What Really Happens If I Call the Suicide Hotline?

“After receiving my diagnosis, I completely went into denial mode, followed by shame and guilt, followed by suicidal thoughts, followed by, "Why me?" - H-I-V.net advocate

The physical (HIV medication, sleep) and emotional (stigma, shame) aspects of living with HIV can contribute to mild, moderate, or severe depression.¹

Suicidal thoughts (ideation) are a common symptom of depression, and a related resource is the 988 Suicide & Crisis Lifeline, a free telephone and chat service operating 24 hours a day, 7 days a week in the United States.²

Michael Milizzo, LSW has been a counselor and trainer at the Lifeline since 2017. He agreed to answer some frequently asked questions.

Is what I’m feeling serious enough to call Lifeline?

We receive calls from people who just want to talk, people in the middle of an attempt, and everything in between.

Since COVID started, there are so many people who have had their lives disrupted, their routines drastically changed, and the fall out from that even 2 years later… we continue to see affect people in new and complex ways.

Who am I going to talk to?

The person answering is a trained crisis counselor - each center has to meet a strict accreditation. And if you are feeling hesitant calling us, I encourage you to take a second and think about who is drawn to this - a lot of us have had a personal experience with suicide in some way, so we’re way past the point of being uncomfortable or judging anyone for overwhelming thoughts or feelings, whatever they are.

We just don’t want to see more lives lost to overwhelming thoughts and feelings. We want to help make them less overwhelming.

It’s a partnership - stay with us, we are down for anything. The most valuable thing we offer is the ear of a confidential stranger you can tell anything to. You’re never going to see us again, and we’ve heard it all. Look to be open, for the chance to unburden yourself. We are good listeners.

What will we talk about?

Our priority is to help, and that starts with understanding you. We can often come up with ways of keeping you safe if we build a partnership with you and get to know your story. People call about everything - relationships, loneliness, hopelessness.

It’s very common to have overwhelming thoughts and to think that those thoughts are facts, especially self-critical ones. We want to help you realize that you can validate and feel your pain, without thinking it is so true that you need to hate yourself. We're ready to hear you out, so you can get a break from that.

Is it really confidential?

All that we know is your phone number and what you want to tell us, it is in your control.

We can’t see your location or identity. We aren’t going to push to find personal information. You do not have to give your name, even if we ask for it. It’s the same if you tell us you’re a minor, we aren’t informing parents.

That said, we want to keep you safe and may ask for this information through the course of the conversation, but we will not be passing it on unless you ask us to, or we are obligated to, and we do not keep records.

Will you call the cops?

There is a lot we can do to keep you safe that doesn’t involve emergency services. We are dependent on you to provide any information that would help people find you. The 911 call center looks like CSI and has the resources to find your location. All we have are phones. We are separate from them and do not have access to their tools.

If you were to cut the call after seeming very risky, the most we can do is look up your phone number and see what county you’re in (less relevant with cell phones) and we call the police department of that county.

If you want emergency services

Seeking help is a scary thing, and we are here to help you with that if you want it. But we are not here to convince you or coerce you. We want you to feel like you have a partner, and if you want emergency services to come to you, we would ask for your information so they can get to you. But we are not first responders, we are a support service that can connect you with first responders.

How does the call start?

In the first moments, we may ask, what is going on? What brings you here today? And start with exploring that. Most people need time to get some trust.

We are obligated to ask if you are thinking about suicide and, if so, if you have a plan. And if you do have a plan, we have to ask if you’ve attempted it before. Those are our standard questions. In the end, we may give you mental health resources, and help you think about how you can continue opening up.

Is it going to help?

Most people are carrying the weight of this alone. If you can’t talk about it, it is gonna make you feel stuck - and when feeling stuck like that, it makes sense to want to escape. We understand that suicide is an escape from pain. Society frames death as inherently bad, as if we can't talk about it, which brings another layer of feeling alone.

What callers have in common

Callers seem to feel they have to hide something about themselves. When you feel you have to hide something about yourself, it’s natural to start doubting yourself even more. And then you feel worse, and then there is more you have to hide, and then more you doubt yourself.

A lot of people who call are doubting everything about themselves. Once they realize they don’t have to hide suicidal thoughts when talking to us, it kind of uncorks all the layers of hiding and doubt. Once past that, they can really unload, and every moment of lifting those layers brings a sense of peace.

They get to see themselves again because what they hide from others, they also hide from themselves. Nothing makes a person want to live more than being their whole selves.

Resources

As of July 16, 2022, when people call, text, or chat 988, they will be connected to the 988 Suicide & Crisis Lifeline. The 1-800 number will still remain active and be available.²

If you or a loved one are having thoughts and feelings of harming yourself, please consider contacting the 988 Suicide & Crisis Lifeline anytime by dialing 988.