IamA suicide hotline worker and suicide prevention specialist at a local nonprofit...AMA!

As someone who has spent some time on the other end of the phone, I want you to know that what you do is awesome and that you really do make a difference.

I've seen on reddit people saying that wouldn't call because they don't want police to come to their house. Have you heard of that?

Also, how hard is it to leave the job at home? You are talking to people at their lowest.

Thanks!

The police are a fairly common concern, and I've gotten into tense situations with some callers because I had to call them, for their safety! There's no really good answer; we have to act based on the information we know about the situation, and if someone presents in immediate danger,(holding a gun and refusing to accept referrals, for example) then we're going to do what we think will keep that person safe. It can be very uncomfortable.

It can be difficult to not take your work home with you. Especially when we work in schools, and see the kind of treatment some of these kids get at home to push them to depression or suicide...it can be very hard. At the hotline we work with at least one shift partner usually, with whom we're encouraged to debrief after difficult calls. I also have a very strong support system of roommates, friends, and hobbies that keep me happy and healthy!

I'm glad to hear you've been able to use a hotline to help. I hope things get better for you. :)

Thanks! My calls were 13 years ago. Things are much better.

I'm very glad to hear that! :)

What are you required to say/not say as a caller to avoid police intervention? I for one know that if the police showed up at my door, I'd feel forced into taking action before they could stop me, even if I might have been okay otherwise. The closest I actually came to suicide was in college when I was on top of a parking garage and a police car approached. I had been just kind of standing in the rain, on the edge being self-indulgent but not really intending to jump. But when that car came by I was suddenly 100% ready to jump if he pulled in. He didn't, he was going somewhere else, so I got down and cried instead, it was incredibly intense and kind of shocked me into a different state of mind. But if he'd pulled in, even by chance, that would have been it for sure.

So I guess my question is, is there some blanket reassurance you can give that will excuse the hotline operator from any obligation to call the police? Or would calling such a line, for someone like me, be painting myself into a corner I can no longer back away from, effectively sealing the deal?

Like I mentioned, we call if we're concerned for your immediate safety. Situations I've come across where I've called the police:

• the caller requested it

• the caller claimed that they had a weapon

• the caller had already done something to harm themselves

These have been the most typical to me.

Okay, so as long as I lie about those things, I would be okay? Or will they "guess" that I'm lying and send cops anyway if they suspect it? Is there any particular phrasing I can use to eliminate their responsibility to send someone?

That's not really something I feel comfortable answering, sorry! I hope you understand.

Thanks to this reply, I will never call a suicide prevention line. Good to know.

I'm sorry you feel that way! If it does make you feel better, police calls happened maybe once out of every 100 calls I took. Way more often than not things can be resolved without that kind of outside influence.

What do you tell people to prevent them from committing suicide?

This is a very difficult question and I worry I won't be able to answer it fully without giving you a huge essay, but thank you for asking!

The biggest focuses we have in prevention is knowing the signs of depression and suicide, and knowing where to go for help. We push community resources a lot - addictions counseling, suicide support groups, community homes, that sort of thing - and we also encourage individuals to access their own support systems (families, friends).

Hopefully that gives you a pretty good overview!

Is there somewhere online a person could go to read what to do?

There are a lot of resources, yes! I'd start with www.afsp.com.

I don't want to kill myself, but I don't really like being alive anymore, and I'm afraid I'll eventually make the transition. Do people ever make explain what happens to trigger the feelings of imminent suicide?

Anything can be a trigger to take someone from depressed to suicidal. Important life events, positive or negative, can cause enough stress to push someone to suicidal ideation.

I'd really recommend seeking some help, or at least a second opinion.

I admire greatly the work that you do. When my brother was in the Navy, he was honorably discharged for attempting suicide, I have had to talk him out of it several times and it is never an easy thing. I can imagine over the years you have had to develop a very strong will and technique for talking to young people. How has your journey taught you about the frailty of life, and how do you form quick relationships with those you speak to?

That's an incredibly brave thing for you to do, I hope your brother is doing better since.

I definitely appreciate the small things more, especially having good mental health of my own. So many people struggle with everyday tasks, even getting out of bed, and I can focus my time an energy outside of myself? Sometimes it just doesn't seem fair, and I try my hardest to be grateful.

I've always been a social butterfly, I guess you'd say, so talking to people is a strong point of mine! That's actually what you hear a lot of hotline workers say - they're the ones their friends come to for advice or to vent about their problems.

Thank you, my brother is doing better, but still struggles at times. I've suffered depression before in my life, and you are absolutely right, some days, just getting out of bed was a monumental task. You feel like a ghost, an invisible entity. I am thankful that I have been able turn myself around, and am now the happiest I've ever been. It sounds like you and I were maybe cut from the same cloth, my friends and family will turn to me often to vent or ask advice. I've always had a strong desire to help people. Especially kids. Growing up in a rough home, I know it can be hard for young people who have to deal with that same way of life. It wears on you.

I'm very glad to hear that! Many of the people I've met in my line of work have a similar story; they went through something very difficult in their own lives and want to turn around and help others because of it.

Keep up the good work and best of luck with your future life!

I'm 17 right now and I consider to choose a similar line of work as you.

Do you have any advice what I should do and what I should look into?

Absolutely!

If you're planning on college, definitely research career possibilities. I learned way too late that there are dozens of branches of psychology that I didn't even know existed, much less explored! Also make sure to get involved in some research or volunteer opportunity; the more experience you have to (I hate putting it this way but) pad your resume the better.

If you can, find a mentor at your school. I was in contact with one of the professors who talked to me at length about her work as a school counselor, which turned me on to the idea of working with teenagers.

I hope things work well for you! Best of luck in your future education and career!

I've dialed Military OneSource in my lowest of low times. I was ready to drive to a local gun store to lock down on getting a gun to end myself, but in a brief moment of clarity--or I guess more along the lines of my lizard brain kicking in and not wanting to die--I called the hotline and got myself free counseling, which then led to more treatment down the road.

One of my first thoughts when I started seeking help was that "Wow, I wouldn't have been able to afford any of this on my own", which prompts my question:

What can you do for people who are suicidal, or actively thinking about committing suicide, but aren't able to afford the counseling or medications? Chances are, money could be a huge factor for the stress/strain in their lives, and it certainly was one of the things on my list of reasons for wanting to. I was fortunate enough to have free resources courtesy of Uncle Sam, but not everyone has that kind of luck when their luck is already at its lowest.

Excellent point.

Monetary concerns are a huge issue when it comes to mental health, especially in the United States. My usual recommendations:

• There's free counseling available in most large cities. There are large waiting lists for many of these, so definitely be prepared for that.

• There's sliding fee counseling available in most cities as well. Sliding fee pricing is basically determined on a needs basis; aka, you pay what you can afford. These sorts of agencies are often willing to help find other resources for you as well.

• Free college counseling! SO many students don't know that their universities offer several free counseling sessions; mine offered 10 sessions before starting to charge. That's huge! Take advantage of it!

Other than those options, seeking out suicide hotlines and support groups can be very helpful, and offer you more resources or referrals than you may be aware of otherwise.

My best friend call the hotline on me a week and a half ago. It was horrible. A crisis worker and a bunch or cops came to my house ready to force me to go with them. I felt like the crisis lady didn't want to be there at all. I actually wrote a post on my experience a few days ago. It left me worse then how I was. Does this kind of thing happen to a lot of people?

I'm very sorry to hear you had a bad experience with it. :(

I've kind of heard the gamut of reviews, honestly. Some people do have similar experiences to yours. Some people have wonderful conversations.

I'm not sure what needs to be done to fix it. Stricter guidelines would mean forcing workers onto some kind of script which gets rid of the individual touch we need to connect to people. Better relationships with the police and training on their end would obviously be ideal, but I've found it difficult to work with law enforcement given their time constraints and concerns.

I'm sorry, I'm not really sure what to tell you. I've never heard of that happening with anyone I personally know on my hotline, but I know this sort of experience does happen.

How do you view people who are "pro choice" in regards to suicide? That, ideally, a human should have control over whether they want to continue living or not?

I dont think the goal of suicide prevention is restricting choice. It's to reduce suffering, so that suicide does not seem like the only option.

I really like that, and definitely agree. Thank you!!

Well, as a worker from a suicide hotline, I obviously value keeping people alive and finding alternatives to ending their life. I don't make a judgment call on that, though. Different people have different beliefs, and as long as someone isn't actively working against keeping one of my clients alive, then that's up to them!

How hard was your first caller to handle?

I feel that I got off very easy; my first caller was a mother calling for help with her son who wasn't in immediate danger.

EDIT: I did just remember my second call. Our first three calls on the line are monitored by one of the two suicide prevention coordinators to make sure they go alright. My second call was a middle-aged woman who had a gun in her hand when she picked up the phone. The call was about 45 minutes long and had a lot of ups and downs, some very tense moments!

I'll always remember, though, that right before she got off the line she thanked me for being there. It's moments like that that really help me keep going.

This was asked earlier in a disrespectful way and maybe it's just a disrespectful question but have you ever lost someone while they were on the line? How did it effect you?

This is actually usually the first question I get when I mention I work on a suicide hotline.

The short answer is, not to my knowledge. We are, basically, straight-up forbidden from staying on the line with someone while they complete. I've heard of people being asked to just stay there while someone dies because they "don't want to be alone"; that's not what we're here for, and for the mental health and safety of the hotline workers it's not something we're allowed to do.

That being said, I've spoken to individuals who have injured themselves then hung up, and I don't know if they ended up safe. One woman I'll never forget, injured herself at the beginning of the call and didn't mention it until right before she hung up on me. She wouldn't give an address or name, and called from a private number, so we weren't able to find her.

Those kinds of calls are awful, but I just try to keep in mind all of the good we do with others on the line.

I volunteer with a 'suicide hotline' and we are to stay on the phone even if someone is ending their life. We are there to support them whatever they choose to do; and offer emotional support . Often people have experienced callers 'fading out' as they are on the phone . You never really know what has happened though.

Interesting. I can't say I agree with that practice personally, but it's useful to know that there are hotlines out there that do that!

What made you decide to become a suicide hotline worker?

The nice answer: I've always wanted to go into mental health care. I really enjoy helping and making connections with people, and the suicide hotline was an early volunteering experience that allowed for that.

The slightly worse answer: I failed a class my senior year of college and, in order to complete my degree, volunteered for some credit hours. My volunteer position on the hotline led to my full-time prevention job, though, so it all worked out in the end!

How often do you get prank calls?

Not as often as you'd think, but still more often than I'd like. It's almost always kids or teens, and they're usually fairly transparent (you'll hear their friends laughing in the background). That's my least favorite kind of call to take. It's enraging.

What do they say?

It varies. Some will say they're depressed and then say ridiculous things that will tip you off to it being a prank. Some will pretend that they dialed the wrong number and hold up the line trying to order pizza.

In the end, it comes down to them wasting time that could be spent saving someone's life.

What would you tell them?

We simply hang up on the hotline. If I were to meet them in real life, I'd probably have some very strong words for them...

I'm not sure how to go about this, so bear with me because I haven't though out my answer ahead of time.

As a suicidal individual, if I were actually determined to kill myself, I'd deliberately avoid reaching out. If I want to do it, it's my life, my body, and I don't believe in an afterlife, so any guilt that may come only lasts until I actually die. I feel like I was born into a world where I have an arbitrary system forced on me (that I never agreed to and almost entirely disagree with) by people I neither know nor have any inclination to know. I lack interests that mean anything to me, don't have any interest in exploring a world that's been exploited for corporate interests and tourists. I thoroughly believe the system is rigged to keep a few people on top at the expense of people like myself, and I doubt there'll be any change to that without blood.

The point is, when I kill myself (and I do actually believe that will be how I die eventually), I will not share that with anyone who has a chance to prevent it.

With regards to the people that call you, have you ever had the impression that any of them truly wants to die? Is there more of a sense of desperation with a lack of direction/understanding? I just don't grasp that you can really want it and call in.

Thank you for sharing your story, and I'm sorry to hear that you're struggling.

You're right, suicidal individuals rarely actually want to die. What they want is to find an option out of the suffering they are experiencing, and death is the best available option as far as they can see. Plus, as I mentioned elsewhere, tunnel vision is a phenomenon most suicidal individuals experience in which they can only see the one narrow set of options in front of them.

I apologize if this comes across as condescending, or speaking down to your personal experience! This is merely what I've seen in my position.

Thanks very much for your answer, I was concerned that I was going to come off like I was talking poorly about what you do (which I hope I didn't).

You absolutely did not, don't worry about it!

What would you suggest to people that are afraid to ask for help? Like what if someone knows they need help but they know that when they go seek help they're going to get a red flag on their file to disqualify them from future jobs or will effect other aspects of their life?

That's definitely a tough one! I'd advise them to think about mental health in terms of physical health: if you broke a leg, would you try to just let it heal on its own? If you were having a heart attack, would you try to just "get over it"? Plus, if you don't seek the help you need now, then who's to say you're even going to be in a position to get a job later?

The stigma around mental health is also (slowly!) decreasing. More employers are becoming sympathetic to mental health concerns for their employees and potential hires.

Are all your callers suicidal, or are some (not to sound insensitive) seeking attention, in a way? Can you tell which is which?

It's important to remember that even those just seeking attention are doing so for a reason!

That being said, we run a full assessment on every caller, including many of the biggest risk factors for suicide - military status, plan or access to means of suicide, alcohol or drug use, etc. We use that information to determine their level of risk and have different strategies for each level.

Have you ever talked to someone who's personal circumstances were so tragic that you said to yourself: "I would kill myself if that happened to me?"

No, I have not. I've definitely encountered individuals with some very difficult circumstances though!

In the end, everyone experiences things differently. I've gone through things in my life that have made me depressed that other people would probably laugh at.

What's the best advice you can give to someone who has a friend/family who has suicidal thoughts/tendencies?

If they're telling you they're having these thoughts or tendencies, then that's actually a good thing; it's a cry for help. Make sure they're in a safe place - find out if they have a plan, and if they do then make sure they don't have access to the means to make that happen.

Then do what you can to address the concerns. My first step is always to see what mental health resources they have, or that they can access as soon as possible, whether it be a counselor, support group, or other professional.

I would like to piggy-back on this with a question of my own.

A close friend of mine has mentioned a few times that he has had suicidal thoughts before. I forget how exactly this came up in conversation those few times, but I never got the impression from him that he was having these thoughts currently or even recently. I do know that he goes through periods of depression once in a while so it isn't something I take lightly from him. What should I do in this type of situation?

There's nothing wrong with doing check-ins. We get protests from the kids in schools sometimes, who say that it's really awkward to ask a friend if they're feeling depressed or suicidal. But I'd rather have a few awkward minutes now than potentially lose a friend later.

It's also important to be direct; some people will try to ask "are you feeling like hurting yourself?" That can be a good start, but you really need to get the "s" word out in the open. "I know you've been going through a really rough patch lately, and I really just want to see how you're doing. Are you thinking about suicide?"

Do you ever get calls from people who just want to talk? Do you have repeat callers or callers who specifically ask for you?

Yes, yes, and yes!

At my specific hotline, we have a binder full of individuals who call persistently. Some present as suicidal, and some don't, but we typically have protocols for those extremely high-volume callers who need specific kinds of help.

I've had two callers attach themselves to me during my time on the hotline - a young teenage girl, and an older woman. We are discouraged from any sort of personal relationship with callers, as that kind of relationship can quickly become dependent or inappropriate. So, while it's nice to know that people specifically want to talk to you, you do have to try your best to open them up to other professional resources!

Would you still stay on the line/help someone just seeking attention that really seems like they need it? or is there another line for that?

Great question! We take calls from anyone in crisis, and will talk to anyone who needs help. If someone is not suicidal, we'll do what we can to direct them to appropriate resources.

One great resource is warmlines. These are similar to hotlines, but are designed specifically for individuals who just want to talk, and aren't necessarily in crisis. Just like many areas have local hotlines, many places also have local warmlines!

What is the most common or re-occuring issue/struggle you hear from your callers and what advice do you give them for it?

A big theme we see with callers is tunnel vision; suicidal individuals are often only focused on the negative, what's happening right now, not the future or anything hopeful. Our main task is to get them out of that tunnel vision and reconnect them with resources they almost always already have.

For example: one woman I talked to recently spent 20 minutes describing how she was always alone, couldn't talk to anyone, and felt like no one cared about her...then I heard someone talking in the background and found out she lived with her very supportive boyfriend who was taking her to a counseling session tomorrow. It's very easy to focus on the negatives when in a suicidal crisis!

Firstly, well done for all the amazing work you've done.

Has anybody ever told you their story that was so hopeless and terrible it made you question whether suicide really wasn't the best option?

Thank you!

No. I'm of the belief that life circumstances are incredibly changeable, maybe not in ways we can expect. Our job on the hotline is to make sure someone stays alive and safe for 24 hours, then we can reassess and try new strategies. So, even if something isn't working for someone right now, it might tomorrow, or in a month, or a year. And there's always something someone hasn't tried yet.

Do you have any good advice for those who have lost someone very close to suicide and are having trouble coping? I lost my best buddy since 6th grade to suicide on June 1st, 2013. We were roommates and were just about to turn 30 together. He was a brother to me and its gashed a a hole in me I just don't know how to mend. Its honestly changed me as a person more than I can even begin to understand. I've always been a pretty happy guy still, but for some reason I have never got the wind back into my sails and kind of feel like I am carrying around a weight I can't drop.

Shorty after it happened I met a girl and we have been dating almost two years now. She's incredible and I can't imagine my life without her, but I feel like I am still not able to be the man for her I want to be, like I am still missing part of me that was lost when my friend took his life.

Sorry for the rant (although I am sure your used to it!), and keep up the good work!

Thank you for sharing, and I'm so sorry you've been through all this. It sounds very painful.

I'd suggest checking out Survivors of Suicide chapters in your area; there is usually at least one local group that has resources and group meetings. I've spoken to many survivors that say sharing their story with others who have experienced a similar grief is very healing. (To clarify, "survivors" of suicide are those left behind by individuals that take their own lives. The terminology can be a little confusing.)

I also recently read the book "My Living Will" by John Trautwein. It's an incredible story of a father who lost a son to suicide, and how he's dealt with the loss and found a new sense of hope.

It also sounds like you might benefit from counseling or therapy. It can sometimes help to tell your story to others.

I hope you can find some solace soon. Losing someone to suicide is incredibly difficult.

From your time and experience as a suicide hotline worker and suicide prevention specialist - What were the lessons (about life, human nature etc.) which you have learned that struck you to the core and in which you would carry onwards in life? What fears were often heard or resonated amongst those who called?

1. Context is so, so important. What might seem like a minor event to me - a 13 year old girl breaking up with her boyfriend of a month, an older gentleman losing his car keys - may be what pushes someone to attempt suicide. We absolutely cannot devalue or ignore other people's struggles.

2. People are much more resilient than we often give them credit for. I've spoken to some people in truly horrific living conditions, who are still fighting for their mental health. It helps put in perspective my own needs and struggles.

As for common fears, being alone and not having a purpose in life are ones I hear very, very often. It's comforting to know that I can be there for someone who really has no where else to turn.

What is the toughest case you have handled and how did you takle that ?

My hardest was last summer when a woman called in very clearly intoxicated. We're not really supposed to stay on the line with anyone heavily under the influence, since it's probable that they won't retain anything we say to them, but something gave me an uneasy feeling about this caller in particular, so I waited.

Eventually she said an offhand line about "the blood dripping down her arm", and I worked out of her that she'd cut her wrist very badly in an attempt right before calling. I did my best to figure out where she was, to even get a name or a phone number, but she refused and hung up shortly after admitting the attempt.

It was incredibly stressful. I still don't know to this day if she made it out okay. I do my best to remember all of the times I've done really great things on the line and in my work.

I've felt pretty helpless when talking to people with mental health issues and I know taking to people like yourself and the UK equivalents at The Samaritans has really helped so thank you.

My question: Are there any tips that you could offer people in similar situations on how to keep calm and not panic if someone approaches them with a problem?

Well...!

Seriously, though, the more educated I've become about these issues, the more comfortable I am in them. So get out there and research mental health!

Also, you can keep in mind that, even if someone is approaching you for help, that doesn't mean that they expect you to have all the answers. It can be incredibly helpful for someone in a crisis to hear something like, "I'm a little scared and lost, too. Do you want to see if we can find a better solution together?"

How do these calls affect your own mental well-being? I know psychiatrists have the highest rate of suicide among doctors by far. Your job is similar, if not more strenuous than theirs.

It can be very stressful, but it's definitely an acquired skill to not bring your cases home with you. Having a great personal support network (friends, family), good coping skills (for me, video games and biking), and excellent coworkers that can help you debrief are a godsend. :)

12ish years of helpline work here, half if it on helplines for the suicidal. Very interested in the differences between the dominant services in different parts of the world (I'm in the UK, and my wider work has put me in touch with Australian and New Zealand services too, among others):

• Is your organisation principally run by paid staff? By volunteers? Some of both?
• Is your service interventionist and to what degree? For example, would you ever pass on details of a call to emergency services without the permission of a caller? If so, to what degree is that a matter of policy and to what degree a matter of the law?
• How do you organise your rotas and "who does what shift"? Are you individually a 24-hour organisation? Part of a 24-hour network of organisations?

Thanks for the work you do.

Hey! Glad to see another one in here!

Is your organisation principally run by paid staff? By volunteers? Some of both?

The hotline I work on is 100% volunteers, with two paid volunteer coordinators in charge. It's run through a community mental health center. At my paid position, every position is paid.

Is your service interventionist and to what degree? For example, would you ever pass on details of a call to emergency services without the permission of a caller? If so, to what degree is that a matter of policy and to what degree a matter of the law?

Yes, at both locations. We deal with callers on a case-by-case basis, but it boils down to if the person in crisis is in immediate danger to themselves or others. We pass on any relevant details - if the caller has a weapon, the age and gender of the caller.

How do you organise your rotas and "who does what shift"? Are you individually a 24-hour organisation? Part of a 24-hour network of organisations?

The hotline at which I volunteer has 4, 6-hour shifts per day. We have a pretty large pool of volunteers, who are required to work at least one of those shifts a week during their volunteer commitment.

At the nonprofit, there are much fewer callers, and they work by availability. Since I don't work that one, I'm not entirely sure of the schedule, but I know shifts are typically 8 hours.

Both are 24-hour hotlines, and the nonprofit also offers information and referral services through the hotline.

What is the most interesting conversation you have had with someone? Anything we wouldn't expect?

Well, one woman who called feeling suicidal felt that way because of a bedbug situation she was currently having...and, having just had bed bugs that were taken care of the week before, I was able to walk her through the process a bit. That was a little different!

Do you feel like there is a fairly standard amount of time that people can do your job before the stresses of it take their toll? do people burn out?

The hotline: Hard to say! We have some plaques in our phone room for individuals who have worked upwards of 25 years on the hotline. It definitely depends on your personality and resilience.

Suicide prevention/education: I know the average time someone has lasted in this position is about 2-3 years, but that may have more to do with the age of the individuals being hired for it. I know the burnout rate for social work in general is ~5 years.

Do you have a script to follow, or do you take it on a case by case basis?

We have assessment questions we're supposed to answer - things that indicate risk factors, for example. We also get funding from several government programs that require that we get some demographics: age, gender, military involvement.

Other than that, we're on our own. We like to be as genuine as possible, and reading from a script would really hinder that!

I'm curious about the process in what happens when you call. If say a person were under age, would you notify parents/guardians? Would the call go onto their medical records? Is it anonymous? Because I would think that kids might be afraid to ask for help and might be afraid to call because they don't want people to know.

The only time we release any information is to the police if the person is in immediate physical danger (to themselves or others), or if there's some child abuse going on. We'll never contact your parents, we have no access to your medical records. You don't even have to give your name if you don't want to.

What is the reason people keep on living. What makes them turn around and not give up on their life? Im very curious thanks!

It varies by the individual. One woman I spoke to was a mother of 3 and wanted to improve her mental health for their sake. One man I spoke to was living so that his pet cactus wouldn't die in a few weeks. It's impossible to give a universal answer, because everyone has different things they care about!

Does this job at times give to much stress to the point of not going to work for a day or something like that ?

It hasn't for me (yet, I guess). We're encouraged to engage in lots of self-care and debriefing with coworkers to keep ourselves from hitting that point. It's also been explicitly stated that "mental health days" can quality as paid sick days.

I often feel very suicidal in the mornings even after a happy night. Have you had anyone in the same situation and what advice did you give them?

I'd give the same advice to anyone feeling suicidal, at any time in their life: that feeling needs to be addressed, whether it be through self-care or professional help. No matter the duration of it, if you are having thoughts of injuring or killing yourself, then you need to find help to keep yourself safe.

What advice could you give someone who is struggling with mental illness/suicidal thoughts, but has no means to seeks medical treatment?

I'd get creative with it.

Seek help from free local counselors, check for sliding fees scales, talk to your general practitioner even. There are support groups for many mental illnesses that can be helpful. Hotlines in your area can also be part of your treatment plan.

FINALLY

So I called the suicide hotline once, only once, for the first time. I was sobbing (which I think is acceptable considering the situation). The woman on the phone let out a HUGE sigh, and said "you know i cant understand you when you cry. you call here every day, and I can never understand you when you cry." To which I responded "I've never called here before" and hung up.

What gives?

It wasn't me that answered the call, so I'm sorry, but I can't answer that question. I'm sorry you had such a poor experience with it. :(

Could someone pm you here instead of calling the hotline?

I'd prefer not to offer any sort of one-on-one counseling, as I do not think I am qualified to do so particularly over the web.

There are, however, online-based "hotlines" that you could try if you're uncomfortable with the idea of talking on the phone!

http://www.suicidepreventionlifeline.org/gethelp/lifelinechat.aspx

https://www.imalive.org/

http://www.crisischat.org/chat

What are your thoughts on "right to die"?

I know this is going to be an infuriating answer, and I'm sorry, but...my opinion on it really doesn't matter! In my position as a suicide prevention educator and suicide hotline worker, it is my job to make sure you don't die. I personally don't like to get involved in that debate, since my opinions aren't really formed enough to.

Sorry!

Thanks for the reply. We recently had an assisted suicide here in Oregon, so I was wondering your thoughts. I can see your aversion to the debate.

With every job there is the possibility of indifference and/or profession detachment. Do you ever find yourself becoming indifferent or professionally detached? If you did would you tell me?

If you did would you tell me?

Haha that cracked me up a bit!

There's always the risk of getting too involved or completely distancing yourself. I recently had this discussion with a coworker who does relationship counseling. We agreed that, as you progress in the field of mental health, you encounter so many sad cases and disturbing truths that you do have to distance yourself to a degree.

There's a large amount of burnout in this field, which is understandable. I guess it just comes down to striking a good balance between caring too much and not caring at all. As someone who's only been involved for around 2 years now, I don't think I'm in danger of that yet!

At what point are you legally forced to call the local police to deal with the situation?

That's a difficult question to answer. It comes down to our own discretion; if we can't determine that the individual is safe, or can safely assume that they will be unsafe when we get off the phone with them, and they refuse to give an address or seek help that we can confirm, then we'll call the police to do a safety check - this basically means that they'll go to your house to make sure you're not injuring yourself or anyone else.

If I were to come across someone sat, say, on the edge of a multistorey carpark, about to jump, would you suggest that I talk to them while waiting for police? If so, what do you recommend I say to try and keep them alive?

If you're comfortable doing so, then absolutely. Showing someone in suicidal crisis that you care and that their death would very negatively affect at least one person, even if it's someone they don't know well, can be an enormous protective factor.

What I'd try to do is listen to their story, and see if there are any chances you can (realistically) offer to help. Connecting with someone on a personal level is the most basic human behavior that can save someone from death by suicide.

Thanks for the response. I have friends who have been suicidal in the past, I would be very anxious doing it but I would feel an obligation to try and help.

Are you suggesting, for example: if they have no money, giving them some; if they feel alone and that they have no friends, inviting them over to get to know them and talk, etc? I'm assuming the true, but generally useless, line of "don't do it, you have so much to live for" isn't always helpful?

I'd definitely steer away from promising anything you can't follow through on. I'll just stress again that making a connection is important. Helping that individual realize that there's something there, right now, that wants to help them and cares about them is a big thing.

Around how many have you prevented so far?

It's really impossible for me to guess. I much prefer to think about specific calls that have connected with me than the bigger picture number, because it's the individual lives I interact with that inspire me.

I am interested in volunteering, how do I find somewhere local to get started?

Try checking here! If you don't live in the US, do a search for local crisis lines!

Keep in mind that there are crisis lines for all kinds of different demographics, as well. In my town we have a suicide line, a teen line, an elders line, and several domestic violence / sexual trauma lines!

Thank you for doing the AMA!

Have you ever had someone who has recovered thank you?

Well, in a way...I am known around town as "that suicide lady" by some of the kids I've taught!

More seriously, I've had people thank me both on the hotline and in schools for what I do. The most touching instance I can remember from the hotline was a young girl, maybe around 15-16 years old, who started the phone call sobbing and ended it thanking me for saving her life. It's incredibly powerful.

As someone who feels you should get paid a lot of money for your help, is there any way we can donate to the cause?

Haha, well I'm a volunteer on the line, but it makes me happy to hear you say that!!!

As for donating: check out any local nonprofits that work with public mental health. Many have strong suicide prevention programs. Large national ones are also great! Here are two I've had personal experience with, that use their donations very responsibly:

https://www.afsp.org/

http://www.suicidepreventionlifeline.org/

how busy are you at work?

thank you so much! :)

Currently, not very! Over the summer we don't present in schools, so we just focus on community presentations and other efforts.

My organization does put on a Suicide Prevention Walk every fall, though, so we're busy preparing for that!

Thanks for the answer.

I meant on the hotline. If there is at least two of you, how busy are you? What do you do if there is nothing to do?

Whoops, sorry!

Ok, so to re-answer your question:

I work the graveyard shifts on the hotline, so most of what we get are regular callers, the same people every shift. I'll pick up maybe 3-4 calls outside of those per shift, same for my shift partner. So, maybe 20 calls total over 3 hours between two people. It really is a pretty slow time of night!

Our hotline room is actually fantastically set up. There's a futon if someone needs a nap, a Wii, a DVD player, a mini fridge. The agency does its best to make sure the hotline workers are comfortable. So my shift partner and I will watch Netflix, talk, surf Reddit, that sort of thing!

How many jokers do you guys usually get? Can you often tell right off the bat? Have you ever sent help to one of them?

I've gotten maybe 10 prank calls, which is still more than I'd like. They're usually fairly obvious. One group of teens kept me on the line for about 20 minutes by being fairly convincing. Usually once you offer to send help they'll panic and hang up, because they assume (rightly so) that they'll get in a lot of trouble.

Have you lost any one yet, on your watch? How do you deal with that guilt, that you tried your best and they still couldn't hold on?

I lost my brother to suicide and that guilt is kind of haunting.

I have not, as far as I know, but there have been cases when they may have completed after getting off the phone.

It's really important to remember that we all do the best we can with the information that we have. Guilt is a very common emotion when grieving a death by suicide.

Can we roleplay a somewhat typical scenario that way we get an idea of your process?

I'd prefer not to, but I could definitely try to answer any specific questions you might have.

This may also help you understand the process a bit better!

Do you ever get too sympathetic to the point where you feel so bad for the person you are talking to that you feel depressed afterwards? If so, how do you cope with that?

It's happened a couple of times. Keeping detached enough from the job to stay safe, while still being able to empathize with the client, is a hard balance to strike, but gets easier with experience.

I've become very good at throwing myself into coping skills - talking to friends and coworkers, hobbies, music.

Could you give a run-down on how the conversation usually plays out when you get a call? Like, say I'm a suicidal person who's never used your service, what is our first conversation going to be like in varying degrees of severity?

Also, thank you so much for what you do. Mental health is such an important facet of our existence but it gets so little attention. If a person breaks their arm, they go to the emergency room. If a person starts having anxiety attacks, they try to ignore it until it goes away. It's a messed up cultural thing.

We'll introduce ourselves. You don't have to give your name if you don't want to. We'll probably talk for a bit about what prompted you to call today/tonight; there's usually a specific event/situation going on that has pushed the person to approach help. I will eventually ask you directly if you're thinking about suicide. If you say yes, I'll probably want to talk about your plan if you have one, if this has ever happened to you before.

And then we'll get down to the meat of things. What kind of support systems you have in your life. What you want to get out of this call. What life events you're going through right now. Conversation is going to vary based on what you've told me and what I sense your needs to be.

On our hotline, and I get the impression that many/most are this way, we're going to want you to talk a lot. This is a safe space for you to anonymously share with someone your very personal emotions, and the more you're able to share with us the better we're going to be able to understand your situations and offer suggestions.

You're absolutely right. The stigma against seeking help for mental health is huge, and it's very upsetting because it prevents people from seeking the help they need!

Thank you for the response, I have a person with suicidal tendencies in my life and it's been a struggle to make her feel comfortable with seeking help through services like yours. If you don't mind one more question, what is the most common outcome when people call seeking help?

The most common outcome is the person in crisis feeling better, promising to call back if they feel suicidal in the future, and holding a number of resources they can attempt to access to improve their situation.

I'm sorry to hear your friend has been uncomfortable with accessing these kinds of services. I hope I've been able to answer some of your questions well enough, and I do hope she'll try giving a call if you become comfortable in the future! Remember that you are always welcome to call for her, to get advice or suggestions about what you might be able to do to encourage her.

1. How did you get into this sort of job?
2. Do you see yourself doing this for a long time?
3. What kind of recurring themes do you see in the calls that you've handled?

Thank you for doing the kind of work that you do. I've always told myself whenever I'm depressed that there's the Suicide Hotline that I can call in case I get desperate, so thank you.

I began on the hotline for some school credit over a year ago, and stuck around because I enjoy it and I sense it's helped me grow professionally and personally! I actually got the education/specialist job through a job posting there.

I eventually do want to move into counseling, whether it be private practice or continuing to work in schools, but suicide prevention feels like a good thing for me to be doing right now. :)

First off, as someone who has volunteered for support phone lines, I wanna give a giant: THANK YOU YOU ARE AWESOME for working on a suicide hotline. This leads to my question: how would a suicide hotline differ from a general support/distress line where we are also trained to deal with suicide? Do you have more extensive suicide training?

Pretty much all we get is suicide training...or "crisis training"! We learn some basics about call management, empathy, and safety concerns, but we mostly talk about suicidal ideation and its implications for a hotline.

Thank you for all you do. Really it means alot to know people like you care. So my question is,what in your opinion is the worst thing to say to someone who is suicidal?

"Do it. You won't."

I see people who haven't been trained express this as a viable option a lot, challenging someone who says they're going to kill themselves to actually follow through. It doesn't work. Please, nobody do this.

Seriously? They'll actually say that? And like think it works??? This sounds like something a teenager trying to be edgy would say,not someone supposedly specialized in suicide prevention.

The hotline is run by volunteers, and some of them do get screened out during the training process. You'd be surprised at what some people think is appropriate.

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Ugh, yes. I've only gotten two (thank goodness). During training, actually, the women were pulled into a separate room and given special training on indecent callers, since we tend to get them more often.

What's your longest phone call?

The longest I can remember was an hour and a half. I had a shift partner spend 3 hours on a call once. You have to have good call control!

Oh my! That's a long time! You guys have shift changes right? What if you're still on that phone call, do you wait until you're done and then go on break?

We typically run 6-hour shifts, so if we're still on a call at the end of our shift, we'll either stay over our time, do our best to wrap it up, or ask the caller if they're comfortable with us passing the call. Typical calls last about 20-30 minutes here, though, so that's not usually a big problem!

A few weeks ago I called a suicide hotline and talked with a very nice person, really spilled my guts about who I was and the upcoming events that might cause me to become suicidal again.

He gave me his name and number to call back if I needed and he really seemed to genuinely care.

Would it be appropriate to call back and ask for him to let him know that I'm doing alright, and that he really helped that night?

That's absolutely fine, and honestly he'd probably really appreciate hearing you're okay! If he's not there you could leave a message with another worker.

I have a twin brother who has attempted suicide in the past. It's been a few months now. What are day-to-day steps a family member can take to proactively work at preventing something like this from ever happening again?

Make sure the individual is seeking counseling, medication, a support group, or some other mental health outlet that can keep them accountable for their safety. Regular check-ins with family and friends can be helpful as well!