Guidelines for nonprofessionals who receive suicidal phone calls.

In the United States the primary mode of service offered by suicide prevention programs is 24-hour-aday telephone consultation (1). The telephone has become the main instrument for treating a suicidal crisis despite recent findings that telephone services help only a small percentage of people and do not significantly lower the suicide rate (2,3). Yet even critics of suicide prevention centers acknowledge that many callers benefit and that the competence of volunteers compares favorably with that of professionals (3). The National !nstitute of Mental Health recommends that telephone services be manned by trained personnel who are familiar with crisis intervention techniques (4). Howeven, nonprofessionals who lack clinical training, such as hospital switchboard operators, also receive suicidal phone calls. These calls are usually highly emotional and create a sense of urgency and need for action. The callers may be uncooperative and manipulative or, worse yet, abusive and threatening.