A Lifeline: Reflections from a Suicide Hotline Responder
Far and away the most interesting aspect of working on a suicide hotline is the stories we hear. I wish badly to share them with you; it would be the easiest way for you to understand what the hotline is like. Besides, if I were the one reading this article, I’d want to hear those stories, especially if when you hear “suicide hotline,” you picture what I first did: tense middle-of-the-night calls talking people down from the edge. For the sake of the callers, however, their stories are confidential, as they should be.
I also wish I could tell you about the hotline through my experiences as a volunteer. I’ve come to take pride in the fact that I chose and did this work, especially at my age. Yet despite these points of pride, it would be a dishonest glorification of my experiences if I did not say how much stress, apprehension, insecurity, and guilt it has caused me.
But to focus solely on my own challenges and strengths would – I strongly believe – contradict the very essence of the hotline. The hotline is not about the volunteers and staff; it’s about the callers. It’s hotline policy never to talk about ourselves or answer any personal questions. Moreover, my challenges in working on the hotline pale in comparison to the struggles of the callers themselves. And so – while I will share anecdotes and opinions along the way – I cannot allow myself in good conscience to sit here and tell you only about my own relationship with the hotline.
Being unable to discuss in depth neither the callers nor my own experiences, I am left to discuss the hotline itself. Our hotline covers one county. Volunteers cover the majority of the shifts day-to-day, while staff members cover the rest. There is always a staff member on call (though not always in person), for any difficult situations that volunteers may need help addressing, or processing afterwards. On-call staff make the hard decisions about what steps to take in certain high-stakes situations, especially centered around when to send police intervention to ensure the safety of a caller. However, once a volunteer or staff member picks up, he or she doesn’t pass the phone; the call is theirs. I remember early on in my duties, I came home and told my mom I had gotten a really difficult call that day, and she asked if we didn’t pass those off to staff. My response: “no, Mom, I’m it.”
So far, I have referred to the hotline as if it were a single unit. However, in reality the hotline is three lines. First and of lowest priority is the county’s hotline. The hotline is a catch-all; anyone can call about pretty much anything. We get a diverse range of callers, from mental health professionals in search of more resources to help a client, to someone who is lonely and seeking connection, to people searching for the number of some organization you would not expect someone to call a hotline about. Over time, the hotline has developed a diverse cast of regular callers. Regular callers are frequently people who are lonely and live more isolated lives, and often (though not always) struggle with a chronic mental illness. I still haven’t met all of the regulars, but many of what used to be vaguely familiar names became voices I recognize instantly on the phone, and my calls with them went from being uncertain to somewhat routine.
Regular caller or not, however, there are limits. Hotline policy is firm on a few key things. For one, we don’t allow cursing or overly graphic descriptions of sexual interactions. As mentioned earlier, we don’t answer any questions about ourselves or express our own opinions. Most importantly though, hotline calls should not last more than 20 minutes and callers cannot call more than once a day. Of course there are exceptions, but only if there’s a good reason. The policy is in place to set a limit on caller’s dependence on the hotline. The hotline is not a replacement for friends, family, or professional mental health services, and – according to our training – research shows that 20 minutes of talking with someone is long enough to provide some emotional relief. Certain regular callers sometimes get very frustrated with this policy. Most volunteers, including myself, have gotten an earful on that one at least once. But the policy stands nevertheless.
Our second priority line is the county’s youth hotline number. The line gives children and teens a resource devoted specifically to them. If the youth line rings, volunteers must get off any hotline call they may be on to answer it. However, I have seen a call come in on that line only a few times and have never answered one.
Our final and highest priority line is the lifeline. Calls coming in to the National Suicide Prevention Lifeline that have our area code are directed to our particular center. Volunteers must get off all other calls to pick up lifelines. You get three rings to answer it before it bounces to the next center, and so on, until a center can pick it up.
Lifelines are different than other calls. While it’s usually best to keep a call close to 20 minutes, lifelines can go on as long as the call specialist deems necessary. My personal record is a little over 40 minutes. And – not surprisingly – they tend to be higher stakes. While there are a few regulars, lifeline callers tend not to be repeat callers. Lifelines can be third party callers, someone struggling themselves, or someone who just wants to talk to someone and is in no danger. You never know what it’s going to be until you pick up and start talking to the person.
Back in the day, before I had gotten a lifeline, I awaited my first one almost eagerly. I had trained for 52 hours to do this work and wanted to feel like I was making the biggest difference I could. I also wanted the challenge.
I was an idiot. To put it simply, lifelines are hard. The day I got my first lifeline, I was alone. It was a Saturday morning shift; I had gotten up early for it and I was tired. After speaking with a couple regulars, I had texted a good friend saying how I just couldn’t do it today. Within 30 minutes of sending that text, I got my first lifeline. After the call, I couldn’t sit still. I circled the hotline room, pacing back and forth, jumping up and down. Then I got a second lifeline. Soon I was checking the clock every ten seconds waiting for the next shift’s volunteer to arrive just so I could see another person. When he finally came, I went home, blasted my country music in the car, laughed it off, and thought I was fine. That night, I hung out with two of my best friends. But I just couldn’t focus on them. I was quiet and distracted. I didn’t realize what was wrong until they finally called me out for being on my phone all night, and I broke down crying on a public bench. When I started to explain why I was crying – not knowing the answer myself until it spilled out of my mouth – all that came out was how stressful the lifelines were. Looking back on it, in comparison to calls I was to take later on, neither of the lifelines I took that day were particularly difficult. But let me reiterate; lifelines are hard.
That day was not the only day I cried because of lifelines. In training, they told us that while you’ll always feel your heart beat a little faster when you see that line light up, the nerves will lessen over time. When I heard that, I couldn’t imagine ever reaching that place. For better or worse, however, they were right. Lifelines will always be hard; but they get easier. For better or worse, you get a little tougher. I’ve always been one for sarcasm, and I have found myself on more than one occasion joking to a close friend or parent, “what’s a day without a little suicide?” The fact that I can crack even this feeble joke scares me sometimes. I desperately do not want to become calloused to the kinds of distress that lifeline callers experience; it feels inhuman. Yet at the same time –given the emotionally taxing nature of the job – I feel it is crucial that call specialists learn how to (when appropriate) maintain a light attitude, for their own sake.
Now with this discussion of lifelines, there’s at least a chance that you’re thinking something along the lines of, “shit, I could never do that.” The truth is, though, that I bet many of you could. Sure, it’s definitely not for everyone. It can be stressful, emotionally draining, and the techniques don’t come naturally to everyone. My volunteer class started with nine students; we finished with four. The average completion rate of our hotline’s training is 50%. But while there is no script, we are thoroughly trained and the skills that we use are simple. I believe it is about developing the selfless mindset more than anything else. As a call specialist, everything is about the caller. At first, this can be an incredibly hard mindset to adapt. As humans, we naturally talk about ourselves. If you don’t believe me, try even an hour of conversing with others without mentioning yourself once. At first, it’s really awkward. We roleplayed this skill a lot in the first couple of classes, and there were a lot of pauses, pained sighs, and nervous giggles.
In the beginning stages of training, we develop this selfless mindset and learn the building blocks to being a successful call specialist. On the first day, I thought these skills were a bit frivolous. I thought the hotline was a complex map of if they say this then you do this and if they claim that you ask this. I didn’t think we would be given so much freedom. Contrary to my expectations, however, the majority of what one says on the hotline is just using building block skills. These skills are at the core of every call we take, including lifelines. Without them, you really cannot get anywhere in a call. The building block skills are as follows: no judgment; expressing genuine curiosity about the caller’s life; exploring the caller’s issues through open-ended questions (questions that cannot be answered with a yes or a no); strategically normalizing caller’s feelings in order to make them feel less alone in their situation; verbally acknowledging that we are listening with things like mmhmm; keeping the focus on the conversation on the caller by deflecting questions about ourselves or our opinions; and most importantly I believe, reflecting both the feelings and strengths of the caller that we hear back to the caller so know they are understood and so they can realize their own strengths. These skills all aim to focus attention on the caller and provide supportive listening to them.
Once we master these basic skills, we get more specific training on a variety of crisis and mental health situations, especially suicide. While I will not and could not tell you every single thing we were taught in that more specialized training, I will convey arguably the most important takeaway: contrary to what some may believe, studies have shown that you cannot give someone the idea of suicide. Therefore, if you have reason to suspect someone is in danger of harming themselves, you can ask directly if he or she is thinking of attempting suicide. Given that one of the essential role of lifeline calls is to assess and ensure the safety of the caller or third party, this simple fact is incredibly important.
As we complete more specific training, we also receive two rounds of role-plays in order to make sure our skills are strong enough that we are safe to put on the hotline. We also have training shifts, where we observe other volunteers and then later are observed ourselves. Assuming we pass both roleplays, we are finally released onto the hotline to pick our shifts and begin our full responsibilities as a volunteer.
I could discuss the hotline for hours on end. It’s been an incredibly meaningful experience for me. The hotline has given me a new sense of confidence. I’ve come a long way from my early days as a volunteer. I may look like a deer in a headlight when I’m hostessing at a restaurant, but at age 19 I’ve handled crisis situations that many adults never will. I’m incredibly far from perfect at the job, but I know I’ve helped people. But more than anything, the hotline has humbled me. I came into the hotline arrogant. I don’t know if I’ve ever been so humbled. The hotline has completely evolved how I view those suffering from mental illness, because as much as you know objectively that you should not do so, it can be so easy to let a person’s mental illness color how you view the rest of his or her life. The hotline has taught me how wrong this is. Every caller is so much more than their mental illness and I have tremendous respect for each of them. The strength and hope they show in so many calls –often in the face of challenge – is truly beautiful. And my coworkers, the volunteers who take their calls, are amazing in their own right. Each is down to earth and kind. Everyone just puts their head down and does their job. And man can their job be hard.
I know I’ve written about the hotline in near angelic terms that may seem over-the-top. And it might be. Certain callers are jerks, others have had the same conversation with call specialists for the past 20 years, volunteers sometimes make mistakes, and some days I just wanted to go home. But I speak so highly of the hotline because I truly believe in its work. At the end of the day, we make a difference. And at the end of the day, what we do more than anything else is just listen.