The Globe and Mail
We fume while trapped on hold, taunted by a cheery jingle. Or hang up in frustration when the same dreary song starts again for the 16th time.
But what if we aren’t calling about a cellphone upgrade or airline ticket refund? What if that music might save someone on the worst day of their life? What tune will keep a person contemplating suicide waiting on hold for help?
This is the question that Toronto’s Centre for Addiction and Mental Health needed to answer, with only months to go before the country’s new 988 suicide crisis helpline was scheduled to begin taking calls.
Now, more than a year later, trained responders at the national helpline have answered more than 315,000 calls and texts. In October, 22,654 voice calls came in, with an average hold time of 44 seconds. (For text chats, the wait for a reply was about a minute longer.)
Considering the long hours that people often wait on hold, that’s an impressive record. But a 2012 survey by Velaro, a customer engagement company, suggested that 60 per cent of people would wait only one minute before hanging up, and 30 per cent may refuse to wait at all – a worrisome finding for a suicide prevention helpline.
So, ensuring even a few dozen seconds pass as smoothly as possible became an important consideration for the CAMH team back in late summer 2023 – and choosing the right hold music would be key.
“We want to create an environment that supports people, and doesn’t cause additional distress,” said Allison Crawford, the helpline’s chief medical officer. “If they feel hopeful with the music choice, that would be even better.”
But when the clinical team searched for science to guide their decision, they didn’t find many studies about hold music and helplines. They knew that sound was better than silence, said Dr. Crawford, because otherwise “people stop feeling a connection, and they start to feel uncertainty.” A customer service study suggested a slower tempo makes the wait seem shorter. And a too-short selection that needed to loop over and over again would make the wait feel longer.
Lyrics were deemed too open to unintended interpretation. They wanted to avoid music that fit too narrowly into one genre – a country tune might alienate rock fans, and vice versa. Given the range of people calling, the time spent on hold needed to be universally welcoming.
With those guidelines, Helen Davies, the communications and marketing manager for the helpline, scrolled though the massive music subscription database the centre uses for multimedia and promotional projects. She looked for samples that were neither upbeat nor sad, but neutral enough that they didn’t churn up strong emotions. They couldn’t be so busy the music overwhelmed the caller, but not too boring either. Also, Ms. Davies said, “It had to be the least annoying to the largest number of people.”
Listen to the hold music here:
She came up with 10 options to present to the community advisers – a committee of people who have lived experience with mental health and suicide. This group provided input on the helpline, including the website, the voice message when people called in, and the manuals that would train responders.
In the room that day was Kristen Bellows, an adult educator in Oshawa. In 2016, when she was pregnant and struggling with high emotions related to a mental health diagnosis, Ms. Bellows called a helpline and waited on hold for about 30 minutes, before hanging up; the next day, when she tried the helpline’s chat feature, the same thing happened. Luckily, she calmed herself down. But when CAMH asked for volunteers to consult on the national line, she figured her input might spare someone else the experience.
Ms. Bellows listened to the samples. “It got me thinking about all the hold music that we hear,” she said. “It can really impact how you’re going to go into the conversation with the person who picks up the phone.” So she asked herself: “Would I be okay, possibly listening to this for 15 minutes?”
One option reminded her of something from the soundtrack of Netflix’s Bridgerton series, which turns pop songs into swoony classical numbers. She rejected a second because it made her feel like she was on an epic fantasy quest. She eliminated more upbeat samples that might make a caller feel judged. “When you’re in such a deep dark place, you’re not thinking clearly,” she said. “To hear something so far from how you’re feeling can make you feel worse.”
In the end, she went with her gut, and came to the meeting with her definite nos, her maybes and the ones she liked best. The group of community advisers, she discovered, was generally in agreement. They came up with three preferred choices – and the top one was selected, after one option was ruled out because it didn’t sound great on the phone.
The final choice – one of Ms. Bellows’s top picks – is a gentle, four-minute-long piece of piano music. “We all found it calming,” she said. “It’s something that I would imagine myself playing while doing some deep breathing.”
The helpline team at CAMH has already started an evaluation process that will look at every aspect of the service by consulting with those who used it in the first year. And if people don’t like the piano melody, Dr. Crawford said, “We will test new music.”