Inside the National Suicide Hotline: Preventing the Next Tragedy

As U.S. suicide rates rise, experts are divided over which strategies save more lives

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Kevin Hines paced along the Golden Gate Bridge, trying to figure out whether to obey the voices in his head urging him to jump. Anyone paying the slightest attention to Hines should’ve seen that something was horribly wrong. Sure enough, after about a half-hour, a woman approached him. Hines thought she was there to save his life.

Instead, she was a tourist wanting Hines to take her picture. The look of desperation on his face apparently didn’t register. Elation crumpled into despair. “Nobody cares,” he thought. “Absolutely nobody cares.”

Hines soon hurdled a railing, stepped out onto a ledge 25 stories above San Francisco Bay and jumped. He immediately regretted it. Falling 75 miles an hour headfirst toward the water, Hines realized that if he was going to save himself, he had to hit feet first. So he threw his head back right before he plunged 80 feet into the cold waters, shattering two of his lower vertebrae. He eventually surfaced and was rescued by the Coast Guard. Only one out of 50 who jump survive.

Thirteen years removed from his attempt, Hines is now an author and lecturer, and doing quite well considering his experience. Hines frequently travels around the country talking about what happened on September 25, 2000. Diagnosed with bipolar disorder, he still has auditory and visual hallucinations as well as paranoid delusions. But today, he has a support network of family and friends that check up on him and identify early warning signs that could lead to Hines harming himself again. He logs his symptoms into an online document he shares with others so they can keep an eye on him. Hines says that’s what separates him from so many others who have suicidal thoughts.

“When you learn to be self-aware with mental illness, you can save your own life,” Hines says.

In May, the Centers for Disease Control released data showing that in 2010, 38,364 people weren’t able to save themselves. For the first time, the number of suicides surpassed deaths from motor vehicle accidents and most researchers believe that number is low, if anything, because many suicides go unreported. The suicide rate for Americans aged 35 to 64 rose 28.4 percent from 1999 to 2010. According to the CDC, $35 billion is lost due to medical bills and work loss costs related to suicide each year. And while suicide rates are not as high as they were in the early 1990s, they’ve climbed steadily upward since 2005.

As more Americans commit suicide, some in the field question the effectiveness of current prevention programs. Over the last 15 years, public policy and federal funding have shifted toward a broader mental wellness movement aimed at helping people deal with anxiety and depression that could eventually lead to suicidality. But that shift may have left those most at-risk of suicide, like Hines, without the support they need.

One program sits at the intersection of those two approaches. The National Suicide Prevention Lifeline, which expects 1.1 million to 1.2 million calls this year and receives about 15 percent more callers each year, is broadly marketed to the general public through billboards and ads that reach those suffering from anxiety, depression and loneliness but are often not actively suicidal. At the same time, it’s an emergency resource for those who are at immediate risk of killing themselves and who struggle with chronic mental illness. But some in the field question its effectiveness, along with the effectiveness of many other services and programs funded and promoted on a national scale. Those in the field often use the metaphor of a river to illustrate the divide: Is it worth getting to more people upstream or narrowly targeting those like Hines downstream?

At the Waterfall

The bridge phone inside New York City’s suicide prevention call center only rings about once a month. But when it does, often in the middle of the night, it emits distinct, deep chirps – as if the phone itself is in distress. The operators manning the 24/7 LifeNet hotline recognize the ring immediately. It means someone’s calling from one of the area’s 11 bridges, and they’re likely thinking about jumping.

LifeNet, a mental health and suicide prevention hotline servicing New York’s metropolitan area, is located in the H2H Connect Crisis Contact Center, which serves as one of 161 call centers that make up the National Suicide Prevention Lifeline network, headquartered in the same building. During its busiest hours from 9 a.m. to 7 p.m., the hotline has roughly 20 operators working the phones inside their unassuming L-shaped office space in lower Manhattan. The operators could easily be mistaken for a collection of telemarketers. The large computer screen at the head of the call center showing the number of lines being processed could easily reside inside QVC’s customer service center.

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You don’t get a sense of what truly happens in this room until you run across the bridge phone, which is a direct line to the call center. It’s LifeNet’s equivalent of the Oval Office’s mythical red phone. On the wall above it, black Ikea picture frames display detailed information for each bridge and the locations of its call boxes: “Northbound 3rd Avenue Exit,” “Westbound Light Pole 60.” If someone calls, they can use the caller ID, check the information above the phone and immediately locate the caller and send help.

If it were up to those who work at LifeNet, however, they would get rid of the bridge phone altogether. “What we want is to get people upstream,” says John Draper, director of the National Suicide Prevention Lifeline. “We don’t necessarily want to get people who are on the edge of the waterfall. If they are, we can help them. But it’s a huge cost savings for the entire mental health system if you can get people further upstream.”

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15 comments
sam.caggiula
sam.caggiula

Josh - you do a disservice to Kevin Hines by calling him an author but failing to mention the book he is actively promoting - the one book he has published.  The book he wrote to tell his personal story and to help others who may be dealing with a mental disorder.   Kevin's book is titled Cracked, Not Broken: Surviving and Thriving After a Suicide Attempt.  

JeremyWillinger
JeremyWillinger

This is an important and poignant piece. Please know that anyone in distress can call the National Suicide Prevention Lifeline at 800-273-TALK (8255) anytime, anywhere. It is free and confidential.

Sibir_Russia
Sibir_Russia

Sequester  will affect not only the FBI. One of the main reasons for the increase of suicides - is the deterioration in the quality of life, loss of confidence in the future. Foreign policy of USA should  to focus on diplomacy in full accordance with international law. If the United States will be concentrated in the field of foreign policy on diplomacy in full accordance with international law - it will allow to save considerable funds for solving internal problems and then, despite all the trials, will confidence in tomorrow. Americans should be confident that their children and grandchildren will live better than their parents - it will become a powerful stimulus to overcome the difficulties.

kamsites
kamsites

My first thought is the Hotline number should be in the headline. 
I think both upstream and immediate aid are required. The current HIPAA policies are also somewhat of a problem. Confidentiality in therapy and treatment is extremely important. The problem steps in with medications. Some of these produce behavior changes and suicidal behaviors, especially at the start or when a drug just isn't the "right" one. My therapy includes both psychologist, a NIPA (Psychiatrist) for drug treatment short visits. How well does she/he know my my progress is.  My psychologist cannot prescribe medications and my doctor often dismisses real illnesses to "hypochondria" from anxiety.  It would be so helpful if people were required to have a "medication partner" someone who could note the side effects I sometimes didn't even realize I had. One medication made my raging angry, no one knew it was from my meds. no one could help me until my Psychiatrist realized I needed to get off them. How much better for my family it would have been if someone close to me like my wife understood and knew what I was taking. And now I'm on a waiting list to see my therapist. Not going well. And even sometimes, especially when older, the thoughts appear to be very, very rational. My emotions go too numb most days now. 

evantbyrne
evantbyrne

The real solution to suicide is a basic reasoning! Anyone reading this thinking suicidal thoughts just remember these things:

1. You are capable of rational thought.

2. Focus on rational thoughts rather than emotions, because clearly your emotions are betraying you.

3. If for some reason life is pointless (which I doubt is the conclusion you will come to if you follow #2), then there is also no reason to kill oneself.

4. If for some reason #1-3 still leave you with suicidal thoughts, then please do call a suicide hotline. You are obviously on the internet, so you have the ability to reach these resources.

HankRodgers
HankRodgers

Well the public medical costs of suicide (presumably mostly the unsuccessful attempts) are of some concern, but what must really worry us are what are described here as the "lost work" costs. Just think how many hours at minimum wage we might have gained from those poor souls whom we could have saved and maintained as wage slaves ... until, of course, they die anyway. 

Sibir_Russia
Sibir_Russia

Very disturbing news...
In the United States may "festival of disobedience" for the bandits.
The FBI just goes on holiday.
 

Reduction of expenses of the budget of USA can force the Federal Bureau of investigation to suspend its work during the fiscal year 2013/2014. According to sources, the Bloomberg Agency, the FBI evaluate all the options and continue to fight for funding” on the threshold of 1 October, when the United States will begin a new fiscal year and the effect of automatic spending cuts. In early September the post of Director of the FBI took James Comey. His predecessor Robert Mueller said the spending cuts will be one of the most complex problems, with which will face the new head of the FBI. James Comey said: "I was very surprised to learn about the impacts that sequestration is having on the FBI," Comey said. "Not only am I having to lose 3,000 positions, but there's a very real prospect, unless something is done, that I'm going to have to send home, for two weeks without pay, the good men and women who work in this building behind me."http://www.huffingtonpost.com/2013/09/12/fbi-sequestration-impact-_n_3915781.html

Cap'tNemo
Cap'tNemo

Suicide survivor here.  Most recent 2010.  The day my home was auctioned in foreclosure.  Turned myself into VA.  They bkept me locked up for three days.  Never once asked what led me to the attempt.  VA totally failed me, not once twice.  I knew I was in trouble, they ignored my requests.

Call the VA now and they will say (You screwed up again, call a different number) call the Suicide hotline for help.  When you are seeking help as a last resort the chances that you have paper and pencil handy is slim.

Yes the thought of suicide is an everyday event.  No family,no friends close by, no support.

Kargarden
Kargarden

Severe depression sends a person downward. It is a sad, lonely and devastating feeling. A person feels hopeless and despair. My parents were both depressed and had 4 depressed children. In different ways we survived it for a time. By Gods good grace. Always know even in the depths of depression you will come out OK. It is work and slow. You will move forward in a better place. Much more is known about mental disorders than in the 50s,60s,70s,80's,90's and 2000+. My parents and 1 brother are gone. 5 yrs. ago my younger brother survived an attempt and lives in a group home. My sister and I work at staying well. Our children struggle with depression but not to the degree we did. Knowledge & medical advances move us forward. 211 info line will direct you to help

Openminded1
Openminded1

@Cap'tNemo as a vietnam vet i have had those thoughts too, years ago i understand the feeling and had to fight the urge many times. If family is not close by and you feel you have no friends or any real support, then go out and rescue a Dog or cat at a shelter you will then have something that will love you with no conditions attached and that will need you as much as you it. Pick one that matches your personality and give it love it will love you back and i assure you you will feel better. Do what i tell you it will save your life and your pets life.

joshsanburn
joshsanburn

@Cap'tNemo Please stay safe. If you're having suicidal thoughts, you can call 1-800-273-TALK. It's available 24/7.

kguitar44
kguitar44

@Cap'tNemoPlease don't harm yourself sir. I know you feel all alone and nothing will help, but I promise things can change. Move far, far away. Just up  and leave your current life and go start a new one. If things are bad, try to change. If that doesn't work, please seek help.