Warm line: a mental health support, answered by people who can relate - North Carolina Health News
By Taylor Knopf
When Aiden feels lonely or is struggling with sobriety, he calls the number to the warm line. He can relate to the person on the other end of the phone because they also have experienced personal mental health or substance use issues.
“Sometimes it keeps me from drinking, other times it’s just that I want to talk to somebody,” said Aiden, whose name has been changed at his request to protect his identity. “And I don’t know who to talk to. I have no friends left because I screwed up so much.”
Aiden, 29, is currently a full-time student at Central Piedmont Community College and hopes to become a firefighter when he graduates. An addiction therapist referred him to the warm line, which is a non-crisis support line operated by a mental health services agency in Charlotte called Promise Resource Network. What’s unique about Promise Resource Network is that it’s run by peers, meaning all of the staff and management are people who have dealt with personal mental health issues, incarceration, homelessness, substance use or a combination of these.
When the COVID-19 pandemic lockdown began in March 2020, the staff at Promise Resource Network shifted all of their mental health support sessions and classes online, and they expanded the warm line operation hours to 24 hours a day, seven days a week. They’ve received more than 10,000 calls since then, averaging almost 500 per month this summer.
Peer-run warm lines — staffed by people who have lived mental health experience — have been shown to reduce loneliness and participants’ use of mental health crisis services. Additionally, a review of several studies found that digital forms of peer support improve the lives of people with serious mental illness by “enhancing participants’ functioning, reducing symptoms and improving program utilization.”
Looking to call the PRN Warm Line? Here’s how to reach out: (833) 390 7728
More than 20 percent of PRN’s warm line callers live in Charlotte, about 30 percent live in the Triangle area, and the remainder of calls come from people across North Carolina and sometimes from other states.
“I always check in with certain people because they like to hear from me. It’s almost like the suicide hotline, but not quite,” Aiden explained. “They want to hear from you just to make sure you’re doing OK. They are wonderful people.”
When the warm line staff share stories of their own struggles with mental illness or substance use, Aiden says their ability to relate to him “helps tremendously.”
“If you’re triggered, if you’ve got cravings, it doesn’t matter,” Aiden said. “You can call and talk to them about it. Just call them and talk. It’s worth it.”
Someone who’s been there
Charlyne Boyette started answering calls to the warm line in September, and many callers were anxious, depressed, lonely or filled with grief due to the COVID-19 pandemic.
While she offers support and lends a sympathetic ear, Boyette can also relate to the feelings and experiences of those calling the warm line.
Boyette, 50, has lived with mental health and substance use challenges most of her life. After graduating from Elon Law School and Campbell University with a master’s in divinity, she had lots of expectations for her future. None of those included being able to talk about her mental health and substance use issues, she said.
“I felt like I had to keep that stuff secret in order to accomplish the other goals in my life,” she said. “I finally found some healing when I was in prison at age 42.”
She learned to see herself and past trauma differently from the many volunteers at the Swannanoa Correctional Center for Women. She’s paying it forward now by encouraging those who call the warm line.
“While a clinician may be listening to someone tell their story and thinking about all the different symptoms they have so that they can diagnose them and tell them what’s wrong with them,” Boyette explained, “a peer support specialist is listening to them to hear all the things that are right with them, so that we can remind them that they are more than the challenges they’re going through right now.”
Support without fear
People with mental illness can be hesitant to disclose feelings of depression or thoughts of suicide, especially if they have been involuntarily committed to a psychiatric hospital in the past.
Boyette gets this question from callers a lot: “If I tell you what I’m thinking or how I’m feeling, are you going to call the police on me?”
She said many who call the warm line are reluctant to call a suicide hotline because they fear it might trigger a call to law enforcement. This is the protocol once an involuntary commitment has been initiated because someone is considered to be a danger to themselves or others. Law enforcement officers typically put the person in handcuffs and leg shackles as they’re transported to the hospital in the back of a cop car. Patients are often left traumatized.
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So far, Promise Resource Network has not needed to send emergency services or initiate an involuntary commitment for a warm line caller.
“We have this happen a lot, people call and say: ‘I don’t want to live anymore,’” Boyette said. “While another line might call 911, we try to assess whether they have a plan.”
Warm line peer support specialists have Emotional CPR training, ALT2suicide training and Intentional Peer Support training. The ALT2suicide training follows a four-part protocol, Boyette explained.
“First we validate and acknowledge that their emotions are real and what they are going through is hurtful,” she said. “Next, we become curious, asking questions without judgement to figure out what they’re going through and who they are.”
This allows the peer support specialists and the caller to gain a better understanding of where these feelings are coming from.
“And 99 percent of the time it’s related to trauma,” Boyette said.
The third step for the peer support specialist is to become vulnerable and share part of their own story.
“As people in recovery, many of us have had multiple experiences with feeling like we didn’t want to live anymore for different reasons,” she said. “We can share those.”
Finally, Boyette said a peer will attempt to make a connection with the caller. She will either try to make a plan to call the person back later in the day to check in or try to connect the caller with peer support services in their area, such as Promise Resource Network’s recovery hub in Charlotte, Green Tree in Winston-Salem or Sunrise in Asheville.
“The goal is to communicate compassion and care and empathy. So that’s how it’s different than a typical suicide hotline or access line,” she said.
If a caller says they have already taken an action toward suicide, Boyette said warm line staff would call emergency services. If they are concerned that someone might carry out their plans, warm line staff call an emergency meeting of trained peers to discuss the situation and next steps. This happens about one to two times a week, Boyette said.
CEO of Promise Resource Network Cherene Allen-Caraco said she’s received countless messages from callers who are so grateful for the warm line.
“I can’t even tell you the number of people who have said ‘you saved my life,’” Allen-Caraco said of the warm line.
Peer-run warm lines are not expensive to operate, she said. And they are one alternative way to support someone struggling with their mental illness and keep them out of the hospital.
“There are alternatives that we could put into our communities that are not tied into Medicaid dollars, not tied into clinical services that could become safety nets,” Allen-Caraco said.
