Sprawled in an armchair at the Grassroots counseling center in Columbia, Amy, a slender 28-year-old volunteer counselor in jeans, sits for hours with a phone cradled under her ear.
The voices at the other end of the line often crack in pain, spilling out a bottled-up stream of anger, loneliness and despair. They are the voices of those teetering on the brink of suicide, heard every day by Amy and others staffing Maryland's youth crisis hot line.
"We try to be a listener and not an overbearing parent," said Amy, who asked that her last name not be used to protect her against the threat of harassment. "A lot of the times the people call up crying. Some are yelling. Some have attitudes. But what they really want is someone to listen." Last August, Maryland became the first state in the nation to introduce a toll-free, 24-hour hot line that automatically relays calls to one of six counseling centers.
The phone line, made possible through a decentralized 800-number system, gives teen-agers in crisis a chance to talk to somebody -- even if they live in a county without a hot line.
In the first year, 5,765 people dialed the center. Though there were fewer calls than projected by AT&T, counselors across the state lauded the hot line as a major step toward helping stem the state's youth suicide rate, which rose rapidly in the late 1980s.
The most recent state health department report, for 1988, found that 104 youths from 15 to 24 committed suicide.
Use of the hot line has "exceeded my expectations," said Jeffrey Maszal, director of the Grassroots crisis counseling center, which handles the Baltimore metropolitan region and about 50 percent of all the calls.
"With teens and young adults, they tend to be a little impulsive," he said. "They want to dump it all out and talk. You have to catch them before they do something drastic."
About half the callers so far have been the target age group, between the ages of 12 and 17, said Henry L. Westray Jr., the state's suicide prevention coordinator. The majority were girls, who typically called after school or at night. Most wanted to talk about problems at home or with their relationships.
More than 660 called to talk about suicide. Some picked up the phone after swallowing sleeping pills or trying to slit their wrists. Many others called to prevent their friends from attempting suicide.
In a recent call to the Prince George's hot line, which serves that county and four others, a 14-year-old talked shakily about ending her life, the hot line's director said.
She was staying with an older sister in Charles County when she tested positive on a home pregnancy kit. Worried that her 17-year-old boyfriend would get in trouble and convinced that her family would punish her, she thought suicide was the only way out.
A hot line counselor, the director said, helped the girl find some solutions, including arranging for a pregnancy test and setting up a family conference with her sister.
Although suicide often was mentioned by the callers, many were seeking help for drug problems, eating disorders and family violence, Mr. Westray said.
"Suicide always was up there, but we even had calls from people who were homicidal," he said.
Many of the calls were from youths scared by physical or sexual abuse. Reports of child abuse have soared in the last decade, rising from 5,330 in 1980 to 13,507 last year, according to the state Department of Human Resources.
Richard Reap, program coordinator for the Prince George's hot line, said he believes the state line has been especially successful in serving youths who had no access to 24-hour crisis counseling. Many of Maryland's more rural counties used to rely on state police to handle crisis calls at night.
"I really felt that we needed a resource for kids in any kind of trouble, any place in Maryland, to call and get help," he said. "It's hard to do a concrete measurement, to gauge how well you succeed. But by having this available, we can help."
Maryland Youth Crisis Hotline number: (800) 422-0009