What to expect when calling a suicide prevention hotline

Friday marks World Suicide Prevention Day

When a celebrity dies by suicide, or when the topic is making headlines, it’s common to see the phone number for the National Suicide Prevention Lifeline flashed on TV or included in online articles.

But what happens when you make the call? What might you expect?

Dr. Ron Samarian, the chief of the Department of Psychiatry at Beaumont Hospital, in Metro Detroit, spoke with us about what goes on behind the scenes when someone dials in for help.

How is my call being handled?

There’s more than one hotline, but for today, let’s talk about what happens when you dial the National Suicide Prevention Lifeline (which can be reached at 800-273-8255).

After a short automated message, you’ll be connected with a person who will redirect you to someone at a local-to-you facility.

Sometimes there’s a bit of a wait, and other times, your call might be taken right away. It all depends on the time and the day.

What will this person ask me?

The person on the other end of the line will usually start with some open-ended, gentle questions, such as, “Why do you think you’re calling us today?” It’s important to answer honestly, Samarian said.

Eventually, the voice on the other end of the phone might ask you some pointed questions, too. For example, “How safe are you? Do you have any plans to hurt yourself?”

The focus is on the immediate safety of the individual dialing in for help.

Who exactly is this person I’m talking to?

It’s a volunteer trained to help you at this exact moment.

He or she is trained to work with you on whatever's happening in your life that has prompted this phone call.

You can feel safe talking to this person.

How long does the call typically last?

The length depends on the circumstances and severity of your call. In most cases, it lasts however long it takes to help you feel more safe and stable. It will be different for every person and every situation, Samarian said.

I can stay anonymous, right?

Most of the time, yes. If you’re calling in for help and you’re receptive and the conversation is going well -- meaning the call is headed in a positive direction, and you’re not threatening yourself or others -- then you’re anonymous. And that’s the ideal situation. Let’s say a celebrity calls, for example. No one would have to know that. However, if the listener determines that there’s a threat, then that person can choose to trace the call.

“(And) if the person who’s calling in is still (not doing well) by the end of the call, the listener has to make the decision on whether to override the confidentiality involved and call local police to get that person to a safe place,” Samarian said. “Usually, the listener wants to do everything but that. It’s way more preferred to get that person to a hospital or in touch with a family member.”

If the person calling the hotline is outlining a specific (and dangerous) plan, that’s an example of a situation in which the listener should override the confidentiality agreement, Samarian said.

This sounds a lot like an in-person therapy session. How similar is the experience of calling in?

It’s definitely parallel, Samarian said.

As the listener, or therapist, that person has to use his or her best judgment as to whether the caller is safe.

The anonymity factor is much like the in-person therapy experience, as well. A doctor will breach confidentiality in some cases, in order to save someone’s life.

What if I feel uncomfortable about reaching out?

First of all, know that you’re not alone.

“Yes, unfortunately, there is this kind of mentality (of), ‘I don’t want to embarrass myself (or) I don’t want anyone to find out I’m getting help,’” Samarian said. “It’s kind of like the mentality with going to therapy. But people need to know that it’s OK to reach out. And it’s potentially life-saving.”

Keep in mind, the person on the other end of the call is going to show empathy and show that he or she cares. These listeners aren’t trying to rush you off the line or go through the motions of helping. They genuinely want to assist.

They’re on the phone to assess the threat level and offer suggestions and alternatives. They’re not there to scold or demean.

“There’s no ‘Pull yourself up by the bootstraps,’” Samarian said. “That’s not what people want to hear when they’re calling for help.”

How will the call end?

Typically, with some kind of recommendation. Usually, the listener wants to leave the call having suggested some resources to the person struggling, or some steps moving forward. Maybe the caller has agreed to speak with a best friend or his or her therapist the next day.

Hopefully, the caller and the listener will feel better by the time the conversation wraps up. “Better” means the caller will feel like he or she has somewhere to turn, and the listener will feel confident that that person will go seek the resources suggested.

The call ends when the person in need is feeling more secure, and feels safe to be with his or herself.

When should I call?

You should absolutely call if you’re struggling with suicidal thoughts. If you feel as if you need the hotline, that’s what it’s here for -- and you shouldn’t hesitate for a second to take advantage of this free and potentially life-saving resource, Samarian said.

That said, the suicide hotline isn’t the place to turn in every situation.

“If (you’re feeling) like, ‘My life stinks. Do I need to call a suicide hotline?’ Maybe not,” Samarian said. “But when you’re backed up against the wall, or thinking of doing something to hurt yourself, that’s the person who we want to reach out. Just do it and see if it’s helpful. It’s a free service, it’s out there, and it’s, for the most part, anonymous. And it can save someone’s life.”

Get over the idea that there’s shame involved in calling. On the contrary, you’re stronger for calling.

These are limited resources, and sometimes, people will call in who are intoxicated and a little lonely -- as in, they just want someone to talk to. And then the listener will have to say some form of, “I’m sorry. We can’t help you tonight.” But it’s important for the people who are struggling to get on the phone in the event of a crisis, Samarian said.

Again, there is no shame for calling. You're not a burden, nor are you a waste of time.

Can I call any time?

The hotline is open 24 hours a day, seven days a week, 365 days a year, even on holidays.

“Absolutely they’re gonna be open on Christmas,” Samarian said.

Is there anything else I should know or pass along?

It doesn't have to be you who's struggling. A listener can help if you have a loved one who you fear might hurt himself, and you're not sure what to do. If you have a friend who seems ready to take his or her own life, take advantage of the hotline. Maybe the person on the other end of the line can help you intervene in helpful ways.

There are also specialty listeners available, meaning people who are bilingual or specialize in LGBTQ+ issues. Texting for the deaf is an option, as well.

When it comes to suicide, Samarian reiterated that this is a real and very serious problem.

“It’s not easy to fix, but it’s easy to step in and give the person a chance to think about it,” he said. “Having that connection with another human can get (someone) through that minute or hour and get them off the edge -- and remind them that this too will pass.”

This story was published in 2018. It has since been updated.