Approaching institutional boundaries: Comparative conversation analysis of practices for assisting suicidal callers in emergency and suicide helpline calls

Abstract

Emergency numbers and suicide helplines are two institutional settings with different support for persons in crisis. Emergency calls have a single focus of getting pertinent information to send police, fire, or ambulance. Suicide helplines offer callers a chance to talk through their problems by providing emotional support. However, on occasion, call-takers in emergency lines might need to provide emotional support to get the caller to give their location, and call-takers in suicide helplines will sense that callers need emergency service. Using conversation analysis to compare cases of U.S. 9-1-1 emergency calls and Swedish suicide helpline calls, we identify practices for assisting callers whose interactional home is in the other arena. Our analysis presents cases of missed opportunities, when call-takers respond to callers’ boundary pushing by sticking to institutional routines. Then we show practices by which participants build new institutional contexts in each helpline while still pursuing institutional goals, such as when emergency call-takers display other-attentiveness and suicide helpline call-takers elicit callers’ location. By explicating routine and boundary pushing practices in these different settings’ crisis management moments, we contribute methodologically to the study of institutional talk, in particular, how a comparative analysis reveals aspects of institutional boundaries in suicide preventive work.