“Sounds like a really scary time for you”: Affective inferences as transition devices in helpline calls about suicide.

In the UK, mental health helpline services provide support and guidance to callers with a range of health concerns, including those who express suicidal ideation. Despite receiving training to manage these challenging environments, call-takers face the recurring interactional dilemma of navigating the transition from empathic listening to the implementation of new institutional tasks (e.g., risk assessments, signposting to other services). Using conversation analysis allied with discursive psychology, we investigated recordings of telephone calls to a British mental health charity helpline, focusing on how interactants oriented to and managed moments in calls where suicide talk became manifest. We found that call-takers regularly produced affective inferences (Ekberg et al., 2016; cf. Hepburn & Potter, 2007) that attended to callers’ emotional states, in turn prefacing the initiation of new action sequences. By explicitly orienting to callers’ affective status, call-takers’ affiliative displays hearably act as conversational pivots, preparing the ground for new, sometimes disaligning institutional activities (callers can resist call-takers’ moves to different action sequences). The ways in which this transition device facilitates a shift between activities in a uniquely urgent, high-stakes institutional setting offers new insights into how mental health formulations feature in the institutional management of empathy, affiliation, and immediate, possibly risk-oriented, tasks (cf. Jefferson & Lee, 1981). Findings from this study can be developed into evidence-based training resources.