How effective is volunteering at a suicide hotline?

Months ago my local EA group had a meeting around the concept of Effective Volunteering.  EA is not opposed to volunteering anymore than it it’s opposed to working directly for a cause, but it is more skeptical than the general population that this is the most effective way to help the world.  This doesn’t mean volunteering is bad, it can have all sorts of benefits outside of helping the world- building community, buffing one’s resume, and generally feeling good.  But if you want to justify volunteering on its helping-the-world merits, you have to compare it to the standard option of “work more, donate money.”

[I’m ignoring the argument that most people aren’t paid hourly because “learn skills to boost wages, donate excess” is an equally valid plan]

Based on the local discussion plus this post by Ben Kuhn, I propose that volunteering is most effective when some critical mass of the following are met:

  1. The product produced by volunteers is not the same as that produced by minimum wage workers (e.g. food kitchen volunteers are generally more cheerful than McDonalds workers)
  2. The volunteer has some comparative advantage in the task (e.g. pro bono work by lawyers)
  3. The activity does not take away from paid work (e.g.I have more hours in the week total than hours in the week I am capable of programming).

The problem is that 2 and 3 are often in conflict.  People’s comparative advantage tends to be used at work, either because that’s what led them to the work or they developed the talent there.  So it either has to be someone not capable of working regularly, or the person has to have two different comparative advantages.  I happen to think I fall into this category, because I’m very good at both programming and crisis chat counseling and they use entirely different parts of my brain.  And actually crisis chat makes a good play for having trait 1 as well: it’s heavy emotional work, and there are a lot more people capable of doing it 4 hours a week than 40.

Which got me thinking: how effective is crisis chat?  I’m fully prepared for the answer to be “not very”, it really seems like it’s on the less efficient side of things, but let’s run the numbers.

First step: how much does running a suicide hotline cost?  The first posting I found that listed a salary said $16.00/hour, and that’s for bilingual workers in an area with a cost of living 60% higher than the national average.  Let’s say $20/hour to include taxes, phones and computers, vacation time, etc.  GiveWell considers anything under $5,000 per life saved to be extremely cost effective, so to be competitive a hotline worker would have to save one life every 250 hours worked.  Statistics on chat line effectiveness are hard to come by because they’re anonymous by design, but I worked ~170 hours last year and I know for a fact I was 1/2 of a team that saved one life, and find it plausible that I saved more.  I work on the text line, which for various reasons is less likely to attract people who are imminently suicidal, so I suspect the phone line workers are more effective.  By this measure, suicide hotlines are competitive with GiveWell’s top charities.

The complication is that the hotline doesn’t do this alone.  I gave myself half a life because I called in a rescue for a phone worker who contacted me via chat, but that success depended on emergency workers finding the person and a mental hospital to take him in.  Malaria nets don’t work alone either (they can’t solve famine or war), but this seems more like evaluating the cost of the nets without the cost of employees to distribute them.  On the other hand, some percentage of chats may talk people out of suicide without requiring an active rescue.  If I help a person form a plan to keep themselves safe until the urge passes, that’s incredibly effective.

The other way to look at it is what would people pay for the service.  My gut feeling is that the service I provide is more valuable than anything the visitors could buy with $20*.  The most comparable services, therapy and psychiatric visits, start at $60/hour.  Crisis lines are not a substitute for psychiatry or counseling, but a marginal hour of chatting may be a reasonable substitute for an hour of either, given how much of their sessions is empathetic listening.    Even if hotline workers are not as effective at listening because they are lower status, that’s still substantial savings.  Plus we get a good chunk of people are uncomfortable talking to a real professional because they are so high status, but feel okay talking to us.  On the other hand, I’m pretty sure most of the bottom billion would take the $20, or even $2, over an hour talking with me.  Competitive within the sphere of 1st world interventions is not the same as competitive.

Still, that’s a much higher effectiveness rate than I was anticipating.  And it manages to hit all three of my criteria above (for people who are good at listening but don’t do it professionally), which is a pretty neat trick.  Unfortunately it does not work for Kuhn’s use case at all, since he was looking for things EAers could do as a group on an ad hoc basis.  I suspect this is not a coincidence.

*Testing this directly would be hard, since there’s nothing to stop someone who wants two hours of chatting to say they want five, but will accept two + $60.

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