IMAlive.org is an online crisis counseling service that uses an instant message (IM) chat interface instead of phone or SMS texting.

Out of Sight is not Out of MindI maintain Online Suicide Help, a global directory of services which are usually restricted to one country or even one small town. This has meant that most countries in the world could not access any services. Recently I learned that IMAlive changed its service area from US and Canada to be the first crisis chat service available worldwide, and I emailed to find out more about this change. John Plonski, IMAlive’s Director of Training and Developer of its Helping Empathically As Responders Training (HEART) program, kindly wrote back to share more.

Q. Why was IMAlive created as a web-based crisis counselling service?

A. The advent of IMAlive marked a logical next step in the evolution of providing helping services to those in crisis or at risk of suicide. As internet use became ubiquitous (it took 70 years for 90% of American homes to have electricity it took only 26 years for the Internet to reach a similar saturation level) those of us in the helping field made a move that paralleled the shift from face-to face assisting to telephone helping that happened in the early 1960’s. The internet represented barrier free portal to help paralleled the use of the telephone.

Q. Why do people prefer it to a phone helpline or texting service?

A. Allowing that the IMAlive platform handles text and chat (IM) in the same manner and those who come to us use either method this answer will address the user preference over telephone access. Additionally, I feel I need to make the clarification that the advent “digital interactions” (DI) has not created a paradigm shift from telephone services. Rather (citing the experiences of agencies that have both telephone and DI access) the numbers of telephone interactions have continue to follow statistical norms and DI has augmented the total number people reaching out. But back to the question:

• The person reaching out “digitally” is most likely using the most accessible means of communication available to them.
• The perception of confidentiality – When I say this I am not speaking in terms of the “agency” standards of confidentiality and anonymity but the fact the person reaching out does not have to worry about someone overhearing their conversation. Think in terms of privacy rather than confidentiality.
• The DI provides a sense of protection to those who feel they are judged, ridiculed or viewed as being “different” by those around them.
• Some people have more confidence in expressing their thoughts and feelings using the written as opposed to the spoken word. This can be attributed to the asynchronous nature of DI which allows the person to “say” something then review their thoughts before passing them on to the other person in the interaction (although spell-check does make for some interesting thoughts). A corollary to this is sometimes just easier to write something than speak something.
• Telephonophobia – There is a population that is uncomfortable talking on the telephone. The reasons for this dynamic are varied but chat provides the option to get real-time help without doing something that makes the person uncomfortable.
• DI alleviates situations where the person’s dialect, accent or physiological condition makes understanding the spoken word difficult.
• The Multitasking Myth – The public’s attachment to tech devices has deluded them into thinking they have become expert multitaskers. It’s not uncommon to see someone watching TV while working on their laptop, texting a friend, following a Twitter feed about the show and listening to their fave music mix. The reality is they are not multitasking. They are effectively “taskswitching” – though probably doing it poorly. Chat enables the individual to continue doing what they are doing while receiving assistance – even while at school or work.
• In some cases people feel that they receive better assistance in a chat session than they would on the phone. The dynamic working here is – “These guys are smart enough to have chat so they are probably a good resource for me!”
• The DI allows some to feel they are in more control via the written word. This coupled with other dynamics listed above helps them feel they are in control of the conversation and can be more explicit in what they want to communicate facilitating a more productive exchange of ideas.
• The ability to scroll back through the chat session to recall information that was mentioned previously without having to ask the other person to repeat what was said. Also helpful in those times when we say to ourselves, “Gee, What did I say when…?”

Q. Do you think having the support of the PostSecret community and its founder Frank Warren has made you more web-savvy? How about the influence of your other major supporters?

A. We at IMAlive are very appreciative of the support afforded us by PostSecret and the many others who have recognized the need to remove the stigma and taboo surrounding crisis, mental health and suicide. Granted I am perhaps more of a luddite having learned my skills in a world of rotary telephones and databases that lived in shoeboxes full of hundreds of 3×5 cards. However, as a presenter at the 1997 Alliance of Information and Referral Systems National Conference, I did present a well attended workshop titled “Everybody’s Gone Surfin’ ” which addressed providing help through the internet. At that time the internet was a “Golly gee whiz!” thing. Dial-up connections and “You got mail” were the reigning technologies. How times have changed? I think, if nothing else, Frank helped the founders of IMAlive have the foresight and power of conviction to be the first virtual crisis intervention network. It is that foresight and conviction that has nurtured IMAlive into a service with approximately 200 volunteers on 5 continents. IMAlive’s 10-hour online video, Helping Empathically As Responders Training (HEART), coupled with hours of individualized observation sessions of potential volunteers ensures a consistency of service based on accepted crisis intervention standards that is reinforced and supported by our global network of volunteer supervisors. For this – “Thank you all!”

Q. Why did you make the decision to begin offering services globally?

A. While it may be considered laudable the decision to offer services globally was not made by the principles of IMAlive. That decision was made by the platform we use for our chats which does not have the capability to differentiate the location of incoming chats and filter out those coming from other places. With that in mind a decision was made to accept all incoming chats regardless of country of origin. It just seemed that turning someone away because of location would violate the basic mission of IMAlive.

Q. How are you able to overcome obstacles that some other services talk about: regional funding and professional liability within borders?

A. To answer the first part of this question I will simply say that in today’s fiscal environment all non-profits are faced with a daily battle to secure funds in an effort to maintain viability and sustainability. By regional funding I will assume you are referring to government funding. At present IMAlive receives no funding from any government and relies on private donations and the support of our organizational benefactors. As for professional liability – My total lack of knowledge of things legal means I will not be able to provide an adequate answer beyond my understanding from 30+ years of experience in the field that tells me Good Samaritan laws offer legal protection to those who give reasonable assistance to those who are in need or at risk.

Q. Do you offer translations, service in any language other than English?

A. IMAlive does not offer translation of languages other than English. Having said that it is interesting that people whose language is not English have been able to reach out to us and receive help using the various translation apps available on the internet.

Q. Have you adapted your volunteer training to make it more culturally sensitive?

A. At the risk of sounding culturally insensitive about cultural sensitivity I will reply in this manner:

As the developer of HEART this is an issue I have given much thought to over the years. When I consider the topic I find myself going back to the core of HEART. One of HEART’s core tenets maintains the Responder and the person experiencing crisis are equals. This tenet discounts the concept of the omnipotent Responder and empowers the individual who may be feeling powerless as the result of their crisis permitting the Responder and the person to collaborate regarding a solution best suited to the needs of the individual

The tenet of equality is closely coupled to two of HEART’s core fundamentals which are Acceptance and Respect. Acceptance is the “non-judgmental” piece of Crisis Intervention. Acceptance maintains that regardless of what we think or feel about a person we will not judge them, their situation, their actions, or their ability. Basically people, situations, actions, and abilities are things to be acknowledged, not judged.

Once we accept the need to be accepting and non-judgmental we can then embrace the concept of Respect. This means Responders will respect each person’s unique individuality and ability even in those times when a person’s ability may not be immediately evident to the Responder or the person in crisis.
Basically the Responder will respect the individual enough to accept that they can learn new skills or adapt to resolve the crisis at hand.

Does this mean we teach our Responders to ignore cultural differences? Not at all. Ignoring the cultural differences that exist all around us represents a judgment. Some of them have a positive impact on individuals. Others are potentially, if not inherently, negative or dangerous. The strength of HEART lies in the fact the cultural differences would be acknowledged and the person would be engaged in a discussion that would address their own inherent strengths and abilities to empower them to effect personal change which will help them to survive, thrive and regain control of their situation.

So does this mean IMAlive ignores the existence of cultural insensitivity? No. In fact, our selection process and training of new Responders has a structure to screen for those views people may have which would impact their effectiveness as Responders. Of course this begs the question, “Why not train cultural sensitivity?” Generally the issues we would address with sensitivity training are fairly well ingrained in the individual embracing certain beliefs and mores – and that is okay as we would not judge the person based on thier belief system. However, Crisis Intervention work can be stressful enough without adding the stressor of “Abandon your core beliefs!” So rather than create additional stress for the individual we offer them volunteer options that may be more suited to them and therefore more satisfying for them.

Q. For crisis services there’s something known as “Active Rescue,” which means if someone needs emergency medical care, police will be dispatched to the person and they’ll be taken to a hospital. Does IMAlive practice Active Rescue, and if so, how do you manage it in countries where emergency services may not be available?

A. The simple, and accepted answer is, “Where immediate risk of harm or death to the person or others is exists and where it is possible to ascertain the location of the person IMAlive will do all it can to intervene actively.” The appropriate answer in more involved. To appropriately address the question we need to talk about several issues.

First we need to understand there is a distinction between “Suicide Prevention” and “Suicide Intervention”. If we think of a persons “journey”, a continuum, from no thoughts of suicide – to a precipitating event that evokes thoughts of suicide – to a point where the thoughts placing the person at risk are addressed and suicide risk is ameliorated OR the person acts on their thoughts.

Suicide Prevention is a concept that applies to both ends of the continuum of suicide risk. Ideally Suicide Prevention is a combination of efforts by government, helping organizations as well as mental health and related professionals to reduce the incidence of suicide attempts and death. These efforts include, but are not limited to:
• Restricting or controlling access to lethal means (weapons and drugs)
• Reduction of conditions that constitute risk factors for suicide (poverty, bullying, abuse)
• Community awareness of the indicators a person maybe at risk and a corresponding care network those at risk can be readily referred to
• Programs to lessen the stigma and taboo surrounding mental health and suicide
• Accessible treatment for those experiencing depression and its psycho-social symptoms
• Responsible media reporting regarding suicide and deaths from suicide
• Providing social supports to address issues that lead to suicide risk (education, living wages, abuse prevention initiatives)

In short suicide prevention is not a top down solution (government, clinical professionals, society) but a combination of top down and bottom up initiatives. Think of it this way – Government and the mental health community can develop the best programs to help those at risk but unless we, the people that comprise society, take an active role in identifying those at risk all the efforts and money spent are for naught. This is the one side of Suicide Prevention.

This brings us to the other side of the suicide continuum – Suicide Prevention involving Active Intervention. The news tabloids and Hollywood have created an image that thoughts of suicide are unstoppable and portray the graphic image of a person who has a reflective moment before they leap to their deaths or the camera fades to black and we hear the fatal gunshot. This widely held, though erroneous, view rejects the reality that the person at risk wants to live and the majority of the time will do so. Estimates indicate that 3% – 5% of a population has thoughts of suicide at any given time. Yet the number of deaths from suicide, though tragic, is incredibly small if you accept the prevalence of suicidal thoughts. This tells us the vast majority of persons at risk are able to somehow shift from the danger of suicide to relative safety. Part of this dynamic is IMAlive and the many, many crisis intervention/suicide intervention services available to those at risk globally.

However there are those rare times when an individual has traversed the continuum of suicide and they are in immediate risk of harm or death to themselves or others. What may have been an opportunity for intervention has now become an emergency and IMAlive will attempt to take whatever steps are necessary and possible to protect and preserve life. Yes, there is “Caller ID” and that was helpful in providing Active Rescue until the advent of mobile devices and internet intervention services as identifying information is more device dependent than location dependent – despite what Hollywood would have us believe. What needs to be mentioned here is that the only resource generally available to those, like IMAlive Responders, looking to provide Active Rescue is their training and their supervisory support staff – the majority of the time that teamwork results in a person in need of Active Rescue achieving safety.

Thanks for the wealth of information!

IMAlive.org is always seeking volunteers, who can contribute online from anywhere in the world. Please visit the web site to learn how.

If you are in crisis, please reach out anytime from anywhere to this helpful service.