In a small office space, at the back of the Gerstein Crisis Centre in downtown Toronto, Collette Kelleher answers the phone in a calm and caring voice as she tries to create an instant sense of connection and support.
"Good afternoon, 9-8-8, my name is Collette how can I help you?" said Kelleher, a responder with 988, Canada's Suicide Crisis Helpline.
That human connection is said to be a lifesaving aspect of this service.
"A lot of people when they call, they may be in an acute state of distress. When we get in the tunnel vision, we don't feel we have options, or they don't feel they have options and they're thinking about they would want to kill themselves, the only way out is death," Kelleher said.
Launched on Nov. 30, 2023, the simple three-digit number was designed to be a lifeline for Canadians in crisis or those seeking to find support services for someone else.
988 is funded through the Public Health Agency of Canada and run by the Centre for Addiction and Mental Health (CAMH).
In its first year, 988 responders in communities nationwide have answered more than 300,000 calls and texts. Responders in British Columbia answered an average of more than 3,500 calls and texts per month, with 3,000 in Alberta and roughly 12,000 in Ontario.
Those numbers are right on target with the expected call volume CAMH projected, say officials, who deem the first year a success.
"I think it's absolutely been a success, and I think a success because of the many people committed to this and working on it and because it was needed," said Dr. Allison Crawford, the chief medical officer for the helpline.
'It saves lives'
The average wait time in October was 44 seconds for phone calls and one minute and 47 seconds for texts.
While satisfied with those numbers, those involved are still working to improve.
Data for suicide rates is often years behind. Experts note they'll continue to study the numbers but feel Canada's service is on par with others.
"This is one thing the world health organization promotes for suicide prevention and we're seeing across the world these services emerge, especially having three digits. We know having a three-digit number increases the speed of access to care and we know that works, it saves lives," Crawford said.
The same 988 national crisis line was launched in the U.S. in July 2022.
"It's evidence based, it's supportive to people, and so we want people to know about it and we’re preparing to meet an even bigger demand," Crawford said.
Close to home
Demand for the crisis line is expected to only grow as more people become familiar with the service. Recent studies have shown that mental health distress and mental health challenges are greater than ever across the country.
While CAMH oversees this service, it is designed to be community based and calls are not centralized to one generic call centre. All calls and texts are answered by trained responders, working with roughly 40 crisis networks across the country.
So when someone reaches out, they are getting a response from someone as close to home as possible.
"The person who will answer your call will be familiar with how you live, where you live, the kinds of supports that are available, often that means greater cultural safety," Crawford said.
Those people are trained responders like Kelleher, who has been working in mental health for more than three decades. With a passion for helping people through crisis, she takes great pride in letting people share their story and helping them recognize they are not alone, though every call is different.
"You're always nervous because you don't know how you're talking and I'm always hoping that they will trust me enough … to share their story. So there is always a level of anxiety, because you don't know if someone is actively engaged in self harm at the time or whether its an emotional distress call," Kelleher said.
A real person
The average length of a text conversation is about 34 minutes and phone conversations average a time of 15 minutes, but Kelleher says it's not uncommon to spend an hour on the phone with someone, going through a series of exercises and conversations.
"Breathing exercises, bringing them back to the here and now, what's happening listening to their pain, also opening up a conversation by asking directly, 'Are you having suicidal thoughts? Are you feeling suicidal today? Do you want to kill yourself? Do you have the means'?" Kelleher said.
Responders are trained in risk management and can call 911 if needed. The goal is to create a connection with someone, to have them understand it's a real person on the other end of the phone speaking to them or answering their text message – it's about taking someone out of a place of high risk to a place of safety.
Kelleher does that by sharing her name and personal anecdotes from others.
"I'm always impressed with people's own coping skills, their narrative. I find it magic that they will even be willing to trust me and that makes me feel really humble when they share their story," Kelleher said, adding that people are strong but may just need a little support.
"People have huge resilience, but when they're in an acute state of crisis they forget that."
Staying grounded
It's a weight that responders are willing to bear knowing they make a difference in the lives of others. Kelleher says that before she answers a call, she grounds herself – "parking her own stuff," she says – for that person to be able to lean into their story.
She also focuses on grounding herself outside of work hiking and spending time with her grandchildren to work on her own self.
988 isn't just for those in an acute state of crisis but also for those seeking supports for others, and some crisis centres are seeing a different demographic call now that the number has been expanded and marketed to Canadians.
"We have a lot of people reaching out that haven't historically accessed services in the past," said Melody Grant, a 988 supervisor at the Gerstein Crisis Centre.
She says it's been remarkable to see people from all walks of life use this service for help.
"It's a first point of contact for a lot of people that maybe don't know about the supports in their community or maybe they know the service provider so they're afraid," Grant said.
That's something Kelleher can attest to, knowing every time she answers a call or text, there's a very unique story on the other end. She hopes this will also help end the stigma around mental health, in that it's not just one "type" of person or demographic who needs supports.
"It's any Canadian, it could be me tomorrow, it could be you tomorrow. It's when our stress level has become accumulative, when we're sitting in pain and we're not seeing anything. And that could be anybody from doctors to nurses to daycare workers to 'Joe Blow' on the street."
