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The following is used with permission. The original article appears on http://www.reddit.com/r/suicidewatch and was authored by reddit contributor SQLwitch, who has many years experience as a crisis hotline counselor. If you are in a crisis situation, please do call the appropriate hotline number for your country or area.
Risk Assessment happens on almost every call
The phone counselor or volunteer will try to find out how immediate your
risk of suicide is. You may be asked questions about your feelings, ideation
(not just how much you think about suicide, but whether you have a plan to kill
or harm yourself), your history, your circumstances, and your support network
(family, friends, therapist, etc.), The best thing you can do is answer the
questions as honestly and completely as you can; try not to second-guess or
overthink your answers. You don't need to try to make your situation sound more
serious than it is; if you were worried or frightened or hopeless enough to
call the line, your situation is serious enough for them to talk to you.
They need to know your level of risk because it helps them connect you with
the appropriate resources. Most crisis lines don't "screen out"
callers whose situations aren't serious enough, but will try to connect
everyone who calls with helpful resources that are appropriate to their
particular situations. If you repeatedly call a crisis line when you are not in
any kind of crisis, however, then there may be consequences. Sadly, a few
people do abuse these lines, making it harder for the people who really do need
help to get through.
Don't be afraid that you'll automatically trigger a police/ambulance rescue;
rescues are extremely expensive and are only sent in cases where the caller is
believed to be in mid-attempt or is unable to make a short-term safety
agreement (see below).
The phone counselor may try to help you stabilize your emotions, at least in
the short term. This can happen in a variety of ways. If you're asked questions
about how you're feeling at any given moment compared to the beginning of the
call, answer truthfully even if you're feeling worse in that moment. But if
that happens, try to keep working with the person you're speaking to; most of
us have quite a variety of strategies and techniques and we don't always pick
the best one to try first. We are all doing our best, but sometimes there's
some trial and error in the process.
There's a good chance you'll be offered one or more referrals to counseling
or other agencies, depending on your situation. Most crisis lines train their
staff carefully with regard to selecting appropriate referrals, but, again, no
system is perfect. If you don't feel comfortable with the referrals you're
offered, say so politely and try to indicate what kind of resource you think
would be better for you. If you follow up on the referrals you're given and
they don't work out for any reason, call the hotline back and politely let them
know what happened. There are all sorts of reasons why things may not work out
with a particular referral. We usually have more options than we give to
callers all at once, though, so we may be able to offer you other options.
Contracts or Safety Plans
Even if the call goes well, your phone counselor may want to work out a
"contingency plan" for you, so that you have a clear idea about what
you'll do if you start to feel worse. You might be asked to agree to call back
if you feel you are close to attempting suicide, for example. Thinking through
this kind of plan with a supportive person while you're feeling relatively good
(assuming the call has gone well) can be extremely helpful in the short term.
Don't make commitments that you don't feel you'll be able to keep; if the phone
counselor proposes a plan that is not realistic for you, that's their failure,
not yours. Let them know politely why you don't think that will work and
they'll most likely get it right the second time.
Who will find out about my call?
Typically, suicide or crisis lines have a
"life and limb" confidentiality policy, meaning that they will not
disclose any personal information except in order to avoid death or physical
harm to the caller or to a third party. If you are concerned about
confidentiality, it is absolutely appropriate to ask (politely) what the policy
is early in the call, before you disclose any sensitive personal information.
Regarding call display and call tracing, agencies vary in the access that they
have to callers' phone number and directory listing information and their
ability to trace high-risk calls, so, again, if you're concerned, ask.
I called and had a bad experience (or I was rude on the phone), but I still
Call back. This is not an exact science; chances are you won't get
the same person twice in a row and even if you do, they'll still want to help
and will most likely try different things. People in crisis are not easy to
talk to, but we do our best. Personally, if I have a call go "south"
on me (it doesn't happen often but it happens to all of us occasionally),
nothing makes me happier than to know that the person called back. If you found
yourself being rude or verbally abusive, apologize, but hang in there with us.
We understand that people in crisis struggle with self-control, you don't need
to be calm or businesslike but it really helps if you can show us that you're
trying your best to work with us. (That's why I have used the word
"politely" so many times in these guidelines!)
I am worried about a friend or family member. Can I call for them?
legalities around third-party situations are such that in most jurisdictions,
crisis lines can't offer all the same kinds of assistance in third-party
situations that they can if the suicidal person calls on their own. In particular,
it's not usually possible to send a rescue on a third-party call. However, you
should absolutely call your local suicide hotline if you are worried about
someone else. You'll get expert advice on how to determine how dangerous the situation
is, and lots of good information about how you can help.