Every time Jose Martinez clocks into work, he must be prepared to meet strangers at their loneliest moments in life — without ever seeing their face and, sometimes, without knowing as much as their names.
Martinez is one of 34 counselors at the Warm Line, a mental health hotline established in 2014 by the Mental Health Association of San Francisco. All together, the counselors field about 130 calls a day.
Within minutes of answering the phone, Martinez, whose name has been changed to ensure anonymity, often finds himself toeing a thin line between choosing to share his personal struggles with distressed callers or staying quiet to listen.
The Warm Line counselors are prohibited from giving advice. Martinez’s only job is to offer emotional support, as stripped of judgment as possible.
“What I try to do is use ‘I’ statements all of the time,” the 35-year-old said during a recent visit by the San Francisco Examiner to the Warm Line office. “If a caller is experiencing domestic violence, I’ll say something like, ‘If I hit you, and you didn’t tell the police, I might think it’s OK. I would do it again, because there are no consequences for me.’”
In California, one person dies by suicide, on average, every two hours, according to data provided by the American Foundation for Suicide Prevention. In 2015, there were 4,167 reported suicides in the state — but that statistic is dated. And because of ongoing stigmatization, suicides are often underreported.
The Warm Line was founded with a $1.2 million state grant and a goal of serving 20,000 clients annually. Now in its fourth year of operation, the Warm Line reaches some 30,000 people each year.
In November, the service was expanded to operate overnight on three nights per week. Previously, callers were only able to dial in between 7 a.m. and 11 p.m. daily.
The Mental Health Association is hiring up to eight more counselors in an effort to keep the Warm Line operating continuously. But with the service’s grant ending in June, the organization’s leadership is also tasked with renegotiating funding support.
“We get a lot of hits from other counties, so we don’t necessarily feel that San Francisco should be the only one paying for this service,” said Rachel Del Rossi, the Mental Health Association’s executive director. “And we don’t want to limit our call base.”
The organization is also seeking to add additional support services, such as an online chat, to meet a growing demand.
Of all the calls that the Warm Line receives, as many as 86 percent are from repeat callers.
“I do think people are becoming increasingly isolated,” Del Rossi said. “The sense of community in San Francisco isn’t quite what it used to be, particularly at the neighborhood level.”
The Warm Line is peer-run, and all of its counselors are transparent about their struggles with mental illness.
“It is a job requirement to have your own personal mental health challenges,” Del Rossi said. “Ninety percent of our staff and everyone on the Warm Line” identifies as having a mental illness, she added.
There are a handful of suicide prevention services in The City. At San Francisco’s Suicide Prevention Hotline, there are time contracts on certain conversations, like non-crisis calls, according to Del Rossi.
The Warm Line was meant to bridge this problematic gap in service, she said.
“We don’t want people to get to that point,” Del Rossi said. Calls to the Warm Line are not limited in length or frequency for San Francisco residents. Those calling from outside of the 415 area code are limited to half-hour calls on three days per week.
Warm Line counselors often make referrals to other city services as needed. Callers who are contemplating suicide are transferred to the Suicide Prevention Hotline, and police are only involved in allegations of elder or child abuse, she said.
Over the winter months, call volumes at the Warm Line are up.
“Talking about the Holiday Blues — we get many calls from very lonely and isolated people,” said Brian McCarty, a Warm Line supervisor whose name has also been changed. McCarty said he has personally taken some 5,000 phone calls in the three years he’s worked for the service.
Mental illness takes many forms, and many are often duly burdened with the weight of prevailing stigmatization, Del Rossi said.
Since its inception seven decades ago, the Mental Health Association has been working to change that. The organization was founded in 1947 by “a group of mostly white men who were clinicians and therapists and wanted to address some of San Francisco’s issues,” Del Rossi said.
She said the organization was “progressive” for the time.
The Mental Health Association began collaborating with local police around mental health. Its members recognized racism as a mental health trauma as early as the 1950s, and hosted panels on homosexuality, Del Rossi said.
The organization pushes for policies around mental health issues and resources, and advocates for the humane treatment of those seeking them out. It also serves as a path into the workforce for those living with mental illness.
“The actual way the grant came to us was partially a workforce development program,” Del Rossi said. “We do have a lot of people who work on the Warm Line where this is often their first step into the workplace.”
After spending the better part of 15 years either homeless or in prison, Martinez, the counselor, said he tried to kill himself.
“I shot myself in the arm,” he said.
The bullet pierced Martinez’s arm and lodged itself in the fatty tissue. It didn’t hit a single blood vessel, nor did it break a bone. “That wasn’t my time,” he said.
It was the moment his life shifted, Martinez said.
Martinez often calls on his own experience when attempting to instill hope in Warm Line callers that one day, such a shift could take place in their lives, too.
Supporting his fellow humans at their lowest points in life “helps me in the long run,” he said, referring to his own recovery.
“There was a time in my life, if I was calling a line like this, somebody like me would have been like, ‘Wow, why don’t you do something with yourself. Why don’t you get better?’” he said. “It all comes with time.”
HELP ON THE LINE:
To speak with a counselor at the San Francisco Warm Line, call (855) 845-7415.
For the Suicide Prevention Hotline, call (415) 781-0500.
Editor’s note: This story has been updated to clarify that the San Francisco Suicide Prevention hotline does not place time limits on callers who may be experiencing a breakdown or who are in critical distress.