As these and other research findings have come out, they’ve been used to standardize and improve the training and practices of Lifeline counselors. Mishara’s research, for example, suggested that simply listening is not enough to help distressed callers, so training guidelines were revised to teach more collaborative problem solving. “It takes a certain kind of person to not be judgmental and to be in a moment with someone who is talking about life and death,” says Shari Sinwelski, the associate director of the Lifeline and a former director of three crisis call centers. “But if they have that natural ability to listen and put themselves in that person’s shoes, then the communication skills can be taught.” Volunteers typically undergo 80 to 100 hours of training before they start answering calls.

According to Mishara, research dating back to the 1960s suggests that people without advanced degrees in psychology, social work, or related fields are better than professionals at helping suicidal callers. “The skills that people learn to be a therapist are different from the skills you need to help someone in a suicidal crisis over the phone,” he says. “Psychotherapy involves an established relationship in which you see the person for many weeks or months, and the focus is often on diagnosis and long-term treatment.” Quickly finding common ground with a stranger in distress seems to be a different skill entirely.

That’s not to discount the importance of long-term care. Gould’s research suggests that despite some lasting benefits for suicidal callers, nearly half later experience a recurrence of suicidal thoughts. As a result, the majority of Lifeline call centers now make follow-up calls to people deemed to be at risk. But even that’s not always enough. Ideally, Gould says, the Lifeline would act like air-traffic control for people in crisis, not only averting the immediate danger, but also connecting them to resources in their area that could put them on a more permanent path to safety.

Before the newly recommended phone number can become a reality, the FCC needs to complete its formal review, a months-long process that will include soliciting and reviewing public comments if the plan keeps moving forward. If the number does go into effect, Lifeline administrators predict that calls could double to 5 million in the first year and keep growing to 12 million to 16 million by the fifth. Meeting that need will require more funding and staff for the local call centers, many of which are already struggling to meet the demand for their services, says John Draper, the Lifeline’s director.

The Lifeline currently receives $6 million a year from SAMHSA in the form of a grant to Vibrant Emotional Health, the New York City nonprofit that administers the Lifeline (and employs Draper and Sinwelski). This money covers administrative and operational costs for networking the individual call centers around the country so that each call gets routed to the nearest available one. (Veterans who dial the Lifeline can opt to be routed to a dedicated line run by the Department of Veterans Affairs.) The SAMHSA grant does not cover the operations of the local call centers themselves, which mostly rely on funding from state and local governments. Some receive additional money from foundations or from contracts to answer calls for insurance companies or health-care systems.