GREAT FALLS — "Crisis line. How may I help you?" asks Jackie Fitzgerald when she answers the phone for Voices of Hope, a suicide hotline.
On a recent day, she received two calls in a matter of minutes.
Both were fairly routine, but for some callers, her warm, compassionate voice might be the first ray of hope they have heard in a long, long time.
Fitzgerald started working for Voices of Hope as a volunteer on the hotline's database 14 years ago and is now the executive director.
It is incredibly rewarding, Fitzgerald said, remembering the times when she got off the phone knowing that she saved a life.
"If it only happens once, it's something that can never be taken away," she said. "And it happens on a daily basis. We do sometimes get calls thanking us. I wish it happened more often because it brings the morale of my staff up."
Over the last 30 years, Montana has ranked in the top four states for the highest rate of suicides. Among Montana teenagers, suicide is a leading cause of mortality, second only to vehicle crashes, according to a media release from United Way Cascade County, which helps fund the hotline with a $24,000 grant.
Every hour of every day, people in crisis have someone they can call for help thanks to Voices of Hope. The Cascade County nonprofit provides a 24-hour crisis line to anyone who calls 1-800-274-TALK or 453-HELP (453-4357).
Voices of Hope has four full-time and four part-time employees and a team of volunteers, who all go under rigorous training to handle very stressful jobs. About 1,000 calls come in each month, but the load varies.
Poor weather and the holiday seasons can see a sharp increase.
"Holidays are busy, but it's often the days after the holidays," Fitzgerald said. "Because even though we don't like crazy Aunt Martha, we're still going to invite her to Christmas, but then she goes home. And she's alone again."
And holidays don't always show up on calendars and have greeting cards. They can be the date of a divorce or the anniversary of a spouse's death.
"I know on certain dates, I'll hear from certain people," she said.
Beyond recruiting and training volunteers and answering phones, Voices of Hope does community outreach to both prevent suicide and help the victims of sexual violence. The nonprofit provides educational services to staff members and students at Great Falls Public Schools, to service members and civilian family members at Malmstrom Air Force Base.
Fitzgerald said a big part of her job is to cut down on the stigma associated with mental illness and depression.
"It used to be the word sex," she said of a topic that once was taboo. "In my day and age, my father probably had a heart attack, the first time I said it. Now? It's not a big deal. Has it stopped teenage pregnancies? No, but it has reduced them."
She believes that taking away the stigma of talking about it will help cut into the number of suicides. She has hopes to get Montana out of the top 10 and then top 20, but she knows it will take time.
The state's long winters, relative lack of wealth and the fact that it's so rural, all make it hard to move the needle.
Fitzgerald also mentioned Montanans willingness to self-medicate with alcohol or drugs, and then guns.
"And I'm not in any shape or form trying to take our guns away," she said. "I'm a hunter. I have ranch animals."
But she said that when she talks to students, she challenges them and asks how many could get a gun and bring it back within an hour.
"Ninety-eight percent say they can," she said. "Should they have the access? If they are trained, yes."
But it gives Fitzgerald pause since guns are, Fitzgerald points out, the most lethal form of suicide.
Women attempt suicide at a much higher rate than men (in fact, they make up the majority of callers), but men are more successful because men use guns.
Voices of Hope also is part of this collaborative effort that works specifically with Native American youth throughout Montana to help prevent suicide.
The crisis response team coordinates services to help develop a plan to manage and treat people with mental illness in crisis. Voices of Hope also can connect sexual assault victims with a survivor advocate 24 hours a day, 365 days a year.
"The services that Voices of Hope provides our community are critical to advance two of United Way's health goals," United Way President Gary Owen said. "The Crisis Line service helps vulnerable people make it through times of personal crises in their lives. People have shared stories of times when they or a family member were contemplating suicide who called the Crisis Line and were able to reach a stable point and get further assistance for their lives."
Fitzgerald remembers one high school girl who called the line five or six years ago.
The memory still brings chills up and down her spine.
The young lady said she was going to keep the conversation short since she knew it was being traced. In that conversation, she laid out a detailed plan to kill herself and told Fitzgerald, "'If I hear sirens, I'm just going to do it.' That young lady called me more choice names."
Fitzgerald only reports calls to authorities if she feels the caller is in imminent danger, such as in this case. They came without sirens and when the police broke into the area of the girl's home, "She was mad at me, mad at the line for breaking her confidence. She called me names I didn't know the meaning of. But I knew I had saved her life."
The girl was institutionalized.
Fitzgerald said she got a letter from the young lady a short time later, and she was still mad.
"I had a hard time with that," she said. "But I could understand why she was mad: I broke her trust."
Months later, the girl wrote again and thanked Voices for saving her life. She was on medication and getting counseling and had plans to attend college.
Not every call ends so well.
It can be stressful, Fitzgerald said, but her staff band together to support one another.
There is no script or one-size-fits-all manual. Instead, everyone answering calls handles them to the best of their abilities.
"The one thing we can do wrong is do nothing," she said.