Operations

• Availability to callers: 9 a.m. to 9 p.m.

• Answering service will bridge calls to the volunteer who is on for the day.

• If volunteer is not available, message will be left by voice mail or text. If answering service worker is told the caller has an emergency, caller will be told to call 911. In a non-emergency situation, caller is told to expect a callback no later than 24 hours hence (worst case).

• Calls that come in during off-hours will be held for next day at 9 a.m. Answering service will phone such messages to volunteer who is on for the next day.

• Publicized number is 909-399-0305

• On average, each volunteer (or volunteer couple) is available two days per month.

• In-service meetings will happen about four times per year. Bring your information forms (salmon sheets) to the meetings.

• Lainie Lapis keeps the volunteer rotation calendar. You will be asked for your available dates by e-mail prior to each new month and will send a schedule accordingly. Names and phone numbers of volunteers are on the schedule for your convenience if you need to seek a trade of dates.

• If you line up a replacement for a given day, you are responsible to inform the answering service of the change. Call (909) 625-1044 Barbara’s Answering Service.

• If you get stuck on how to handle a particular call, please contact Lainie Lapis.

“The most basic of all human needs is to understand and be understood. The best way to understand people is to listen to them.”

– Ralph Nichols

• Objectives:

  • To listen and learn what the caller seeks To respond with supportive comments and attitude To refer to services provided by NAMI and/or community services

• Before taking the call:

  • Reduce or eliminate background noise. Have your resource manual available. 

  • Be calm, comfortable, and ready to listen and learn.

• Answer the call:

  • Give a warm greeting and put the caller at ease by introducing yourself:

    • “Good morning/afternoon/evening. My name is _____, and I’m responding to your call to our NAMI Helpline. How can we be of help?” (You may also wish to ask if you can call the inquirer by their first name.)

  • Let the caller speak while you take notes of important information.

  • Key questions if the call is from a family member. 

  • Inject the questions at appropriate times while moving the discussion to the core of the issue:

    • Are you calling for someone or yourself? 

    • How old are they? 

    • What is your relationship to them? 

    • Have they been diagnosed? 

    • Are they taking medication? 

    • Are they violent or a threat to self or others?

• If the caller is a consumer, most of the above questions may be relevant, but should be asked in a non-threatening, invitational way.

• When caller (family member or consumer) shows signs of agitation, remember:

  • Keep questions and comments direct and uncomplicated. 

  • Don’t argue or force a point. 

  • Be calm, patient, and willing to repeat.

• Confirm that you understand the information the caller is after by repeating back: “Am I correct in understanding that you need support and wish to understand more about mental illness?”

• Most calls will be from family members seeking information about NAMI programs or services provided by community agencies.

• Sometimes the caller will ask for advice for handling a difficult situation. Remember:

  • Don’t offer advice unless asked. 

  • Keep the emphasis on relevant referral to NAMI programs, resources, professional services, and community.

  • And when you actually do give advice, always lead with this disclaimer: “I’m not a licensed counselor and can’t tell anyone what to do, but here’s what I think I would do if I were in your situation.”

• On rare occasion, the caller may be a family member or consumer in crisis.

• Ask if they could harm self or others. If the answer is yes, direct the caller to dial 911.

• Remember:

  • Try to get to the core of things and respond within 10 to 15 minutes.

  • Evaluate yourself: were you a good listener?

  • Write in your log: date, nature or call, crux of your response, follow up task, and name plus any relevant contact info.

In evaluating suicidal patients the following guidelines should be kept in mind in order to get a complete picture of the seriousness of the attempt and the present danger. Remember that history repeats itself – if a patient has attempted suicide in the past, then it is more likely that they may try again.

A. Evaluation of Previous Attempt or Gesture:

a. Method (or plan if no attempt was actually made) – The exact method including number, type and strength of pills, depth and location of cut, etc.

b. Situation – Where was the person? Who was around? Was someone expected? Etc.

c. How was help obtained – Did the person call for help? Was the person found accidentally? Did the person arrange to be found?

d. Rescuer – Who was the intended rescuer or who was the person who was called for help?

e. Desired effect – What effect did the person wish to have on significant others? How did the person want the other(s) to change in the relationship as a response?

f. Severity or lethality – How serious was the attempt? Was this a gesture, a true attempt, or somewhere in the middle? Rate on a 1 – 10 scale with 10 being fatal.

B. Evaluation of Current Suicidality:

a. What suicidal thoughts are present?

b. Evaluate the strength of the impulse to act.

c. Evaluate the person’s ability to resist the impulse to act.

d. Is the person hearing voices urging them toward suicide?

e. Is the person responding to a real or imagined loss?

f. What method is being considered?

g. Does the person have the means to carry out the plan?

h. How serious do you feel the danger is?

The following are common misconceptions about suicide (from the NAMI Advocate)

1. “People who talk about suicide won’t really do it.”

Not True. Almost everyone who commits or attempts suicide has given some clue or warning. Do not ignore suicide threats. Statements like “you’ll be sorry when I’m dead,” “I can’t see any way out,” — no matter how casually or jokingly said, may indicate serious suicidal feelings.

2. “Anyone who tries to kill him/herself must be crazy.”

Not True. Most suicidal people are not psychotic or insane. They may be upset, grief-stricken, depressed or despairing. Extreme distress and emotional pain are always signs of mental illness but are not signs of psychosis.

3. “If a person is determined to kill him/herself, nothing is going to stop him/her.”

Not True. Even the most severely depressed person has mixed feelings about death, and most waiver until the very last moment between wanting to live and wanting to end their pain. Most suicidal people do not want to die; they want the pain to stop. The impulse to end it all, however overpowering, does not last forever.

4. “People who commit suicide are people who were unwilling to seek help.”

Not True. Studies of adult suicide victims have shown that more than half had sought medical help within six month before their deaths and a majority had seen a medical professional within 1 month of their death.

5. “Talking about suicide may give someone the idea.”

Not True. You don’t give a suicidal person ideas by talking about suicide. The opposite is true — bringing up the subject of suicide and discussing it openly is one of the most helpful things you can do.

988: Reimagining Crisis Response

Starting Saturday, July 16, every person in every community nationwide can dial “988” to reach trained crisis counselors who can help in a mental health, substance use or suicide crisis. 988 is the first step in reimagining our crisis response, but there’s more work to do to ensure everyone receives the help they need — and deserve — in a crisis. Too often, people with mental illness do not receive a mental health response when experiencing a

mental health crisis. Instead, people in crisis often come into contact with law enforcement rather than a mental health professional. People in crisis deserve better. The lack of a robust mental health crisis system leads to tragic results. One in four fatal police shootings between 2015 and 2020 involved a person with a mental illness, and an estimated 44% of people incarcerated in jail and 37% of people incarcerated in prison have a mental health condition — and people with mental illness are booked into the nation’s jails around 2 million times every year. Millions more end up in emergency departments that are often ill-equipped to address mental health crises, often waiting hours or days to access care. NAMI is committed to advancing efforts to reimagine crisis response in our country. We believe that every person in crisis, and their families, should receive a humane response that treats them with dignity and connects them to appropriate and timely care. NAMI is calling for a standard of care for crisis services in every community that includes — 24/7 call centers that answer 988 calls locally, mobile crisis teams and crisis stabilization programs — that end the revolving door of ER visits, arrests, incarceration and homelessness.

In 2020, the nation took a significant step forward with the enactment of the National Suicide Hotline Designation Act, a bill NAMI advocated for that created a nationwide three-digit number (988) to assist people experiencing a mental health or suicidal crisis. The Federal Communications Commission (FCC) determined that this number would be available — by both phone and text — in July 2022, and is now available in communities across the country.

What Is 988?

988 is the new three-digit dialing code connecting people to the existing National Suicide Prevention Lifeline (now the 988 Suicide and Crisis Lifeline) where compassionate, accessible care and support is available for anyone experiencing mental health-related distress — whether that is thoughts of suicide, mental health or substance use crisis, or any other kind of emotional distress. People can also dial 988 if they are worried about a loved one who may need crisis support. The goal of the 988 Suicide and Crisis Lifeline is to provide immediate crisis intervention and support. When someone calls 988, a trained crisis counselor will answer the phone, listen to the caller, understand how their problem is affecting them, provide support and share resources, as needed. Crisis counselors are trained to help in a variety of crisis situations, and no caller is required to disclose any personal

information. For most callers, calling, texting or chatting 988 is the intervention. Crisis counselors will be able to resolve the urgent needs of the majority of callers on the phone or via text or chat, reducing the need for an in-person response overall. Additionally, SAMHSA, which oversees the 988 Suicide and Crisis Lifeline, states that, “Currently, fewer than 2% of Lifeline calls require connection to emergency services like 911.”

However, NAMI is advocating for everyone to have resources like mobile crisis teams in their community (see below). Communities that currently have robust crisis services estimate that more than 80% of crises are resolved on the phone, and mobile crisis teams, staffed by behavioral health professionals, are dispatched when an in-person response is needed — with most dispatches resolved in the community. The work is ongoing to make this available everywhere. You can reach the 988 Suicide and Crisis Line by calling 988, texting 988 or chatting via Lifeline’s website.