Hey, just to note that today's episode does contain discussions of suicide. Please listen with care. Oh wait Listening to radio lab from WNY All right, we're gonna start with a phone call hello. Hey, is this Donovan?
Hey Donovan Simon here? How are you? I'm good. How are you?
I'm all right. I'm a producer Simon Adler. You're back at school today, right? Do I have that?
Am I remembering correctly? Yes, it's a first day back. Although we're not back in person They move everything online for today because of the temperatures. Yeah, so a little while back I gave this guy Donovan a call Donna McBride and I'm a law student in Chicago Illinois on a day the weather was just awful It's somewhere around negative 30 outside.
Oh, Jesus. Yeah, no some of the trains were breaking down So how cold it was Lulu you can attest to that I can schools were canceled for cold alone Yeah, okay, so I called him on a very cold and dark day to talk about a pretty dark moment in his life Yeah, so it would have been the summer of 2020 Um, I had graduated college during the pandemic. So I spent the last semester college Online for the most of it and I moved to Chicago for a job And I was also working that job virtually and it was awful What what were you doing? So I was a project assistant at a law firm Which basically means if 1000 documents need to be renamed you do that if you need to call the same hospital every day And argue with someone to get medical records pulled you do that, you know and things like that not really the life after college You'd imagine right and then you know on top of that.
This is the summer of 2020. So COVID is full swing Go to full swing and every day just kind of felt shut in boxed out hopeless, you know, depending on the day And so, you know, there was a despondency lurking um Until probably August of 2020 and I had a series of a couple days where I barely can move from bed You know, I was feeling very like physically heavy like I couldn't move like I felt very far away from people physically but then also emotionally and All my thoughts were centered on like the rest of my existence is gonna be this boring little job While the world falls apart around me It was what I now know is basically a major depressive episode and you know, certainly in the moment I felt like like it can't keep being like this to the point. He says that one one evening I felt quite honestly, I think closer to death than ever before and There was kind of a switch that flipped me where I was like Either tomorrow I'm getting out of bed and I'm gonna find a way to be part of the world again or I'm not Like this is the point like this is the moment. Well, yeah, and he says that at that moment He remembers thinking is there someone is there someone that's basically required to talk to me right now?
Like I think I need help, but I don't know I don't want to bother my family or scare my friends And I realized that there was someone technically who would be required to talk to me Which is you know the 98 number 98 is the federal government's response to the suicide crisis in the United States It's basically 911 but for mental health emergencies. That's great. It is great. I didn't know it's federal government Yeah, they've had a suicide crisis phone number for 15 years 20 years maybe I'm really glad that that exists.
Yeah, it's awesome It's amazing that they do this and so you know Donne of in heat picks up his phone. I mean my bed crying at that point And I call and lying there living through possibly the worst moment of his life This is what he hears Suicide and crisis lifeline we are here to help but it's my note Open these remain on the line while we route your call to a lifeline crisis counselor your call may be monitored and recorded for quality assurance purposes Your call is important to us. Please continue to hold if you feel like you are about to act on boss I suicide now, please contact 911 for emergency help for tools to help cope with emotional distress Please visit 988 lifeline org or vibrate org forward slash safe space. Thank you for your patience No No, it was truly truly for a while.
No like I'm attempting to confront one of the biggest personal challenges that are confronted and Like it's just I feel like I'm like in the waiting room You know waiting room with a robot voice and some snazzy jazz music which in retrospect is objectively hilarious That is that's ridiculous. Yeah, it's like mad. It's like painfully toned up. It's a Monty Python sketch I know that's like offensive.
Yes, but but Donovan. He did stay on the line. Okay, eventually got connected I remember she picked up the line and kind of just asked well what brings you here? Like what do you want to talk about?
Um, and I don't know it was very very comforting. Oh good That's great totally but like Donovan, you know, he's not everybody something like three million people calls 988 every year and hear this and 13% of almost 400,000 people they just hang up Yeah, almost half a million not getting help. Yeah, they're left feeling alone right in the moment. They need help most Yeah, that's the kind of feeling that could compound, you know, yeah, it's such a dangerous moment If you've been on hold I'm someone who doesn't like those automatic messages and I'm the person yelling like any operator operator operator Whenever I can so this is Stephanie Grocer technology lead for 98 at SAMSA within the Health and Human Services Department And what does that mean a technology lead and just I will be interrupting you a good chunk But that's not because you're doing anything wrong.
Okay, just the way we started to do it. Okay, great. So yeah, what is the technology lead? Technology lead looks at improving how the government is interacting with the public in the case of 98 that means what does the experience look like for people calling 98?
And so how can we do better, right? We don't want a 90% answer rate obviously we want to improve access to care And she says, you know, the easiest way to do this would be to just hire more people to answer the phones But funding right funding for mental health is hard to get and so they're stuck putting people on hold in the worst possible moment However, right around two years ago Stephanie and a couple of her colleagues They started wondering if we could actually improve the experience would that help people hold longer? Like could they get more people to sit through being on hold? Simply by changing the automated message and replacing the hold music with a new song That's right or is that another way could they swap in a song and literally save lives?
Oh Man It's like the highest stakes hold music situation in the universe. Yeah, that's a great way to frame it Alright, so this is Radio Lab and we the Miller on what they've not sir and today the search for this holy grail of hold music a song That could accomplish the impossible and get people to stay Right when they're thinking I believe it but to start not to be glib here But whose idea was it to make suicidal people sit on hold? The story of how we got here well, you could you could take it way way back But I think really it began with a guy named Ed Schneider. Okay, that's author and historian George Colt I spent quite a bit of time with Ed researching my book and He sort of Well, he's just quite a character.
He was this small compact Bolin and China show but a very very intelligent bull Anyway, the way he got things kicked off was in 1949 He was a psychologist working in the Los Angeles Veterans Center He was a psych PhD in World War II veteran actually studying schizophrenia And he was asked by his boss to write letters of condolence to two veterans who had killed themselves And so he went to the coroner's office to find out more about these two people Corner said their records should be down in the basement and in that dusty basement room He found suicide notes and not just in the folders of the guys he was there to learn about No, Ed liked to push things to the limit and so he ended up looking through almost every folder in the room And what he essentially found was seven hundred and twenty one suicide notes So all of these folders had suicide notes in them now Ed he hardly knew anything about suicide It wasn't something that psychologists really studied suicide was not even a word that people wish to utter in public There were so many different euphemisms for it to make away with oneself to do away with oneself The whole topic was so taboo that the general treatment and I use that word in quotes Was just to take away, you know anything sharp and hope they wouldn't take their own lives But Ed being a young ambitious research psychologist. He was suddenly intrigued He realized that this was just a cash of research material as he said to me I felt like a Texas millionaire coming home and stumbling into a pool of oil. I Don't know why I'm bothering to write this. I'm leaving out so much This is Ed years later reading through one such note in an oral history It's probably I won't be able to explain myself even if I took the time to write rings of material It's just it's so difficult to transmit information to get through others preconceived notions And in this note and others he noticed the authors trying and struggling to articulate why they were about to kill themselves No, I'm not going to try to help it if I want to commit suicide is my privilege dammit And he thought maybe that by reading enough of these notes He could decipher why people killed themselves and help stop others in the process Suicide prevention I mean there was no question.
I wanted to be a little ahead of the time and push the issue But to do that He knew he was gonna need help and so he got in touch with a friend of his name Norman Farberow Who was also a veteran's administration psychologist instead of the yin to his yang I mean if Ed was a little tightly wound ball of energy Farberow was tall slim reserved quiet dignified And well Schneider was sort of the big idea guy Farberow was wonderful at assembling data at doing research and quickly Farberow was like these suicide notes They are fascinating, but they're sort of all over the place one of the notes for instance was dear Mary I hate you love George I mean there just wasn't that much to be gleaned about why these folks took their own lives and so Farberow said we're gonna need more data And so they began this incredibly vast examination They come through records at psychiatric hospitals diaries therapy records sorted through all of this stuff and then began to make some conclusions And they really did find some of the concepts that still hold true today for instance Suicidal people are often ambivalent There's a part of them that wishes to kill themselves perhaps and a part of them that wishes to stay alive And if you can get them through what's called a suicidal crisis essentially an overwhelming But oftentimes brief flash where the desire to die overtakes the desire to live if you can get them through the crisis They can find other alternatives to suicide and they discovered the best way to do that Totally by accident what happened was that as they were gathering all this data much of it from hospitals You know nurses would say gee would you mind go talking to this fellow over in you know room 102 He's suicidal and we really don't know how to handle him and so Schneiderman and Farberow would say well We okay and sitting down with these people Schneiderman and Farberow thought that they were just doing research But they discovered that these suicidal people just by having somebody to talk to the part of them that wish to kill themselves was relieved Listening the very thing nobody was willing to do was the thing these folks needed it was this simple notion of Listening will help and so Schneiderman and Farberow said goodness. We've got to do something about this So they got some money. They got a five-year grant brought on a third guy The fellow named Robert Lippmann director of the psychiatric unit at Cedars Sinai Hospital and on September 1st 1958 these three perhaps nutty Psychologists opened the Los Angeles suicide prevention center The very first of its kind trying out this treatment of just listening to folks in their moment of crisis with one phone line and a staff of five And it worked or at least people were eager to talk to them Especially as they advertised their phone number more and more people began calling in searching for a sympathetic year But I mean these guys were based in LA and it was all still pretty local to LA until that is Marilyn Monroe case 1962 the chief coroner asked Farberow and Lippmann to help him determine what caused Marilyn Monroe's death It's worse two weeks later Sitting in front of a bank of microphones Schneiderman Farberow in the corner they held the press conference Ladies and gentlemen now that the final toxicological report and that of the psychiatric consultants have been received and considered It is my conclusion that the death of Marilyn Monroe was caused by a self-administered overdose of sedative drugs And the motive death is probably suicide and that work Like a light You could say that it got the nation's attention the New York Times the New York mirror the daily mirror all did stories on her death He has unwittingly played the greatest role of her career in focusing attention on the gravity of suicide and a name Schneiderman Farberow Oblepman and the work they were doing Attempting to help those who can't and play self-destruction and as their names bounced around the country their idea that just listening to someone over the phone could save Their life it did too. They were actually movies about this dial hotline and the slender thread I just want somebody to talk to maybe I can suggest somebody for you to see Dramatized volunteering at prevention centers Cheese people were excited at the notion that all I need to do is open up a phone line listen and I could save lives And so by 1969 there were more than a hundred prevention centers with different names We care dial a friend learn baby learn lifeline help rescue ink I mean this network of independent and amateur call centers It grew like hotcakes or perhaps more like a spider's web or more like a I don't know what's a good phone line It went viral and what happened there actually Was not necessarily a good thing because you have to understand that at the LASBC the Los Angeles who said prevention center Schneiderman and Farberow and Littman prided themselves on their professionalism and they're very carefully trained volunteers But at a lot of these other newer centers That was just not the case many of them They'd open up without really any training and I think things got a little bit dare I say out of control This is a recording from one of those centers first voice you'll hear is the callers She's slurring her speech a little bit clearly exasperated And there you hear the volunteer chiding her saying We can't be your fairy godmother Here's the caller again And again the volunteer We can't be there holding your hand Again edge night I was stuffed these are just horrendous examples of what not to do on the telephone I felt in part in the fight to go into Alabama and charge our charge until people want to do I mean when he heard recordings like that one He began to worry that these centers were actually doing more harm than good So he tried desperately to get hold over these proliferating lines across the country But there was no way to enforce the notion that you have to have standards Which brings us back to today because in the years that followed the federal government Decides like okay, we got to get our arms back around this and the way we're gonna do that is by centralizing And basically what that has meant is a system where when someone calls 988 the suicide crisis hotline The person who answers it is is patient and is empathetic and well trained and professional But because there's not unlimited funding to train these people to hire these people for mental health in this country when you call You first get this This is this is oversight this is standardization.
Yes, so how on earth do you make this an experience someone thinking of ending their own life will sit through We get to that after a short break Anxiety depression bipolar disorder at least half of us will experience a mental illness in our lifetime in a new podcast from call to mind We hear about the mental health impact of stress climate change immigration and more I'm Angela Davis joining for conversations with people managing hardship and expert seeking solutions from American public media comes call to mind Listen and subscribe on your favorite podcast app. Hello again. I'm Latip Nasser I'm with a miller This is radio lab before the break producer Simon Adler had just told us the story of how three professionals built and then lost control of a nationwide Network of crisis hotlines of suicide crisis hotlines how the federal government swooped in and built its own network to restore order And how the consequence of that safer standardized network is folks in crisis sitting on hold? Yeah, that's right and so two years back with an influx of cash 98 brought in these two tech wizards to try to solve this problem Yeah, so we both worked for the United States digital service and I was at dSAC and dSAC really likes to support Samsung Jesus Christ So many acronyms.
I know also dSAC is just not a very nice one like a samsa so much nicer than dSAC I know I mean, this is wizard number one Melissa Eggleston user researcher and designer and wizard number two So from a technology perspective Stephanie Gresser We met back at the top of the episode and as Stephanie explained to me They were able to use big data to tackle this big whole music problem because we're centralized We have the ability to track a lot of information about the cost coming in and our answer rates across the country I mean they could actually see precisely when people were hanging up and could talk to callers who had volunteered to give feedback So for example, this call may be monitored and recorded for quality assurance purposes There was a spike of hang ups during that part and talking to people with lived experience They said, you know when we call 988 thinking about suicide We need to hear affirmations things like we want to talk to you Please stay on the line and so with all this data They started tweaking the script going back and forth on different words How many syllables were in different phrases that hired someone to be the new voice of 988 this person Jan amazing isn't just a place You take yourself. It's where that place takes you who sounded a little bit like a yoga teacher and happens to have been the voice of enjoy Illinois dot com Illinois tourism. Yeah, and from there everybody was very clear like this jazz music has got to go It was time to tackle the whole music. Okay, so what the hell do you do next like how do you set up to try to make this better?
We work to determine like what are the characteristics of this to reflect and it's things like human and hopeful and calm and reassuring and warm But not too peppy And so it was really like a fine line that we were trying to have between calming but also uplifting And so we have a routing company and they actually have a bank of music And so we went to them to get between like 30 and 50 songs And we have people independently listen and ring them and we compared everyone's rankings to come up with the top four that we would bring to our public research Okay, what are the four options and like can we hear each one briefly? Yes, perfect. Okay. Okay.
Copy drop-box link. Okay. It isn't it is in the lovely. Okay, should we do number one hit it?
Okay I'm a home depot commercial for outdoor rugs Outdoor rugs is very good. Okay. Okay, so that's number one right. Okay, number two if you else too generic somehow like it's like this is This is a therapist office.
Yeah, and maybe that's good. I don't know. Okay, three three I'm not sure I feel the cosmos Just just some chases. I don't mind in this one like it's it's just so hard to know what'll feel right to someone at that moment Yeah, this is one of the challenges But last but not least number four Oh, fuck.
No, not this one. I don't mind it You don't mind that it's like a commercial for Wonder Bread's new brand of wheat Wonder Bread The piano is offensive. It's just like Well, those are your choices. Okay, what out of those what are you doing?
I'm I feel like I'm gonna make an unpopular choice I think number one maybe oh the home run of it the home depot out or rugs Yeah, I think so too much too many sunflowers I feel assaulted and forced into being in a good mood by somebody who doesn't understand. Okay, fair fair fair I'm gonna wear where do you fall? I'm like, okay. Okay.
Can you play three again? Sorry just for one second? That's fine. There's like a little bit too much club encouragement for me to dance.
Yeah of all of them It's the most neutral which I appreciate well, okay So what we just did right now is basically what Stephanie and Melissa set out to do literally We went to the National Mall in Washington DC and stops people walking on the mall and yes I put on my nine eight eight shirt great We had granola bars and out and we had people listen live through our phones and vote on which one they like the best And so we did a little tally of what people voted on and by and large everyone really agreed on the same music choice Okay, so yeah, what if you will be disappointed to know neither of us? No, sorry people really liked the inspirational piano music Oh the Wonder Bread with one massive caveat. We have certain limitations that we were working in okay We're actually limited to without going through a approvals process. We're limited to talk to nine people Wait, sorry, that's crazy.
What nine people what does that mean? What does that look like? You've got nine people and those are the only nine people? You can ask yeah, yeah, that's ridiculous Of millions of people depends on these nine strangers on the mall.
Yes, so thanks to the Paperwork Reduction Act of 1980 Which was passed to minimize the amount of paperwork the government could ask you and I to fill out Is Stephanie and Melissa wanted to talk to more than nine people? They would have to go through this month's long potentially years-long process to get approval However, you know who isn't bound by the Paperwork Reduction Act? Okay, one two three four five one two three four five So I took a recorder out to New York's National Mall Times Square Can I ask you a few questions and just like Melissa and Stephanie I asked hey, we're trying to improve our national suicide hotline I'm wondering if you would be willing to listen to hold music Sure You all have a question you all How many did you ask 16? Oh, wow double there's a double there's a double yeah I'd hand them my phone you can just hold this right next to your ear and Just tell me tell me what your thoughts are as it goes and first of all my biggest takeaway was I don't like it.
That's depressing. Just sounds kind of art on the ears. That sounds like some hotel lobby elevators. Yeah, right people hated All of them if I'm on hold I want something that I like but Granted these were just random people on the street, but when I forced him to pick their favorite Probably number four is the best one the fourth is the best of the four I like that the best out of all of them The the fourth one number four is what I'm gonna decide on I replicated their results people preferred for oh my god I was the least people hated number one hated number one Wow I wonder how the samples that how the result would be influenced by people who have like struggled with suicidal thoughts Which I'm just only laughing because I'm trying to like get I'm trying to be right I'm like I think my opinion matters more than either of yours as a as having publicly written about my struggle with suicidal thoughts I think they should take my account my opinion should matter more Yeah, I like I think that's that's actually totally fair and right and to the extent that they were allowed to They did take feedback from folks who've called 9-8-N and lived through this experience But I don't know that's just one of like the huge challenges of this project You can't ask somebody in the middle of a crisis.
How does this music? No, but like I what I think is so painful about all of these options Is like they are exactly they are the same they hold the same problem that the original jazzy old music held Which is like you can feel their music Yes, they you can feel their corporateness The question is broad like you can't go you can't hit a broad thing with a specific thing that's gonna turn off half the people You are you're all you are also but I don't know but but go yes I agree something broad and like somewhat innocuous or ambiguous or neutral would be good Like I agree with that these just all sounds so manicured and soulless and that that's like often that distance that like Apartness from humanity is is often part of what's going on like just just give something a little human I will pass your criticism along. Thank you. Please do But okay, anyhow, they did have one way to see how people who actually called in might react after they narrowed it down They cut the country into and did a long national AB test Oh cool, okay, where half the collars would receive the old snazzy jazz experience And half would get the new one we are checking for a counselor who's available to talk you'll hear music while we do this And we'll give you an update in 30 seconds.
You are not alone We care and want to support you someone will be with you soon Okay, and are the results in yet? We are done. Yeah, it was live for the country in the month of August Okay, and so we had a four-week test after all this they managed to increase people staying on by 0.7% okay Not great sure, but also like think about it again. We're just talking about a huge number of people here So it is 0.7% that's like how many people a year so like 36 ish thousand people Man, it's just like all that effort all that time But with those in my opinion doomed choices to begin with I don't know I just I think they could have got a better result with better options That's fair But but maybe it's helpful to keep in mind But despite how big of an effort this was and how modest of a change Like each of those 36,000 people is a person whose life is hanging in the balance Hey, is this porta chista?
Yes. Hi. How are you a person like? Porat Chista Kapoor here.
I'm good. How was your did you get to have a long weekend? Well, it was kind of a crazy weekend because we're still unpacking kids are apartments Porat Chista is a writer here in New York City. I always wanted to live in New York I wanted to be a writer and luckily I was able to do that moved here when she was 18 from California The thank you bill Valley specifically and pretty much in fun.
I've been mostly here and the other constant inner life She says has unfortunately been mental health challenges. Yeah, I go pretty in and out of severe depression Okay, often But I never felt a moment of suicidal ideation like I did on Christmas Eve this year at the time She and her boyfriend were months into trying to find a new apartment work was particularly stressful and you know as a writer She's got a bit of an online following and was just getting an extra dose of shit from people on the internet About how this next book of mine like nobody cares like to hate full step. So it was just like a perfect storm Sorry if I'm getting emotional. Um, you're fine It was a mess and then I happen to see this tweet that said hey front if you feel like you're an emotional danger tonight, please call 988 So I remember I was in bed.
I've been crying for so many hours and my boyfriend had just brought me like some takeout food And I just called to see what would happen and there was just something from the beginning that made me feel really comfortable By December the new hold experience was the hold experience for everyone and so I have to ask do you remember the hold music? It's been an interesting question. I'm trying to think well It was something somewhat pleasant and I was just very surprised because years before I called some sort of old school suicide Hotline and I got not the phone pretty fast because I just it just didn't feel right, but this call was 98 felt different than that Everything from the music all the way to the person. It felt really natural It didn't feel like a scripted government anything and I guess that's that's why it worked And it's like that was the best you can ask for that's the dream.
Yeah, like not that the music's good I guess but that it's almost invisible. Yeah Since everything wasn't like okay now you have no problems, but it kind of reset my brain It made me feel like I could buy some more time before you know, I make this horrific decision One more thing before we go. Uh, I gotta say Like as great as it is that 988 got 36,000 more people to stay on the line Like to your earlier point lulu I do still feel like we could do better here. Yes me too.
I'm with you. Uh like no shame to 988 to Melissa Does Stephanie true props to them fighting with fight from within? Uh, they were working within some crazy constraints like the paperwork reduction act Like having to use music from the library of hold music And so as I was finishing up reporting this I started wondering like could I find somebody to make a song? That would work even better.
Hello. Hello. Sean. How are you?
I'm well. How are you? I'm all right. We're uh, where am I speaking to you at?
Uh, I'm helping you know clear Wisconsin. So I reached out to musician Sean Kerry here because uh, well He makes the antithesis of hold music You Probably best known for being an original and current member of the band bony bear But he makes his own just haunting heartbreaking music like this song sunshower under the name s Kerry I'm not trying to write that music. I'm just trying to write like Uh beautiful music. I would guess yeah, that's definitely more the more the vibe And you know, I told him the whole story about 98 and then I asked him like Would you be willing to try writing something for this?
Is that something you'd be interested in? I could definitely try that. Yeah, probably whatever do is I would experiment and really try to emphasize with being on the other side of that line You know, you want soothing you want warmth and so I guess I would think about human voice Maybe using that as an instrument and white noise like you can play with it. So it sounds like waves or sleeping on the beach or something So I guess that's where I would where I would start and see what Do what happens.
Oh we later I called him back up It was definitely like one of the more challenging things I've ever done. I think it was just hard to know what to do I mean when I actually got in there and was creating I just trying to create a hug like just like okay What's gonna like feel like a hug Um in audio form coming through a phone. He says in essence. What he ended up going for was hold music That feels like it actually holds you so I don't know.
I mean that that was that became more of the goal But who knows I think for some people they might despise it And uh here it is It's called you are not alone And Melissa Stephanie everyone at 988 if you're interested be in touch Thank you s kary And thank you simon adler This episode was reported and produced by simon adler and edited by pat waltors fact-checking by nadley middleton If you are having thoughts of suicide you can call or text 988 to be connected after only a brief hold to a living breathing human Or go to speaking of suicide.com resources for a list of additional resources special thanks this episode to dr matt ray at temple university sherbet willows jenny benet and mond kajansen Sherryson welsky and the folks at dd hersh jag jaguar records and george colt for sharing his cassette tape interviews of edg Nagin with us and big special thanks again to s kary for his original song you are not alone and for all his other work But you can go listen to wherever you listen to the music that's it. Thanks so much for listening and for sticking with us Catch you next week. I'm rade and i'm from kittsburgh rade lab was created by jad abin rud and is edited by sorn wheeler Lula miller and lathes method are co-host dill and keef is our director of sound design Our staff includes simon adler jeremy blue back up wrestler a kettie foster keys w harry for tuna David gable maria paz good tears sending me on a song from them matt keel tea and you kewen alex leason sara kari sara sinebeck iron wack pat waltors and molly webster our fact checkers are diane kelly and we grieger and that way middleton Hi, this is le from cleveland, ohio Leadership support for radio lab science programming is provided by the gordon and bedding more foundation science sandbox a simon foundation initiative and the john templeton foundation foundational support for radio lab was provided by the alfred p-flown foundation