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About every other day, we get a question from a schizophrenic person. By "schizophrenic", I don't mean crackpots or people making elementary mistakes, I mean people with an actual mental disorder. For example, in their posts, they may mention being formally diagnosed with the disease, hearing voices, hallucinating, and so on. Others seem to be in the first stages of developing the disease and report milder symptoms. My impression is that we get more of these people than other SE sites, because a common symptom of schizophrenia is becoming convinced you have a theory of everything.

To preserve some semblance of privacy, I won't be linking any examples.

We always close and downvote their questions, because don't make any sense, and then the Community bot deletes them a while later. Sometimes they receive rather mean comments.

This is in accordance with our established results, but do we have some moral obligation to do better? I fear that downvotes and nasty comments might just make their situation worse. Perhaps it's possible to make a standard "get psychiatric help" comment with some useful links? Have any other SE sites or forums dealt with this?

Edit in response to comments:

  1. No, I'm not diagnosing people as schizophrenic just because they spell badly. I'm referring to posts where people explicitly refer to such a diagnosis. In one particularly memorable post a few months ago, a guy mentioned that his father was diagnosed with schizophrenia and that he had been warned he might be developing it too. The post essentially asked if his hallucinations were real. Some users here left mean comments, and the question got downvoted to hell, closed, and automatically deleted.

  2. I have personally noticed one such question about every month, but upped the estimated rate because these questions are usually downvoted off the main page within 15 minutes. After they pass -5 votes, they become invisible, so you essentially won't see it unless you were one of the first 5 people to.

  3. As further evidence that this actually happens -- we had one of these questions literally two hours ago, and yet some commentators claim that they've never seen such a post. That's how fast they get downvoted to invisibility.

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    $\begingroup$ There was a similar case recently when a user mentioned that they're on the autism spectrum. Someone pointed out to that user that there's very little we can do on this site, and that it's best for people to search for support in 'real life'. (Obviously I'm deliberately not adding links; tell me if it's OK to do so and if it isn't very obvious) $\endgroup$
    – user191954
    Feb 25, 2019 at 16:09
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    $\begingroup$ "a common symptom of schizophrenia is becoming convinced you have a theory of everything" - I could only get a copy of DSM-IV, but it doesn't mention this as a symptom. If you have some specific backing for this statement in the psychiatric literature, please add a reference. If not, then, to be frank, pretending to ascribe psychiatric authority to that kind of interpretation is grossly inappropriate. $\endgroup$
    – Emilio Pisanty
    Feb 25, 2019 at 17:01
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    $\begingroup$ More generally: yes, we absolutely do have a moral responsibility to treat all users, and particularly those with mental disorders, with care and compassion. But that starts by withholding diagnoses like "schizophrenic" unless there is credible evidence that there is such a diagnosis made by a psychiatric professional. (As a baseline: observations made from a user's writing on the internet without seeing them in person, or by someone who isn't a psychiatric professional, are not sufficient.) $\endgroup$
    – Emilio Pisanty
    Feb 25, 2019 at 17:05
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    $\begingroup$ I can't say I've seen many, or even any examples of someone mentioning being schizophrenic. Also, it seems like assuming anyone is schizophrenic based off of questions and responses is well outside of the scope of things we should even really consider IMO. There may be a reasonable question here, but the framework seems to assume a lot of things in a way that isn't beneficial. $\endgroup$
    – JMac
    Feb 25, 2019 at 17:07
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    $\begingroup$ Also, the estimation of some 15 questions/month in your first sentence looks rather inflated to me. This is a problem and an important question to discuss regardless of the actual frequency (unless it were, say, one question a year), but there is no need to inflate those numbers. Have you got observations of that frequency that you can share? (Link only to deleted posts if privacy concerns dictate it.) If it is indeed 15 q/mo, that's pretty surprising and should be examined separately. If not, then that's a pretty alarmist start and feels inflammatory and out of place here. $\endgroup$
    – Emilio Pisanty
    Feb 25, 2019 at 17:10
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    $\begingroup$ Perhaps they've all been hoovered up, but the post you refer to is literally the only one I've ever seen on here like that. And I can't find any on Google either. $\endgroup$
    – Chris Mod
    Feb 25, 2019 at 17:32
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    $\begingroup$ @EmilioPisanty It thought it went without saying that I am not claiming to be a "psychiatric authority". Your snark is rather unhelpful, but I edited to address some of your concerns. $\endgroup$
    – knzhou
    Feb 25, 2019 at 17:40
  • $\begingroup$ @JMac Edited to address your concerns. $\endgroup$
    – knzhou
    Feb 25, 2019 at 17:40
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    $\begingroup$ @Chris It's quite tricky because they get downvoted and disappear from the front page within 15 minutes. I can specifically recall about 10 (they're quite distinctive) but I have no idea how to find them. Obviously, there's no easy way to search for them. $\endgroup$
    – knzhou
    Feb 25, 2019 at 17:43
  • $\begingroup$ @knzhou I'd expect to have seen one in the Close Vote queue by now at least, if they really are so common. $\endgroup$
    – Chris Mod
    Feb 25, 2019 at 17:44
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    $\begingroup$ None of my comments above are snark. As I said in my second comment, the very first responsibility is to avoid irresponsible use of psychiatric terms, and this question, while attempting to help, risks causing harm through that irresponsible use. There is a real and important question in here - I wish you'd remove all the harmful stuff that's currently cluttering it out. $\endgroup$
    – Emilio Pisanty
    Feb 25, 2019 at 17:49
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    $\begingroup$ Just to clarify, I've seen plenty of posts where users attempt to propose their own theories based off extremely flimsy understandings of physics. I cannot recall any specific evidence that they were schizophrenic, or "pre-schizophrenic". This just seems to be based off misconceptions to me. The amount of users who specifically mention being schizophrenic is extremely low; and regardless of if they do or do not say that, I don't think any "get psychiatric help" message will help. If anything it would make such users feel singled out more so than they generally seem to be when we respond. $\endgroup$
    – JMac
    Feb 25, 2019 at 18:09
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    $\begingroup$ As for searching for these questions, the 10k moderation tools lists about two days' worth of deleted questions, and this and this queries contain additional data. This obviously involves a fair amount of manual trawling but the data is there for any 10k+ user to analyze. $\endgroup$
    – Emilio Pisanty
    Feb 25, 2019 at 18:10
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    $\begingroup$ @JMac I thought I said pretty explicitly that I wasn't talking about regular crackpots -- 95%+ of crackpot posts are not of this type. $\endgroup$
    – knzhou
    Feb 25, 2019 at 20:32
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    $\begingroup$ While it is impossible to diagnose someone for laymans from an internet post, the symptomes are enough clear. I think this question could be formulated as "how to handle people showing scyzo-like symptoms" or so. And the answer is that we can not fix them, but we can help them. Maybe it seems a little bit... rude, but it is not: we can politely suggest them to get some expert help. Sad truth is that scyzophrenia can be well treated today, the problem is that most people having this won't ever visit a doc. Beside that, we can also help them with real physics knowledge. $\endgroup$
    – peterh
    May 19, 2021 at 14:32

3 Answers 3

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Do not consider the author's mental (or any other) condition when responding to content on this site. Respond to the content itself. If it's a good question, vote it up and think about an answer. If it's a bad question (e.g. hard to understand) respond with an edit, a down vote, a close vote, or a helpful comment as you see fit.

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I think the following two things are mostly uncontroversial:

  1. Don't leave mean comments. This isn't specific to any particular sort of user at all. If you see a mean comment, flag it. It doesn't matter whether you think the target of the comment is a schizophrenic, a troll, a confused child or Einstein.

  2. Don't diagnose people over the internet, but help where you can. In the cases where the post is explicit about mental illness, i.e. no speculation on our part involved, then it's fine to leave a comment with links to resources that help people in this situation. However, leaving this type of comment on any post where there's inference on our part involved would just be asking for trouble.

Votes are another matter. Every user is free to vote as they like on the content they encounter. Even if there was a self-evident universal moral obligation to not downvote the posts of people with mental illnesses, there would simply be no way to enforce it, so I feel it's a waste of time to debate whether or not there is such an obligation. If you think it's wrong to downvote a certain kind of post, don't downvote it. That's all there really is to it.

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We are not experts in psychiatry, and not even a practicing doc could diagnose someone from a single internet post. He would likely need multiple in persona visits for that. So we can not say from an OP that he would be scyzo.

Furthermore, we can not treat them. Scyzophrenia is treated by a combination of mental therapy and medicines, none of them can we give from the Internet.

Contrary the common belief, in most cases scyzophreny can be treated well since some decades. There were even very famous people living with this sickness. Typically they need to fight lifelong with their own mind, but they can live a nearly normal life.

The symptomes of the scyzophreny are enough well known, even for us. And there are things what we can do, to help both of the OP and the site. Obviously we must do them so politely and non-intrusively as possible.

  1. To help the OP: we can feedback them that his posts/communication is problematic. Most of them can not see any problematic in his views/behavior. If he seems cooperative, we can also politely suggest them to get expert help. This is very important - most people living with scyzophreny never visits a doc.

  2. To help the site: give them real and useful physics knowledge. Do not say them, "your idea is a crap", or close/delete his post. Instead, explain him, what is the problem with his posts, and what is the currently best known scientific reality. Giving them well-connected facts, is not only useful content (for the site), but it also helps them to get a better connection with the reality.

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