Reach Out and Help Someone
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.
"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.
Even when Chuck and the hotline's other counselors have saved a life, few people call or write to say thanks. "There's very little gratitude," Chuck notes; nevertheless, the twenty staff members and volunteers who take phone calls during a 24-hour period get other satisfactions. "You go home from a shift feeling that Miami's a little better," he points out.
For 26 years the Switchboard of Miami, located in the Brickell area, has been making life easier for many in Dade County, first for college students and hippies, later for the entire community. Now it is a $1.7 million a year operation whose 40 staffers and 75 volunteers offer more than just phone help; that includes in-person counseling for teens, antidrug and AIDS-prevention efforts in schools and in the Annie Coleman Gardens Housing Development, and a few other initiatives, including an after-school T-shirt business that serves as a mentoring and apprenticeship program. (The largest share of its revenues, 47 percent, comes from the Florida Department of Health and Rehabilitative Services, with the United Way providing 18 percent of the funding and the federal government 16 percent.)
Still, the heart of the organization remains the helpline, the county's only comprehensive 24-hour counseling, crisis intervention, and information and referral hotline. Since the late Sixties it has continued to be a window into the underside of life in sunny Miami, even as its calls have evolved from desperate inquiries about bad acid to questions about AIDS. Through it all one thing has remained constant: "There's so many people with so many problems," says Jerry, a retired Miami Beach police department administrator who works the Friday overnight shift. "It's like the old TV show -- there are seven million stories in the naked city." These are a few of them.
The dedicated people who field all these calls are, in some ways, like a special breed of telemarketer. "We're selling life," says Denise, a Southern Bell technician who previously worked as a sales rep for the company for a few years. At Southern Bell she learned how to prod people subtly to think about the advantages that new phone features could bring them. "Similarly, I'm going to try to help people figure out what benefits they can get in their lives," she explains. "It's not very directive. You ask, 'What can you do tonight to make yourself feel better? What do you like to do?'" She adds proudly, "I can talk to people easily."
She can use this skill, if necessary, to keep a person on the line long enough to ask police to trace a call during a life-threatening emergency. Curiously, she now works in Southern Bell's "networking center," which is responsible for implementing all trace requests, and she's actually been in the center when the helpline has requested a phone trace, information used by rescue teams to go to the location of someone in imminent danger. It is, however, the operators' ability to project empathy and warmth, rather than any sophisticated technology, that ultimately keeps people alive.
When Chuck faces a potentially lethal crisis, for instance, he pulls out all the stops in his relentless effort to convince a person that life is worth living. He is, basically, trying to close a very valuable deal. When needed he'll abandon the low-key style favored by most counselors and turn on all the extroverted charm he can muster, as if the caller might be made to believe that a world in which such friendliness exists might not be so bad after all.
Take the morose girl who calls a short while into Chuck's recent Thursday-night stint. She clearly needs encouragement, and as the call progresses she'll get more and more of it. Early on he senses how fragile she really is, and, seeking to make a connection, asks -- and gets -- her first name, Rita. She had phoned the night before to speak to another counselor, and in a halting, fuzzy voice she now tells Chuck, "I have a problem. I still feel like killing myself." She's in a program for emotionally handicapped kids and, she says, both her parents beat her.
"Do you want to report your parents for abuse?" he asks.
"I called HRS but they didn't do anything. I showed them the bruises but they didn't care."
He tries to reassure her that she's a credible person, and if she continues to report the abuse, the social services agency will take some action.
"We care, I assure you. I can't run out there and stop it, but I can report it to HRS. They generally take reports from us seriously. I'd be happy to take your full name and address and phone number."
She won't give him that information and soon begins harping, in a childlike way, on what has helped make her so depressed.
"Everyone hates me," she says, her voice tinged with a petulant sadness.
"Do you think I hate you?"
"Really? Well, let me share with you -- the only person I can truly speak for is me. I do not hate you."
"You're just paid to say that."
"I beg your pardon. I'm not paid to say that. I'm not paid at all here. Rita, I'm a volunteer." He sounds, oddly enough, almost like an offended gentleman in some drawing-room comedy.
"I want to get out of this fucking world," she continues.
"I don't want you to get out of this world, I want you to get to someplace that's safe," Chuck says. He asks if she's tried living with any other relatives, and discovers that she's stayed with an aunt and uncle -- and found it tolerable. Although they want her to live with them permanently, she insists, "They don't like me."
In fact, she adds sadly, "Nobody likes me. I take drugs, I cut my wrists."
"Those are not the characteristics of a person who is unlikable," he says with an air of mock formality. "Those are the characteristics of a person with problems."
As they continue talking he learns that she has a boyfriend who might want to live with her, relatives willing to take her in, and only a few months to go before she turns eighteen. "It seems that you have a lot of possibilities other than killing yourself that could help your situation," he tells her.
"I still want to kill myself."
"I understand that, but there are other things you can do." He soon gently raises the possibility of low-cost counseling; her family has nearly exhausted funds for the psychiatric care she once received, but he still sees hope for her. "We don't like the fact that you want to kill yourself," he adds. "Is that okay with you?
"It's not okay with you? You would rather that we want you to kill yourself? You're going to have to accept us for what we are, people who'd much rather if you don't kill yourself." There's something strangely jocular about all this, a form of repartee that doesn't completely mask its deadly serious purpose. Eventually all the back-and-forth makes her laugh.
"See, you just laughed," he points out.
"No I didn't."
"Don't kid me," he says with a broad smile on his face. "I gotcha. The world isn't entirely black -- you laughed."
"You were laughing at me."
He's talking to her now like an old friend. "Oh, you know you're just trying to hold on to this black depression and not let me get you out of it!"
Her defenses are crumbling. "You made me laugh," she asserts.
"Yes, it was totally deliberate!" he proclaims, acting amused by it all. "It's true that I did it."
After the laughter she seems more willing to talk about the things she likes in her life, although her conversation is still laced with grim references to pills she can take or the glass she can use to slit her wrists. Still, before the call ends she reads him a poem she has written and tells him that her boyfriend is coming over later. She is, he believes, out of danger -- for now.
"Call us back at 358-HELP whenever you need somebody," he concludes.
"Bye," she says in a friendly way. No miracle cure has been achieved, and before retreating back into the silence she at least knows there's a place she still can turn to.
The call has taken about an hour of Chuck's time. "I usually don't spend that much time with a caller," he says, "but she was really depressed." He completes the suicide-assessment form, and ranks her as a moderate risk. "She's probably not going to do anything tonight, but in the long run she's a potential suicide."
Direct suicide-related calls make up roughly two percent of Switchboard of Miami's helpline cases, but the possibility of it exists for many of their callers. And each new phone call also may bring with it the threat of a crisis in progress. With 70 or so hours of classroom training and supervised phone work, the volunteers are expected to handle it. Even the newest volunteer may be called on to diffuse a dangerous situation. On a recent Tuesday night Jim, a bearded cabinetmaker, begins his first solo shift as an operator after four earlier sessions monitored by a supervisor. On this 5:30 to 9:00 p.m. shift there are three counselors on duty, and it falls to Jim to take a frantic call from a Spanish-accented young woman who is screaming, "Is this suicide information? Our friend is trying to do it! She's taken a lot of pills!"
"What kind of pills?" Jim asks, but he can't get a clear answer. Part of the problem is that Jim doesn't speak Spanish and there's no one manning the phones now who is fluent in the language. (At least one bilingual person is usually on duty at all times, although today that volunteer, Steve, is running slightly late.) It seems that the caller's friend, a recent Central American immigrant stuck by herself at a relative's house, may have taken as many as twenty pills. A nearby operator, Karen, a volunteer for two and a half years, rushes over to hear the ongoing conversation, then recommends that they set up a three-way call between the caller, her friend, and the switchboard. They need someone who speaks Spanish, so they ask another volunteer to go look for Jorge, the switchboard security guard who -- like everyone else associated with the organization -- has been trained in phone counseling.
Before they can find Jorge, however, Steve breezes in, arriving after speeding along the highway from West Palm Beach. A young fast-food store manager, he is there on only his second day of volunteer work and he is expecting to enjoy a breather before starting to answer the phones. As the only Spanish speaker in the room, though, he's thrust into the crisis immediately, takes the headphones from Jim, and, after setting up the three-way call, begins coolly talking to the pill-popping woman, Maria, and her friend. As he speaks to them -- mostly in Spanish -- he occasionally presses the mute button and fills in Karen on what's going on: "She took the pills to get high.... She's been drinking...."
He needs to keep Maria talking while he waits for her friends to show up at the house where she is staying. As they talk, it becomes clear to Steve that the woman is not in imminent danger of overdosing: The drugs are prescription medicines for migraine headache. Still, the woman is high and maudlin and has fallen down a few times. He soon finds himself in the midst of a domestic melodrama when her boyfriend gets on the line, and Maria, weeping, tells him, "I promise I won't do it again." Steve continues to listen and talk until one of her friends enters the house and picks up the phone. Then Maria speaks up again: "Everything's fine."
During his 25 minutes on the phone, Steve says after hanging up, he was so focused on Maria's needs that he didn't have time to be nervous. "You're so well-trained," he points out, "that I was only feeling caring and concern."
Most calls -- more than 80 percent -- are not so urgent as Maria's. Usually they involve people with a range of worries and emotional problems, often involving relationships. The callers seem to feel there's nowhere else to turn for advice. And a weekend night can be a particularly tough time to be alone and confused.
It's around eleven on Saturday night, and Jorge, the short-haired, muscular security guard, is settling in for his overnight counseling shift. A teenage girl phones, her voice shaky with panic, and says, "I'm worried that I had sex with my boyfriend. He penetrated for just a second, and I told him to get off. He didn't use protection. Ten minutes later, he came." She wonders if she can get pregnant.
Jorge won't answer the question directly -- "I'm not a medical doctor" -- and tries instead to get her to take precautions for the next time. She moans in distress and he tells her, "You can't change the past. But you can plan ahead for the future." Because she didn't ask for a birth-control referral, there's not much more he can do.
Confusion about sex is still rampant among the young, at least according to the phone counselors who field such calls frequently. Ed, a retired business-college teacher who volunteers twice a week, cites two common questions -- Can the girl get pregnant if she did it standing up? Can she get pregnant during her period? -- and an uncommon one: "A fifteen-year-old boy called after he used a condom, and asked me, 'Can I use it again on the other side?'"
There's also a small group of callers who turn to the hotline not as a resource for sexual questions but as an outlet for their kinky fantasies. The operators usually can tell when they're being used that way and make sure to hang up if such talk continues. Sometimes a counselor isn't sure and may give the caller the benefit of the doubt for a while. So on one Friday night, shortly before eleven, a man calls and tells the 76-year-old woman who answers that he's not sure if wants to watch his wife having sex with another woman. He keeps talking earnestly about his wife's desire to dominate him, but when he asks to speak to another woman counselor the switchboard operator knows it is likely a bogus call. "You have to make up your own mind," she says, before hanging up the phone with matter-of-fact irritation. "I think he was masturbating."
Other callers have sicker reveries. One man is simply listed in the switchboard's files as "Penis," because he calls with an elaborate, plausible explanation of how he lost his member in an accident, or as a result of illness. Before a novice counselor knows what's happening, this caller feverishly jerks off. How he simultaneously reconciles a castration fantasy and masturbation in his own mind has not been made clear.
Most calls, however, come from people in genuine pain over their troubled personal lives. On any evening you can hear a teenage girl complain about her 29-year-old mother sleeping with a 17-year-old boy, or an overweight woman in her 40s who feels trapped still living at home with the mother she envies.
For some, the turmoil in their love lives has lasted for years and there's little the switchboard operators can do to alleviate it. In the last few weeks a middle-age woman, Jane, has begun calling the hotline regularly in the evenings to mull over what do about the man she's been seeing for fifteen years. On a Friday night she calls again and says to Amy, a young counselor, "I love this man I know and he doesn't love me."
"You refuse to let go," Amy says. "We talked about this a few weeks ago." At the end of their conversation Amy gives her the name of a Women Who Love Too Much support group to call, and Jane seems willing to go. Still, the next night she calls to talk about her unrequited love all over again. If this keeps up Jane may find herself classified as one of the "actives," the disturbed or simply lonely people who call as many as several times a day.
There are about 150 actives and the helpline operators have come to know them well. These regulars know the counselors and their shifts, too, sometimes timing their calls to try to reach their favorites. Novice counselors can refer to computer files on the constant callers; it doesn't take long, however, to learn their stories.
One of the most persistent is Larry, a manic-depressive who lives alone on Miami Beach. He calls only when he's in his manic phase, and when he can't sleep he may call as many as fifteen times a day; recently, with the aid of new medication he's been taking, he's started sleeping at night more, giving the counselors a break from his incessant phoning. "It's nice to get a little peace," says one. Yet Larry still calls frequently to discuss whatever happens to be on his mind. Even so, the operators manage to treat him with friendliness and respect.
Sometimes, his calls refer to what are probably fantasies about his career. By about 8:30 on a Thursday evening when he calls in for the third time that night, he starts expounding about his dreams of running for office. Each call at the switchboard is answered randomly and so now Chuck is his designated listener. The man wants to run, he insists, an "upbeat" campaign.
"Sounds nice," Chuck says amiably during their five-minute talk. "Maybe you'll turn into one of those wise old people with acolytes listening to your every word." Not surprisingly, Larry calls back later.
On the phone he sounds extroverted, coherent, almost normal. The file on him tells a different, grimmer story. "Comments: Larry has been hospitalized for depression and suicide attempts.... Meds: Lithium, Haldol, Prolixin, Prozac.... Action plan: General support. Active listening. Encourage him to continue his group support at [a local clinic]. Reinforce his participation in social activities. Time Limits: 5-10 minutes, reduce after first call."
Chuck, who has spoken to Larry for years, has a tolerant attitude toward him, offering him plenty of warmth but little in the way of direct advice. "I'm not going to help his situation by doing it any other way," he explains. The switchboard must be doing something right -- Larry is still alive, after all.
While some of the other regular callers often are in more serious pain than Larry, there is little the counselors can do except offer reassurance and urge them to continue seeing their doctors. Their conversations offer insight into lives shaped by a chronic mental illness. So when Nancy phones on a Saturday night, the prescription medications she's taking are starting to kick in and she tells Jorge, in a rambling, slurred manner, how unhappy she is. "Should I try to make myself go into a coma?... Call the cops and make them shoot me -- I'm suffering, but I'm not capable of killing myself. I don't think God put me here to kill myself."
Eventually she gets tired, and Jorge tells her, "Get a little rest and call us tomorrow."
Nancy answers, "Tomorrow, tomorrow, tomorrow, it's never going to come any more. There used to be tomorrows, but after my mom passed there's been no tomorrows, there's only been todays. I have to stay here and suffer."
The file on Nancy tells why she has so little to look forward to: "Black schizophrenic female with substance-abuse problems and multiple hospitalizations. Resistance to medications. Suicide attempts." The recommended "action plan" includes "assessment of her intent to suicide" and "focus on identifying problem and alternatives she can take." For "significant other," it lists only a doctor.
Hearing so much misery on a regular basis can take its toll. These helpline counselors, though, are devoted to their work. In addition to her day job as a secretary at the University of Miami, Amy, 26, generally works two eight-hour weeknight shifts that end at 3:00 a.m. A plus she volunteers at a hospice on weekends. She, like many of the others, downplays her own altruism, saying only, "My interest is in psychology." Most are drawn to the work because of a simple desire to help others and serve their community, and for some those reasons are deepened by pain they've experienced personally. It enables them to relate closely to a caller, even though the lives of a counselor and client may be very different. Denise, the Southern Bell technician, notes that as an overweight woman, "I'm able to be sensitive to others. I understand how they feel."
The challenge the volunteers all face, though, is not letting their caring for others overwhelm them. Jorge, after finishing his talk with the schizophrenic Nancy, observes, "You've got to train yourself to leave it right here in this room." Chris, working the overnight shift with Jorge, adds, "You empathize with them, but you try not to feel their pain so much that it interferes with what you're trying to do." Both Jorge and Chris are still young, however, and have been fielding calls for only eighteen months. They might not be so sanguine about it all if, like Chuck, they had been listening to tales of suffering for more than two decades.
It has not been easy for Chuck to strike a balance between caring too much and caring too little. "You can't do this work effectively unless you're relatively empathetic, but if you overempathize, you take the problems home with you," he points out -- and ultimately become ineffective. On the other hand one risks becoming mechanical and insensitive. This issue became so pressing that Chuck dropped out twice from the hotline in the Seventies, once for six months in 1974, the other time for a year in 1977. "Both times, I felt myself becoming jaded," he says. He noticed that he was getting impatient with callers, waiting for them to tell their stories so he could place them in a category -- such as "teen pregnancy" -- and then offer them a standard response. In recent years he has been able to find a middle ground between the extremes of being oversensitive or blase.
He's certainly had plenty of time to work on his counseling style. When Chuck first volunteered for the switchboard, the organization and Miami were very different from the way they are now.
Back then he was a 25-year-old air force officer at the Homestead air base who was seeking a place to offer his help. Chuck showed up one spring day in 1971 at the two-room switchboard office in the Center for Dialogue building abutting a church on NW 26th Avenue. When this air force officer, with his short hair and tie, came into the office, he saw a room covered in black with an upside-down American flag painted on the ceiling. A long-haired young man with a beard, headband, and beads came around a corner to greet him, and Chuck said, "I'm sorry, I'm in the wrong place."
It was indeed the Switchboard of Miami, founded in 1968 by students at Miami-Dade Community College as a housing referral service and eventually evolving into an emergency hotline for the hippie community and other young people. The Center for Dialogue was then a magnet for radical groups, and Chuck recalls walking down the hallway and seeing bullet holes from a shooting incident involving the cops and a black militant wanted for a school bombing. "It was a very exciting time," Chuck remembers, and part of that intensity was found in his sometimes risky volunteer work.
On his very first call after completing his training, he listened to a young man shouting, "We've got an overdose here, man. You better get here now!" At the time -- and for the first five or so years of its operation -- rather than call police or fire-rescue squads, the switchboard sent out its own volunteers on emergencies. "There was so much polarization then that calling them could get our callers arrested," Chuck recalls. He and another counselor rushed over to an old third-story apartment only to find the door wide open, and, inside the bedroom, a young "freak" in shorts sprawled across a bed, unconscious. Chuck tried CPR and couldn't revive him. Then they called police to report the death.
A lot of the calls in those years involved illegal drugs. Callers were generally younger and they sometimes wanted to know answers to such questions as, "Is the orange acid the good stuff?"
The truly desperate also turned to the switchboard then as they do now. Once, in the late Seventies, Chuck got a call from a man who'd lost his job as a janitor after eighteen years at the same firm. He said he planned to kill himself. "I'm just calling to say goodbye," the man told Chuck, a loaded gun laying ready next to him. Chuck convinced the caller to let him and another counselor visit, and when Chuck and a female colleague arrived they encountered a bizarre scene: a polite, heavyset man with a gun in his belt who served them tea and cookies while he spoke about blowing off his head. While talking to him they found he cared a lot about a young boy he mentored as part of a Big Brothers-style program. They got him to think about the impact his death might have on his young friend, and then, when he left the gun on a coffee table to go back into the kitchen, Chuck removed the bullets. Before they left they helped him realize there were friends who could perhaps assist him in finding work and a young boy who would miss him. Then they all hugged each other, and when Chuck walked out he felt drained but exhilarated.
"It felt great," he remembers. "We'd made a difference for someone I liked and kept him from dying."
In a few cases even the most determined counselor can't save a life. Chuck has had the horrifying experience of listening on the phone to a woman getting steadily weaker after taking 200 Valium. The rescue crew arrived too late to save her.
Almost always, though, his intervention makes a difference. He once kept a frightened twelve-year-old girl on the phone as he summoned HRS caseworkers to her house; all the while he heard her father pounding on the door, trying to get in and beat her up. The week before he'd broken her arm.
To Chuck, after taking thousands of calls, the underlying problems people face in Miami haven't really changed. People still get lonely and depressed, and, he argues, callers' needs for a place to stay, medical care, and food are no different today than they were years ago -- with one difference. "We used to deal with poverty-stricken students. Now there's a different population," he observes, referring to the influx of poverty-stricken immigrants.
Switchboard of Miami helpline director Nelson Rodney sees it differently: "We get different calls now, because society has changed in 26 years. The problems we get now are more complex, more difficult to handle." Rampant homelessness, crack addiction, AIDS -- in some ways, they make dealing with an overdose of 'ludes seem easy.
The mission, however, remains the same. "We've always been on call to help the community meet its human needs," Rodney explains. In doing so the hotline also serves as an early warning system for gaps in social services: Frantic calls for food following Hurricane Andrew made it clear there was no centralized resource for food distribution or referrals for the hungry, and that spurred Switchboard of Miami's leaders to join with other groups in lobbying for a government-funded food bank. It also has pushed for more slots in drug-treatment programs and homeless services. In the future, Rodney predicts, the helpline will follow the latest innovation in this field: setting up kiosks in drugstores with a do-it-yourself computerized-referral program and a direct phone line to the switchboard. No matter how high-tech the switchboard may become, however, the need for one-on-one help will remain.
The personal touch the hotline offers is no lucky accident; it arises from a thorough, in-depth training program. The program is considered valuable enough that other organizations, from Metro Police Department 911 operators to South Miami Hospital, are willing to pay up to $500 a day for it. "You can't teach empathy," says Nelson Rodney, "but you can teach people how to project empathy." The 60 hours of classroom training offered by the switchboard is free to potential volunteers who make a six-month commitment to work the phone lines. In recent weeks the switchboard has been teaching the staff of the Center for Haitian Studies, along with a few other volunteers; the Haitian graduates then will add their Creole-speaking abilities to the hotline.
On a recent weekday a dozen students are being plunged into the grim world of suicide intervention. Cathryn Lowe, the training coordinator, tells them, "People are ambivalent A they want to get rid of the pain but they don't want to die. That can be your lucky ring; you can get your hooks into that ambivalence." Besides learning in these classes about such topics as family disputes, the hallmarks of depression, and the types of suicidal behavior, students also are given an instruction sheet about the "Do's and Don'ts of Suicide Intervention." Among the missteps: "Don't engage in a debate with the suicidal person because you may not only lose the debate, but also the person." Another no-no: "AVOID GUILT TRIPS."
Students are asked to perform the roles of both counselor and caller, but before they do that Lowe plays them two tapes: one of a successful role-playing exercise, the second a blood-curdling conversation between a Metro-Dade 911 operator an actual victim who has ingested pills before calling. The operator clearly hasn't been trained in intervention techniques. Her comments during the crisis are a textbook illustration of counseling mistakes: She makes value judgments, puts the caller on hold, fails to establish a human connection, tells the person not to cry.
The students will, Lowe hopes, do better. The role-playing today involves a Haitian man, Romuald, and Carolyn, a young psychology student. (Before the weeks of training are over each student will have undergone hours of role-playing.) Their chairs are placed back to back, and he acts noticeably depressed. "I received bad news today," he says, and Carolyn responds, "Do you want to tell me about it?" Gradually he reveals that he's tested positive for AIDS. "I want to put an end to it all," he says, then admits that he's got a loaded gun on him. "Do you have any friends you can talk with?" she soon asks.
Lowe interrupts, pointing up to Carolyn, "You need more reflecting of his feelings." One key to keeping the caller on the line -- and alive -- is what the switchboard calls "active listening," in effect reflecting back to the caller the sentiments he's expressing and listening for the emotions that underlie his words. "Acknowledge his aloneness," Lowe instructs. And she offers a note of reassurance: "As long as you're getting communication going, there's no need to reach for the panic button just because there's a gun."
In the real world that sort of advice is helpful because it can be far more nerve-wracking trying to counsel a real potential suicide than one of your fellow students. For instance, on a Friday night, shortly after 10:00, a caller barks at Amy, "I'm a fucking suicide." He's slightly drunk and quite upset: "I can't let go of my past." He's just finished watching the film Platoon and it's dredged up all his old memories of the Vietnam War.
"What did this movie bring back to you?" she asks.
"The killing of a bunch of innocent people," he says with true anguish in his voice. "I tried to put it all behind me, but it's not going away." He can't bring himself to tell his girlfriend about it, he drinks to drown his guilt, and even a visit to Vietnam a few years ago didn't salve the wounds.
"The bottle's not helping," Amy tells him.
"The bottle has nothing to do with it!" he snarls.
"This pain is never going to go away if you try to keep it quiet," she says softly. "Is suicide going to cure the pain?"
He admits he doesn't really want to kill himself because of a fear that he'll be denied a fulfilling afterlife. Nevertheless, he has a plan anyway: "I'm thinking about slitting my wrists. If you place a band around the wrists to raise the veins, you'll die quieter."
Amy asks, "You're telling me you don't really want to do that, so why not try counseling?"
Halfheartedly, he responds, "Okay."
She gets his number for a followup call, then tells him if he wants to call back later tonight, "I'll be here."
The promise of someone who'll listen at the other end of the phone line is what keeps people calling around the clock. What makes the Switchboard of Miami work is the willingness of counselors like Amy and Chuck to offer simple human warmth to whomever calls, no matter how serious -- or mundane -- their problem may be.
The last call Chuck takes tonight is from a lonely college girl who's just broken up with her boyfriend. She's distressed by a dating scene that puts so much emphasis on physical beauty. "Everyone needs somebody to care about them, and I want to find someone I'm comfortable with," she says.
"That sounds reasonable," Chuck agrees. He tries to comfort her by saying, "I think there are relatively large numbers of people out there who don't put a priority on having a woman look like Christy Brinkley."
She perks up. "I'm going to try it, I'm going to meet this person," she says. "Thank you for being there."
The shift is over, and by the time Chuck drives home to his apartment in his white Mazda, he has put the evening's calls behind him. He has a dinner to eat, cats to feed, legal cases to think about. And before he goes to bed, just as he does every night, he'll say the Lord's Prayer, and ask the Lord to send blessings and care to those who deserve good health and a safe return home. He usually mentions his parents, a few friends, and his two ex-wives, but tonight he adds another name to his prayer list: Rita, the young girl trapped with abusive parents and a heart filled with despair. The counselors at the hotline aren't the only ones ready to listen. God's switchboard, it seems, is open all night, too.
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