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Here's What Happens When You Call Into A Suicide Prevention Hotline

Suicide hotlines can provide free and confidential support 24/7. Here's what to expect when you make the call.

Posted on June 8, 2018, at 5:56 p.m. ET

[If you or someone you know is in immediate danger or having a medical emergency, call 911.]

The National Suicide Prevention Lifeline (1-800-273-8255) is a toll-free hotline in the US for people in distress who feel like they are at risk of harming themselves. But what actually happens when you call?

Suicide is complicated and sometimes hard to predict, but health experts say it can be preventable. That's why there are services like the National Suicide Prevention Lifeline, and the hope is that people will use them if they, or someone they know, are having a crisis. But for many people, there is still some mystery about what actually happens during these calls, and some misconceptions can keep people from picking up the phone. So we put together a step-by-step guide about what to expect when you call a suicide hotline. Keep in mind, however, that everyone who calls into a suicide hotline may have a slightly different conversation and experience. And there are also hundreds of different suicide and crisis-prevention hotlines and chat services. For the purposes of this post, we will focus on the National Suicide Prevention Lifeline and another line that you can text, called the Crisis Text Line.
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Suicide is complicated and sometimes hard to predict, but health experts say it can be preventable. That's why there are services like the National Suicide Prevention Lifeline, and the hope is that people will use them if they, or someone they know, are having a crisis.

But for many people, there is still some mystery about what actually happens during these calls, and some misconceptions can keep people from picking up the phone. So we put together a step-by-step guide about what to expect when you call a suicide hotline.

Keep in mind, however, that everyone who calls into a suicide hotline may have a slightly different conversation and experience. And there are also hundreds of different suicide and crisis-prevention hotlines and chat services. For the purposes of this post, we will focus on the National Suicide Prevention Lifeline and another line that you can text, called the Crisis Text Line.

First, the basics: Lifeline provides free, confidential support 24 hours a day, 7 days a week, for anyone of any age — including non-English speakers.

Anyone can call the Lifeline, whether they are thinking about suicide or not, and get emotional support. There is no minimum age, and you can receive support at any time, even on holidays. As long as you have a phone, you can call the number and talk to someone. Lifeline is also available for non-English speakers and people who are deaf or hard of hearing.

If you are a Spanish speaker, call the Spanish-language Lifeline at 1-888-628-9454. Si hablas español, llama a 1-888-628-9454. Lifeline ofrece 24/7, gratuito servicios en español.

If you speak another language, call the main line and wait to be connected to a person at a local crisis center who can connect with a translator. According to Lifeline's website, the crisis centers work with a service that can translate calls in over 150 languages.

People who are deaf or hard of hearing can reach Lifeline via TTY by dialing 1-800-799-4889 or use the Lifeline Live Chat service online.

When you first call, you will get an automated greeting with additional options. A person does not come on the line immediately.

After dialing 1-800-273-8255, you will hear the following automated message:

"You have reached the National Suicide Prevention Lifeline, also servicing the Veterans service line. If you are in emotional distress or suicidal crisis or are concerned about someone who might be, we're here to help. Please remain on the line while we route your call to the nearest crisis center in our network."

The automated message also provides additional options for Spanish speakers and veterans. If you speak Spanish, press two. If you are a veteran or an active duty member of the military or calling about someone who is, you can press one.

"We work in partnership with the Veterans Crisis Line, so when you press one the call will be connected to a special center that's operated by Veterans Affairs," Shari Sinwelski, associate director for the National Suicide Prevention Lifeline, told BuzzFeed News.

You can also reach the Veterans Crisis Line by sending a text message to 838255, or by clicking here to chat with a VA responder online.

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Then, the call is routed to a local crisis center. Music will play. Wait times are usually under one minute, but they can be longer depending on the center's resources.

Lifeline is actually made up of a network of 161 crisis centers across the country, Sinwelski said. Most crisis centers are non-profit and are staffed by both professionals and volunteers. When an individual calls in, they will be routed to the crisis center located closest to them.

"The reason why we do that is because we believe local crisis centers, ideally, are best able to help people in their own communities because the staff are aware of the resources in that community," Sinwelski said.

There is also a backup network, so if your community doesn't have a crisis center or your crisis center is swamped with calls, you can still reach someone. According to Lifeline, they are able to answer 85% of calls within 30 seconds after the greeting, and 97% within 75 seconds or less.

However, there are occasions where people have to wait to talk to a counselor. Wait times might vary depending on where the person is calling from, whether their local crisis center has enough resources and staff, and the volume of calls coming in. "We've seen a big increase in calls in the past year or two across the entire network," Sinwelski said. Some crisis centers are better staffed and larger than others, so they can answer calls more quickly.

Regardless of the wait time, you will be connected with someone. "Lifeline strives to answer calls as quickly as possible," said Sinwelski.

A trained crisis worker will answer the phone.

The person you end up speaking to will be a skilled, trained worker from the crisis center — they may be a staff member, professional, or a volunteer. But everyone is required to go through the same training to answer the Lifeline, said Sinwelski.

Crisis workers are trained to talk comfortably and calmly, use active listening, assess risk, and determine if a person is in danger. "They are able to listen to you and your emotions in a way that's non-judgmental and comforting so callers feel like they can trust the person on the other end of the line," Sinwelski said.

They will answer with a greeting, but the worker won't immediately ask you a specific set of questions. You can start the conversation however you want.

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The call can last as long or as short as you'd like — the goal is to help the caller feel supported and safe.

All individuals and situations are different, so no call will look the same. You can share as much as you are comfortable with sharing, and talk about anything. People may call to discuss mental or physical illness, relationship problems, physical or sexual abuse, substance abuse, financial problems, sexual identity, or anxiety.

Crisis workers do not follow a script, so the conversation will be open. But they might ask you some questions to better understand your problems so they can share the most effective resources to help.

"There is no time limit, but volunteers will always try to make sure they use time wisely so they can talk to as many people in need as possible," Sinwelski said.

Whether or not the call is effective or helpful depends on a variety of factors. In many cases, crisis workers are at least able to help the person feel better. "Finding a connection with someone is the first step in helping to feel better with thoughts of suicide — we're going to do everything we can to help a person feel safe," said Sinwelski.

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If you are calling about a friend or family member who is in distress, the person on the phone will walk you through how to help and provide resources.

When you think someone you know is having a suicidal crisis, you might not know the best way to reach out to them or how to provide support. Or you might be nervous or afraid of saying the wrong thing. The Lifeline can also be a resource in these cases. "The crisis worker will give guidance on how they might help a friend or family member — we try to break it down in a very simple way and go through the steps," Sinwelski said.

If you are concerned about someone, do not hesitate to ask if they are okay or thinking about harming themselves — this is one of the best ways you can help. Check out the Lifeline's "#BeThe1To" (Be the One to Save a Life) website for more resources.

In higher-risk situations, crisis workers will do everything they can to work with the caller and come up with a safety plan without an intervention.

Some callers may be higher risk if they are having suicidal thoughts or actively considering suicide. "Our imminent risk policy requires a counselor to work collaboratively with the person on the line to come up with a safety plan and that both can agree upon," Sinwelski said. In most cases, crisis workers are able to de-escalate the situation and help the caller feel safe without any intervention from, say, the police.

Occasionally, the caller might still feel unsafe or want to hurt themselves even after talking with a counselor. In those situations, the crisis worker will try to brainstorm ways to help the suicidal person in ways that are acceptable to them. These might include having a counselor from the center come to their house, calling a family member or friend to help, or calling them back later to check in.

"You recognize that it can be very overwhelming for someone in crisis to feel like their control is taken away, so we work together so they can feel good about the plans and we can keep them safe and alive," Sinwelski said.

The Lifeline uses clinical policies created by both professionals and a committee of people who have survived suicide attempts, been suicidal, or lost someone to suicide. "That committee helps us stay aware of what the concerns and fears of individuals who are using our services," said Sinwelski.

In rare cases, the crisis worker might need to alert the local police to make sure a person is safe.

Some people may be afraid to call the Lifeline and talk about thoughts of suicide because they are concerned about losing autonomy. But it is rare for a crisis worker to contact police about a caller, and in most cases, they are able to de-escalate the situation or come up with a safety plan with the caller.

"Sometimes there are situations where confidentiality might be broken in order to keep people safe, but that happens very infrequently — less than 3% of calls require any intervention," Sinwelski said.

An alternative to the Lifeline is the Crisis Text Line (741-741), which offers confidential support 24/7 via text message.

If you are in a situation where you can't talk over the phone, the Crisis Text Line might be a good option. "It's an excellent alternative to the hotline because you can be anywhere, anytime having a crisis and reach out for help and nobody will know — there's a tremendous sense of privacy and anonymity," Dr. Shairi Turner, chief medical officer of Crisis Text Line, told BuzzFeed News. You just text 741741 — you can start with "hi" or "I need help" or anything you want — and you'll get a few links and be asked if you want to be connected with a trained volunteer. Your number will come up as anonymous and there's an option to erase the conversation and remove it from the system. "If we're tying it to this week's tragedy with Kate Spade and Anthony Bourdain, you could be a celebrity and text in and stay completely anonymous — nobody would recognize you," Turner said. The text line is also beneficial for people who are deaf, hard of hearing, and those who have speech difficulties. Sometimes, it's just easier to describe your problems in a text rather than a phone call. The Crisis Text Line uses an algorithm to detect "high risk" phrases and answer those texters immediately.The goal is to de-escalate and provide the person with coping skills and resources. Similar to Lifeline, volunteers try to work with the person to come up with a safety plan before calling the police — which only occurs in about 20 out of over 3000 text conversations each day, Turner said.
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If you are in a situation where you can't talk over the phone, the Crisis Text Line might be a good option. "It's an excellent alternative to the hotline because you can be anywhere, anytime having a crisis and reach out for help and nobody will know — there's a tremendous sense of privacy and anonymity," Dr. Shairi Turner, chief medical officer of Crisis Text Line, told BuzzFeed News.

You just text 741741 — you can start with "hi" or "I need help" or anything you want — and you'll get a few links and be asked if you want to be connected with a trained volunteer. Your number will come up as anonymous and there's an option to erase the conversation and remove it from the system.

"If we're tying it to this week's tragedy with Kate Spade and Anthony Bourdain, you could be a celebrity and text in and stay completely anonymous — nobody would recognize you," Turner said.

The text line is also beneficial for people who are deaf, hard of hearing, and those who have speech difficulties. Sometimes, it's just easier to describe your problems in a text rather than a phone call. The Crisis Text Line uses an algorithm to detect "high risk" phrases and answer those texters immediately.

The goal is to de-escalate and provide the person with coping skills and resources. Similar to Lifeline, volunteers try to work with the person to come up with a safety plan before calling the police — which only occurs in about 20 out of over 3000 text conversations each day, Turner said.

If you or someone you know is in emotional distress or suicidal crisis, check out the resources below.

* Call the National Suicide Prevention Lifeline1-800-273-TALK (8255). Here is a list of international suicide hotlines.

* Text TALK to 741741 for 24/7, anonymous, free counseling.

* Call the SAMHSA Treatment Referral Hotline, 1-800-662-HELP (4357), for free, confidential support for substance abuse treatment.

* Call the RAINN National Sexual Assault Hotline, 1-800-656-HOPE (4673), for confidential crisis support.

* Call Trevor Lifeline, 1-866-488-7386, a free and confidential suicide hotline for LGBT youth.

* 7 Cups and IMAlive are free, anonymous online text chat services with trained listeners, online therapists, and counselors.

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