The life-changing question of the moment, to Jessica Pirro, becomes one of definition.
She is chief executive officer of Crisis Services of Buffalo, whose mission is built around 24-hour crisis intervention for people going through the hardest moments of their lives.
Pirro understands the way many Western New Yorkers interpret the purpose of the agency, which serves Erie County, manages the Chautauqua County hotline and provides after-hours support in Niagara County.
She knows Crisis Services is often seen as a last stop, a place to which you turn only when trapped in the most anguished corner, a call you make only if you feel every option for hope has been extinguished.
The 24-hour hotline is 834-3131. Certainly, emphatically, Pirro wants anyone staggered by such desperation to call that number.
Yet she is also reaching toward a much larger group.
She wants everyday Western New Yorkers, amid an unprecedented level of shared trauma, to allow themselves the chance for seeking help when they struggle.
“We know crisis is different for each person,” she said, “but also the steps leading to a crisis vary.”
In other words: If you are feeling overwhelmed or isolated, if you are frightened or depressed and believe there is no one who hears you?
“I would hope someone would use our services whenever they need any kind of support,” said Haylee Clark, a crisis counselor specialist who puts it in fundamental terms.
Despite what many might believe, you do not have to be at the point of contemplating suicide to reach out.
Around the world, specialists are warning about the grinding toll on mental health, as a result of Covid-19. Pirro said calls to Crisis Services climbed by 20% over the past two months, since the threat of the pandemic changed life as we know it. Going back to March 4, at least 1,500 individuals have called with what Pirro calls “Covid-related needs.”
She and Clark decline to speak even in general of any specific caller. They are fiercely protective of the confidentiality of those who use their service, and they do not want to say anything that might in any way discourage a call.
What they acknowledge is civic alarm and anxiety so palpable that “a lot of people are having stress about a lack of security,” as Clark puts it.
Residents of greater Buffalo, hit harder by Covid-19 than any region in the state except metropolitan New York City, wake up each day to relentless worries. Small business owners who invested all they have in what they do wonder if their restaurants, shops or offices – often shuttered now for months – will survive.
A legion of workers, laid off or furloughed, fear their jobs might never return – and many struggle in the meantime to obtain unemployment benefits from a state system so overwhelmed it can be maddeningly hard to reach a living voice. Those trying to manage heavy debts, people now without a paycheck, see no long-term way they will possibly keep up.
Parents, some bearing every responsibility alone, find themselves confined to houses and apartments with restless young children going through their own frustrations. Older women and men, many widowed or by themselves, are unable to even visit with neighbors – or grown daughters and sons – who fear bringing the virus to people they love.
Clark said she has heard from callers in recovery from alcoholism or drug addiction, people accustomed to regular face-to-face support within 12-step organizations, left uncertain without the traditional, everyone-in-the-same-room comfort of those groups.
It is also an especially difficult period, she said, for people already courageously and quietly taking care of their mental illness through long-maintained schedules of treatment and therapy.
Even the idea of collective comfort or mourning – the once-certain opportunity to maintain a vigil at the hospital bedside of someone gravely ill, or to grieve in community at a wake or funeral – has been taken away by the pandemic.
Pirro speaks with concern about victims of domestic violence, aware that "the lack of outlets like work, like visiting family, puts them at even higher risk for abuse." She wants them to know they can turn to Crisis Services for help.
Intertwined with all of it is the presence of a contagious virus that has claimed hundreds of lives in Western New York and made thousands of others sick – and uncertainty about what happens as the region gradually reopens and people once again venture out to live their lives.
The issue, then, is not identifying who is most vulnerable to being hurt.
The issue is understanding no one is exempt, and that acknowledging those pressures is a sign of healthy awareness, not weakness.
“The whole world is in a crisis right now,” Clark said, “and the whole world has been affected.”
Her reminder: The number is 834-3131.
If you are feeling buried by any of these pressures, please call.
“This is all really trauma, if you think about it,” said Pirro, whose crisis counselors often serve as a bridge in linking callers to services that help with particular needs.
The pandemic falls upon a nation that statistically was already struggling with a quiet layer of desperation. Almost 50,000 Americans died by suicide in 2018, according to the federal Centers for Disease Control, part of a 35% increase over the past 20 years. The opioid epidemic is a stark reminder of a similar desolation.
Now, Covid-19 is turning daily routines and discipline inside-out, creating and amplifying a sense of general unease from which even the 80-member Crisis Services staff is hardly immune, Pirro said.
“How we operate as an organization is very team-oriented, and this is a huge shift for us,” she said. Typically, members of the hotline staff sit side-by-side as they speak to those in need, “and there is an energy and support when you can turn and debrief.”
Faced with the pandemic, many of those employees are now "spread out to individual offices in the facility," Pirro said. The mobile outreach staff – the workers who rush to the homes of people in immediate crisis – have the additional worry of protecting themselves from the virus, which she described as another layer of concern at moments of urgency.
As for Clark, she said the pull toward the profession began for her in high school, as she grew old enough to realize how struggles with mental health were affecting some people she loved. After studying psychology in college, she eventually joined Crisis Services, work she describes as both fulfilling and demanding.
She understands, in terms of sweeping and universal impact, that we are at a moment unlike anything the nation has experienced in such a collective way since the Great Depression and World War II.
Her mission with every phone call is always specific to the instant. Some callers simply need reassurance, a warm presence to listen or remind them to take care of themselves. In these cases, she will often speak of coping skills as routine as taking a shower or going for regular walks – rhythms to help reestablish some peace of mind.
With other callers, with men and women in situations of high risk, Clark will stay on the phone until she knows they are safe, “until we are sure you’ll be able to make it through the day.”
While Pirro said suicide numbers in Erie County have not "spiked" in the pandemic, the ongoing and uncertain nature of the struggle leads her to join Clark in making the same point. Their agency, by fundamental definition, was created for anyone going through a crisis, which includes a lot of people who never felt so trapped before.
The number is 834-3131.
If you even suspect you ought to call, Pirro said, you already have your answer.
Sean Kirst is a columnist with The Buffalo News. Email him at firstname.lastname@example.org or read more of his work in this archive.