The Fire Department cannot force you to do anything. However, the police department can. The transport in the ambulance is called an "IVT" or InVoluntary Transport. This is used then the patient cannot be trusted to make judgements in their own best interests.

A good example of a person who might not be thinking clearly is one who walks to the Aurora Bridge and then uses the emergency phone to try to chat with someone about his student loans.

This is crap. Any time you say ANYTHING about self-harm to Emergency Services personel, you can expect to end up at a hospital. The idea is that field personnel do not have the training to evaluate the mental fitness of the individual in question. Should they, in fact, let someone go - someone who later kills themselves, they would be liable for that death.

What the hell were they supposed to do in this circumstance? Let the guy who used the suicide phone go free to wander around the Aurora Bridge some more to see if he came up with any better ideas?

Ambulances are expensive because no-one in this country has health insurance. Fewer than 30% of the people in Harborview's ER have any insurance at all. Just think about how much more expensive a burrito at Taco Del Mar would be if 70% of their customers walked out without paying - and then factor in the occassional customer who just randomly sues them for a few million. You'd probably end up with a pretty fucking expensive burrito.

This guy was an idiot, and on paper this is a classic cry for help. Debt is a classic trigger for suicidal ideation.

What the fuck ever.