When a woman living in a rural community in northern California suddenly lost her husband of 50 years, her grief was compounded by her geographic isolation.
Her social worker suggested that she call the Friendship Line, a crisis intervention hotline as well as a “warm line” for non-urgent calls, all specifically designed to serve older people.
“She was very despondent and depressed – and isolated,” says Patrick Arbore, founder of the Friendship Line and director of elderly suicide prevention and grief-related services at the Institute on Aging in San Francisco. “That is the kind of person we are really interested in connecting to.”
Dr. Arbore, who recounted the woman’s story, and his team later learned that her call to the Friendship Line proved to be pivotal in helping her cope with the drastic change in her life.
“That is a very typical kind of call that we get,” he says. “We listen to people, and it really makes a difference.... We believe that connections are what binds us to life.”
The Friendship Line is the only accredited 24-hour, toll-free crisis intervention program for seniors in the United States. Calls are answered by a combination of staff members and volunteers trained to recognize signs of depression and suicide. They also help maintain connections with older people.
According to the Institute on Aging, people between the ages of 65 and 84 are nearly twice as likely to commit suicide as those between 15 and 24. And the risk is even greater for those older than 85. An average of seven calls per month to the Friendship Line involves someone who is in crisis and requires immediate assistance, Arbore says.
The concept of the Friendship Line came about in 1973 when Arbore was studying aging and mental health. Despite high rates of suicide among older people in the San Francisco Bay Area at the time, health practitioners were not seeing a commensurate number of calls to traditional suicide prevention centers.
Arbore was convinced of the need for a hotline for seniors that would offer a conversation rather than potentially a confrontation – one that would be “a more inviting way to connect” than a traditional suicide prevention hotline. He was originally the only person to answer calls.
“For a number of years I was answering it from my apartment,” he says. “I was kind of on 24-hour duty. It was really a labor of love for many years.”
Once the Friendship Line expanded beyond Arbore’s apartment, it was established as part of its own nonprofit organization. It later merged with the Institute on Aging, a group with the mission of “preserving the dignity, independence, and well-being of aging adults and people living with disabilities.”
Initially, the warm line received some 50 to 100 calls a month. It launched its toll-free number and went national in the 1990s; it now receives about 8,000 to 8,500 calls a month.
“Little by little, we are starting to realize that we have many, many more older people than we have had in the past,” says Arbore, referring to the baby boomer generation and the expanding need for the service.
Those at the Friendship Line can make outgoing calls to older and disabled adults, both for safety checks and to help provide ongoing conversation – sometimes at particular times of the day when grief or isolation might feel strongest. Some of the adults even have an arrangement that if they don’t call the Friendship Line to check in, someone will contact them – and eventually, an emergency contact – to make sure they are all right.
“We really believe that even one person that is providing meaningful conversation with a lonely older person can make all the difference between life and death,” Arbore says.
Indeed, Arbore is still passionate about what he started some 44 years ago. And despite a recent funding shortfall stemming from the unexpected loss of a government grant, donations and some partnerships on the horizon continue to keep the Friendship Line alive.
Greacian Goeke first connected with Arbore in 1986, after her father committed suicide and a friend suggested she contact him. Although Ms. Goeke was hesitant, she knew just from talking to him that he was the right person to call as she struggled with grief.
“The minute I heard Patrick’s voice over the phone,” she says, “there was some connection – an instant recognition that here was someone who could really understand me.”
Goeke participated in Arbore’s support group for those grieving the loss of a loved one from suicide – and she still participates from time to time. She praises Arbore’s commitment and dedication.
“His life has been one of service and giving,” she says. “He is just one of the most sensitive and empathetic people to be guiding people who are truly broken and lost. And when you’re in his presence, you always know that there is a way forward.”
• The Friendship Line can be reached at 800-971-0016.