Suicide Watch

Dick Berger, executive director of Living Support Network, doesn't want to be interrupted, so he takes the phones off the hook, one by one. His personal line. The Youth Support Line. The Suicide and Crisis Hotline.

"It's okay," Berger explains, his voice competing with the insistent, high-pitched beep of handsets removed from their cradle. "They can leave a message."

"There are other hotlines," points out Melissa, the crisis line's sole volunteer.

Together, Berger and Melissa constitute the entire staff of the Living Support Network (or LIS'N), which is promoted as a 24-hour-a-day "safety net for people who are depressed, suicidal or in need."

Except, of course, for those times when the phones are off the hook. But that's not the only complaint leveled at LIS'N by its critics. They charge that Berger, who established the crisis line sixteen years ago, is actually endangering the lives of the very people he proposes to help. And they're outspoken in their desire to shut LIS'N down or, at the very least, to shut Berger up.

Over the years, hotline volunteers and callers have accused Berger of false advertising, using sexually inappropriate language with women callers, utilizing crisis-line calls to "develop social relationships," staffing the phones with untrained volunteers, failing to provide consistent service and, yes, being unavailable to callers for long stretches of time.

The Colorado Mental Health Grievance Board, which oversees the state's psychologists, has received three formal complaints regarding Berger over the past six years. But while board president Clarissa Pinkola Estes directed at a recent board meeting that the latest Berger complaint receive "fast-track priority" since it deals with the state's "most vulnerable population," nothing is likely to come of it, just as nothing has come of the previous complaints.

The grievance board hasn't intervened because it has no jurisdiction in a case unless a person represents himself as a psychotherapist and charges a fee for his services, explains Amos Martinez, the board's program administrator. And as Berger's attorneys have been quick to point out, LIS'N does not meet those criteria; it is a nonprofit organization funded by grants from charitable foundations, and Berger does not receive a salary.

In fact, it appears that no one, including the newly formed state Office of Suicide Prevention, has jurisdiction over Berger. Anyone with a phone can start up a suicide hotline.

"There is nothing that is unlawful, (or) improper for an individual to exercise his constitutional rights to try to assist persons who contemplate some self injury and turn them to the proper social agency," LIS'N attorney Martin Miller recently wrote the grievance board.

"Richard Berger," Miller continued, "should be commended for his voluntary efforts."

In the late '70s, Berger, now 49, reached the nadir of his existence. A former high school golden boy, Boettcher scholar and onetime law school student, he was spending his days "shlepping up and down Colfax," frequenting Sid King's strip bar and eking out an existence as a freelance writer. "In essence," Berger says, "I was a lowlife. But in a very positive sense."

His slide began after he was diagnosed with multiple sclerosis and the disease began robbing his legs of strength. He was angry and depressed. "It wasn't that I was suicidal," he recalls, "but I was desperate."

Minutes later, however, he amends his claim. "I tried to do it [suicide] a couple times," he says. "Not very successfully."

During that period, Berger discovered that help was hard to come by. After he sought aid through a number of traditional routes, including therapy and psychiatry, a vocational counselor suggested that Berger go back to school and take up rehabilitation work himself.

Berger graduated from the University of Northern Colorado in 1980 with a master of arts degree in vocational rehabilitation. He found that he enjoyed the counseling aspects of the work, and the same year he graduated, he formed a nonprofit corporation called Suicide/Depression Anonymous. Berger spent the next two years visiting hospitals and self-help organizations, holding telephone consultations and familiarizing himself with research on mental-health issues. "People were hurting, and hurting bad," he says, and few nonprofit groups were stepping into the void to help them.

So in 1982, Berger began conducting weekly self-help meetings. The SDA Crisis Line debuted in 1984. He set up the Youth Support Line -- a crisis phone line for teenagers -- in 1986 and changed the organization's name to the Living Support Network.

For a time, Berger operated out of his home in Capitol Hill. Within a few years, however, the group began renting an office at the Capitol Hill Community Center, at 1290 Williams Street. As a consequence of its tenancy, LIS'N was able to take advantage of low rental rates for the center's meeting rooms, and the organization hosted weekly self-help groups there. Included in the meeting roster were a depression support group and one for suicide survivors.

Despite the businesslike trappings, critics say the crisis line and self-help groups were never run in a professional manner. Of particular concern to people in the suicide-prevention field was LIS'N's dearth of volunteers.

Finding and keeping enough capable volunteers to staff a 24-hour suicide hotline is a difficult, time-consuming task for any agency. "It's tough to sit there and listen to people's agonies," says Diane Ryerson, co-chair of the Suicide Prevention Coalition of Colorado. "It's a huge responsibility, too."

But many reputable organizations have discovered ways to solve the staffing dilemma. When a hotline is busy, for example, calls to some agencies automatically roll over to another crisis center. Some lines contract with an answering service to contact on-call counselors. Other lines simply use an answering machine, which provides callers with phone numbers for alternative crisis lines.

LIS'N utilized the latter option off and on, with mixed success.

During the first few years of LIS'N's operation, Berger's answering machine referred the callers to Comitis, another crisis group. But the two organizations had a falling-out over the appropriateness of the calls being sent to Comitis, Berger says.

The problem wasn't with the calls, counters Comitis director Richard Barnhill, but with Berger himself, he says. "We have believed for some time that Berger's activities with clients have not been appropriate," he says carefully. Specifically, Barnhill adds, he and others were concerned over what they deemed "interference" by Berger after he referred calls to them.

In response to one Comitis complaint, Eugenia Berger -- Dick Berger's mother and a member of the LIS'N board -- defended the hotline's policy of forwarding the calls. "This seems to be a responsible way of handling the problem when more than one or two persons are calling at the same time," she wrote. "But we do need to be able to refer to another line. The alternative is to have a busy signal; callers in crisis hate busy lines. They want help."

But after LIS'N dropped the Comitis number from its answering-machine message, instead of a referral number, callers to the LIS'N line often got busy signals.

In a 1995 letter to the Mental Health Grievance Board, Kathie Jackson -- then director of the Safe and Drug Free Schools program for the Colorado Department of Education -- reported receiving complaints about LIS'N from counselors with the Colorado Mental Health Association and the Boulder County Youth Initiative. Some of their clients, Jackson said, repeatedly tried to call LIS'N's suicide support line only to get "an answering machine or busy signal for prolonged periods of time."

The reason for that was apparent when Jackson visited LIS'N's office: Berger answered the hotline himself the majority of the time. "When he is tired or unavailable," Jackson observed, "he removes the phone from the hook and an answering machine takes over."

The message on the answering machine asked people to leave their name and number. "You'll be called back," it promised. But sometimes callers discovered that the answering machine was full, Jackson said, and they were unable to leave a message at all.

And even when Berger was answering the phones, he sometimes had no time to speak with a caller.

In a January 1995 letter to the mental-health grievance board, a caller reported receiving short shrift from Berger.

Initially, the Lakewood woman wrote, she'd called a group called Women in Crisis "because of a devastated state." But a staffer there felt she needed to talk with a suicide-prevention agency. It was a Saturday, so the crisis center staffer called LIS'N to make sure someone would be able to speak with the woman at length.

The staffer told the caller that Berger was available "and had given his okay," the woman wrote. "I called immediately in a histerical [sic] state of mind.

"I was told almost immediately by Mr. Berger that he was attending an art show, and could I call him back Sunday or Monday, and that Monday would be better. I never conveyed my situation and the seriousness of what was happening to me. Mr. Berger hung up."

Although the woman eventually was able to get help from another crisis agency, she remained upset by Berger's behavior.

"The help line run by Mr. Berger is bogus," she complained to the grievance board. "It needs to be looked into. He's getting funding for a job he isn't doing. I found out the hard way. I'm still alive and well because of another line ... Someone else may not be so lucky! Please help!"

But the grievance board couldn't help.

"The board found that it does not have jurisdiction to intervene in this matter, because a 'professional' client-therapist relationship did not exist," boardmembers wrote in their response to the complaint. They suggested that if the woman wanted to pursue the matter further, she might consider mediation.

By 1994, some of Berger's own volunteers were beginning to complain about how his hotline was operated.

Chip Frye was one of them.

Before coming to Denver, Frye worked as a volunteer with a suicide hotline in Los Angeles that's known nationally for its prevention work. He also served as a certification examiner for the American Association of Suicidology, a nonprofit group that provides education and training for professionals and volunteers in the area of suicide prevention. (Membership in AAS is voluntary; the organization has no statutory power to enforce its guidelines.)

In the late '80s, Frye became an unpaid trainer for LIS'N, teaching hotline volunteers how to assess crisis situations, how to de-escalate suicidal threats and how to connect someone with psychiatric help if needed.

But as he saw how LISN's hotline was handled, Frye grew worried. His biggest concern, he remembers, was a lack of "safety processes" in the program.

AAS has specific ethical and safety guidelines that must be followed before it certifies a hotline: Hotline workers must maintain a professional distance and never meet with clients face-to-face; they should not give out their real name; they should not discuss their own problems with callers in such a way that it dominates the conversation.

Frye contends that Berger had problems in all of those areas, and he shared his concerns with an investigator from the Colorado Mental Health Grievance Board in 1996. Berger "may have some face-to-face contact [with a client] when he has a particular interest in a female who has called the hotline," Frye told the investigator. And although Berger represented those sessions to the caller as a form of counseling, it was Frye's opinion that Berger used the contacts to develop "social relationships."

Frye also told the investigator about an incident involving a man who had led the suicide survivors' group. According to Frye, the group facilitator (a volunteer) became linked romantically with one of the female group members. The woman committed suicide, and the facilitator left LIS'N. But despite the tragedy, Berger reportedly brought the group leader back to head the sessions on a regular basis.

When he realized that Berger might be stepping over some ethical boundaries, Frye says, he could not sit idly by.

"At one point," he remembers, "I went to all the people around [Berger] who were in support of him, and I said, 'I'm trying to empower you people to get him off the line, to convince him that he needs to manage the volunteers, because he's using the line inappropriately for his social needs.'

"We met privately before meeting with Dick and decided that Dick either needed to get off the line or turn it into a talk line or that we would have to quit. We tried to encourage him to do just a talk line to meet his needs and individuals' needs in the community."

They also suggested that Berger remove himself from the line because his MS had affected his voice and sometimes made it difficult for him to be understood. "We gave him as much opportunity as we could. But he said no," Frye says. "He said he felt he needed to remain in the suicide arena because it was something that was not available anywhere else."

Frye quit after Berger refused to leave the line -- and he wasn't the only volunteer to go, he remembers.

But Berger says he was never taken aside by the volunteers, and that no one ever asked him to take himself off the call line. Suggestions that he used the line as an opportunity to meet women are "really inappropriate and untrue," he says. "That's not the idea of this at all."

Berger also says he knows "almost nothing" about any improper relationship that may have taken place between a group facilitator and a group member. Nor does LIS'N have any written regulations regarding such relationships. "It isn't articulated," he adds. "It's an unspoken rule."

A second complaint to the mental-health grievance board suggested that Berger was making inappropriate advances to callers.

In October 1995, Pat Rollins made a desperate call to LIS'N.

Rollins (not her real name) was despondent. She had been raped and wanted to die. She called LIS'N and told Berger of her intent. After Berger got off the call, he phoned the fire department. Firefighters rushed to Rollins's home, where she'd closed herself in a garage with an idling car. She was hospitalized overnight.

After her release from the hospital, Rollins called LIS'N a second time -- Berger had asked that she call back to let him know she was all right. They spoke for two hours, during which time Rollins revealed childhood sexual abuse and made other personal disclosures.

Rollins later told an investigator with the state grievance board that Berger, too, made some personal disclosures during that conversation. According to Rollins, Berger told her that he was going to have a penile implant to allow him to have sex and that he thought he could fall in love with her.

Rollins was taken aback by these revelations, she told the investigator, and wondered whether she had prompted them by talking with Berger about sexual abuse.

After that two-hour talk, Rollins said, Berger called her frequently, asking her to become a volunteer and asking when he might meet her in person. She eventually became so spooked by the calls that she had her phone number changed.

Rollins had started seeing a therapist after her suicide attempt, and she subsequently told the therapist about her conversation with Berger. The therapist then contacted Kathie Jackson, who helped Rollins file a formal complaint with the grievance board.

In her own letter to the board, Jackson requested that LIS'N be served with a cease-and-desist order until an investigation was completed and "all allegations resolved."

This time, both Jackson and Frye met with LIS'N's board of directors to discuss their concerns.

But the board "seemed to turn a blind eye to it," Frye says. "It was said that we had something against him and that it was personal. In actuality, it was strictly out of concern for people who were being victimized when they called his hotline."

The LIS'N board did promise to talk with Berger about the complaints to the grievance board.

Berger gave the grievance board a terse response regarding the Rollins matter. He did not practice psychotherapy, he said, he was not trained as a psychotherapist, he did not hold himself out to the public as a psychotherapist, and his services were provided free.

That's all he needed to say.

In a letter back to Berger, program administrator Amos Martinez wrote: "After thorough review of the information available, the Board found that it does not have jurisdiction to intervene with this matter because you do not fall within the definition of an unlicensed psychotherapist..."

However, Martinez added, "Please note that the Board expressed concern with your involvement in this matter and directed the staff to forward a copy of the Board's case to Bea Romer, M.A., and Pat Pascoe, Ph.D., who are listed as honorary directors of the Living Support Network."

Pascoe is no longer listed as an honorary member. She says she resigned her position two or three years ago, not because of complaints or any letter from the board (she doesn't remember receiving one), but because she did not have enough time to keep herself abreast of the operation.

"A reporter called asking me about [LIS'N]," she says, "and I couldn't tell him anything. I just didn't know. That's when I resigned."

Bea Romer, Colorado's former first lady, is still listed as an honorary director on LIS'N's board.

The state grievance board may not have been much of an obstacle to the hotline's operations, but there was a threat to its existence, and it came from an unexpected source: the Capitol Hill Community Center.

The center, where Berger had maintained an office for about ten years, declined to renew LIS'N's lease in January 1998. The decision was simply a matter of practicality, says center spokeswoman Jane Hedlund; the center needed the space for its own offices.

Although Berger had been using the building less and less -- he was confined to a wheelchair and had become much less mobile as his disease progressed -- losing the lease was tough on him, says Roger Oram, president of LIS'N's board of directors.

"Losing that community center was a blow to him," Oram says. "It gave him some official status."

For economic reasons, as well as issues of Berger's mobility, the LIS'N board decided not to look for more office space. And so the hotline was moved permanently to Berger's condo.

The switch made sense in many respects, but it had a negative effect on Berger's volunteer recruitment efforts. "It was easier to get people to come to the community center than to his apartment," Oram explains.

LIS'N no longer sponsors self-help groups, because it has no meeting space, and its roster of volunteers has shrunk considerably. From a high of 35 volunteers, the staff has shrunk to two -- just Berger and Melissa.

Melissa got involved with LIS'N earlier this year after calling the hotline seeking help. "I was having a panic attack," she says, "and I needed to talk it out."

Berger and Melissa became friends, she moved into Berger's apartment, and now she helps with the hotline. (She asked that her last name not be used, because she says she's a victim of "serious" domestic abuse.) She's been answering calls for about three months, and she makes a little money on the side by doing typing for LIS'N. "Melissa is one of the best counselors I have worked with," Berger says. 'She knows a whole lot about issues that are imperative to these people who call. She is able to cut to the quick."

"I can get just about anybody calmed down," Melissa says. "It's a gift I seem to have."

That Melissa has no counseling degree does not bother Berger. That she has not received specific training -- other than listening to some of Berger's old training tapes -- does not bother him, either.

"I am contemptuous of people who say, 'Does she have a degree?'" Berger says. "Credentials, in my opinion, are not that big a deal, although they can be."

But Melissa's involvement with the hotline violates accepted standards in a number of ways, irrespective of her lack of training. (AAS recommends forty hours of initial training, followed by in-service training and evaluation.) "We do not take [volunteers] who are in treatment," says Eleanor Hamm, executive director of the Pueblo Suicide Prevention Center. "They have to have been out of treatment for a while. Certainly we would not take a new victim. Sometimes victims feel strong and believe that they can help. But they need to allow themselves an opportunity to deal with their own trauma.

"Suicide is a highly volatile issue," Hamm continues. "People are tremendously vulnerable." And it's of utmost importance, she says, to make sure that volunteers are not staffing a suicide hotline to somehow meet their own needs.

Melissa, however, has improved LIS'N in at least one way -- she has begun logging the number of calls and keeping track of the types of requests that come in to the line, something Berger hadn't done for years.

"We started doing it September 4 just so we have an idea how many calls we get at a time," Berger says. "Sometimes we'll get three a day, sometimes 23.

"I don't think anyone ever thought of it before," he says, smiling at Melissa.

But more than five years ago, Kathie Jackson told the grievance board that she had discussed the importance of recordkeeping with Berger. His response, she said, was that he felt "something was better than nothing."

LIS'N's problems continue. At its September meeting, the mental-health grievance board discussed, among other things, yet another complaint regarding Berger and his hotline. Berger appeared before the board in his wheelchair, accompanied by his mother and LIS'N attorney Marty Miller. Although the board's case file remains closed until the board determines whether it has jurisdiction, Miller acknowledges that the charges include accusations of impaired judgment on Berger's part.

"In an unsupported charge by (name deleted), she complains that Richard is using untrained and severely mentally ill persons to answer the crisis line," Miller wrote in a legal memorandum to the board. In addition, Miller wrote, the woman said she feared that Berger's physical impairment could cause him to drop the phone in the middle of a call.

The board took no action at the meeting, because it has not been determined whether the state has jurisdiction over the latest complaint about Berger. Miller, however, contends that it does not. The board is expected to make a decision on the matter by its next meeting, in late November. The complaint has already had one repercussion, though: According to Oram, LIS'N board president Reri MacLean resigned, in large part as a result of it. An old college buddy of Berger's, Oram took the board's reins after MacLean's departure.

Although Berger's methods have been questioned, even his critics believe that his heart is in the right place. "LIS'N has always been an effort of goodwill on the part of Dick Berger, and I've got to give him a lot of credit," says Frye. "I'm sure he has done a great deal of good."

Berger has also been recognized with a number of humanitarian awards, including John Elway's "Hometown Hero" award and the Minoru Yasui Community Volunteer Award. And for now, it appears that his hold on the hotline remains secure. The Boettcher Foundation has given Berger's group a $3,000 grant for this year, and LIS'N's membership in the Community Shares program assures the group another $2,200 -- enough to keep the phones up and running. (The Boettcher grant was a three-year entitlement that expires this year, says a foundation spokeswoman. The trustees select the organizations, "usually from someone they're familiar with or that we've given to before." Community Shares is a cooperative membership organization that raises money through payroll deductions; according to executive director Greg Truog, groups are usually asked to resign their membership only if they fail to honor a commitment to work with Community Shares forty hours per year.)

Berger should expect more heated competition in the hotline field, however. The National Hopeline Network, 1-800-SUICIDE, is now available to callers throughout the state. The calls are answered by Hamm's Pueblo group, which has been AAS certified since 1985. When the Pueblo lines are busy, the calls are routed to the closest available certified crisis center (which, in Colorado's case, might be Los Angeles).

And the Pueblo line, which is run by professional counselors, is subject to regulation by Colorado's Mental Health Grievance Board.

But Berger doesn't worry about competition from the 800 line; there is room for what he does, he says.

Hamm agrees -- to a certain extent.

Sometimes volunteers can establish rapport with callers faster than professionals can. "Some people want to talk to a doctor," Hamm says. "Others want to talk to someone they think genuinely cares. They want to know they're being listened to, and they want someone to understand how much they hurt."

And Berger, she adds, established the hotline from the vantage point of a "consumer," not a professional. Consumers, she says, "see themselves on a peer level with a caller, not a professional level. That's not really appropriate to what we do on our hotline. Our volunteers have strict guidelines to follow.

"I think as long as there is a public awareness of what the limitations are," there may always be a place for grassroots suicide-prevention programs, she adds. "Maybe that's something (Berger) needs to define. Maybe he needs to define for them that he's not a therapist. People need to know that. Unfortunately, when people are hurting, they're desperate to connect with anyone. If they think they're talking to a mental-health center or a hospital, he would have to correct them right away and explain what his limitations are."

And while LIS'N's limitations are considerable, there are only a few other options for people in crisis.

"One reason I think there hasn't been more pressure to shut [Berger] down is because there's no statewide phone system that currently exists," says Frye, calling the situation "a real travesty."

"Here we are, rated one of the top states for suicide, and there's not a statewide center taking calls. It's a failure on all our parts that a center so below standard has been allowed to operate for so many years and put a lot of people in danger."

Just this past June, Colorado established the state Office of Suicide Prevention, with a budget of nearly $160,000 and a staff of two. But until a full-time director is hired, the office has no firm focus. For now, acting director Stephannie Finley is compiling information about suicide-prevention efforts around the state. She says the group isn't nearly ready to establish a statewide phone line, nor does it have a mandate to crack down on hotlines run by non-professionals.

LIS'N president Oram says he'd be happy to see the state get more involved in the business of suicide hotlines. "But the state doesn't want be involved more intimately," he explains. "They don't want the responsibility. The state health board is getting a little bit involved, but they're not staffing any suicide lines. They don't want the liability for it.

"People are wanting to put Berger out of business, but he's providing a service no one else can provide, given the circumstances the state offers. I'd be very happy if the State of Colorado could put Dick out of business. But the real question here is, who's going to fill the void if Dick is not here?"


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