Dustin K MacDonald

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Starting a Crisis Line or Hotline

Posted on January 25, 2016November 25, 2018 by Dustin

Table of Contents

Introduction

Update: May 22, 2017 Please see Ultimate Guide to Starting a Crisis Line for a much more comprehensive treatment of this same topic!

Do you want to start your own suicide hotline, crisis line or helpline? This is an extremely ambitious and admirable goal and I admire you for thinking about your community! Thousands of suicide lines listen to millions of people across the globe every year, preventing thousands of suicides and making the world a better place.

While some areas have lots of crisis lines and supports in place, other communities have a complete lack of them. Especially outside of North America, crisis lines can cost money to call, or may not even exist at all.

Most crisis lines are started by volunteers like yourself, who took the task upon them for the good of their communities. Eventually most lines receive some form of funding, but in the beginning they’re often run out of churches and with volunteer labour.

A few of the things you’ll need to start your own crisis line include:

  • Office space
  • Phone Service
  • Helpline Software / Computers
  • Crisis Line Training
  • Hotline Evaluation

Office Space / Phone Service

These may seem daunting, but they’re not as complicated as they may initially seem. Office space, for instance, is often donated by churches or other community groups for fledgling non-profits. All you really need is an area for taking calls, and an area for performing administrative work. This can be in a single room to start, and could be someone’s house.

Phone service can be expensive, but using VoIP services can help reduce the cost and improve the accessibility to your volunteers. Something to keep in mind is the possibility of doing call forwarding. What this means is that if your volunteers are at home, the calls can be forward to their home or cell phone and they can answer them from there.

Helpline Software / Computers

Initially your helplines can use paper call reports to record information, later switching to a database, or if you can afford it you can subscribe to an online web-based software like iCarol that will give you much more freedom and flexibility.

It may be helpful to get in touch with local crisis lines in your area (or in larger cities) to learn about the way they code calls. This will help you to understand the basics, before you create your own call report that uniquely captures your population.

Crisis Line Training

Crisis line training is probably the most difficult element to starting a crisis line. Working with a neighbouring crisis line to undergo their training is helpful. Additionally, a lot of crisis lines have local mental health professionals work as clinical supervisors until the organization has enough institutional expertise to provide their own.

Tools that can be used to assess crisis line volunteers include the Suicide Intervention Response Inventory (SIRI) or the Crisis Center Discrimination Index (CIDI). Suicide risk assessments are also an important element of starting a crisis line because you’ll need to respond in an effective and reliable method for determining a caller’s suicide risk.

Some suicide risk assessment tools. include the CPR Model (Current Risk, Previous Exposure, Resources), the DCIB (Desire, Capability, Intent, Buffers) Model and the NGASR (Nurse’s Global Assessment of Suicide Risk.)

Helpline Evaluation

Evaluating your hotline is an important element of operating it. If you ever want to receive funding, you need to show that your line is actually beneficial.

This can be as simple as establishing standards for your volunteers (e.g. all volunteers will undertake a 40 hour training session, all volunteers will fill out detailed call reports with outcomes measures, etc.) or as complex as having a silent monitoring system to allow supervisors to listen to calls or research where callers are contacted afterwards to find out their experiences.

Cite this article as: MacDonald, D.K., (2016), "Starting a Crisis Line or Hotline," retrieved on March 29, 2023 from https://dustinkmacdonald.com/starting-crisis-line-hotline/.

32 thoughts on “Starting a Crisis Line or Hotline”

  1. Donny Marcell says:
    May 1, 2016 at 3:00 am

    I have dealt with depression, anxiety, and panic disorder. Also I have tried to take my own life. I’m here to help you get past all of that by talking to you and giving you a person to vent to that will truly listen and help you on your journey to be happy.

    Reply
    1. Dustin says:
      May 31, 2016 at 2:06 pm

      Thanks for the comment Donny. You may find volunteering with your local crisis line or even starting your own if none exists in your community very rewarding! Let me know how it goes.

      Reply
      1. Sharon says:
        November 25, 2020 at 3:59 pm

        Hi I would like to start a help line for those misdiagnosed given wrong treatment from mental health. Any ideas

        Reply
        1. Dustin says:
          November 26, 2020 at 5:53 pm

          Hi Sharon,

          I don’t have any specific ideas for you beyond reading this article and another one I wrote (http://dustinkmacdonald.com/ultimate-guide-to-starting-a-crisis-line/). Start small, and good luck!

          Dustin

          Reply
  2. AW says:
    August 8, 2016 at 2:36 pm

    Wonderful to find your site — this came up when I Googled “how to start a local hotline” — & I’m curious to know more about setting up local phonelines that work as dispatch lines more than as hotlines. Any thoughts or resources that you can e-mail me will be much appreciated. (Perhaps taxi people have expertise in the dispatch aspect aspect, too.) I live in the USA where we need more options than the 911 line; so many situations need reliable, appropriate response that is not 911. So I’m interested in starting local lines that dispatch specialized situational responders.

    Reply
    1. Dustin says:
      August 8, 2016 at 5:22 pm

      Hi AW,

      (I emailed you but I’m posting here as well.)

      Most communities have mobile crisis teams that require some form of dispatch. You may find it valuable to contact the one in the nearest big city and talk to them about what their service works like. Unfortunately I don’t have any resources related to dispatch in particular. If you’re looking for information and referral (I&R), I would check out the Alliance of Information and Referral Systems (AIRS).

      I’m sorry I can’t be more helpful,
      Dustin

      Reply
  3. Alan says:
    October 7, 2016 at 10:50 pm

    Thank you for this post Dustin.

    I myself have experienced terrible anxiety and hotlines were a godsend to me. I am between jobs right now and would love to give back and help others, just like I was helped. It seems like quite an investment though. How do you apply for funding and if I was to do this as a career would I be able to take a salary or is this type of business strictly a volunteer, something to do on the side type of deal.

    Any feedback would be greatly appreciated.

    Reply
    1. Dustin says:
      October 8, 2016 at 2:06 am

      Thanks for your questions Alan!

      Most hotlines started as fully volunteer-run operations in the 1970s but there are very few still in existence that don’t have professional staff (at least in the US and Canada), and new hotlines open every year. Usually they either have a hub and spokes model (with some paid administration and many more volunteers who actually work the phones like at my organization) or a blended model (a number of direct service staff mixed in with volunteers.)

      My knowledge of the funding side comes mainly from Canada, so it may not be as applicable to the US or other countries. Funding to start crisis lines often comes from organizations like United Way, or through municipal or provincial/state funders that are interested in piloting the program.

      Grant applications can be made to those organizations who can pilot your program, and if it shows good outcomes they can agree to fund it on a more permanent basis (in the case of somewhere like United Way), or you can seek more longer-term funder (e.g. if a state funder gave you a 3-year trial grant, you might apply for permanent operational funding.)

      As an example, my crisis line receives funding from our Regional Municipality (equivalent to a county), our local United Way, a large fundraising event we do each year, and then donations throughout the year.

      The admin staff do draw salaries, though like most non-profits the wages are lower than equivalent director or administrative jobs in the corporate world.

      To get started, I would look for the nearest local crisis line and see if they’d be interested in expanding to your area in a satellite operation. If you’re more interested in the direct service (actually staffing the phones), I would try and volunteer for an existing mental health organization or crisis line to get the training and experience.

      Hope this helps! Please let me know if you have any other questions.

      Reply
  4. Adwoa says:
    November 3, 2016 at 2:49 am

    Thanks so much for this. In the early stages of starting a call line (not a crisis one though). Do i need to register it as a non-profit first with board of directors before i can operate?
    Thanks

    Reply
    1. Dustin says:
      November 3, 2016 at 9:44 am

      Hi Adwoa,

      Thanks so much for writing. You don’t need to register or incorporate your line as a non-profit, but that will provide you with several advantages:
      – Ability to apply for funding designated for charities/not-for-profits
      – Easier to keep track of funds
      – Preferential rates on software and other expenses
      – If registered as both a not-for-profit and a charity you can give tax receipts to donors
      – Board of Directors can help share the workload

      My crisis line was started in 1970 and incorporated in 1974. You can absolutely get your line up and running first, and then incorporate later once you’ve got a demonstrated history behind you.

      Reply
      1. Adwoa says:
        November 3, 2016 at 5:15 pm

        Thank you. I’ll launch it and see how it goes from there. I think i’ll tap into other resources like ‘Gofundme’ for now. Scary and exciting new adventure for me but i’m up for it. Thanks again.

        Reply
      2. Tuborah Hamilton says:
        March 4, 2019 at 1:57 pm

        Hi Dustin,
        My name is Tuborah Hamilton and I am in need of your mentoring and expertise. My email address is tuborah@yahoo.com.

        Reply
  5. Dr. Ronak Gandhi says:
    March 11, 2017 at 2:17 am

    Hi,

    Thank you for the article.

    Do you have an idea about any other software than iCarol? its pretty expensive for a helpline like us in India.

    Thank you.

    Reply
    1. Dustin says:
      March 11, 2017 at 2:51 pm

      Hi Dr. Gandhi,

      You’re right, iCarol is very expensive for an Indian organization. Unfortunately I’m not sure of any services that are geared to that budget. If I come across any I will definitely send them your way!

      Dustin

      Reply
  6. Jacina Moore says:
    May 16, 2017 at 1:05 am

    Hi Dustin,

    I’m totally new to this process and do have a clue where to start! I’ve always wanted to do this because it’s so near and dear to me but unfortunately I lack the funds or knowledge to get started. Is there anyway you could give me sort of a play by play for a lay person on where to begin? I only have a name for my company and that’s about it! Thank you so much if you’re able to provide this information.

    Reply
    1. Dustin says:
      May 16, 2017 at 4:02 pm

      Hi Jacina,

      Thank you so much for writing. There’s a lot I could say in a comment, but instead I’d like to write a more comprehensive article that expands on this article – and goes much more in-depth with step-by-steps to starting a crisis line. Expect it on Monday, May 22!

      Dustin

      Reply
  7. Pingback: Ultimate Guide to Starting a Crisis Line - Dustin K MacDonald
  8. Jeffrey Jones says:
    September 12, 2017 at 6:03 pm

    Are you in Canada? Does this information also apply to the United States?

    Reply
  9. Melissa says:
    May 14, 2018 at 11:22 pm

    Hello,

    I am in the process of trying to start a non-profit, I am curious to know is there special licensing that you have to get for suicide prevention?

    Reply
    1. Dustin says:
      August 28, 2018 at 5:38 pm

      Hi Melissa,

      There is no special licensing required for suicide prevention but you should make sure that you’ve received training from another crisis line, or completed some education in the field so that you can be adequately prepared. Good luck!

      Dustin

      Reply
  10. Tammy says:
    April 23, 2019 at 5:02 am

    Hi Dustin,
    I’m in the u.s. I would like to start a vent 800 line. Not a suicide prevention line. I’ve been doing a little research. I was going to do it as a pay per call. What do you think about that?!

    Reply
    1. Noah says:
      September 10, 2021 at 11:33 am

      Hi Tammy, Did you get an answerto your question?

      Reply
      1. Dustin says:
        September 10, 2021 at 5:17 pm

        Hi Noah,

        I may have emailed Tammy directly – I can’t recall as it’s been a few years. Generally vent lines are not done as pay-per-call, but this could be successful in some niches (e.g. psychic hotlines.)

        Dustin

        Reply
  11. Lotus Ahmed says:
    December 9, 2019 at 1:48 pm

    Hey Dustin:

    I just read through your informative guide. I wish to start a “helpline” for a community in NY where the major obstacle in getting from point A to B is language. So this helpline is designed to help a group of people who speak a particular language, lets say Spanish for example. Now I have the office space. (can that be a room in my existing practice?). Do I need to open a nonprofit LLC? How do I get a 1800 telephone number? Can I use excel to record ANONYMOUS calls. Can the outcome measure simply be whether we were able to provide information? Should this idea/plan be discussed with local religious centers? What to do first?

    thank you inadvance for your help!

    Reply
    1. Dustin says:
      December 9, 2019 at 2:09 pm

      Hi Lotus,

      Thanks for writing. I’ve responded below:

      Now I have the office space. (can that be a room in my existing practice?
      Yes, absolutely. You could use a room in your home or an existing office space, no problem. The main thing for confidentiality will be that people who are have not signed your confidentiality agreement (generally members of the public) cannot overhear.

      Do I need to open a nonprofit LLC?
      An LLC would allow you to protect your assets if you expect to go into debt or generate profit from fee-for-service arrangements. If you wanted to receive tax-deductible donations or grants you can file for 501(c)(3) status, though I believe this takes upwards of $1,000-1500 nowadays. If you didn’t want to do those things you could take donations privately, but you’d then have to pay taxes on those donations as regular income.

      How do I get a 1800 telephone number?
      Lots of providers rent 1-800 numbers. If you google “get a 1-800 number” or similar you’ll see dozens of services. Basically they’ll host the 1-800 number for you (which for even large corporations is a “virtual number” that forwards somewher else) and then you can tell it where you want your calls to go. So, 1-800-555-1288 could redirect to your personal cell phone, 212-555-5321. You’ll pay a flat-fee for the line (e.g. $10 or $20 a month) and then you’ll pay per minute for the calls (e.g. 5 cents a minute) that come in.

      Can I use excel to record ANONYMOUS calls.
      Sure, absolutely. Lots of crisis lines when they first start, use Excel or paper forms to record information.

      Can the outcome measure simply be whether we were able to provide information?
      It can be, but the good thing is that you don’t need to rely on what information you explicitly collect from the caller. For example, you could have your helpline workers tick boxes to indicate things like:

      [ ] Gave information to client
      [ ] Referred client to other agency
      [ ] Provided emotional support

      These sorts of things are subjective, but take only a few seconds to tick the boxes after each call, and that data can be extremely valuable later. You could make your single outcome measure “did we help?” But the more detailed, the better.

      Should this idea/plan be discussed with local religious centers?
      You can. The first crisis line I worked for actually started in the basement of a church 40 years ago. They might be able to provide space or other resources. If the faith community is a strong source of support for your potential callers they may also represent a way to let people know your service exists. The tricky thing is making sure people safe to call. For example, an LGBT helpline I know had difficulty getting people to call because the advocates staffing the line were so well-known in the community that people didn’t want to risk calling up and sharing with someone they might know outside of the phone.

      What to do first?
      There’s lots of thoughts on that. I think the first thing would be to assess the need. Are there others who agree this is an issue? Can you collect 10 of them together to build an informal Board of Directors or advisors? Then you can figure out your priorities. For example, your first year of operation might have the following goals:

      1) Obtain office space Month 1-2
      2) Raise core amount of funding ($5,000) Months 1-12
      3) Execute marketing plan to build awareness Months 6-12
      4) Develop training for helpline workers Months 9-12

      And so on.

      Good luck, let me know if you have any other questions or concerns.

      Reply
      1. JR says:
        December 27, 2019 at 8:42 pm

        Any specific tips for starting something like this in a very remote area with no neighboring cities and extremely limited resources of any and all kinds?
        Any thoughts on starting up using a radio station as a home base?

        Reply
        1. Dustin says:
          December 31, 2019 at 9:28 am

          Hi JR,

          You could use a radio station if you meant you needed office space and a phone. At minimum, of course, you need a single cell phone to take calls on. As you get more advanced you’ll add forms to take calls, software to digitize things, perhaps a 1-800 number, and office space. It takes ~$1,500 to incorporate as a 501(c)(3) but you might be able to run a fundraiser to get your start up capital.

          Good luck!

          Reply
  12. Cedric Bell says:
    March 16, 2020 at 12:44 pm

    Hello Dustin
    My husband and I have initiated a Non Profit for Suicide Prevention in Florida and we are looking to start a Suicide Hotline in our area. Can you contact us for support!??

    Reply
  13. Darrell I. Williams says:
    April 13, 2020 at 1:41 pm

    Hello Dustin,
    I am interested in starting a distress line. A line where the lonely, abused, those who can’t sleep, in pain, paranoid, frightened, grieving, dealing with family problems, suffering from a mental/physical illness, in unhappy marriages, can’t find or keep a partner or those who have lost a partner through accident, illness or divorce. People with family problems, financial problems, in fact just about anybody. To listen to them all without making judgments or being critical. All I have at this point is a desire to provide a caring and sympathetic conversation and /or listening whichever the caller wishes. How should I get started?

    Reply
    1. Dustin says:
      April 13, 2020 at 2:39 pm

      Hi Darrell,

      Thanks for reaching out. I would recommend getting in touch with a crisis or distress line near you, and seeing if you can go through their basic training. That will help equip you with some of the skills that you need.

      Once you’ve got some training, you can then decide what kind of hours you’d like to hold. Many distress lines start with 4 hours a day and recruit ~10 volunteers who volunteer once a week, but you could also choose one day a week to make your line available.
      Then you can start advertising and taking calls, adjusting as you go. It will take some time to learn things like how to put limits on people who want to talk to you for hours or who begin to get dependent on you, but I have blog posts on this site you can consult for that.

      Good luck!
      Sincerely,
      Dustin MacDonald

      Reply
  14. Ashley Pennybacker says:
    August 31, 2020 at 12:16 pm

    I am in my counseling internship and have been approved by the head therapist to start a crisis/ additional support line for my internship site/ work place. I am working on masters in both clinical mental health counseling and addiction, but the calls will be from SUD outpatients. I am pretty much on my own and have bought my own phone to do this with. I think I can manage it with about 1.5 years of supportive counseling, but I am not sure what to expect (if anyone even calls the first week). What are some recommended articles to read or templates to document with that may be helpful?
    Any other suggestions would be greatly appreciated!

    Reply
    1. Dustin says:
      September 11, 2020 at 1:44 pm

      Hi Ashley,

      Sorry for the delay. I’m going to shoot you an email with some articles on this site and some other resources that might be helpful.

      Good luck!

      Reply

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