I just called a psychotherapist colleague and listened to her voicemail greeting with the now-ubiquitous message, “If this is an emergency, hang up and call 911.”
My professional voicemail will never include that message. Here’s why.
It conveys our patients are idiots. Do we really think they wouldn't know, without instructions, when to leave a voice message for a therapist and when to call 911? In more than 20 years of practicing and supervising therapy, I have not encountered an adult who didn’t know the difference.
It is at cross-purposes with therapy for patients prone to feeling helpless and incapable. Therapists should not collude with such self-perceptions. But the message says, in effect, that we agree with them. Why else would we leave instructions appropriate for a 6-year-old?
It is absolutely not the way to handle suicide risk. If a patient is a suicide risk, this needs to be addressed during office appointments. There should be a clear, well-thought-out, mutually agreed plan about how suicidal crises will be handled and exactly what the patient and therapist will do when they occur. If such a plan exists, the 911 voicemail message is superfluous. If not, the message is not a substitute.
The subtext of the 911 message is that we are not available to our patients 24/7. Of course, we’re not, nor should we be. We have other patients and other responsibilities, not to mention lives of our own. Psychotherapy should begin with a clear understanding of the roles and responsibilities of both parties (what therapists call the “frame”). There is no need for a voicemail message to convey this unless the therapist conveyed false expectations in the first place.
I used to tune out those 911 messages. Now they leave me wondering whether the therapist is an expert professional, or just following the herd.
If you or someone you love is contemplating suicide, seek help immediately. For help 24/7 dial 988 for the National Suicide Prevention Lifeline, or reach out to the Crisis Text Line by texting TALK to 741741. To find a therapist near you, visit the Psychology Today Therapy Directory.