This story contains descriptions of sexual activity.

Lily Lantz started full-time as a crisis counselor in 2023. PATH Crisis Center in Bloomington, Illinois. It is part of the national network known as the 988 Suicide and Crisis Lifeline.

He said this was his first job out of college and it was common to have back-to-back meetings with people who no longer saw the point in living.

Sometimes the work was hard and tiring, but he always wanted a job helping people and felt called to it.

If you or someone you know is in crisis, please call, text or chat the Suicide and Crisis Lifeline at 988 or the Crisis Text Line by texting TALK to 741741.

But there was a job hazard he never expected: Nearly every shift, he said, he talked to people masturbating on call.

“Sometimes they would say things like, ‘Your voice sounds so good right now, you make me feel so good,'” Lantz said.

NPR interviewed 10 current and former counselors from five different call centers who encountered similar sexually inappropriate behavior. They have become a chronic and troubling problem in the hotline industry.

There are other types of abuse, such as jokes, racist or sexist slurs, and personal attacks on crisis counselors. in that 988 Suicide and Crisis LifelineThose who perpetuate this type of behavior are known as “abusive contacts.”

The number of malicious people is not tracked nationwide, but since 988 launched nationally Call centers network in 2022 more than 10 million persons.

Data from a local crisis center in Portland, Oregon. Lines for Lifeshows that malicious contacts account for just over 1% of nearly 5,000 monthly interactions.

Counselors emphasize that even a harassing phone call can be distressing, and there are not enough measures in place to prevent such calls or help people cope when such calls occur.

Impact on retention of 988

Five former 988 counselors told NPR they no longer want to work at the hotline because of sexual harassment.

Daisy, another crisis counselor, said she quit because of the abuse. Daisy was the name she used to callers at her job at the PATH call center. He does not want to be mentioned by his legal name when discussing this issue because he does not want his personal or professional circles to know about the abuse.

What happened was traumatizing. “I didn’t sign up to be a sex worker,” Daisy said. “I signed up to help people who are having a hard time.”

Lantz lost his job during layoffs at PATH in June. He said the only reason he didn’t leave work earlier was because he switched to the day shift, where there were fewer abusive calls.

Following the termination, Lantz decided not to take another job at 988 due to sexually harassing calls.

Instead, she is pursuing a master’s degree in social work to become a trained therapist. (Counsellors who answer 988 calls are trained only in crisis intervention and 988 is not intended to be used as ongoing counseling. In some states, including Illinois, 988 counselors are not required to have psychology-related degrees.)

“We are losing good people because of the emotional toll,” Lantz said.

A long-standing problem for helplines

Managers of crisis centers are acutely aware of the problems but say there are no easy solutions.

Harassing callers have been targeting crisis hotlines for years, according to Greg Borders, chief clinical officer at Lines for Life in Portland.

“It’s definitely nothing new,” he said. “I’ve been with Lines for Life for 12 years, and it existed long before I got there, and it still exists.”

It is difficult to deter or punish malicious callers. Calls to 988 is anonymous To protect callers’ privacy, there is no way to see who is calling or from what location.

The only information available to the consultant is the phone number.

Counselors can never block numbers associated with harassing callers because someone with that number may have a real mental health crisis in the future.

Another hurdle is the strict rule that for every incoming call, counselors must ask whether the person is at risk of harming themselves. This part of the conversation is mandatory, even if a malicious caller keeps calling again.

At PATH, this means counselors may hear repeated verbal abuse before transferring the person to a pre-recorded message line.

Some repeat harassers know about this policy and use it to trap them, Lantz said.

“They would say they were suicidal,” he said. “I can’t say for sure if this is true or not, but they were masturbating on the phone.”

Protective protocols may vary

It is managed by the 988 system. Vibrant Emotional Healtha nonprofit organization with a federal grant to oversee 207 crisis centers in the national network.

Shye Louis, who works on clinical standards and training for Vibrant, said Vibrant has recommendations for crisis centers facing this problem, but most of them are optional.

This flexibility is necessary because individual centers may be subject to different regulatory requirements from government agencies or accrediting bodies. American Suicide Society.

Managers in crisis centers tried to solve the problem. In 2020, Lines for Life in Oregon began allowing counselors to transfer abusive calls to a supervisor, Borders said.

PATH implemented a new policy in Illinois in 2023. If miscreants continue to call the center after being warned about their inappropriate behavior, they may be transferred to a pre-recorded message.

The message informs people that their recent call has been “considered inappropriate or potentially harassing” and strictly requests that they stop calling because it is blocking legitimate calls.

Both PATH and Lines for Life allow the counselor to hang up if the caller becomes abusive, but only after the counselor determines the person is not at risk of harming themselves; This is a rule of Vibrant.

Six former consultants are suing in Colorado Rocky Mountain Crisis Center They argue in federal court that the organization makes it overly complicated to disconnect abusive callers.

In an email to NPR, the crisis center denied the allegations. “RMCP has maintained protocols that give our team members the authority to set a boundary and terminate the call when such a call is suspected,” an email notification reads. “Such protocols are guided by and consistent with Vibrant Emotional Health, the administrator of 988.”

One of the plaintiffs, Myriah Montoya-Gallegos, told NPR of an incident involving a man masturbating on the phone. He said the supervisor listening to the call did not allow him to hang up.

Instead, he said, he was told to redirect the conversation and focus on the caller’s feelings. “When she finished orgasming, she laughed about it, thanked me, and then hung up,” she said.

Iris Halpern, an attorney for the former counselors in the case, argues that crisis centers are legally obligated to take action.

“The Colorado Anti-Discrimination Act specifically says you have to do something, even if the harassment has been common in the past,” he said.

Solutions to make 988 sustainable

PATH CEO Adam Carter said tackling this issue is important for the future of the 988.

Malicious calls can drain resources and increase wait times for people who really need it, he said. He wants the Illinois legislature to help 988 counselors by designating first responders.

First responder status in Illinois protects It relieves employees of legal liability in emergency situations and provides additional benefits such as: access to a preferred mental health provider.

Counselors at several crisis centers believe stronger state laws could help deter abuse.

In the 911 system, local laws often prohibit repeated misuse of this line. Caller ID and services that allow police to track a caller’s location can help officers respond to malicious calls to 911.

None of this is available for the 988.

Illinois “has a responsibility to protect crisis counselors” because 988 is funded in part by government grants, Daisy said.

“There are people who misuse words and excuses are made as to why we can’t deal with the consequences of this action,” he said.

Other affected advisors say they want change but still believe in the future of the 988 Lifeline.

“This is a great resource for people in crisis when used appropriately,” said Angel Elrich, another plaintiff in the Colorado case. “I have so much faith… I think the 988 is amazing. I really want it to be sustainable.

This story comes from NPR’s health reporting partnership WGLT And KFF Health News.