What is suicide prevention lifeline like

This post is all about my experience volunteering at the Suicide Prevention Lifeline. While I’m going to refrain from getting into too many details, I will be talking at least tangentially about suicide throughout this post. There’s a chance that something may come off as triggering for certain individuals. Please be mindful and click away if you’d rather not read.

The Suicide Prevention Lifeline is a free, 24/7 service. Help is available in English and Spanish. Some areas are also working to expand to other languages, too. There’s also a text option!

Suicide Prevention Lifeline Phone number: 800-273-8255.

Text program: https://suicidepreventionlifeline.org/chat/

Finally, it should go without saying, but these opinions are my own and do not reflect the opinions of the volunteers, staff, or organization I worked with. Furthermore, I understand there’s been some organizational changes since I’ve left. This experience may not fully capture the current experience for most volunteers.

The Big Decision

Suicide is the tenth leading cause of death in the United States. Suicidal ideation—having thoughts of killing oneself—is tightly connected to feelings of hopelessness. Sadly, like other diseases of despair such as addiction, this sort of ideation is on the rise in this country. In fact, in 2018 alone, there were 1.4 million suicide attempts. The COVID-19 pandemic and its effects has only accelerated this trend, putting us squarely in a mental health crisis. There’s a decent chance that you or somebody you know has experienced thoughts of killing themselves at some point in their lives.

The first time I learned about the Suicide Prevention Lifeline was when I worked in residential life, at college. Someone I knew had thoughts of killing themselves, but I’d always assumed that my only option was to call 911 on them. The idea of getting police to show up at the door and carry this person away in a straitjacket horrified me. It was a non-starter, acceptable only as a last resort. Immediately, I wish I’d known about the line sooner as a possible tool if the person ever felt unsafe.

I filed away the information and refocused on my studies and extracurriculars, which kept me busy until I graduated straight into the Great Recession. Jobs were scarce, especially for fresh-faced Psych grads like myself. I applied to a million different jobs—that number feels like a lowball by the way—and clawed my way into real adulthood.  This idea of volunteering for the Suicide Prevention Lifeline stuck around for years, surviving every excuse I could think of.

“I’m not qualified.”

“Would I be able to handle it?”

“I’ll be tired all the time.”

Eventually, I ran out of excuses.

In order to work in mental health at the level I wanted, I knew I needed to go back to graduate school. But is that something I really wanted? I came to see the Suicide Prevention Lifeline as an opportunity for me to test out my career interests and bulk up my resume, all while serving a good cause. I contacted my local Suicide Prevention Center and, after a couple of interviews, got accepted to their ranks.

Suicide Prevention Lifeline

My eyes just about bulged out of their sockets when I read the training schedule. My precious weekends were going to be gobbled up for a month and a half?! I was working part-time and could afford to be a little busier, I told myself. Feeling a little intimidated and unsure, I jumped into the training.

What I didn’t realize was that I’d treasure my time in that building for the rest of my life.

The Suicide Prevention Lifeline Training

For six straight Saturdays and Sundays, I hung out in a big room with thirty other new volunteers. Bagels, coffee, and watermelon slices were always kept fresh in the back. This layer of homey comfort was like a big warm blanket tucking us in as we rolled through difficult topics. I later came to recognize this casual atmosphere not only as a volunteer retainment tool, but a cultural glue holding the whole operation together. More on that later.

Training began with educational lectures about suicide. The numbers came hard and fast. If a person’s loved one died by suicide, they were six times more likely to attempt suicide themselves. Studies showed that South Korea, a nation with one of the highest rates of suicide, frequently saw a flurry of attempts following suicides by pop stars. This was the first time I understood suicide to be an epidemic, a type of disease that can be spread.

Then it came time to apply that knowledge.

We went through the ASIST program, a strict and regimented certification program for people who want to be crisis callers. In essence, the procedure of a call broke down to a few simple steps: gather information about the person and their whereabouts, assess level of suicidal intent and risk, deescalate risk, and develop a safety plan. Asking about suicide sounds uncomfortable, but it gets easier with practice. Some people believe that asking about suicide may put a person at greater risk, yet research shows this isn’t the case. Asking about suicide doesn’t inject the idea into somebody’s head. It’s already there, or it isn’t. If anything, giving someone space to talk about suicide can come as a huge relief after carrying the burden quietly for so long.

All sorts of speakers came in: veteran crisis counselors, suicide prevention advocates, doctors, and hostage negotiators. They shared fascinating stories, both on the line and through their own work, in which they spoke with people in some of the most vulnerable moments. They said the essence of this work came down a basic principle: sit in the dark with the people in crisis. Don’t contradict them and say it’s all going to be better. Hear them, and together find a way to get through today.

Integrated amongst all these lectures was a wealth of hands-on experience.

We participated in vigorous amounts of role plays, both as counselors and distressed callers. Practicing as a counselor felt a little intimidating at first, but this space was highly supportive. Both the trainer and all the participants graded each other and gave constructive feedback, turning a potentially scary exercise into a warm and productive one.

Surprisingly, playing the person in crisis offered insight on its own. Trainees were given vignettes to act out during role play. These page-long descriptions, listing out how this caller should sound on the phone and relevant parts of their past, were all taken from the stories of anonymous callers. Stepping into the role of these callers and imagining what they may do or say, you start to get an idea of how they’d become hopeless enough to consider suicide. And when you talk with a crisis counselor – even in an office facing away from each other, surrounded by audience—you live the experience through the vignette.

Resistance or questioning by the crisis counselor often entrenches you further in the character’s crisis. Playing the part, you notice that another human being’s validation and safety from alleviates distress. In one role play, I remember trying so hard to keep up the intensity of my depression as the caller, yet I couldn’t. The counselor had so warmly listened to me that I felt comforted and safe. This moment proved to me the power of validation, and informed my own approach on the line.

The last element of training was shadowing actual callers at the Suicide Prevention Center.

The Process

A lot has changed since I volunteered at the Suicide Prevention Center. For one, they’ve built a new building, which in pictures looks far nicer than the one I worked in.

Didi Hirsch Suicide Prevention Lifeline
Fancy!

They were also in the midst of changing the basic protocol of how calls came in to crisis counselors. I can speak to my experience at the time, but it’s no doubt an outdated one. Still, I believe the spirit and work itself has not changed all that much.

As I headed into my first shift watching crisis counselors, I wasn’t sure what to expect. The trainings infused humor and hopefulness into morose topics, but how did that translate to the actual work? How would I feel after sitting through four hours of conversation about suicide?

I remember gasping when I walked into the call center for the first time, and not because I’d just walked up the stairs. The waiting room’s white walls and old carpet would’ve been at home in any office building. Yet there was an unmistakable warmth. A round table at the center of the room carried a box of donuts. Volunteers sat together on the couches, talking and laughing about a TV show they’d watched. Stacks of board games, books, and magazines stood at the ready by the fax machine. The overall vibe landed somewhere between clocking in for work and visiting an old friend’s house. This room brought light and relief between calls.

Taking a call was surprisingly simple.

When a caller contacts the suicide prevention lifeline, they are forwarded to a call center closest to their area. When I was volunteering, a shift supervisor would pick up the phone first. My understanding is that it is now the crisis counselor answering directly. Either way, the caller is first asked to provide a first name, the reason they are calling, and the zip code they reside in (this is for funding purposes). From there, the crisis counselor moves forward from the call.

I shadowed listening in on another line and taking notes for several shifts. Every volunteer came with their own style. Some people said barely a word, working instead to foster a safe space for the caller to get everything off their chest. Others were quite active in conversation, collaborating with callers to paint a picture of where they are, and what they could do next to keep themselves safe. Everybody I listened to was compassionate and present as they helped guide callers through their darkest hours.

After shadowing shifts, conquering role plays, and passing several tests, I finally earned the chance to go on the line to volunteer.

The Calls

Each call followed its own course. The youngest person I spoke to was 10 years old, while the oldest was late in her 80s. Callers from innumerable racial and religious backgrounds phoned the line. I spoke to people suffering homeless in the streets, and suffocating within the stresses of high-profile careers. The vast majority of calls came from people in the surrounding area, but when I manned the texting system, I connected with people from far-off states and countries. Anybody can have suicidal thoughts. In my experience, a conversation usually lasted anywhere between 20-40 minutes. Depending on what was going on, though, I had calls that lasted less than five minutes, and one that lasted well over an hour and a half. For the vast majority of people I spoke to, emergency services were never even considered.

Through every call, I tried to meet people where they were at.

While sadness was certainly a dominant theme of these calls, emotions frequently rolled in all sorts of directions. My goal as the crisis counselor was always to steer them toward a more stable, healthier emotion by the end of the call. In my experience, most people considering suicide feel isolated, hopeless, and powerless. Research backs this up—psychologists found that hopelessness is the most predictive symptom of whether somebody is going to consider killing themselves. People can embody hopelessness in all sorts of ways, though. Sometimes, callers’ words were sucked out of them, like they had nothing to say. Others couldn’t stop talking. Some people, overwhelmed and angry at the world, tried to assert power and control through insults. Many were intoxicated by the time they finally called the suicide prevention line.

Suicide Prevention Lifeline - Isolated

Over the course of the call, I tried to build a safe space. An avenue they could express their deepest fears without judgment. I began to work together with them on building a plan that would keep them safe through the night. A plan could entail anything. Eating a meal or drinking water could be a revolutionary act. You might be surprised by how lack of nutrition and self-care fuels depression. Talking to a friend or family member could be cathartic, and allow them a chance to get support. A great way to stay safe might involve going for a walk, watching a TV show, or playing a video game. Whatever worked for them. After listening to callers, providing support, giving resources, and collaborating on a safety plan, the vast majority of people I talked to remarked that they felt in a better mood and less suicidal.

Some rare calls even led the caller and I to such a place that were able to laugh together. There is an almost spiritual quality to being able to sit with someone in their darkest moments and to share their surprise when they stumble across a surprising light moment.

You never knew what kind of call you’d get.

Prank calls weren’t unheard of. Whenever a Skype number called in, the staff and volunteers in the room groaned and braced themselves for melodramatic stories and threats that turned out to be lies. Worse, callers looking for sexual thrills phoned in from time to time. These were usually pretty obvious— these callers hung up as soon as I picked up the phone. Who knew I had such an effect on people?

Sometimes, people called out of concern for a friend or family member, and the conversation centered around finding appropriate resources and providing support to the caller. We assessed for level of risk as best as we could, but information is usually sketchy when it’s coming second or third hand. If somebody sounded in danger, I encouraged the caller to reach out to emergency services. If the person in crisis sounded distressed but safe, I provided pointers to the caller in how to open up a conversation about suicide and safety with their loved one, and encouraged them to give them the Suicide Prevention line’s number.

Occasionally, we had to call 911 to help. For this, the shift supervisor coordinated with emergency services while I stayed on the phone with the caller. I never hid what I was doing– I calmly explained I was worried about their safety and that somebody was coming to check on them. Sometimes they got furious with me. Other times they felt scared. As always, I heard them out and stayed with them in that dark place until help arrived.

Saying Goodbye to my Suicide Prevention Lifeline Family

Happy together at the Suicide Prevention Lifeline

I’d never planned to leave the Suicide Prevention Lifeline. Circumstances forced the issue. Three years into volunteering, I moved and began my Masters of Social Work program. Suddenly, mountains of homework sucked away my time. Then there was the longer commute. Driving so much and coming home at 1am, just to wake up hours later to start an internship, wasn’t sustainable. With a heavy heart, I quit.

I still think about my time at the crisis center often. The staff and volunteers there were so special to me. I learned so much, too. Not just about mental health, but also life and human nature. People fall into crisis for all kinds of reasons. Listening to people’s most intimate struggles is a privilege I will never overlook. It’s one reason I’ve built a career around helping people as a psychotherapist.

I hope you found this account of my time on the Suicide Prevention Lifeline helpful. If you’re interested in helping out, I’m sure they’d appreciate donations and volunteers. And if you or someone you know is ever having emotional difficulty, please reach out for help.