The Social Security Administration has instructed employees newly assigned to answering phones to tell callers expressing suicidal thoughts that suicide is “one option,” raising concerns from employees and experts in the field who called the approach unorthodox.
SSA recently began shifting new swaths of its workforce to phone answering duty, including those who normally receive and process retirement and disability claims, manage the agency’s technology and work in the agency's finances unit. Those employees received brief, three-hour training before they began answering calls.
As part of that training, they were warned some callers may express suicidal ideation and presented with examples using a theoretical employee named Fiona.
“It's important for Fiona to keep the caller engaged and to remind her that suicide is only one option,” the animated trainer told employees in the video, a copy of which was obtained by Government Executive, “and that there is no urgency to make any decisions.”
Employees at the training, which occurred on Jan. 26 for benefits authorizers and post-entitlement technical experts, were taken aback by the comment and asked their supervisors for clarity. One employee at the training said there was “disbelief that it was just said” among those in the room.
Caitlin Thompson, a clinical psychologist who spent eight years at the Veterans Affairs Department as a clinical care coordinator on the Veterans Crisis Line and later as the department’s national director of suicide prevention, said SSA's approach did not follow commonly accepted best practices.
“It’s not a normal thing to say,” Thompson said. “No. That’s not the thing you say to somebody who might be suicidal.”
Instead, SSA would be better suited telling employees to ask callers if they feel safe in the immediate term and if they say no, to tell the caller that they will work with their supervisor to get them in touch with a crisis line.
“It’s a very specific thing to be able to talk to people,” Thompson said, noting that employees were not hired or properly trained to handle issues that arise on phone calls like those SSA processes. Of potentially suicidal callers, she added, “It can’t just be a ‘sorry to hear that.’”
This is a good thing to do.
Suicidal thoughts are not necessarily suicidal intentions. Usually suicidal thoughts are not suicidal intentions.
If someone really has suicidal intentions, they are likely to commit suicide rather than ruminate endlessly about it.
The knowledge that there is at least that escape can make it easier to process depression, and it’s provides a sense of agency and control that is otherwise elusive.
Agreeing that the option exists is actually empowering. The worst thing is to leave them feeling helpless, with no escape.
They know suicide is an option. Suicidal thoughts can be a crutch that prevents feeling absolutely helpless. Removing that final sense of agency is a bad idea.
Suicidal thoughts can be an assertion of self-control and power in a moment of deep crisis.
::: spoiler cw discussion of suicidality
When I was last in an ideation place, one of the things that made me feel heard, that felt unselfish and like the person actually respected me, was my friend saying to me that she understood, that suicide is an option, not a good one but one that is there, and that she wouldn't judge or hate me if I took that route. She helped pull me out of that place, and her realness and understanding was a big part of it. I dont know if a stranger would have had the same effect with those words, it was more meaningful because she was my friend, but actually listening and acknowledging what's happening is important. If someone is going to kill themselves, they're gonna kill themselves. For me the people who have acknowledged that have had a far greater and more positive effect on the ideation not becoming intention than those who deny, ignore reality, or try to handwave away problems.