By Daniel Fisher, M.D., Ph.D.

They suggest soft, fuzzy images, but do not be deceived: warm lines are proving a powerful approach to reducing hospitalization. Warm lines are a form of social support and a complement to hot lines whose time has come. In this age of social isolation, the phone is proving itself a lifeline for people with mental illness who are either too afraid or alone to connect with family or friend.

In New Hampshire, a survey1 was conducted with Emergency Services (ES) phone call answering services staff about their experiences before and after a consumer-run warmline in the region was established in the region.

The survey results indicated that non-emergency calls by consumers to the ES phone line were reduced by sixty percent with the establishment of a local warmline.

Warm lines run by people in recovery from mental illness hold a special appeal for callers with the same label. Many people with mental illness refuse to call a crisis team because they are afraid they will again be committed. Indeed a survey of previously hospitalized consumers by the Well Being Project in 1987 found that 47% of them refused to even contact a clinic due to the trauma of hospitalization. This means that consumers would rather wait until their crisis reaches the point where they could no longer be calmed by respite or other alternatives to hospitalization.
I interviewed the director of a typical consumer-run warm line in New Hampshire. He stated that they grew out of the expressed need of club members to have support available after the club closed. These members felt unsafe calling the crisis team. The warm line operates with a different person receiving calls each day. They are given training and supervision by the director of the club. He stated that an unexpected benefit has been the preparation and motivation the job has provided to the workers. Several of them have gotten full-time jobs and have gotten off disability.

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1 The survey was conducted in 1995 by the Community mental health center (CMHC) for the Derry/Salem region (BBH Region 10) of New Hampshire. The CMHC, now known as CLM Behavioral Health, together with NH Department of Mental Health found that establishing a warmline was of benefit as it freed ES workers from handling non-crisis calls so that they might be free to focus on responding well to consumers in a genuine crisis.