Chances are, if you’ve seen any of the suicide prevention awareness efforts of mental health advocates, you’ve heard about suicide hotlines. Suicide hotlines are one of the most prominent and visible outreach methods for preventing suicide. Their numbers are frequently shared by celebrities, schools, doctors offices, politicians, and companies. A song with the number of the American National Suicide Prevention Lifeline in its title even reached number three on the US Billboard Hot 100 in 2017. Most people in the United States are aware of the line or one of its variants, even if they have never felt suicidal themselves.

The goal of suicide hotlines is an admirable one: to prevent as many suicides as possible. By popularizing hotlines and normalizing their usage, mental health advocates hope to create a world in which no one is ever alone in crisis. Despite this commendable intent, not everyone agrees that the hotlines have been successful. Interestingly, most of the criticism for suicide hotlines comes from people who have struggled with suicide themselves. Some former users report bad experiences, with slow response times and alienating advice. Others say that despite the best efforts of the person on the other side, the hotline just wasn’t enough for them in the moment. 

I’ve had quite a bit of experience with suicide hotlines myself. The first time I used one, I was only in middle school. I was struggling with undiagnosed depression and had started to feel suicidal. I had never talked to anyone about my mental health, and I was scared to tell my family and friends about how I was feeling. I felt really alone, and thought I had no one to talk to. One night, I started to feel especially suicidal and as if I might act on my thoughts. In an attempt to distract myself, I tried scrolling through social media, and came across a post my friend had made about the Crisis Text Line, a text hotline. I decided to give it a try. With the help of the person on the other end, I was able to diffuse my crisis and keep myself safe for the night. 

That was over five years ago. After that night, I became a strong advocate for suicide hotlines, especially the Crisis Text Line. I was always confused by people who said they found hotlines to be unhelpful, because I credited the line with saving my life. If someone turned to me in crisis, I would recommend that they send the line a text. The Crisis Text Line even had its own contact in my phone. 

Unfortunately, that was not the only time I felt the need to reach out to them. I have treatment resistant depression, and because of it, chronic suicidal ideation. Over time, I started to find texting the line to be less and less helpful. I’ve come to understand why so many people have disavowed hotlines as a whole.

Hotlines can be a brilliant resource for those struggling with their mental health. Their main function, however, is simply to prevent a crisis from reaching its peak. They can help redirect users to other resources, provide a distraction, and serve as a reminder that the user is not alone. They cannot solve the problems in a user’s life that have led up to the crisis, and are not meant to help with long term mental health problems that lack a crisis-like peak. They also cannot stop someone who has already made up their mind about harming themselves. Unfortunately, this limited scope is rarely mentioned by the celebrities, television shows, and advertisements that promote them, which means that they are often recommended to people who would be better off with a different resource. Too often, people are directed to suicide hotlines, when their crisis really needs a higher or lower level of support. This mismanagement can be anything from annoying to incredibly harmful.

It’s great that suicide hotlines are everywhere: this makes it so that people are already aware of them before they need to use one. The problem comes when suicide hotlines are the only mental health resource that is promoted, and when their limitations aren’t advertised. There are many other types of resources that are lesser known but can better handle mental health problems that require different forms of support than a suicide hotline. Community-specific resources can be especially helpful. If you consider yourself an advocate for suicide prevention and mental health, consider researching and promoting some of these resources alongside suicide hotlines. This can help raise awareness for other types of mental health support and help prevent people from having bad or confusing experiences with hotlines. 

One thing to be aware of is that there are different resources for people who are actively suicidal than for people who are passively suicidal. When someone is actively suicidal, they are in an immediate crisis, with a plan, an intent, and the means to harm themselves. Most of the people shown to be suicidal in the media are actively suicidal. Someone who is actively suicidal may benefit from immediate medical care or hospitalization. Depending on the individual, they may be a good candidate for a suicide hotline. In contrast, a person who is passively suicidal is not in immediate crisis. They may wish they were dead or want to die, but do not have a plan, an intent, or the means to end their life. People who are passively suicidal may appear calm on the outside but be struggling internally. These people are often better matched with lower levels of support, like a therapist or a support group. 

Do some research! If you or a friend is struggling with suicidal ideation, or if you just want to be aware of resources in your community, there are lots of resources for you. Listed below are some such resources, including suicide hotlines and support groups. If you or a friend are in immediate crisis and need more help than any of these resources can provide, consider calling your country’s emergency line or going to your local emergency department. Help is out there, even if it doesn’t come in the form of a suicide hotline. (note: most of these resources are specific to the United States, but there are more out there that can be found in your country and area!)

• National Alliance on Mental Illness (NAMI)
  • NAMI is a hub of mental health resources, and an excellent place to go if you are looking for a therapist, a support group, or another form of mental health support that is more long-term than a hotline.
• National Suicide Prevention Lifeline
  • The primary suicide hotline in the United States, can be reached at 1-800-273-8355.
• Crisis Text Line
  • A text alternative to the National Suicide Prevention Lifeline, the Crisis Text Line provides free, 24/7 support from trained crisis counselors. You can talk to them about whatever’s on your mind, including suicide, abuse, and everyday stressors. Really good for people who don’t have access to a therapist or just want one-time support. Can be reached by texting ‘HOME’ to 741741 in the US and Canada, to 85258 in the UK, and to 50808 in Ireland.
• National Institute of Mental Health (NIH)
  • Similar to NAMI, NIH can help direct you to the mental health resource that is right for you. Clicking the link above will direct you to a guide on the NIH website dedicated to helping people seek help.
• The Trevor Project
  • The Trevor Project provides mental health resources specifically for LGBTQ+ youth. Their organization includes a hotline, a text line, a community space, a support center, and workshops for adults working with LGBTQ+ youth.