Reach Out and Help Someone

Potential suicide. Sexual anxiety. Adolescent angst. No matter how hung-up you are, the counselors at Switchboard of Miami won't hang up -- or give up -- on you.

It always starts with a voice in the night.
"Switchboard of Miami. How can we help you?"
"I'm tired, I'm real tired," the caller says softly, his words a bit slurred with fatigue and liquor, and on this Thursday night the volunteer who answers the call in the switchboard's fourth-floor SW Eighth Street office knows in his bones that there could be trouble ahead. For close to 23 years, Chuck, a 49-year-old attorney with the state government who lives in Bay Harbor Islands, has been coming practically every week to take the calls of anyone who needs help in the Miami area, offering them guidance, referrals, a person to talk to, or, in some cases, a reason to live. Chuck has handled thousands of calls over the years, but each one, marked by pain or confusion or simple loneliness, has to be treated as a special case. Each of the callers needs someone to listen to his or her problems, and Chuck, an outgoing man sporting a well-trimmed mustache and a gray pinstriped suit, knows how to listen.

(Like most of the other Switchboard of Miami counselors, Chuck doesn't want to give his last name because he'd like to be shielded in his personal life from the dozens of disturbed people who regularly call the hotline. Other volunteers use aliases on the phone lines to preserve their privacy.)

The man on the other end of the phone line -- one of 9000 callers the switchboard averages each month -- is depressed about his continuing drinking problem and says he wants to enroll tonight in one local hospital's inpatient treatment program. The hospital, though, won't admit him now, and he's desperate to get in right away. He's convinced that no other program will do. Married for more than twenty years, he's also certain he's become a burden to the wife and kids he loves dearly. Chuck suspects something more is going on. About fifteen minutes into the conversation he learns what it is.

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"Do you know what a .380 hollow-point bullet can do to a heart cavity?" the man suddenly asks.

"I have some idea," Chuck answers, remaining calm.
"I've got one right here," says the man, Dave. [All callers' names and a few identifying details have been changed to protect identities and honor Switchboard of Miami's strict confidentiality policy.] As they continue talking Chuck speculates that the gun isn't in the same room with Dave, and learns that the family is elsewhere in the house. He reaches for a special "suicide-assessment form" and begins circling answers to statements that place each suicidal caller in different risk categories. Under the risk factor labeled "means," Chuck circles the word gun, which marks Dave as high risk, as does his alcohol use.

Chuck wants, above all else, to keep Dave on the phone. "As long as he's talking," Chuck notes later, "he's not killing himself." He allows Dave to unburden himself about his past failed flirtations with alcohol treatment, then steers the conversation to Dave's feelings about his wife and two kids. "You deeply care about your wife and kids," Chucks points out, seizing on what the counselors at the switchboard call a "hook," another reason to stay alive.

Chuck tells him, "There's a program that could help you, but you can't get in it until tomorrow. If you can hold on a few more hours, your life might be able to be different." Helping someone make it through the night -- basic as it may seem -- is one of the hotline's main goals with their most depressed callers.

To that end, Chuck gets Dave to agree to talk tonight to a counselor with Alcoholics Anonymous. It is a small victory for hope. Chuck, wearing his phone headset, turns to his computer screen and punches up AA's 24-hour crisis line, one of 2000 social-service programs listed in the switchboard's database. To Chuck's way of thinking, a recovering alcoholic can, in this case, do a better job of dealing with Dave than he can A plus he can't stay up all night talking to Dave. Chuck's shift ends at 9:00 p.m.

He reaches into an adjoining empty cubicle and places the call to AA on another phone while Dave listens. There is a certain danger in all this: At any moment Dave simply could hang up and decide to carry out his suicide threat. Soon Chuck gets an AA operator on the line and tells him, "I'm talking to someone who is threatening to kill himself." He makes arrangements for a counselor to call Dave and then firms up a commitment from Dave to call the switchboard back if anything goes wrong.

After the conversation ends Chuck feels a bit down himself. He's done his best yet he's troubled by the continuing apathy in Dave's voice. Afterward Chuck says, "I still see significant danger for him." It is one of the frustrations of this work that Chuck usually will not learn what happens to callers after he talks to them. In this case, however, the switchboard's daytime counselors contact Dave twice over the next few weeks and learn that he has entered the treatment program, joined a support group, and says he's doing fine.

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