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When You Call a Suicide Hotline

The people who work at crisis and suicide hotlines are there because we want to help. I want to show you some of the basics of our approach so you’ll feel more comfortable reaching out and calling us if you need help. I hope that, by giving you a sense of what to expect, I can help you feel safe about calling or referring a friend.

If you’ve ever watched a TV show or movie where someone calls a crisis hotline, you’ve probably gotten a pretty negative idea of what happens when people call us. I’ve seen films where the hotline workers were smoking dope, where they started talking about their own issues, where they called SWAT teams, where they dared callers to “just do it”. All of which tells me: Hollywood doesn’t know very much about crisis hotlines.

So let’s talk about what really happens.

The Bottom Line

We want to listen to your story. We want you to talk about how you’re feeling, because research and experience show that talking really helps. Most of the time, people feel better after talking, and many of them don’t need anything beyond listening.

We won’t tell you what to do. We do a lot of listening. We’ll help you tell your story, we’ll reflect the things we hear, and we’ll listen with intense compassion. But we’re mostly not going to tell you what to do or give you advice unless you ask.

We want to build trust and help you feel safe. A lot of people have concerns about confidentiality, and wonder whether they can trust us with their stories. Please know that, as a field, we take confidentiality and privacy really seriously.

We want you to be safe. If you’re thinking about suicide, we’re going to ask you some frank questions about it. We’ll ask whether you’ve already taken action on your wish to die, whether you have a plan, etc. These questions help us understand you better, which is our main goal.

We prefer talking rather than sending active rescue. Our goal is to support and empower you to choose life. Sometimes, though, callers are struggling so hard that they can’t keep themselves safe long enough to talk. Hotlines have different policies about what to do in this case—what we call “active rescue”—and whether to send rescuers to help keep you safe right now. Whatever the hotline’s policy, I want you to know that the vast majority of suicide calls just involve talking.

We care about you. At my hotline, one of our core values is that nobody should have to suffer alone. Many of us have been through tough times ourselves, and we want to help—even if all you want is someone to listen and someone to care.

What Happens in a Suicide Call

When you call the crisis hotline, we’ll say hello and start listening. We’ll invite you to tell us how you’re doing and what made you call us today.

During this time, we’re trying to establish a rapport with you so you’ll feel comfortable talking with us. We’re also trying to get a sense of how acute your crisis is right now—is it bad enough that you’re thinking about suicide?

If the answer is yes—if you’re thinking of suicide—we’re probably going to ask a few quick questions to ask whether you’re in immediate danger. If there’s a medical emergency, we want to help you deal with that right away. We want to make sure it’s safe to spend some time together, talking about how you’re feeling.

Assuming that you’re not in immediate danger, we’re going to get you talking about how you feel. What’s been happening in your life? What’s brought you to the point of calling a crisis hotline? If you’re thinking about suicide, what’s making you hurt so much right now?

One of the key factors in our training is that we’re not going to try to convince you to be happy. We do believe that most people have reasons for staying alive mixed in among the thoughts of dying, but we’re not going to focus on them right away. We want to hear the hard stuff. We want to give you a chance to talk about why you want to die.

We believe that it’s important to talk directly and openly about thoughts of suicide, and that talking about them lessens their power. We aren’t going to ask you to pretend that you’re not hurting. We’ll ask directly about suicide, and we’ll invite you to talk about why you feel that way.

We’re not going to try to fix you. We’re not going to assume you’re broken. We’re not going to judge you for thinking about suicide. We won’t call it a permanent solution to a temporary problem, and we won’t label you. We’re going to meet you in that dark place and, if you let us, we’ll join you in looking at the tough stuff. You don’t have to deal with it alone.

Often, talking is all people need. Something starts to shift as you get a chance to tell your story and be really heard, and the thoughts of suicide start to recede.

Once you’re starting to feel better, we’ll probably talk about a safety plan for you—people who can help you stay safe, what to do if you start feeling worse, that kind of thing. The goal is to empower you, leave you feeling like you’re in charge, and equip you for staying safe.

If talking isn’t helping, we’ll work together to figure out what else needs to happen. As before, we want to support you in getting whatever help you think you need. Sometimes we’ll offer ideas; other times we’ll help you plan for getting additional help. This is different for each person.

Most of the time, talking is enough. People start to feel like they can carry on for a while longer. Sometimes that’s measured in years; sometimes in hours. We want you to know that you can call us back if you need to. We care about you.

If you’re struggling, I hope you’ll reach out and talk to us.

How to Get in Touch

Many communities have local hotlines: Google for “crisis hotline” or “suicide hotline” with your town or city’s name.

National hotlines:

  • In the USA: you can call the National Suicide Prevention Lifeline free from anywhere at 1-800-273-TALK.
  • In the UK: you can call the Samaritans anytime, 24 hours a day, 7 days a week, on 08457 90 90 90.
  • In Scotland: you can call the Breathing Space phoneline, which is available 24 hours at weekends (6pm Friday – 6am Monday), and 6pm – 2am on weekdays (Monday – Thursday), on 0800 83 85 87.

National online chat resources:

Want to read more? Check out my other articles about suicide and crisis hotlines.

Hotlines exist all over the world, and they’re all a little bit different. We’re all here to help you, but specific policies and approaches may differ. The methods I’ve described here are common for suicide hotlines here in the United States, but results do vary. If you’ve called a hotline and found that it didn’t match your needs well, I encourage you to try another!

If you’re struggling, please reach out to one of the resources listed above rather than leaving a comment—I don’t check the comments immediately, and I want you to get help sooner rather than later!

Want more? Check the index or these recent/related posts:
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6 thoughts on “When You Call a Suicide Hotline

  1. Beautiful, Hollis! I think you’ve described the things that all crisis line workers hope to provide when people are struggling.

  2. What a great description…I hope that there are pamphlets or other kinds of literature which can be given out with this information in them.

    One thing I did not see you mention is medication. I would think that a person would and should be asked what medication(s) they are on. And if they have used or are using drugs such as heroin, meth, pot, etc. — in confidence of course.

    In particular, I think it’s important to know if a person is on antidepressant medication and if they are, how long have they been on it. I say this because I was on an antidepressant for several years and attempted suicide three times. Turns out, it was the antidepressant causing my depression! Once I got off of it, I returned to my normal crazy self, but I have not had any suicidal thoughts since then. I know this kind of reaction occurs mostly in teens and young adults, but I was unlucky enough to be in the small percentage of older folks who have this side effect when taking an SSRI antidepressant.

    It would probably be very difficult to ascertain whether this is going on, but if a caller is a teen or young adult and has started taking an SSRI and has somewhat uncontrollable thoughts of suicide, this possibility must not be ignored.

    I offer these thoughts up so that others may possibly benefit from my experience.

  3. I’m a person with mild depression and I don’t really care about my issue with death. But I am aware of the fact I am a danger to myself in certain times. I feel like every day of my life is a waste of time and I am never going to reach my dreams or impact anyones life for the better. So what else can I do wait until I die or do it myself because in the end does it really matter to anyone?

    1. Hi Joe,

      Thanks for writing in–you matter to me, and to us. I appreciate the time you’re taking to write. I’d love to encourage you to try talking to some folks about the way you feel, whether that’s a counselor or one of the national hotlines (1-800-273-TALK) is a good bet. I don’t always receive website comments right away, so I’d recommend giving one of the hotlines a try!

      Other than that, though: how would you like to impact people’s lives for the better? I find that, when I’m not sure what to do, it often helps to spend some time clarifying what I really want–the answer frequently arrives as I’m in the middle of typing or talking with someone. If you’re not sure where to start, maybe try volunteering locally on something you care about. It’s a good way to meet people and share excitement while, as you put it, making an impact.

      Good luck, and thanks for writing!
      Hollis

  4. are you aware than due to many helplines having an “active rescue” policies many people who could benefit from their services in times of crisis (including me) now refuse to use them?

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