Life at the other end of the crisis hotline

Breathing exercises, refocusing techniques, empathy and reservoirs of calm are what crisis hotline specialists call on in the course of a shift

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To the right of her open laptop is the large hotline telephone that links Stevie Shuchart with unknown callers who may be suicidal, or stressed out, perhaps isolated — always in crisis.

She grabs the call, which can come on any of four hotlines in Montgomery County, including those sent to the county’s Lifeline by the National Suicide Prevention Lifeline network.

Shuchart answers with two names: that of the hotline and her hotline alias. She listens intently. Maybe she’ll seek to calm a caller as emotions and stories pour out. Maybe she’ll want to jot a note on her pad about something that may help the caller, or look up resources online or in the EveryMind manual within easy reach. Her goal is to help the caller find an emotional space where their struggles are more bearable right now — and, if they’re interested, to suggest longer-term resources.

A volunteer, Shuchart does this once a week for four hours, sometimes adding another shift. She worked “sometimes three shifts during the height of the pandemic.”

Shuchart is among the 70 crisis specialists who answer calls from within the county to the 24-7 Lifeline plus calls to the county mental health support hotline, and two other county hotlines: youth support and information for homeless persons.

The hotline service is free and confidential. At the end of her shift, “I shred any notes that I’ve taken,” she said.

“These are unsung heroes, the people nobody knows about. They are the first responders that no one knows,” said Dipika Cheung. She is a manager of Crisis Prevention and Intervention Services of EveryMind, the nonprofit organization that handles the calls from the four hotlines, all free and confidential.

Stevie Shuchart. Photo courtesy of Stevie Shuchart

Shuchart, 72, thought she’d be retiring from clinical social work when she and her husband moved to Bethesda about three years ago. Instead, she completed the rigorous 80-hour hotline training. She also opened a part-time, unrelated clinical social work practice locally, but she works the hotline because, “It’s a mitzvah.”

Like Shuchart, some are Jews who volunteer or are paid staffers who signed on as a way of helping others, one person at a time.

Hotline specialists offer no judgments, opinions, tough love or therapy. Their contribution is a sympathetic ear and gentle voice from an attentive person with specialized training. They brainstorm with callers, who participate in figuring out what will help them. Information on longer-term assistance goes only to callers who want it.

While hotline callers can be highly emotional, the hotline specialists cannot.

“If you are dealing with someone who is very upset, crying, even sobbing on a call, you want to be empathetic. You don’t leave your humanity on a shelf when you walk in to work, but we need to maintain our composure,” said Jim Linde, 73, of Silver Spring, a six-year hotline veteran staffer whose career included the mental health field.

He later added, “I’m not going to tell you I never have butterflies in my stomach sometimes when I’m on the phone, but the caller will not know.”

The county’s Lifeline, like the other seven in Maryland, is among more than 180 affiliates in the National Suicide Prevention Lifeline network, and receives calls routed locally from a central number, 800-273-8255. The other three — mental health support, youth support and homeless — are county hotlines.

A bill in the current session of the Maryland General Assembly is seeking to establish a statewide trust fund for Lifeline and related mental health services throughout the state. Advocates are seeking to seed it with $10 million, with funding going in part to determine long-term financial need and identify sources, according to the office of state Sen. Malcolm Augustine (D-Prince George’s County).

‘My goal is to help them be safe for one day’

The county’s crisis specialists hail from varied backgrounds (not only mental health), races, religions — including Jewish — and education levels. Their callers know none of that. The lines are anonymous at both ends.

Lifeline calls are the priority. The immediate goal in a suicide prevention call is for the caller to be safe, so hotline specialists are trained to assess the suicide risk.

“You have to listen very carefully before formulating a [safety] plan,” Shuchart said, later explaining, “I want to find out what they are thinking. Is this a vague thought, or have they developed a [suicide] plan or maybe they’ve taken some pills.” Among questions: whether the caller is alone and has weapons. “I am trying to figure out the best way to keep the person from harming themselves and get help and support.”

Said Linde: “My goal is to help them be safe for one day. I ask them, ‘Are you going to work with me to stay safe for today?’”

They brainstorm. For example, talking to a friend or family member may offer immediate help, and if the caller agrees, “we can call the friend together,” he said.

The vast majority of calls are resolved at the hotline. Some callers benefit from speaking with mental health professionals at the Crisis Center.

Dipika Cheung, a manager of Crisis Prevention and Intervention Services of EveryMind, Photo by David Stuck

“Sometimes we have to hand over people to [police] … because the person still can’t stay safe. We feel that the person is at imminent risk,” Cheung said. In one instance, police told hotline workers they arrived to find the caller preparing for suicide. “The police told us, ‘You really did save his life,’” Cheung said.

The hotline tries to check back with suicidal callers a day later — if they agree to that. It serves as a reminder that they can call again and that the hotline staff cares.

Overall, most calls come in on Lifeline and the mental health support line, Cheung said. Hotline workers said they find themselves particularly distressed by young callers talking of suicide; there have been Lifeline callers who are 8 years old.

“I always get very sad when I get calls from a very young people, 10, 12, where they are thinking of taking their lives,” said Shuchart. “I think of the distress a young person would have to be in to call the hotline. … When kids are calling the Lifeline, they are having a bad life, not a bad day.”

Hotline specialists are trained to help youths involve a parent or trusted adult, sometimes by receiving permission from a young person to add that person to the hotline call, the hotline specialists said.

Cheung said she has worked with adolescents and teens to come up with wording they want to use to confide in an adult about a trauma or other need for help.

Cheung, 44, of Gaithersburg, went from stay-at-home parent to being trained and volunteering in 2019 on the hotline, which she chose because it spoke to an earlier situation.

“I’ve experienced supporting people who are going through mental health challenges,” she said, explaining, “It’s sort of like pay it forward.”

She quickly worked her way into a paid position — the hotline fills call-taking staff jobs from its volunteers, as they are already trained and certified, she explained — and into a managerial one in 2020, and she still takes call shifts in emergencies.

Cheung, educated in Hong Kong, converted to Judaism with a rabbi in Ohio about two years ago, and said she sees a parallel: “Even when I was studying with my rabbi, he did not say, ‘No, you are wrong.’ He would talk things through with me.” Her rabbi, she said, also saw one between the work she does and the Jewish values in helping others.

More specialists needed

The training takes potential volunteers through learning techniques such as those to calm and refocus callers through their toughest times, skills that often come into play.

“Sometimes they [callers] are crying hysterically or they are having a panic attack, so we will offer them some breathing exercises or grounding exercises so they can calm down enough to talk to us,” Cheung said.

A three-fold jump in Lifeline calls is expected to start this July, when Lifeline’s three-digit nationwide phone number, 988, is in place, making it easier to remember than the existing 10-digit number.

“Since these [Lifeline] crisis calls can go unpredictably long, the tripling in number of calls can mean a five-time or more increase in call time we will be engaged in,” Cheung said.

With turnover already high, the hotline center is looking to add 40 hotline specialists — more than half the current 70. The center used to run three eight-week training programs a year; now it’s five, Cheung said. Many trainees who start don’t make it through to certification.

Beyond suicide, the call mix includes persons with mental health issues, family situations and COVID-19 pandemic-related issues. From fiscal year 2020 to fiscal year 2021, which includes the pandemic, the number of contacts jumped by about 30 percent, according to figures supplied by EveryMind.

There are distraught youths, overwhelmed adults, individuals having panic attacks, persons seeking to help relatives and so on. There are people suffering in isolation, people suffering from isolation.

Not only the pandemic, but the 2020 death of Supreme Court Justice Ruth Bader Ginsberg, the insurrection last January and the shooting at Magruder High School last month have led people to call, Cheung said.

While not all regular callers are lonely, some lonely people do call daily.

“We may be the only other person they speak to on a given day,” Linde said.

One of the newer, younger volunteers is Jacqueline Katz, 22, of Bethesda, who works at the National Institutes of Health, and wants to pursue a Ph.D. in psychology.

On the hotlines about six months, she already recognizes some callers. “I try to build rapport with callers who are regulars.”

There are also callers who see therapists or psychiatrists. But those people aren’t always available when a hotline is. “It can be 3 a.m.,” Cheung said.

At 28, staffer Elle Miller of Washington has been answering the hotline for three and a half years.

She worked after college, but “I was just looking for something that gave me meaning” and found the hotline.

In addition to helping others, she said she has learned a lot.

“This job has really opened my eyes to what people are going through. This job has made me understand how much we all may have struggles, stress,” she said.

“I didn’t really understand breathing exercises until the hotline,” she said of the controlled breathing used as a calming technique. “It does help.”

As do refocusing techniques that divert a caller’s attention from their crisis. One Miller likes is asking the caller to imagine a color, say, green. “I have them look around them and name things that are green to me.”

About half her contacts are via chat, most coming from young people who open up quickly, she said.

Though rewarding, hotline work can be intense and stressful, and workers said a brief break after a tough call helps them. They have been working remotely through the pandemic, and try to put emotional if not physical distance between themselves and the job.

“I play with my cats,” Miller said. She calls her parents. “I blast music and sing along with the music. Self-care goes a very, very long way.”

Shuchart, for example, said she neatly puts away the tools of the trade — they are out of sight until the next shift — and she turns her attention to something else.

There’s another side to the job.

“Our work is quite inspiring at the same time,” Cheung said. “It really shows us the tenacity of the human spirit. With somebody giving them support and care, they will be empowered to see a little light in the dark.”

Montgomery County crisis hotlines

Number of calls, chats and texts answered on hotlines during fiscal 2020: 23,231
Number missed: 8,792
Number of contacts during fiscal 2021: 30,657
Number missed: 7,491
Caller issues for the latter half of calendar year 2021: Suicide: 9 percent
Mental health, general stressors and family matters: Nearly 60 percent

For more information, or information on volunteering: [email protected]

Information from EveryMind

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