Samaritans in Boston marks 50 years of working to prevent suicide

Fifty years ago this week, the first U.S. chapter of the suicide prevention organization Samaritans opened in Boston.

There were almost two-dozen volunteers in the basement of Arlington Street Church. They had a bank of rotary phones and a wealth of compassion for people who called their hotline — people who were struggling with mental health issues, including thoughts of suicide.

Today, across the U.S., suicide is at an all-time high. Almost 50,000 people took their lives in 2022, more than 600 of them in Massachusetts.

At a State House event marking the Samaritans anniversary on Monday, Massachusetts Health and Human Services Secretary Kate Walsh said there's reason for hope.

"We know that despite the number of painful, heartbreaking losses to suicide we've experienced, there are just as many, if not more, people whose lives were saved through prevention," Walsh said. "And I have no doubt that Samaritans and its fellow providers are a big reason why."

Data from the U.S. Centers for Disease Control and Prevention show 1.7-million people attempted suicide in the U.S. in 2021, and millions made a suicide plan or seriously thought about suicide.

Today there are independent Samaritans branches around the country. Their work includes community education and grief support programs for people who've lost a loved one to suicide.

The Boston chapter long ago left the church basement, and now works out of an office downtown. In the past five decades, according to Samaritans, its center has answered more than 3 million calls and text messages to its helpline. The volunteers who answer the calls are trained to be compassionate, non-judgmental listeners.

Kacy Maitland answered calls at the Samaritans helpline after college. She was inspired by her father, who volunteered answering calls at Samaritans when she was a child. She went on to become a social worker, and she's now chief clinical officer for Samaritans in Boston.

Maitland spoke with WBUR's All Things Considered host Lisa Mullins about Samaritans' work.

On the premise behind the Samaritans helpline:

"The basic principle behind what we do at Samaritans is something called befriending. And the definition of befriending is really the art of listening. And the one thing that I always gained from my father was his ability to be asking the right questions, because he was always asking them in an open-ended way, in a caring way, and that was because that's what he learned to do on the helpline.

"So we're asking every single caller if they're feeling suicidal, and if the answer is no, we continue to befriend. And what that means is continuing to ask questions about what they're sharing."

On how the call takers support and validate callers who are thinking about taking their own lives:

"It's validating that that's a very real feeling and that it's understandable that someone would feel that way at this point in time in their life. And that is a very significant thing to have happen when someone says, 'I hear you. I can understand why you might be feeling suicidal. I can understand why you might feel like that's the only option.' And so then our job on the helpline is to help them think about ways that they can access and gain help in that moment."

On what's changed in Samaritans' work over five decades:

"Suicide prevention has evolved quite a bit over the course of the last 50 years, as you can imagine. We are working with people to safety plan. We are working with people to access the help that they need, whereas before, the idea around intervention was, 'Let's allow people to make decisions about what they want.' And now the intervention is more collaborative. It is, 'How can we get you the help that you need,' rather than you saying, 'I don't want help. Don't help me.'

"The other really major advancement has been the institution of 988, the three-digit federal number [for the suicide and crisis lifeline]. We are answering calls in the state of Massachusetts. So there's five centers that answer those 988 calls [in the state]. Another service that we offer is Hey Sam, a youth text line, peer-to-peer service for folks ... up to the age of 24. And the folks answering those text messages are people up to the age of 24. And so we sort of saw this gap where we knew that teens are using text-based services much more than they are picking up the phone and dialing. And [we were] also hearing from them saying, 'I want to talk to someone who might know what I'm going through. I want to talk to someone my own age.' "

On what is different about conversations via text versus phone:

"They're much longer. So, on average, we're seeing phone calls be between 10 and 15 minutes, depending on what's happening. And an average text conversation is around 45 minutes. People pick up their phone, they put down their phone, they're texting back and forth. They're going to do something, they're coming back to it. But the actual nature of how we befriend is really the same."

On the factors leading the suicide rate to increase despite the prevention work that's  happening:

"I think that we're at a time period where we're just seeing the repercussions of loneliness, maybe lack of access to mental health care. I think one thing to point to that's really important is that [more than 50%] of all suicide deaths are by gun. And so, when you look at the national data of the suicide rates as a whole, and you look at Massachusetts, we rank relatively low. The reason for that is good gun laws. But the thing that we continue to hold onto is the hope that we're going to do better, the hope that what we are doing continues to save lives because we know that it has."

On what we can all do if we know someone who's struggling with their mental health and possible suicidal thoughts:

"I think the most important part about the way that we engage with people who might be suicidal is that we're asking the question if they're actually feeling that way. So we're actually saying the words, 'Are you feeling suicidal?' ... Everybody worries that that's going to plant the seed, and the research does not support that in any way. And my experience doesn't support that in any way.  What you will most likely receive in return of asking that question is relief from the person who is getting that question asked.

"And if the answer is yes, there's a couple of things that you can do. The first thing is [say], 'Thank you for sharing that with me.' The next active step may be, 'Who can we call right now that would be the most helpful to you?' Maybe that's a parent, a family member, a friend, a therapist. ... But it's acknowledging, it's validating, and then accessing help."

Resources: If you're feeling suicidal or are experiencing another mental health crisis, call or text the national Suicide & Crisis Lifeline at 988.

For information on mental health resources, you can call or text the Massachusetts Behavioral Health Help Line at 833-773-2445.