Counselors on the 988 crisis hotline are sometimes targeted by sexual abuse callers

This story contains descriptions of sexual activity.

In 2023, Lily Lantz began working full-time as a crisis counselor for the company PATH Crisis Center in Bloomington, Illinois. It is part of a national network known as the 988 Suicide & Crisis Lifeline.

It was her first job after graduation and she had frequent telephone conversations with people who no longer saw the point in life, she added.

Sometimes the work was difficult and exhausting, but she always wanted to help people and felt called to this work.

But she never expected to be in danger at work: she found that on almost every shift she talked to people who masturbated while talking on the phone.

“Sometimes they would say things like, ‘Your voice sounds so good now, you make me feel so good,’” Lantz said.

NPR interviewed 10 current and former counselors from five different call centers who also experienced similar sexually inappropriate behavior. They have become a chronic and disturbing problem in the hotline industry.

There are also other types of violence, such as jokes, racist or sexist insults, and personal attacks on crisis counselors. On 988 Suicide and Crisis Lifelinepeople who perpetuate such behavior are called “abusive contacts.”

The number of inappropriate contacts is not tracked nationwide, but from 988 implemented in the country in 2022, it received a call center network over 10 million communication.

Data from one local crisis center in Portland, Oregon, Lines for lifeshows that abusive contacts accounted for just over 1% of almost 5,000 monthly interactions.

Advisors emphasize that even one harassing phone call can be distressing and that there are not enough resources to prevent such calls or help them cope when they happen.

Impact on 988 retention

Five former 988 advisers told NPR they no longer want to work at the hotline because of sexual harassment.

Another crisis counselor, Daisy, stated that she left her job because of the violence. Daisy was the name she used to talk to callers at her job at the PATH call center. She does not want to be identified by her legal name when discussing this issue because she does not want her personal and professional networks to know about the harassment.

The events were traumatic. “I didn’t write to become a prostitute,” Daisy said. “I signed up to help people who are going through difficult times.”

Lantz lost her job in June during a layoff at PATH. The only reason she didn’t leave her job sooner, she said, was because she was transferred to the day shift, where abusive calls were less frequent.

After his release, Lantz decided not to continue working at 988 due to the sexual abuse calls.

Instead, she pursues a master’s degree in social work to become a trained therapist. (Counselors answering 988 calls are trained in crisis intervention only, and 988 is not intended for ongoing counseling. In some states, including Illinois, 988 counselors are not required to have a degree in psychology.)

“We are losing good people because of the emotional toll,” Lantz said.

The eternal hotline problem

Managers of crisis centers are well aware of the problems, although they claim that there are no simple solutions.

According to Greg Borders, clinical director at Lines for Life in Portland, aggressive callers have been using emergency numbers for years.

“It’s certainly nothing new,” he said. “I have been with Lines for Life for 12 years and the company has been around long before I joined and still does.”

Deterring or punishing aggressive interlocutors is difficult. He calls 988 they are anonymous to protect the privacy of callers, so there is no way to know who is calling or from what location they are calling.

The only information the advisor has is a telephone number.

Advisors should never block numbers associated with aggressive callers because someone has that number he may have a real mental crisis in the future.

Another obstacle is the strict rule that, with every incoming call, counselors must ask whether the person is at risk of harming themselves. This part of the conversation is mandatory, even if the aggressive caller keeps redialing the number.

On PATH, this means counselors may hear verbal abuse repeatedly before they can transfer the person to a pre-recorded message line.

Lantz said some repeat aggressive callers knew about these rules and used them to catch her.

“They would say they were suicidal,” she said. “I can’t say if it’s true or not, but they were masturbating on the phone.”

Protective protocols may vary

System 988 is managed by: Vibrant emotional healtha nonprofit organization with a federal grant to oversee 207 crisis centers in a national network.

Vibrant has suggestions for crisis centers struggling with this problem, but most of them are optional, said Shye Louis, who works on clinical standards and training for Vibrant.

This flexibility is necessary because individual centers may be subject to different regulatory requirements imposed by state agencies or accreditation bodies, such as American Association of Suicidology.

Managers in crisis centers tried to deal with this problem. Borders says that in 2020, Lines for Life in Oregon began allowing counselors to forward inappropriate conversations to supervisors.

In Illinois, PATH implemented a new policy in 2023. If abusive individuals continue to call the center after being alerted to their inappropriate behavior, they can be moved to a pre-recorded message.

The message informs callers that their recent calls have been “deemed to be inappropriate or potentially harassing” and strongly urges them to stop calling as it interferes with legitimate conversations.

Both PATH and Lines for Life allow the counselor to hang up if the caller becomes aggressive, but only after the counselor has already determined that he or she is not at risk of harm to himself or herself – the Vibrant Principle.

In Colorado, six former advisers are filing suit Rocky Mountain Crisis Center in federal court because they claim the organization made it overly complicated to hang up on aggressive callers.

In an email to NPR, the crisis center denied the claims. “RMCP maintains protocols that allow our team members to set a limit if they suspect such a call and terminate the call,” the email statement read. “Such protocols are maintained and compliant with Vibrant Emotional Health, the administrator of 988.”

One of the plaintiffs in the lawsuit, Myriah Montoya-Gallegos, told NPR about an incident involving a man who was masturbating on the phone. The superior, who was eavesdropping on the conversation, did not agree to hang up, she added.

Instead, she was asked to redirect the conversation and focus on the other person’s emotions, she added. “When he finished (orgasm), he laughed it off, thanked me, and then hung up on me,” she said.

Iris Halpern, a lawyer for the former counselors involved in the lawsuit, says crisis centers are legally obligated to act.

“Colorado’s anti-discrimination statute clearly says that even if harassment has been common in the past … something needs to be done,” she said.

Sustainability Solutions 988

Solving this problem is important for the future of 988, said Adam Carter, PATH CEO.

He said inappropriate calls could drain resources and prolong waiting times for people who really need them. He would like the Illinois Legislature to help designate 988 first responders.

In Illinois, first responder status protects liability employees in an emergency and provides additional benefits such as access to your preferred mental health provider.

Counselors at several crisis centers believe that stricter state laws could help stop abuses.

In the 911 system, local regulations often prohibit repeated misuse of the line. Caller ID and services that allow police to track a caller’s location can help officers respond to abusive 911 calls.

There is no such thing with the 988.

Daisy stated that the state of Illinois “has an obligation to protect (its) crisis counselors” because the 988 facility is partially funded by state grants.

“There are people who abuse this line and make up excuses why we can’t face the consequences of this action,” she said.

Other affected advisors say they want change but still believe in the future of the 988 lifeline.

“It is a great resource for people in crisis if used properly,” said Angel Elrich, another plaintiff in the Colorado lawsuit. “I have such faith… I think the 988 is amazing. I just really want it to be sustainable.

This story comes from NPR’s health reporting partnership with WGLT AND KFF Health News.

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