Crisis Hotlines Jangle With Change

Ed Finkel
January 1, 1999

When someone announces that they’re going to start a crisis hotline for youth, Caressa Singleton gets nervous.

Singleton believes in hotlines — she is, after all, director of one of the nation’s biggest, Covenant House’s Nineline. But she remembers a recent meeting where a young man declared that he had opened a nationwide suicide prevention hotline in his house.

“I was appalled,” Singleton said. “I said, ‘Please don’t put your number out yet.’ I’m hoping we get an opportunity to have an impact on who qualifies to open up a crisis line, and what kind of criteria they have met.”

Such stories are common among people who run hotlines — which is why Singleton and executives from eight other youth crisis lines gathered here in September to try to create standards for the industry. These established hotlines, which require various levels of education, pre- and in-service training for their workers, feel undercut by well-intended activists who start hotlines in their homes or churches with little experience or resources.

Some of the people who run smaller hotlines, however, are suspicious of the big agencies’ motives and offended by the suggestion that they don’t know what they’re doing. “We are qualified to counsel,” says Gary Beneventi, who runs the Christian-focused National Youth Crisis Hotline, based in San Diego. Ken Beitler of Minneapolis, who in 1969 launched one of the nation’s first youth hotlines (Youth Emergency Services), says standards might do some good, but that the movement partly reflects the “big guys” throwing their weight around.

The drift toward standard-setting is one of several changes affecting the hotline industry. Crisis line services have flourished over the past decade with added funding and the advent of computer databases. Such technology has made it easier to get information on who’s calling and to find services to help them. But other advances have introduced perplexing ethical issues, such as using caller ID and star-69 to track calls.

Empowering Kids in Crisis

Children's Hospital in Los Angeles is credited with setting up the first youth crisis hotline in 1968, Beitler says. When he counted them in 1973, he found 1,400.

Crisis lines are designed to listen to troubled youth (or sometimes their parents) and help the callers solve problems, usually by referring them to community-based services. “Our job is to provide crisis intervention and support for whatever’s happening with the caller at that time,” says Chris Monaco of the Scottsdale, Ariz.-based ChildHelp USA, which runs its hotline on $1 million a year and reports handling 2 million calls since 1982. “And then to empower them and help them make decisions in terms of what they can do long-term and short-term. We have over 55,000 resources in our database.”

The biggest database in the world, however, can’t replace a hotline counselor who knows how to take the hand of a kid in crisis and guide her to the best path. Pat Daley, who has been a volunteer at the National Runaway Switchboard for nearly six years, vividly recalls a young girl who had been physically and sexually abused by her dad. Even if she had been able to gather her strength and call police, there was a problem: her father was a police officer in her small town.

Daley talked the girl through her options and “got some good ideas,” including calling a friend’s older brother, who had a car and might take her to a shelter. “Those are the toughest calls, where kids are in a situation where their parents are in control of the peripherals and connected in the community,” Daley says.

The Chicago-based NRS, which dates to 1971, is the only national provider that’s strictly a hotline. Others, like New-York-based Covenant House (operating in 13 cities), Nebraska-based Boys Town (operating in 11 states), along with state-level services in California, Michigan and Florida, sometimes refer callers to their own services as well as to other agencies.

The need for crisis lines is evidenced by the growth in their funding. The National Runaway Switchboard, based in Chicago, receives most of its funding through the federal Runaway and Homeless Youth Act. Those funds have boosted the agency’s annual funding from $300,000 a decade ago to approximately $1 million for 1999. The state-funded California Child, Youth and Family Coalition, which runs a statewide hotline for kids, just received a 30 percent increase in its budget to $338,000 for fiscal year 1999.
The need has also spurred a proliferation of crisis lines — which at first blush seems like a good thing.

Who Is Qualified?

“So many crisis lines are in operation it tends to dilute the standards,” says Kate Fogle, executive director of California Child, Youth and Family Coalition. She says her agency has received calls from parents complaining that other hotlines have encouraged their children to do things that might be illegal or unwise, such as running away from home.

“Everybody thinks they can do it,” says Michael Holt, help line director at the Georgia Council on Child Abuse, which runs a part-time hotline on a budget of about $100,000 with two paid staffers and 45-to-60 volunteers. “I’ve gotten probably two dozen calls from churches saying, ‘We’ve decided to start a help line. Can you help us?’ And they have no idea what they’re biting off.”

That’s why the nine hotlines represented at the Chicago meeting are thinking through a set of best practices, and may form or seek affiliation with an accreditation body. They include the NRS, ChildHelp, Nineline, Boys Town, and several statewide hotlines. At their meeting, participants started with a four-year-old rough draft and worked toward a best practices guideline that they hope will be ready in a year.

Proper training of staff and volunteers is the key, they say. At the NRS, supervisors must have a bachelor’s degree in a relevant field like sociology, psychology or human services. Volunteers must undergo a 30-hour training program that includes lots of role-playing and practicing, says executive director Lora Thomas, “to make sure that prospective volunteers are equipped to handle any kind of calls that come in.” Like many hotlines, NRS has a minimum age requirement (18, or 16 with parental consent), and tries to check job and personal references.

Thomas and others at the conference would like to pass along their techniques to others and to each other. “We get calls all the time saying, ‘I want to start a hotline, what assistance can you give me?’ “ she says. “And we want somebody to start it with quality services in mind...[The working group] is an opportunity for us to get to know each other on a basis where we can pick up the phone and draft responses together and have a united voice. It’s an opportunity for us to hold each other accountable and improve our own services.”

Creating such standards is touchy, however, because many of the smaller hotlines are religious-based and some suspect a bias against them. Beneventi of the National Youth Crisis Hotline is blunt: “I think it’s a ploy from Satan trying to regulate a Christian viewpoint,” he says. His 11-year-old hotline, based at Horizon Christian Fellowship, reports 18,000 to 30,000 calls a month. The service has three paid staff; calls to the hotline are automatically routed to more than 600 volunteers in homes and churches around the country. Beneventi says the volunteers are chosen and held accountable by an “outpost director” at a local church.

The concern, says Beitler, is that “some of these places aren’t going to be honest about what their bias is.” Fogle says that in some cases “folks are given pretty heavy-handed and explicit religious advice” that they’re not expecting.

Beneventi makes no secret of his point of view: “We want to get kids out of their crisis situation and then give them the hope of Jesus Christ.” That does not mean, he says, that his counselors proselytize. “We want to give help and not hassle. We’re not trying to put some marks up on the board.” He says counselors go through a training program that includes a video, use a 500-page manual to guide them in dealing with specific caller situations, and refer callers to nearby agencies for help.

Beitler says the level of expertise required at a hotline depends on what the hotline is trying to accomplish. “The more you advertise yourself as dealing with serious mental health issues, the more you ought to be clear about how much training you’re getting, or what the credentials are,” he says.

Monaco of ChildHelp says the standards effort aims to professionalize the church-based and home-based hotlines, not shut them down. “Hopefully, it’s going to elevate them,” she says. “Hopefully, if they have problems, they’ll turn to us and say, ‘How do you do this or that?’ That’s what I’d like to see, the sharing of information.”

Database Power

The hotlines themselves are taking and disseminating more information than ever, thanks to technology. For example:

The NRS has used much of its increased funding over the years to invest in computer and telephone technology to handle both the volume of calls and the variety of referrals needed. Where hotline volunteers once had to thumb through clumsy stacks of binders to access information, the Runaway and Homeless Youth Management Information System lets workers enter data about the type of call and issues such as family dynamics, school and education, health, and physical and sexual abuse. The system then gives lists of appropriate agencies for help.

“We have evolved the database into meeting the needs of lots of kids, from kids who are at home, thinking about running away, to kids who are already on the road and need intermediary services, to kids who are thinking about going home,” Thomas says.

Putting caller information into the system gives hotlines a good idea of who their callers are and what services they need. ChildHelp USA, which specializes in abuse, changed to a more sophisticated, tailored database this fall. That should help satisfy corporate and foundation funders that the agency is a worthwhile investment, Monaco says.

“We’re going to be able to really go after the demographics, such as how many calls are we getting from certain states, what’s the type of calls we’re getting, are we getting calls from adolescents or adults,” she says.

The Boys Town National Hotline, funded at about $1.2 million a year, can now access the latest information on hot issues for its 20,000 to 30,000 monthly callers, say Dee Kohler, director of support services at the Boys Town National Resource Training Center. This past summer a slew of callers wanted to know about how to watch out for a new “date-rape” drug that rendered women groggy and defenseless against unwanted advances. “We’re able to better respond to some of the trend questions,” Kohler says. “We were able to get better research over the Internet on what’s the media saying, what are psychologists saying, when parents ask, ‘What should I look for?’ “

Covenant House Nineline may soon add a computer mapping function to find the nearest available services for kids who are on the road and can’t pinpoint their location.

Phone Power

Improved phone technology has helped hotlines deal with increasing call volume by, for instance, automatically routing calls to available volunteers. It has also helped deal with the persistent problem of hang-up and prank calls.

Pranksters can upset counselors. Some go beyond hang-ups and dirty talk to wasting counselors’ time with made-up stories. “There’s a trust issue. We’re here to help people, and you’re messing with us,” Beitler says. A caller leads them “down some path, and then they find out after 20 minutes that this is a false story. Then you’re pretty upset.”

Prank calls also cost money, because the agencies with 800 numbers are paying for the incoming calls.

“Some places have pretty elaborate lists up on the wall —Watch out for this person who calls,’” Beitler says. He and several hotline managers suspect, however, that many pranks are from kids in trouble who haven’t gotten up the nerve to make a real contact.

“We have pranksters who call, and then we get a real call,” says Singleton, whose Nineline gets between 2,000 and 3,000 calls a day and functions on a $1.3 million budget with 53 paid staff. “We say, ‘How did you hear about the Nineline?’ and they say, ‘We used to prank.’ The idea is not to close that person down. They’re testing the waters.”

At one point, 38 percent of the Youth Crisis Hotline’s calls were pranks, Beneventi says. He’s cut that in half with technology that enables his agency to keep track of where most of the pranks are coming from, and to “call those phone numbers and remind them, ‘You’re interfering in crisis situations for America’s youth.’ A lot of times they’re blown away because we have their phone numbers.”

That tactic raises a another touchy issue.

Ethical Dilemmas

Features like caller-ID and star-69 tempt providers to compromise confidentiality in favor of intervening in a crisis. Those who don’t use caller-ID are emphatic about their decision.

“We’re one of those groups who has unequivocally said, ‘We don’t want that liability,’ “ says Holt of the Georgia Council on Child Abuse. “Part of the reason people call help lines is because they want to be anonymous.”

“Technology can be a barrier in the process of building the trust and rapport with these people who call,” says Christopher DeAngelis, chair of the NRS board of directors. “We can honestly say, ‘We’re not tracing this call. We don’t know where you’re calling from.’”

Others say that when a serious situation like suicide presents itself, they can’t stand by. Kohler says Boys Town uses caller-ID in rare cases “where we feel there’s a serious situation, and the person isn’t giving us any inclination of where they are.”

The St. Petersburg, Fla.-based HelpLine used to trace calls but decided to get caller-ID this fall. “Crisis lines across the United States are having that debate,” says Micki Thompson, program manager at HelpLine, which gets 200 calls a month on its runaway hotline. “We’ve come to the conclusion that if we’re going to trace it, we have to go through lots of hoops, and counselors often lose the calls. If we have the caller-ID, it’d be much quicker. But most kids will tell us right where they’re at, if they’re wanting to get to a shelter.”

Getting youths to a shelter or service that will help walk them through their crisis is, after all, what all the crisis lines are about — regardless of the technology or philosophy behind them.

Resources

Lora Thomas

National Runaway Switchboard

3080 N. Lincoln Ave.

Chicago, IL 60657

(773) 880-9860

E-mail: LthomasNRS@aol.com.

Dee Kohler

Boys Town National Hotline

13940 Gutowski Road

Boys Town, NE 68010-7535

(402) 498-1077

Chris Monaco

Childhelp USA

15757 N. 78th St.

Scottsdale, AZ 85260

(602) 922-8212

Gary Beneventi

National Youth Crisis Hotline

P.O. Box 178408

San Diego, CA 92177-8408

(619) 292-5683

Caressa Singleton

Covenant House Nineline

346 W. 17th St.

New York, NY 10011-5089

(212) 727-4021

Sidebar:

Crisis Hotlines Jangle With Change: Youth Crisis Hotlines


Finkel, Ed. "Crisis Hotlines Jangle With Change." Youth Today, Dec/Jan 1999, p. 1.

©2000 Youth Today. Reprinted with permission from Youth Today. All rights reserved.

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