IamA counselor for a suicide crisis line. AMA!

Wow. I actually have a couple questions: 1) What's the first step in "talking someone down." 2) Does your job ever make you feel depressed? 3) What kind of training did you receive for your job?

Awesome questions! 1) It depends on the situation, but most of the time the first step in "talking someone down" actually isn't about talking but listening. I notice that a common thread with many of our visitors is a feeling of invalidation, loneliness, and/or lack of support. Maybe they tried reaching out to someone they trusted and their feelings were invalidated. Or they feel that they don't have anyone to reach out to, or that the people in their lives can't be trusted with their feelings. People often contact us because they need their feelings to be known and to be validated by another human being. So in the beginning of most chats, I listen (meaning I read what they type - we are an online chat) and even if I haven't gone through their exact same experience, I can often find empathy through my past experiences and can relate to having felt before the emotions they are feeling. So you listen, and empathize, and validate. Before I try to help them recognize reasons to live, I always first listen to their reasons to die. They are just as valid and important as one another.

2) Yes. It's extremely emotionally exhausting work. I often feel burnt out before the end of my 4 hour shift. In order to do this work effectively we have to feel with our visitors. I can't speak for my fellow counselors, but for me... I climb into the deep dark hole that my visitor is in, I sit next to them, and I allow myself to feel how horrible it is down there. One of the reasons I got into this work and eventually want to be a therapist (working towards that currently with school) is because I have struggled with depression and anxiety for as long as I can remember, the first time I attempted suicide I was 8 and have had regular suicidal thoughts since (one night I wrote a suicide note to my family, didn't go through with it, and went to volunteer the next day), and I am in recovery from an eating disorder. What I've found to be the best thing for my depression and my recovery is helping people. It's such a hard job and I definitely take it home with me, but it's so worth it. I can't describe how rewarding it is.

3) Training was all provided by my organization and involved many presentations and assignments about suicidality, crisis intervention strategies, listening, communication, and more. We got trained on how to use the software and we shadowed several people before taking our first chat (which we were shadowed for). We learned how to make an active rescue (when someone is in imminent danger and needs help sent to them) and how to report child abuse to CPS. Many of our visitors are very young and based on what they have told me, I had to make a report. It's hard to describe all the training we went through! It was very thorough, and pretty much all of us volunteers are pursuing a degree in psychology/therapy/social work (some already have one) so we are always learning and implementing things we learn into our work.

Thank you so much for your questions!

You are such a badass. Thanks for doing what you do.

You are so kind! Thank you <3

Hi. Thank you for your work. You're helping a lot of people and I'm sure you'll make a great therapist.

Um, I know this is personal (and I know what it's like to being going through complex and heavy feelings around that age...I never talked about some of my issues until recently and still don't like to think about them), so no pressure to answer but: what was it like being so young and attempting suicide? How did you recover from those thoughts and become the helpful person you are today?

Thank you for your question! It's not too personal at all. My first suicide attempt was when I was 8. But as an 8 year old, I didn't exactly know how things worked. So I took a jump-rope, sat in my room, and wrapped it a couple times around my neck, and with both arms i pulled in opposite directions, tightening it as much as my arms could. Yeah I couldn't breathe, but eventually my body's natural defenses kicked in and I was flooded with an adrenaline rush that made me drop the jump rope. Even if I could have taken it further, obviously I would have just passed out, let go of the jump rope, and been fine. But I didn't know that, and I had every intention of actually killing myself - so according to my therapist, that's classified as an attempt. The major reason for that attempt was because i was bullied really badly at school and when I tried reaching out to my parents I didn't receive the support I needed, so I felt alone, hated, ugly, worthless, and a lot of things. Little did I know that the hardest period of my life hadn't even come yet - that began when I was 13. I don't really know how to answer what it was like to be so young and attempt suicide. It felt like any other attempt, no matter my age. I felt like I urgently had to get out of here (life). To speak to what it was like to be a depressed little kid - I really think it was situational back then, and as horrible situations kept coming up over the years it turned into a weird mix of chronic depression and situational depression.

I have not recovered from the thoughts. As I said in another comment of mine, "they still come up often for me, even now. As I explain to people on chat, defeating the thoughts is not about getting to a place where they don't come anymore. That'd be awesome, but for a lot of us that doesn't happen. The suicidal thoughts continue to come up throughout our life. The important distinction to make is between thoughts and actions. Defeating the suicidal thoughts is about choosing not to act on them." I hope it's okay that I copy+pasted that ^ getting so sleepy, and I knew I worded it better earlier than when I was trying now, lol.

I've had a lot of years of therapy and I am a very analytical thinker. I analyze my thoughts, and how rational they are, and why I am thinking them. I differentiate between thoughts and feelings. I have learned coping skills that work for me about 60% of the time, and the rest of the time I wait it out. I know that it's not possible to feel as bad forever as I feel in that moment. That's what I remind myself.

As far as what motivated me to help, it was really my life experiences. I never got to really feel like a kid or teenager, so I grew up way too fast. Being bullied, going through serious illness and so many other challenges growing up, I developed a passion to help people, in crisis or otherwise, and to be an advocate for people who need it. During my darkest times, I didn't have someone to talk to. I don't think anyone should have to go through it alone, so that's why I want to be that person for other people.

Officially not able to think straight - I need to head to bed now! Thank you again for your questions

The way you described how you allow/force yourself to crawl into the visitor's pit of despair - it brought me to tears. A few times I've used a suicide line (severe medical illness) and each time the people helping really, truly listened. I could tell the one time when a girl was new, and promised me my illness would get better. I knew she slipped up and ended the call politely.

The second time I called, the guy I spoke with outright said he couldn't promise me I would get better, but he truly listened and acknowledged how much physical and emotional misery I was suffering. And he helped.

Thank you for doing what you do.

<3 I have dealt with a severe chronic illness, and honestly it is what caused my depression and suicidality. It's incredibly hard. I know it takes so much strength for you to keep going. <3

Relating to my comment about empathy, you might like this video: https://www.youtube.com/watch?v=1Evwgu369Jw

It's one of my favorites! <3

Do you support medical assisted suicide in some instances?

Yes. I am a strong supporter of medically assisted suicide for qualifying individuals.

Do you support (the idea of) medical assisted suicide for mentally ill patients?

Ah, that's too hard to answer. Especially since there are so many types of mental illness, and it depends on so many factors.... it's something I've thought about a lot. But it's still too challenging for me to answer.

I think you might come to find that the distinction between mental and physical illness is frivolous, and that you can't allow relief from one kind of suffering without allowing the other. I have no idea where the strongly-held belief that mental illness can be determinately fixed came from, when we have overwhelming evidence to the contrary. I think it's insulting and inhumane to not allow people to die when they are suffering and asking for death, period.

Best of luck in all that you do.

worded beautifully.

[deleted]

Well it depends if it's even legal where you live. But if it is, the first step would be your doctor - assuming it is for medical purposes. They will send you to a psychologist who largely determines if you qualify. There's a mandatory waiting period, lots of sessions with the psychologist. It's a very long process, even for those who end up medically qualifying.

And I think people were down-voting out of concern, not because they don't care or think that you shouldn't be responded to.

Just a note: downvotes are for comments that are out of context or don't provide much insight into anything - and most likely it was just because /u/CrispyBacon_87's comment could have been in a better spot. Most of the time you upvote out of concern :)

Oh thank you for explaining! This is my first time on Reddit.

Euthanasia and suicide aren't the same thing.

Yep, an important distinction.

Do you get many trolls or people you suspect are abusing the service? Are they be punished similarly to 911 abusers? I would think there should be a penalty for tying up that kind of resource when people are in need.

I have been lucky and I haven't come across too many trolls myself, but I have had a couple of them that you can spot right away. If they don't immediately end the chat after sending their inappropriate message (they usually do) then I have to give them this pre-written response that says they are misusing the service and continuation can result in reporting them to law enforcement (we have their IP address) and then I end the chat. Then there's the tricky ones, who disguise themselves as a real person in crisis bringing up real issues, but then as the chat goes on their story gets crazier and crazier and you wonder how this could possibly be true... I know there are people out there that do this, but I can't judge whether or not someone's story is true or not, so I respond to them all the same even if they seem fishy. Even if that person is making something up that isn't true, they still came to me because they needed to talk. Since we are a service for suicide and crisis, we can't really turn someone away who is upset and needs to talk. The definition of crisis different for every single person.

Hey bud, first off. I just want to say thank you for what you do. I am an Iraq VET with PTSD. Been in some bad places, physically and mentally. My old unit had a really bad year in 2015 with way too many guys taking their own lives. I have had quite a few phone calls with old buddies or their significant others when they are on the brink. Thank you for what you do, I kind of know what it's like. I was also an EMT for a couple years, dealt with stuff like this first hand. How are you doing mentally? Dealing with this daily can be extremely hard on a person. You making sure that you are staying sane? I hope so. Feel free to PM me if you need to talk. Sometimes dealing with people on the edge can bring you closer to the edge than you realize. Stay safe and keep up the good work.

I really appreciate your kind words! I am doing alright at the moment :) I'm not sure if you read a couple of my other comments - but I have dealt with depression, suicidality, anxiety and an eating disorder over the years. Things still come up pretty frequently, but I have lots of tools I can use when that happens. Yay DBT! I hope you are doing well too!

Have you had somebody follow through while on the phone?

Our service is an online one, so rather than over the phone we chat in real time with visitors over a software program (we are all in a room together at an actual location though - some people assume we do it from home which is not safe to do because we rely on our fellow counselors to help during crisis).

To my knowledge, I have never had someone follow through during a chat. However I've had multiple chats that ended suddenly, or where the person didn't reply for 10 minutes and I had to end it. I never know what happened to those people (but for that matter, I also don't know what happens to someone once our chat ends), but I can't recall a time when I really got the feeling that a disconnect or silence meant that the person killed themselves. But I don't know. I have also had to make many calls to send emergency help to someone, and I never know the outcome of that either.

Oh the lack of closure would be hard. I do phone triage and get these calls every now any then. Certainly don't envy you doing this all the time but it is pretty fun talking someone down.

Yes, it's pretty difficult. But the positive feedback really helps with all that uncertainty. We have a post-chat survey that most people don't fill out, but when they do I am very appreciative of the feedback. I have had several people tell me that I saved their life that day, and I will forever hold those messages in my heart. They don't know it, but by saying that to me, they are eventually saving my life. When I often struggle with my own suicidality, a big question I have is why am I here - what is the point. Then I think back to those visitors and I remember what my purpose is, and it's very helpful to motivate me to keep going.

so if you have spoken to someone and you want to follow up or he wants to contact you again, how is it possible?

Can he ask to be transferred to you or something

Unfortunately, it's not possible with our current system. The larger organization whose website directs chats to us (we are a small organization) also directs them to countless other centers across the US, and we all aren't affiliated with each other. So each time you chat through the main website, you're likely to chat with a different person each time, quite possibly in a different state.

However, I have spoken with the same person before twice, but it's all just chance.

Crisis line volunteer as well- short answer is that if callers cant agree to be safe we are meant to end the call

That's interesting, we aren't trained to do that. But every crisis line is different. If they can't agree to be safe then we call their local emergency response and have someone go check on them.

This is what I want to know.

Did I answer your question or is there anything else you are curious about?

I have two friends who have said things about committing suicide. They both drink heavily and have had serious issues recently. I don't live anywhere near either of then anymore. My question is how do i help them without actually being there for them? I don't want them to feel like I'm checking up on them all the time and treating then like kids, but i also want them to know i can talk if they need it. How do i help without being like an overbearing parent?

That is a really tough situation. I've been on both sides of it before - I've had long-distance friends who are suicidal, and I've been the long distance friend who is suicidal. Since I don't know them, and different things are helpful for different people, I can't tell you what to do in that case. If I were in your position I would probably ask them what I can do that would be helpful for them - would it be helpful for me to send them a message every now and then saying "hey I hope you're doing ok. Let me know if you need to talk", or would that would annoy them or make them feel pressure to reply when they don't have the emotional energy to? I would tell them that I care about them and that my phone is always on, at any time of day or night, if they need to talk. Maybe I'd mail them the occasional care package with a small something that would remind them that you care. If it was me, I would probably also have a conversation with them about issues with alcohol and if they'd be willing to get treatment for that - in rehab they address so much more than just the substance issue itself. Also, if you know their full name and home address, I'd keep that handy as well as the phone number to their local police department, so that if you ever feel like they are in imminent danger you can call the number and someone can come out to check on them. Ultimately though, there is little that you can do if they make a decision to follow through with it. Even if you were geographically close to them. It's so good that they have such a caring friend as you, just remember that you aren't responsible for them. Make sure you take care of yourself too.

I have had suicidal thoughts and ideations since i was 13 or so. I have tried, and failed 5 times to kill myself. I never called one of these lines before. In those moments where thoughts start to turn proactively violent against ones self, i never even stopped to think of reaching out or calling anyone, let alone a crisis number. How effective are these lines? Since i have never called, i never bothered to check, and i am curious. .

The effectiveness varies from person to person, and there really isn't a way to measure it. We do get a basic idea from our pre and post-chat surveys, for those who choose to fill them out. Among other questions, we ask pre-chat and post-chat how bad they are feeling on a scale of 1-5, and see if the number went down. I often see it go down, sometimes it stays the same even when the person told me they felt better, it's all subjective so I wouldn't really call it an accurate representation. But I believe that for the most part our numbers are good, which is what helps us to keep running (we get a government grant to operate and they consider this data)

Do you recall one specific situation where you felt an overwhelming connection to the person on the other end, whether it be because what they were saying was so rattling or otherwise, that stuck with you for a long period of time? Rather than sharing that experience, how did you manage to deal with that?

I love your question! Yes, I can think of several. They all stick with me, but there are definitely some that have particularly stuck with me and I still think about every now and then. How I've dealt with each particular of these chats really depends on what reaction I had to it, which of course depends on what the person said. I've had people talk to me very abusively, which shakes me up at first but I just deal with it by remembering that this space is about their emotions, not mine. If they need to put their anger into words that happen to be directed at me, I will remember that I shouldn't take it personally and that it is good that they are getting these feelings out. It's always difficult when someone shares such a similar story to mine. We are cautioned against sharing personal details, but there are times I have wanted to share a bit of my story so badly - because I know for me, the therapists I've found to be the most helpful are the ones who have shared a little about themselves when it is relevant to the conversation. To hear a therapist say that they have attempted suicide before, or that they are in recovery from an eating disorder too, or have struggled with some of the other things that I have, suddenly makes me feel truly understood by that person, which makes a huge difference in the outcome of our communication. So there have been a couple times where I am chatting with someone, and I swear I'm talking to myself 5 years ago. To be honest it's been hard to resist giving them my email address in those instances! Even repeat visitors often speak to a different person each time they reach out to our service.

But to really answer your question (sorry, I go off on tangents sometimes). How I cope with anything that comes up as upsetting or triggering is to use my coping skills that I've learned over the years. Or just make a blanket fort and stay in it the whole next day. Plus it helps to be in an office surrounded by mental health professionals who are happy to talk and listen to you vent at any time.

I think you probably don't receive enough credit for the work you do; walking into work is basically accepting that you'll be put in situations that will toy with your emotions, which is made all the more impressive by the fact you've had to deal with suicidal thoughts in your personal life years ago.

You're awesome. Keep being awesome.

Thank you so much <3 I don't feel like I need credit for it though, because knowing that I help people is a huge reward.

And my suicidal thoughts actually did not end years ago. They began when I was 8 (the first time I attempted) and they still come up often for me, even now. As I explain to people on chat, defeating the thoughts is not about getting to a place where they don't come anymore. That'd be awesome, but for a lot of us that doesn't happen. The thoughts continue to come up throughout our life. The important distinction to make is between thoughts and actions. Defeating the suicidal thoughts is about choosing not to act on them.

It just makes what you do even more incredible, given it's still something you struggle with. I don't even know how to properly respond other than by reaffirming how awesome you are. <3

I am extremely grateful and humbled by your kind words <3

Hey, I've been in the situation where I've had to talk to suicidal people previously (cop). When someone is delusional, is it better to play along with their imaginings or point out that what they're saying doesn't make sense? I never know what the best thing to do is. Sometimes, I feel playing along isn't helping them and only affirms what they believe, while on the other hand, pointing out the flaws in their reasoning doesn't really get me anywhere as they only have more elaborate delusions to answer your critiques. Also, it's not exactly rapport building. Any hard and fast rules or do you have to use your own judgement in different situations?

Haha well first of all, there are no "hard and fast rules" when it comes to psychology ;)

Yes, it's about trusting your judgment, but also I would say in general (I can't speak for all situations) when a person is having delusions it is usually better to go along with them - but again, it is so dependent on the situation! I mean there are infinite types of delusions a person can be having.

If you give me a specific example, maybe I can tell you what I'd do in that situation.

How would "talk down" some with bipolar disorder?

That is really too hard for me to answer without more details about them and what they are experiencing. Especially since a bipolar person could be experiencing a depressive episode or a manic episode, or a combination - and you treat each of those differently. But every person is different, even those who have the same diagnosis, in how they experience things and what is helpful for them. I would say that in general I would probably start by the same process I replied with to the other question about "talking someone down". It starts with listening. If you just start by listening to what they have to say, and feeling everything with them, then you will get a clearer picture of what they need. But I can't supply a general answer of what to do with everyone. It's all so specific to the person.

I will say that we don't really use the phrase "talking someone down" to describe what we do. It's a common misconception that when someone is in crisis you need to talk at them, saying as many happy and inspirational things you can think of, until you motivate them to come out of crisis. I've never seen that strategy actually work, in fact I've seen it have the opposite effect - the person shuts down and doesn't feel like they can reach out to you anymore. People want to be heard and validated, including about their reasons they are feeling for wanting to die.

I believe the phrase "talking someone down" originates from the commonly-used-in-movies-scene of a person standing on a roof about to jump, and all a crowd of people stand on the ground, looking up and yelling things to try and inspire the person that life is good and they can keep going. It may work in the movies, but in real life, your best bet is not to stay on the ground. Go up to the roof with them and look at things from their point of view.

1/16/16 5:22pm PST: You guys, it has been so lovely talking with all of you! At this time I can't take any more questions. I am noticing many many repeats, so if you search through previous questions and answers, I am likely to have addressed your question before. Everyone who asked a question before this cut-off time (5:22pm PST) I will try to get around to your questions when I can, but I have spent many hours on this thread and I really need to go get some other things done! If I could, I'd keep it open forever and make sure i got to everyone! But that's really not possible for me. I really enjoyed talking with you all! :)

Also, here's an awesome short vid about empathy: https://www.youtube.com/watch?v=1Evwgu369Jw I think it's worth a watch!

What made you eventually decide that life was worth it?

Hmm, it changes by the day, but my biggest motivation to keep going even when I don't want to, is that no matter how bad I feel, I still have the ability to make others feel better and to help. I stick around for them. It would feel selfish to me if I chose to leave this earth, not because I don't have control and say over my own life and death, but because if I leave, then I am taking away help from people (all the people who I would have helped if I had continued to live) that they need. I sometimes think "someone else will help them" but there's no way to know that for sure

Did you ever feel frustrated when someone complains about their life after you took this job and if so, what do you do about it?

Well I am only human, so occasionally when someone is very upset and venting about something that initially seems trivial to me, the thought pops up "this is not a big deal! i've been through worse!" or "i just talked to a person last night who has been through worse", etc. It's just a quick little thought and it doesn't happen much anymore, but when it does I recognize it and I put it out of my mind and remind myself that I don't know their whole story, and even if I did, their emotions are valid because they are true for them. Everyone goes through different types and amounts of shit, but when you are at a point where you're going through the hardest shit you've ever gone through, whether that's an argument with a friend or being diagnosed with terminal cancer, your feelings are valid. You only have your own to compare to.

if I want to begin volunteering for something like this, how do I do it, and what kind of qualifications or training do I need?

That is going to completely depend on the organization. I would google "suicide crisis line" then your state and see if there's one in a city close to you, go to their website and find information about volunteering.

I've been plagued with suicidal thoughts the last couple of years ( I wouldn't do it!). It's a nightmare but I don't want to go on meds. Going to try SAD light and regular exercise. Once these compulsive thoughts start, is it common for them to go away after a time?

Everyone is so different. There's really no way to predict. For me, my suicidal thoughts began in elementary school, and my brain was still developing and creating all those neuropathways that make you think what you think and do what you do. Suicidal thoughts became ingrained in me, a neuropathway was created that meant that anytime I felt hopeless/sad/anxious etc, I would have the automatic thought of "I should kill myself". In the beginning I would ruminate on that option and let myself spiral, and that's what led to my attempts. Nowadays, I still get the thoughts but I have learned to replace them with the thought "that's not an option, so lets try to think of all the options i do have". That's what personally works for me but EVERYONE is different in what helps them! And different as far as how serious and for how long their suicidality lasts.

Do you get people calling who seem to have an objectively awesome life (great family, great job, etc) but who are still depressed? Can you tell us about any examples (without identifying anyone)?

I don't know how someone could have an objectively awesome life, when "awesome" is a subjective term. 10 different people could hear their life story and form different opinions of how bad or good it seems, and it'd likely differ from the opinion of the person who is living it. I think that our judgment of others' circumstances (whether we think they have a good life or a hard life) depends a lot more on our own feelings and our own experiences. It's a comparison we make rather than a truly rational judgment. If someone has more money than us and we are struggling monetarily, we are likely to see that person as lucky and fortunate, even if they are dealing with other circumstances. Life is hard for everyone, and everyone in crisis is valid for feeling that way. One person might be in crisis because their favorite tv show just cancelled, and another because their partner just died. Both are valid because it's not about the circumstances, but the feelings. That's why they reach out to us, is because of what they are feeling. It doesn't matter why.

Any tips on identifying a serious threat vs one just stating it for attention?

I'm glad you asked this, because it's a common misconception that talking about your suicidal thoughts means that you aren't going to act, or that you are just seeking attention.

A couple things to consider: - About 40% of people who complete suicide have had at least 1 previous attempt (the rest complete suicide on their first attempt) - 8 out of 10 people who complete suicide show signs of suicidality beforehand, like talking about it or contacting a crisis line.

Of course I don't know, but I doubt that anyone would say they want to die or want to kill themselves without meaning it. They want out of the situation they are in. They want to escape the horrible and painful emotions they are feeling. Whether or not they end up making an attempt, completing suicide, or not, does not make their feelings less valid. It is our instinct as sentient beings to try to prevent our death as much as possible. When you have suicidal thoughts, your body and mind get into an argument. Many people go through the process of planning and preparing for their suicide and then when the moment comes, they don't do it, because their body releases chemicals that stops them in their tracks. However just because this happens does not mean that it always will, or that the person won't complete suicide later.

Also, I want to note - most people who are suicidal do not actually want to die (even those who complete it). They just want the emotional (or physical) pain to end, they want to escape from their unbearable reality, and they think that suicide is the only option to do so. The dying part really isn't the part we want. It's painful, it comes with all sorts of unknowns. We just want to be anywhere else but in our own existence.

Do you get paid on commission?

We are mostly run by unpaid volunteers - I fall into that category. We have a couple of paid employees but they are not paid commission (I'm assuming you mean how many chats they take?) they are paid a set salary.

How is the service funded? Is it through a municipality, charity, school? How is it staffed in terms of making sure there are enough people on hand to meet the demand? If you are all in active chats and another person needs help, do you juggle two chat conversations at once? Is there a busy season?

I do not know all the details of our funding, but I am pretty sure that we are funded through government grant, which we acquire by providing data about our chats and then they determine if we are worthy of funding. The data we provide is not personal or identifying information - it's things like how many chats are we able to have in a day, how many visitors don't get a chance to get through and chat because we didn't have enough volunteers on the shift, how many calls to 911 and CPS we had to make, and demographic things like average age and gender of visitors. Nothing identifiable about specific chats! (I just want to reiterate that the service is anonymous because I know it's already hard enough for some people to reach out because they are afraid of being identified) It's all just general number collecting.

The way we are staffed is mostly by volunteers. We are a part of a larger organization that provides many services, and I can't speak for the other departments, but in chat, we usually only have one paid person there at all times who is the chat supervisor (they also take chats themselves and are there to help) and sometimes we have another person there - i can't remember her job title but she's above the supervisor, she is in charge of the whole process of hiring and training volunteers, and she also goes out and does talks at schools.

Because we don't have enough funding, we can only afford 1 paid supervisor at a time (although I believe we were just able to hire a second one) and the rest is volunteers. We don't get to every visitor. We don't have enough volunteers even to fill up all our computers, and even on the rare shift that we do, there are still others who can't get through because everyone is in a chat.

It's our policy that each of us can only take one chat at once, on the basis that it's about quality not quantity. Staying focused during one chat can be hard enough, I can't imagine juggling two at once. Humans can't multitask efficiently. We can do one thing at a time and do it well, or do two things at a time and do them both crappy. That's why we give our full attention to one guest at a time. We are always trying to recruit more volunteers though!

I appreciate you thoughtful and thorough answers.

Thank you! I appreciate it. I also apologize for how late they are coming - I started this thread last night and spent several hours answering questions, and i thought it'd fizzle out, but then woke up to a bunch more, haha! I am happy to answer them I just hope everyone understands why I am getting back late - I have a lot of to-dos on my list today.

i have a couple of questions, 1.if someone is being irrational how do you make them see logic? 2. have you ever lost it at work? 3. how do you keep calm?

1) A large majority of people say something irrational during the chat. I think irrational things all the time, we all do. But crisis intervention really isn't about rationality it's about emotion - when people come to us they are often unable to see rationally because they are 100% in emotion-mind. So it's not helpful to try and make them see logic because they can't in that moment. (I say this as someone who has been in that state of mind many times before!) It will usually just make them feel invalidated and unheard, because they are there to work through their emotions. Logic isn't logic in those moments, emotion is logic. It's that person's undeniable truth.

1. I don't think I've ever lost it there, but I've definitely had to go home early because I was completely emotionally burnt out.

2. In between messages (while I am waiting for the person to respond) I do something that is calming but doesn't take my focus off the chat. The office provides us with adult coloring pages and pencils, and some people even bring their own :)

Hello there, first of all, let me thank you for all that it is that you do. I had one experience with a suicide crisis line (this was during the beginning stages of my mental collapse) and I couldn't work up the courage to talk to somebody on the phone so I tried just talking online to somebody. All I got were "Sorry" "It'll get better". I thanked the person for their time and immediately logged off. Since then, I've been treated at a behavioral health facility to get me on the right medications, and have been going to a therapist twice a week (until this year when we had to switch insurance...). I suppose the biggest question that I want to ask you is; Are there some people who are just too far gone and fundamentally unhappy for there to be any sort of artificial saving grace as opposed to "wait and see if things get better"?

Oh no! "Sorry" and "it'll get better" are two of the worst things you can say to a person in crisis! That must have been horrible for you to go through! :( Rgh, "sorry" is literally the most unhelpful thing. And we use it so much it's lost all meaning that it ever had. Instead of saying sorry, they should have (metaphorically) sat down with you in the space you were in. Let themselves feel how horrible it is down there. Only then can they truly provide empathy, which is what helps us to feel validated and known. As opposed to sympathy - which is what they did by saying "sorry". Awesome video about that here: https://www.youtube.com/watch?v=1Evwgu369Jw

But anyways. To answer your question... I don't know. I don't know how science could even measure that, because they would need to predict the future. There are people who are severely depressed and have been their whole lives, but even with these people, we cannot predict if it will be that way for them forever or not. It takes a lot of hard work and commitment to be in recovery from depression, especially when the depression itself is trying to stop you. It sounds like you have been doing a lot of that hard work, and I think that's something to be proud of. You have still chosen to live thus far (it's a choice you make every moment of every day) despite how painful and scary it is to do so. I think that's the most courageous thing a person can do. I won't tell you to wait and see if things get better, because the only thing we know for certain about life is that it will change - we don't know how. But I want to commend your courage and acknowledge how hard it is. I was in that place for a long time, and although I do still occasionally have spells of depression and suicidal thoughts, I know what happiness feels like again. I believe that anyone can get there, but of course I cannot know.

what's the best part of your job?

We rarely get written feedback from visitors, even if we were helpful to them. But sometimes I do get feedback and it makes me happy that I know I was able to help. I have one specific chat I remember where the person wrote to me, among other things, that I saved their life that night. I printed the comment out and I read it during the especially rough times when I need a reminder of why I do this.

How did you learn about/get involved with the organization that you're volunteering for?

I was out of work and school for a long time dealing with my physical illnesses, but I felt sort of useless and I did have a little bit of energy to spare, so I looked into volunteering somewhere. I found the organization through a volunteer opportunity directory website. I thought "perfect!" because I love helping people through crisis, and I am studying psychology.

How can I get involved?

I would google "suicide crisis line" and your state and see if there's one in a city close to you, then go to their website and find information about volunteering.

What type of issues plague the transgender community that drives one to want to commit suicide and how can we as a community do to help?

Oh gosh, so many... this is a really loaded question. I greatly appreciate you bringing up this topic, I'm just not sure if I have the brainpower and ability to dive into it right now. I will say this - there are a lot of issues, but I think most of them relate back to acceptance. Being transgender is so hard - i've never experienced it myself so I can only imagine. To have to live and function in a society that largely does not accept who you are inside. As a community, we need to practice love, acceptance, and literally treat every person no matter their gender identity or sexual orientation, with the same respect that we would want to be treated with. I think our general misunderstanding of gender identity and sexuality leads to a lot of this judgment. If everyone was educated about it, I think things would be different.

How many customers talk/bitch about disability related stuff? Any patterns you have noticed (within the types of disabilities in what makes people depressed/contact you)?

Occasionally I do get individuals who explain that they struggle with a chronic illness, terminal illness, and/or disability. I can't say that I've noticed any patterns. I myself have lived with a chronic illness since birth that is disabling to certain aspects of my life, so I find that these visitors are often the ones whose feelings I can relate with the most. I can relate to people who are struggling with depression, anxiety, and anorexia because I've been there. But my chronic illness and what I experienced in my childhood because of it is directly why I developed depression, anxiety, and anorexia. Everything comes back to it. So yeah, I feel pretty connected with those people. I think it's that "spoonies have to stick together" community mentality too. I'm thinking eventually when I get my degree and figure out my specialty, that will be it. Many therapists I've seen over my lifetime have had a very hard time empathizing with my chronic illness more than anything else we covered.

Sounds like a good specialty. :) I'd love to see (pun intensed) more therapists and councelors catering for all sorts of disabilities AND neurodivergent population. Sometimes with one disability it can be easier to relate to some others, sometimes not (blind autistic with a non-oral Deaf signer? A fail in a past real life scenario)

I completely agree! I think that the people who have gone through the exact same thing can often be the best help. But also, even if we've gone through 2 different things, as long as our experiences have a similar underlying current, which most do, we can still empathize with one another in a powerful way.

whyyyyyyyyyyyyyyyyyyyyyyyyy are you sooo fucking useless? i was feeling shitty one night, didnt want to call anyone so i found a web chat based "crisis line" , first one told me "they only serve colorado" and told me to fuck off, the second one i found (and these ar every hard to find) was the most useless shit i have seen in my entire life, the dude i saw basically went by some pre written script and 1:1 reworded what i said and sent it back at me. how is this useful?

Some crisis chat services only serve a specific state or region. The one that I volunteer for is a smaller organization but we take chats that come in through http://www.suicidepreventionlifeline.org/ ^ that i know of, that's the biggest crisis chat service out there. There are centers around the country that take chats through them.

Obviously, every crisis counselor you get is going to be slightly different from the rest. Our individual organizations all train us slightly differently, and everyone takes the training differently. I had a couple bad experiences calling a crisis line myself when I was younger, but many people who I've talked to have said that i helped them a lot, and I know that several people who I volunteer with are very good at the job as well. We don't follow a script.

How helpful a chat is for you depends on a lot of factors, one of them definitely being the counselor you are talking to, so I'd try again. Also, if the way they are trying to help isn't working for you, let them know, because they won't know unless you let them. And different people need different things in those moments. So if you are able to identify what it is that you need from the counselor, that will help you both tremendously.

I've often heard "if someone says they are going to commit suicide, they have already decided not to do it"

Is there any validity to that statement?

One of my answers to a similar question goes into more detail, but I'll say this: No. So far from the truth. There are so many misconceptions about suicide that are so harmful to people who struggle with suicidality. I believe many deaths could be prevented if people knew the warning signs and how to help. It's a HUGE and harmful myth that most people who complete suicide kept it a secret beforehand. I can't speak for the whole population, but statistically, 8 out of 10 people who complete suicide show identifiable signs of suicidality prior - most commonly, talking about it with friends & family, or contacting a crisis line.

As I said in the previous comment, it's against our animal instincts to kill ourselves. We have an innate self-preservation mechanism and our body will fight death as hard as it can. People who talk about wanting to kill themselves, who attempt suicide, and who complete suicide, generally do not want to actually die, they just want to escape from their reality, and for their pain to end. And they see suicide as the only option to end the pain.

What's the general age range of the volunteers? Mostly young, old etc?

We have volunteers of all ages, but I do notice that a good chunk of us at my organization are college-aged because many of us are pursuing a degree in psychology and want to eventually be a therapist.

Do you actually have licensure for this (lsw, Lisw, lpc,lpcc, ect.) or do they just train you with some online short course?

Also if someone is actively suicidal, calls the hot line, decides yalls help wasn't sufficient enough, completes suicide, then has parents or love ones blame your agency, what happens next?

I do not have a license (yet - I am going to school) and I don't think any of our volunteers have a license, but there is always at least 1 person in the room who is paid and has a license, to help if need be. Although the training we get as volunteers is very thorough. Several weeks of classes (in person. Lecture/presentations and assignments). A lot of the assignments involve a made up manuscript where we have to write in what our response would be to the person. And then we do quite a bit of shadowing other people doing chats before taking our first chat. Then during our first few chats we are shadowed. Also, no matter how long you've volunteered here, your transcripts are reviewed often and you are given constructive criticism and let know what you're doing right and what you could do differently.

I believe a part of the terms that they have to agree to in order to access the service includes something about that. We do not have control over what decision they end up making. We can do our best to help - and call for an emergency check-in, but the outcome is still truly out of our hands. I don't think we've ever run into a situation like that, luckily.

Have you ever had a case where you where certain that this person committed suicide after the call/conversation with you? If yes, how did this effect your life(guilt, depression, blame, anger)?

Copying from another of my answers to the same question:

"Our service is an online one, so rather than over the phone we chat in real time with visitors over a software program (we are all in a room together at an actual location though - some people assume we do it from home which is not safe to do because we rely on our fellow counselors to help during crisis).

To my knowledge, I have never had someone follow through during a chat. However I've had multiple chats that ended suddenly, or where the person didn't reply for 10 minutes and I had to end it. I never know what happened to those people (but for that matter, I also don't know what happens to someone once our chat ends), but I can't recall a time when I really got the feeling that a disconnect or silence meant that the person killed themselves. But I don't know. I have also had to make many calls to send emergency help to someone, and I never know the outcome of that either.

Your work is incredible and thank you for doing what you do. My question is more for somebody who wants to get involved. I have also struggled with depression and anxiety and tried to stick up for others who do as well. But I'm having some trouble figuring out how to really involve myself and help people. Any good advice on where to start?

There are so many ways you can help people, it just depends on what way you think you'd enjoy and exceed at the most. Are you pursuing a degree/license in a helping profession?

If you're not paid for this, how do you earn bread for thyself? I really appreciate what you do though! :)

I am in school pursuing my psychology degree, and that takes up a lot of time. I do little odd jobs, mostly artistic ones, but for the most part my bread is provided by my awesome and supportive husband. Eventually once I get my degree, I will resume my place as co-breadwinner! ;)

Has anybody every called you and tricked you into having phone sex?

We are an online chat rather than a phone system. I have had a couple people make inappropriate comments right off the bat, but I send them a warning message and end the chat as i've been trained to. other than that, I don't know - You never know what someone is doing behind their computer screen lol! And we do often talk about techniques to relax for the rest of the evening, hah!

Is it really emotionally draining to constantly be dealing with people who are suicidal? I had a family member attempt suicide and I was constantly worrying about them, trying to help, didn't really know what to do, etc. and it really wore me out. It was so exhausting I had to disconnect a bit and stop caring as much. How do you deal with that?

Our shifts are short (only 4 hours at a time - you are so emotionally burnt out by the end) and we are only required 1 shift per week at the minimum. Lots of people do more if they can, but you have to not take on more than you can handle. You take care of yourself first - which may sound selfish at first but it's actually not - if you get burnt out and too emotionally overwhelmed then you can't provide the best service (or any at all, depending on the situation) to everyone who comes in. And also, it's an office full of mental health professionals - so there is always someone you can talk to, and they all understand if you can't come in because you can't handle all that emotion that day. At most jobs you are told you have to leave your emotions at the door and just work, but at this job, we literally have to constantly be feeling emotions in order to provide true empathy to our visitors.

What are you obligated to report the police? If someone is considering suicide, at what point are you required to report them?

We report when we believe the person to be in imminent danger. This basically means that we believe through what they have told us that they are going to act in the next 24 hours, and they refuse to agree to a safety plan. That's just our center though. I don't know about others.

I am getting the feeling that you're struggling right now... feel free to send me a private message if you need to.

I am a physician. What's the best way, in your opinion, to convince a patient to contact a service like yours in a time of need?

Thank you for your question! Hmm, that's a tough one. I would say an important thing is to have cards and brochures for services in your exam rooms and in your waiting room (hell, maybe even the bathroom). Just ones that list the telephone number and website they can access if they are in crisis. I believe the organization which mine works under does print materials like this: http://suicidepreventionlifeline.org/

Chances are, many of your patients who are struggling with suicidal thoughts have not told you (or even lied during a questionnaire). There is a lot of fear around opening up to someone who could choose to have them admitted to a psych hospital. So putting those printed resources in places where patients will see them on their own and can take them without you knowing can actually be hugely helpful. For those who do reveal to you that they have been having those thoughts - besides asking all the questions you need to ask and making referrals - you can hand them a brochure and card for the suicide lifeline, and ask that they please utilize it as a resource. There's no way of convincing them, really. But giving them that resource so they know the number and website is important.

Have you ever been frustrated when someone who is fine talks about their problems and if so what do you do about it?

What do you mean by that? If they felt fine then they wouldn't be having problems, and if they felt fine they probably wouldn't contact us.

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what are the signs of a surebsuicide?

Can you rephrase your question? I am not sure exactly what you are asking.