The other day I was thinking about an article I read in Rolling Stone about the increase in suicides for middle-aged white males in America. As I did this, I was waiting for the Medical Examiner to come out to the second hanging I had been on in my 7 hour shift as crisis counselor/EMT. When I got home, I read an email forwarded from my friend, who is an LCSW. It described how the American Association of Suicidology (AAS), the largest association in this area was in support of a 3-digit National Suicide Hotline. The article explained that the discussion of the 3-digit number, separate from 911 or 211 was necessary due to the suicide epidemic. In the last ten years, suicide rates have gone up across all demographics and is now the 10th leading cause of death overall and 2nd leading cause of death for youth under 25. It’s a devastating issue with a variety of roots, including lack of mental health supports, stigma and loneliness. Talking to someone who is suicidal takes training. Someone reaching out for support needs to feel secure and confident in who they are reaching out to. AAS stated 911 was “not ideal” to handle mental health crises and suicidality. I agree. Here are my five main reasons why.
90 Second Expectation
During my time as a 911 Dispatcher for a major metropolitan area, we never had the luxury of taking much time with each caller. We had a ticker board that would tell us how many 911 and non-emergency calls were holding in the queue and for how long. It would be a constant reminder that we needed to get just the facts and move on to the next emergency. Along with this, our statistics would be pulled and the expectation would be that we would average 90 seconds per call. Essentially, if we took an armed robbery call where we spent 30 minutes getting information and calming the victim before officers got on scene, we would need to balance that with a bunch of 30-45 second quick Q&A calls. Civil Matter. Go back to court. Cat in a tree. We don’t do that. No an officer cannot come make your 12 year old clean his room. Now consider the time and space that someone who is struggling with suicidal ideation needs. We just don’t have the luxury of giving that time.
Hold is unacceptable
Imagine getting to a point in your life where you can’t see any reason to continue living. You’re in so much pain that even the unknown darkness of death seems preferable. Now imagine that just for a brief second, a moment of clarity hits and you reach for the phone. You make that call to talk to another person. To try and get the support you so desperately need. And you hear a hold message. For a variety of reasons, 911 calls are not always picked up right away. Thanks in large portion to cell phones, one accident on the freeway or a house fire can tie up 911 for a ridiculous amount of time. And because every call that comes into 911, even if the person hangs up has to be received, another massive amount of time is spent calling back 911 hang-ups. In an ideal world, when someone reaches out to 911, a real person will immediately answer. But we don’t work in an ideal world and if someone is at the end of their rope and gets put on hold, they might not have the resilience to wait.
911 Dispatchers are not crisis counselors
911 Dispatchers get a lot of training including some crisis intervention training but it is not adequate to handle the immense needs of someone struggling with suicide. Not to mention their loved ones. There are mental health workers who specialize in this kind of support and they get extensive training to be able to offer it. People who work on suicide hotlines or those who do face-to-face interventions have specific training around assessment and safety planning. 911 Dispatchers have a singular mission of getting the information they need to get the field responder to the scene. They should be free to do this life saving work and leave the crisis counseling to the crisis counselors.
Aversion to Public Safety
This is simple. People who are struggling with mental health issues and seeking support for suicidal thoughts do not want a police officer, fire fighter or EMT. They want a mental health specialist. So often, a person will not call 911 because they do not want the police involved. Unfortunately, in my experience, the only time they called was when they were committed to the act and they just wanted us to come and clean up/remove their body before their loved ones came home.
Sheer Numbers
This is one of the main issues the AAS touched on for not wanting 911 burdened as the National Suicide Hotline. 911 is overworked, underpaid and understaffed-chronically, all across the country. Placing the additional work in their already over-full laps would be detrimental to the callers as well as the call takers.
For all of these reasons and more, it makes sense to have a 3-digit number dedicated to suicide prevention and not have it be 911. I would encourage 911 professionals across the country to support AAS in this goal. Although the first public comment session will be over by the time this is printed, I think it’s important for us to continue to monitor and support this initiative. I’m hoping you will join me in this.
