Connections on the Line: Interactions Between Care, Expertise, and Anonymity in a Suicide Hotline in Hong Kong

Suicide hotlines as a form of teletherapy have been associated since conception with questions of non-consensual reporting and intervention. This article investigates how suicide hotline volunteers in Hong Kong engaged with expertise and anonymity to perform care. The analysis consists mostly of semi-structured interviews with volunteers at a multilingual suicide hotline in Hong Kong. Firstly, we deconstruct expertise in hotline care-volunteers separated enacting expert knowledge from authority to simultaneously respond to cultural nuances in caller expectations toward authority and perform non-interventive care. Secondly, we show how anonymity within hotlines creates obscurations between callers and volunteers that raises the stakes to volunteers' decision-making in care. When volunteers embraced uncertainty and committed to providing confidentiality and control to callers, anonymity facilitated the prioritization of caller choice, even in death. Finally, we reflect on how acts of volunteers recognizing and forming connections with callers can demonstrate how we can meet each other, bridge divides, and connect as strangers in the city.

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Publication Details

Journal
Culture Medicine and Psychiatry
Published
2025-10-16
DOI
https://doi.org/10.1007/s11013-025-09954-z
Primary Topic
Mental Health and Patient Involvement
Type
article
Field-Weighted Citation Impact
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article

Connections on the Line: Interactions Between Care, Expertise, and Anonymity in a Suicide Hotline in Hong Kong

Zhiying Ma, Nicole Zhong
Culture Medicine and Psychiatry
Mental Health and Patient Involvement
article

Connections on the Line: Interactions Between Care, Expertise, and Anonymity in a Suicide Hotline in Hong Kong

Zhiying Ma, Nicole Zhong
article en

Abstract

Suicide hotlines as a form of teletherapy have been associated since conception with questions of non-consensual reporting and intervention. This article investigates how suicide hotline volunteers in Hong Kong engaged with expertise and anonymity to perform care. The analysis consists mostly of semi-structured interviews with volunteers at a multilingual suicide hotline in Hong Kong. Firstly, we deconstruct expertise in hotline care-volunteers separated enacting expert knowledge from authority to simultaneously respond to cultural nuances in caller expectations toward authority and perform non-interventive care. Secondly, we show how anonymity within hotlines creates obscurations between callers and volunteers that raises the stakes to volunteers' decision-making in care. When volunteers embraced uncertainty and committed to providing confidentiality and control to callers, anonymity facilitated the prioritization of caller choice, even in death. Finally, we reflect on how acts of volunteers recognizing and forming connections with callers can demonstrate how we can meet each other, bridge divides, and connect as strangers in the city.

Culture Medicine and PsychiatryVol. 49(4)
University of Chicago (US), Ellis University (US)
Openalex Percentile: Top 54%
Mental Health and Patient Involvement
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Connections on the Line: Interactions Between Care, Expertise, and Anonymity in a Suicide Hotline in Hong Kong — Zhiying Ma, Nicole Zhong · Culture Medicine and Psychiatry (2025) | TGRS Research Map | TGRS