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Calling the Crisis Line: FAQ

Who Can Call

Q. I’m not suicidal, can I call?

A. Yes! Almost 70% of our callers are identified as not being suicidal at the time of their call. We like to think that suicide hotlines have the power to support someone before a crisis, preventing potential escalation. That said, we do prioritize calls from people who are suicidal. If we are receiving a high volume of calls we will triage and ask those not at current risk of suicide to call back later.

Q. I’m worried about someone else who is suicidal, can I call?

A. Absolutely! We’re honored for the opportunity to support other caregivers. We can’t call out to the person-at-risk ourselves, but we can give guidance on how to assess for safety, what emotional support tends to be most effective, and referrals that can intervene in an emergency. We also like to emotionally support the caregivers. We know this can be a lot of pressure!

Q. Do I need to live in San Francisco to call?

A. No, many people call us from across the country because they feel a connection to San Francisco.  For emotional support you’re welcome to call us, but in order to find resources and referrals in your area we may direct you to call a local line.

Services

Q. What happens when I call in?

A. You will first hear a recording describing our agency’s name and the fact that your call will not be recorded. The phone will ring until an operator picks up – sometimes this may take longer if they’re on the line with someone else already. The counselor will introduce our service, offer their name and ask you for yours. Immediately after getting your name they’ll need to ask you about your own suicidal thoughts. This is to prioritize safety concerns, and for triage.  After determining risk of suicidality, the counselor will start asking questions about what brought you to call. They’ll probe a bit about what’s been going on recently and how you’re feeling about these circumstances. As the call continues, the operator will start exploring next steps, mostly in terms of self-care but sometimes in terms of addressing issues that may be leading to suicidality.

Q. Do counselors read from a script?

A. No, none of our counselors read from scripts. There are certain listening skills they are taught, and methods of focusing and wrapping up a conversation that may sound similar from call to call. Additionally, each counselor has a personal style and certain frameworks for understanding and communicating with others in crisis, so they may repeat phrases. This is an unintended but inevitable effect of the crisis line model.

Q. How often can I call?

A. For callers who are have access to a lethal means and intent to attempt suicide, we request that they call as frequently as they need in order to maintain safety. Of course, if it doesn’t seem like de-escalation through phone counseling is an option, we may encourage emergency in-person intervention. For all callers who are not imminently suicidal, we ask that they call no more than once every four hours. This is intended to reduce the likelihood of delving into deeper therapeutic issues that our counselors aren’t trained to address.

Q. What happens if I decide to stop talking and hang up mid call?

A. Just the same as you have a choice to pick up the phone to call us, you also have the choice to disengage from our services at any time. In most cases we will just accept this as your choice, however we will call someone back if they seem to be actively engaged in attempting.

Q. How long are calls?

A. Generally calls are between 10-15 minutes. Certain circumstances warrant lengthier calls.

Anonymity

Q. Will you tell anyone I called?
A. No.  In our 50+ years of service we have never provided confirmation of contact, or released any call records.  This is true for both adults and youth.  The only times we lift confidentiality are in times of immediate physical danger, in which case we will only contact emergency services.
Q. Do you record calls?
A. We do not record the audio of any calls. We do write brief case notes for each call for reasons of accountability, evaluation and optimization of individual service.
Q. Do you take notes?
A. We do write brief case notes for each call for reasons of accountability, evaluation and optimization of individual service.
Q. Do you record my phone number?
A. Yes, we document it in our internal database, but will only share it with an outside source in the case of an emergency. It is only used internally to identify repeat callers so that we can customize optimal service for individual them. This customization is traditionally done for callers who call multiple times daily for months or years at a time, not individuals who call sporadically.
Q. Can you identify me?
A. We can identify people internally but not externally. That means we can usually identify if you’ve called multiple times, even if you have a blocked number by call themes. But we won’t try to find who you are outside of the calls we have here, unless you are in imminent danger and we need to send in-person services.
Q. Do I have to give demographic information?
A. Nope! Your counselor may ask but if at any point you say you’d prefer not to answer your counselor is trained to not press the issue.

Emergency Services

Q. Will you call the police on me?

A. We have called the police to intervene, but it is a very rare last resort that is discouraged as common protocol. We will only call the police if a person indicates they have intent to use a lethal plan they have access to within the next 24 hours, and after an extended period of dialogue still seem intent on attempting. We can only send services to people about whom we have enough information, usually address but in some occasions a phone number alone will suffice.  Out of approximately 70,000 calls in 2017, we sent services fewer than 50 times.

Q. Will you call Child Protective Services?

A. We are restricted by mandated reporting laws, and will call child protective services on any qualifying call content. In order to call CPS we need to know that there is a minor that’s being physically, sexually, emotionally abused or neglected. We also need to have enough identifying information to make the call. Our operators are trained to tell callers when a CPS report is required.

Q. Will you call 911 for a friend who I am worried about?

A. We can only call 911 on behalf of someone we’re speaking to directly. We’re happy to act as a sounding board for any callers who are considering calling 911 on behalf of a loved one, and supply directions on how to do it safely and in the most supportive way.

Q. Under what circumstances would you call the police on me?

A. If a caller states that they are definitely going to attempt a potentially lethal act within the next 24 hours, and have a clear and accessible plan, we will do everything in our power to de-escalate this suicidal intent.  If, after an extended conversation, there’s no change in suicidal intent we will try to locate the caller and send in-person help.  When available and appropriate we send alternate mental health support.  We never call in-person services for someone who says they have suicidal thoughts and no plan, or a plan with no intention to use it.

Q. What would happen if you were to call the police on me?

A. If, after a long conversation, the caller still seems committed to attempting, we will ask them if they’d like to access in-person intervention with our help. If not, we will encourage them to call emergency services themselves. If they continue to decline and state their intent to attempt we will try to find a location. First we will ask the caller for their location, but if they don’t offer it we may try to investigate prior call records to find one. If we have a phone number for the person calling in, we can call emergency dispatch and sometimes they can find the location based on the number, whether or not it’s landline or cell. Depending on the accuracy of the address and availability of the emergency personnel, it will take varying times for them to arrive, if at all. We always inform callers when we have contacted services unless we feel that it might prompt a physically dangerous act to one’s self or others.

Calling on Behalf of Someone Else

Q. Someone I know is depressed and I think he may be suicidal. Can you give them a call to check in?
A. Unfortunately, we are unable to make calls out to individuals based on third-party information. We recommend you have the depressed individual call us directly if possible.
Q. Someone has told me plainly that they plan to commit suicide. Can you send the police?
A. We would happy to provide you with phone numbers for any emergency services you need, but we are unable to send services to an individual based on third-party information.

Questions about Protocol

Q. Why won’t counselors talk about themselves?

A. Many reasons! First, we don’t want the call to end up being about the counselor. Many people who call into our services are dangerously hard on themselves, and this manifests in trying to take care of others. If counselors share the difficult things they have been through, the call may shift to involve the caller taking care of the counselor. We don’t want to imply that that could be necessary. Next, we find that if a counselor shares something that the caller finds unrelatable, they may no longer feel the support or insights of that counselor are valid. Last, our hotline is intended to be used for emotional support. If a counselor brings up a shared hobby or interest it may lead the call into a different conversation, that doesn’t address the emotional issues immediately at hand.

Q. Why am I always asked if I’m suicidal?

A. All callers are asked if they’re suicidal to help discern safety concerns as well as prioritize the most in crisis callers. 70% of the calls we receive are from non-suicidal callers, and while we treasure the opportunity to provide emotional support we need to prioritize people in danger of attempting a lethal act. If multiple calls come in at once, we will ask all callers about their risk of suicide, and take whichever person is in the most acute state of crisis OR called in first. Similarly, we need to know right away if a caller has already initiated a suicidal attempt, such as administering an overdose.

Q. How come your office in San Francisco answers when I call the National Hotline?
A. The National Suicide Prevention Lifeline (1-800-273-8255) is a routing service that directs calls to the closest participating suicide hotline. Routing is by area code, so all 415 numbers are first routed to our office. If a center is too busy, calls may be rolled over to the next closest suicide hotline. Because of this 510 and 650 numbers are sometimes directed to our center.