‘Suicide is only one option': Social Security staff newly assigned to phone duties raise concerns over training
SSA recently began shifting new swaths of its workforce to phone answering duty, including those who normally receive and process retirement and disability claims, manage the agency’s technology and work in the agency's finances unit. Those employees received brief, three-hour training before they began answering calls.
As part of that training, they were warned some callers may express suicidal ideation and presented with examples using a theoretical employee named Fiona.
“It's important for Fiona to keep the caller engaged and to remind her that suicide is only one option,” the animated trainer told employees in the video, a copy of which was obtained by Government Executive, “and that there is no urgency to make any decisions.”
Employees at the training, which occurred on Jan. 26 for benefits authorizers and post-entitlement technical experts, were taken aback by the comment and asked their supervisors for clarity. One employee at the training said there was “disbelief that it was just said” among those in the room.
Caitlin Thompson, a clinical psychologist who spent eight years at the Veterans Affairs Department as a clinical care coordinator on the Veterans Crisis Line and later as the department’s national director of suicide prevention, said SSA's approach did not follow commonly accepted best practices.
“It’s not a normal thing to say,” Thompson said. “No. That’s not the thing you say to somebody who might be suicidal.”
Instead, SSA would be better suited telling employees to ask callers if they feel safe in the immediate term and if they say no, to tell the caller that they will work with their supervisor to get them in touch with a crisis line.
“It’s a very specific thing to be able to talk to people,” Thompson said, noting that employees were not hired or properly trained to handle issues that arise on phone calls like those SSA processes. Of potentially suicidal callers, she added, “It can’t just be a ‘sorry to hear that.’”
An SSA spokesperson said their phone agents can sometimes handle “difficult calls” from vulnerable Americans at “the most challenging moments of their lives,” and the employees are trained to encourage the callers to stay on line while they are connected with the suicide prevention hotline.
“SSA trains employees to handle callers in potential crisis situations with calm and compassionate service,” the spokesperson said. “The trainings provided by SSA equip employees with the knowledge to meet callers with understanding and begin discussing how SSA can best get them the help they need.”
The National Action Alliance for Suicide Prevention maintains a best practices framework for suicide crisis lines, which emphasizes that suicide should not be presented as “acceptable.”
“Research tells us that messages that present simplistic explanations for suicide, glamorize or romanticize suicide, or portray suicide as a common or acceptable response to adversity may spur imitation of suicidal behavior among marginalized individuals,” according to the framework.
Another individual who spent their career overseeing suicide crisis lines said it was appropriate for Social Security to prepare its employees for callers who may be expressing suicidal thoughts. Any potentially stressful situation puts people at an elevated risk for crisis, the person said, and callers into SSA could feel helpless. They said the agency’s approach, however, appeared to fall short.
“The whole thing is odd,” the long-tenured expert in the field said. Employees should be trained to recognize signs of crisis, tell callers expressing those signs that it seems like they could use some support and arrange a “warm handoff” to a crisis line, they added.
Presenting suicide as “one option” opens the door to a path the Social Security employee is not equipped to handle, the person said.
“If that is the one thing that they are being told to say, it puts the person on both sides in a potentially precarious situation,” they said.
Reassigned workers are ostensibly handling simple calls, such as those involving changes of address, updates on claims status or Social Security card replacements. Those who have already started their new assignments said the calls just in the first week have become more complex than those for which they were trained, however. Callers presented complicated issues related to their incarceration or immigration status, the employees said.
Presented with these claims from employees, a senior SSA official told Government Executive last week that the workers were mistaken.
“If there's going to be this claim that individuals aren't receiving the necessary training, I mean, it's just not true,” the official said.
The 988 Suicide and Crisis Lifeline is a hotline for individuals in crisis or for those looking to help someone else. To speak with a trained listener, call or text 988. Visit 988lifeline.org for crisis chat services or for more information.
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