Transcript for Hold On

Radio from WNYC.

Hello. Hey, is this Donovan? Hey, Donovan Simon here. How are you?

You're back at school today, right? Do I have that? Do my remembering correctly?

Yeah, so a little while back, I gave this guy Donovan a call.

And a day the weather was just awful.

Lulu, you can attest to that.

Okay. So I called him on a very cold and dark day to talk about a pretty dark moment in his life.

What, what were you doing?

not really the life after college he'd imagined. Right. And then you know on top of that, this is the summer of 2020. So COVID is full swing. COVID full swing.

Well, yeah. And he says that at that moment, he remembers thinking.

Like, I think I need help, but I don't know. I don't want to bother my family or scare my friends.

98 is the federal government's response to the suicide crisis in the United States. It's basically 911, but for mental health emergencies.

Yeah. They've had a suicide crisis for number for 15 years, 20 years, maybe?

Yeah. It's awesome. It's amazing that they do this. And so, you know, Donovan, he picks up his phone.

And lying there, living through possibly the worst moment of his life. This is what he hears.

It's like painfully toned out. It's a Monti Python sketch.

Yes, but but Donovan, he did stay on the line. Okay. Eventually got connected.

Totally, but like Donovan, you know, he's not everybody. Something like 3 million people call 98 every year and hear this. In 13% of them, almost 400,000 people.

Yeah, almost half a million not getting help. Yeah, they're left feeling alone, right in the moment they need help most.

So this is Stephanie Groser.

And what does that mean at technology lead? And just to heads up, I will be interrupting you a good chunk, but that's not because you're doing anything wrong, it's just the way we started to do it. Okay, great. So yeah, what is the technology lead?

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 there's 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 unhold, simply by changing the automated message and replacing the whole music with a new song?

Or, said another way, could they swap in a song and literally save lives?

Well, it's like the highest stakes hold me as a situation in the universe.

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.

Okay, that's author and historian George Colt.

He was a psych PhD in a world where two veteran actually studying schizophrenia.

Coroner said their records should be down in the basement.

Now, Ed, he hardly knew anything about suicide. It wasn't something that psychologists really studied.

but Ed being a young ambitious research psychologist, he was suddenly intrigued.

This is Ed years later, reading through one such note in an oral history.

And in this note, in others, he noticed the authors trying and struggling to articulate why they were about to kill themselves.

And he thought maybe that by reading enough of these notes, he could decipher why people killed themselves and helped stop others in the process.

They're sort of all over the place.

I mean, there just wasn't that much to be gleaned about why these folks took their own lives. And so Farberos said, we're gonna need more data.

where the desire to die overtakes the desire to live.

And they discovered the best way to do that.

Listening. The very thing nobody was willing to do was the thing these folks needed.

be very first of its kind, trying out this treatment of just listening to folks in their moment of crisis.

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 ear. But I mean, these guys were based in LA and it was all still pretty local to LA until that is.

August 1962.

In two weeks later, sitting in front of a bank of microphones, Schneidman, Farbero, and the coroner, they held a press conference.

And that word hit like a lightning bolt.

The New York Times, the New York Mirror, the Daily Mirror, all did stories on her death.

And they named Schneidman Farbero Lippman and the work they were doing.

And as their names bounced around the country, their idea that just listening to someone over the phone could save their life,

I mean, this network of independent and amateur call centers. It grew like hotcakes.

But at a lot of these other newer centers, That was just not the case.

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.

Again, Ed Schneidman.

I mean, when he heard recordings like that one, He began to worry that these centers were actually doing more harm than good.

But there was no way to enforce the notion that you had 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 going to do that is by centralizing every. And basically what that has meant is a system where when someone calls 98, the suicide crisis hotline, the person who answers it 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.

Yes. So, how on earth do you make this an experience? Someone thinking of ending their own life will sit through.

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.

Jesus Christ so many acronyms. I know. Also, D-SAC is just not a very nice one. Like a Samsung so much nicer than D-SAC. 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 Grocer, 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, hold-neasy problem.

I mean, they could actually see precisely when people were hanging up and could talk to callers who had volunteered to give feedback.

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?

Illinois, tourism.

It was time to tackle the whole music. Okay, so what the hell do you do next? Like how how do you set up to try to make this better?

Yes. Perfect. Okay. Copy Dropbox Link. Okay. It is in love. It is in love.

Right. Okay. Number two.

Three.

There's a circumstance. There's a circumstance. There's a circumstance. There's a circumstance.

Well, those are your tries.

Well, okay. So what we just did right now is basically what Stephanie and Melissa set out to do.

Okay, so yeah, what did it do you will be disappointed to know? Neither of us. No, sorry.

With one massive caveat.

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.

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 months-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. Me. Start talking to people. 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,

I'm wondering if you would be willing to listen to some whole music.

Oh, I mean, you have a little aspirin, you all.

16. Oh, wow.

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. In first of all, my biggest takeaway was.

Like people hated.

But in granted, these were just random people on the street. But when I forced him to pick their favorite, probably a number four is the best one.

The fourth one.

I replicated their results. People preferred four. Oh my god.

Yeah, 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 988 and lived through this experience. But I don't know, that's just one of the huge challenges of this project. You can't ask somebody in the middle of a crisis. How does this music make you?

I will pass your criticism along.

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 fun, long, national AB test.

where half the colors would receive the old snazzy jazz experience and half would get the new.

Okay. And are the results in yet?

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 0.7%.

So like 36,000 people.

That's fair. But maybe it's helpful to keep in mind that 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. Hello. Hey, is this Porta Chista?

A person like Porta Chista could pour here. I'm good. How was your, did you get to have a long weekend?

Porta Chista is a writer here in New York City.

Live here when she was 18.

And the other constant in her life, she says, has unfortunately been mental health challenges.

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.

by December the new Hold Experience was the Hold Experience for everyone. And so I have to ask, do you remember the Hold Music?

And it's like, that was the best you can ask for. That's the dream. Not that the music's good, I guess, but that it's almost invisible.

But one more thing before we go. I gotta say, like as great as it is that 988 got 36,000 more people to stand the line. Like two your earlier point, Lulu. I do still feel like we could do better here. Yes. Me too. I'm with you. Like, no shame to 98 to Melissa to Stephanie. True, props to them fighting with fight from within. They were working within some crazy constraints like the paperwork reduction act like having to use music from a library of old 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, Sean, how are you? I'm well, how are you? I'm all right. Where am I speaking to you at?

So I reached out to musician Sean Kerry here because, well, he makes the antithesis of whole music. probably best known for being an original and current member of the band Boni Verre, but he makes his own just haunting heart-breaking music like this song, Sunshower, under the name S. Carey.

I would guess.

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?

He says in essence, what he ended up going for was hold music that feels like it actually holds you.

I don't know. And here it is. It's called, you are not alone. And Melissa, Stephanie, everyone at 988, if you're interested, be in touch.

Hi, I'm Raid and I'm from Pittsburgh. Radio Lab was created by Jad Abenrad and is edited by Sorn Wheeler. The Lumilare and Lothifmaster are co-hosts. Dylan Kief is a director or sound design. Our staff includes Simon Adler, Jeremy Blue, Becca Breskler, a Kettifoster Keys, W Harry Fortuna, David Gable, Maria Pasco-Tieras, Sending Nana Sumbongam, Matt Kielty, Amy Kieran, Alex Mason, Sarah Curry, Sarah Sandbeck, Ironwack, Pat Walters, and Molly Webster. Our fact checkers are Diane Kelly, Emily Krieger, and Natalie Middleton.