When Crisis Calls

New York Public Library develops a policy on callers who threaten suicide

August 13, 2010

Crisis

I recently answered a call on ASK NYPL, the New York Public Library’s telephonic and electronic reference line, from the New York City Police Department. A 16-year-old girl was threatening to throw herself off the Verrazano-Narrows Bridge that links Brooklyn to Staten Island, and the only identification that she had in her effects was an NYPL library card—with its barcode on the back that could provide her identity, home address, and contact information for her parents.

After making absolutely sure that the policeman was who he said he was, I provided him with the necessary information. Fortunately, this child survived. But I dread ever facing another such call and having it end in the loss of a human life.

After I notified my supervisor (and her supervisor) of what had happened, I was given the job of researching and formulating a suicide response policy for approximately 2,500 NYPL employees.

A policy gap

I contacted reference librarians providing service via telephone, e-mail, IM, and text messages at the 12 largest public libraries in the United States, as well as a number of smaller libraries. Many have had experience with this disturbing type of call. But the most striking result of my research is that almost none of the largest public libraries in the United States have any specific policy with respect to response to threats of suicide by either their patrons or other persons. At best, most library systems have only a vaguely worded mandate about contacting the police if anyone threatens to commit a crime or to inflict bodily harm.

I also interviewed many psychiatrists, clinicians, and other authorities on suicide, directors of suicide hotlines as well as legal counsel to public libraries on how to handle this matter, with the best interests of the distressed person as well as the legal protection from liability of the public library in mind.

I was directed to create a policy that could fit on one side of an index card. Public service staff in libraries have varying levels of education and experience, and this particular policy must be immediately comprehensible to anyone.

Highlights of NYPL’s policy are:

  • If the person is in imminent danger of attempting to commit suicide or of causing harm to himself or others, the staff member should, as calmly as possible, attempt to obtain that person’s name, location (address and nearby landmarks), and contact the police at 911.
  • If the threat is not imminent, the staff member should still contact 911, but should also suggest that the depressed person contact the National Suicide Prevention Lifeline at 800-273-TALK; 800-SUICIDE, which is linked to the National Suicide Prevention Lifeline and is easy to remember; or one of the more than 600 municipal, county, or state suicide hotlines in the United States.
  • The staff member should immediately record the date and time of the contact, the staff member’s name and employee ID, and that 911 and any other organization was notified, along with the name and address of the caller.

There are several demographic groups at particular risk for suicide, including the severely mentally ill, those addicted to alcohol and drugs, the homeless, terminally ill patients, teenagers (especially lesbian, gay, bisexual, and transgender teens), and veterans. But the single best predictor of suicide is a previous threat or attempt, and all authorities agree that any mention of or reference to suicide is to be taken seriously and reported. This is why it is imperative, both as a matter of ethics and to avoid legal liability, that librarians both notify the police and refer the depressed person to a hotline with trained suicide prevention experts.

When considering using a local suicide response hotline, consider whether that suicide prevention agency has the ability to contact 911 responders immediately. In addition, all sources that I contacted stressed that the hotlines must be pre-tested before a crisis contact occurs, and re-tested every six months.

Resources and training

Some of the most highly regarded resources include:

  • The Samaritans has trained suicide prevention counselors on hotlines in most of the East Coast states and in a number of foreign countries, and a public education program that provides workshops for students, parents, teachers, guidance counselors, social workers, and others. It offers a collection of resources and the free Suicide Awareness and Prevention Booklet for Caregivers and Health Services Providers.
  • Mental Health America has more than 320 affiliates in the United States and provides speakers and information to educate libraries and other institutions on responses to telephonic and other threats of suicide.
  • Cornell Cares is a geriatric psychosocial website produced by Cornell University’s Weill Medical College that includes, among many other resources, a handout (PDF file) for senior citizens with suicidal issues.
  • The National Suicide Prevention Lifeline (800-273-TALK) offers trained assistance to someone contemplating suicide. It will also route such a caller (based on area code and any other information provided) to the closest available crisis prevention center among the over 145 centers that are located in virtually every state and locality in the United States. Veterans can press “1” to be routed directly to the Veterans Suicide Prevention Hotline.
  • The Kristin Brooks Hope Center is one of the suicide prevention organizations that responds to calls at 800-SUICIDE.
  • The Institute on Aging’s Friendship Line (800-971-0016) focuses on senior citizens. The Trevor Project’s Trevor Lifeline (866-4U-Trevor) offers a 24-hour-a-day hotline for lesbian, gay, bisexual, transgender, and questioning youth.
  • Active Minds is not a suicide hotline, but it is devoted to the prevention of depression and the promotion of mental health on college campuses. To Write Love on Her Arms seeks to bridge the gap between treatment and people who need help.
  • Many state offices of mental health provide suicide prevention education information for free to the public, health care providers, educators, and libraries. There are also now more than 600 municipal, county, or state suicide hotlines in the United States.

Matthew J. Boylan is a senior reference librarian for the New York Public Library’s ASK NYPL. He previously worked for 10 years as an editor and five years as a licensed attorney.