orleans, November 21.
King, S. A. (1994, July). "Analysis of Electronic Support Groups for Recovering Addicts" Interpersonal Computing and Technology: An Electronic Journal for the 21st Century Volume 2, Number 3, pp. 47-56
http://www.notredame.ac.jp/ftplib/Articles/CMC/King94.txtKiesler, S., Siegel, J., & McGuire, T. W. (1984). Social psychological aspects of computer-mediated communication. American Psychologist, 39, 10,
1123-1134.Rheingold, Howard "A Slice of Life in My Virtual Community", Published electronically in the Well. http://www.well.com/user/hlr/vcbook/index.html
Shneidman, E. S. (1986). "Some essentials of suicide and some implications for psychotherapy. In A. Roy (Ed.), Suicide (pp 1-16). Baltimore: Williams & Wilkins.
G. Winokur and D. W. Black (1992) "Suicide - What Can Be Done," New England Journal of Medicine 327 : 490-91.
Footnotes;
1. Dr. Stevens's note was posted on Mon, 31 Oct 1994, as follows
From: Mark A. Stevens, M.D.
To: psychiatry@mailbase.ac.uk
Subject: Re: Suicide on the Internet (long reply/case reports)2. The Suicide Counseling by E-mail was from
THE INTERPSYCH NEWSLETTER
NOV, 1994 VOLUME 2, ISSUE 2 as reposted to the
psychiatry-superlist@mailbase.ac.ukThe Samaritans can be reached at:
The Samaritans of Cheltenham and District
3 Clarence Road
CHELTENHA, Glos, United Kingdom
Emergency phone: +44 242 515777
Press enquiries: +44 452 854017
E-mail: jo@samaritans.org
Anonymous E-mail: samaritans@anon.penet.fiCopyright 1995 by Storm A. King
Created and maintained by Storm A. King
last updated 01/2006
