©2015 Stephen Michael DiDomenico ALL RIGHTS RESERVED HELP SEEKING IN ACTION: MANAGING INTERACTION AND MENTAL HEALTH ON A CRISIS HELP LINE By STEPHEN MICHAEL DIDOMENICO A Dissertation submitted to the Graduate School-New Brunswick Rutgers, The State University of New Jersey in partial fulfillment of the requirements for the degree of Doctor of Philosophy Graduate Program in Communication, Information, and Library Studies written under the direction of Galina Bolden and approved by ________________________ ________________________ ________________________ ________________________ ________________________ New Brunswick, New Jersey October, 2015 ABSTRACT OF THE DISSERTATION Help Seeking in Action: Managing Interaction and Mental Health on a Crisis Help Line By STEPHEN MICHAEL DIDOMENICO Dissertation Director: Dr. Galina Bolden The primary purpose of this study is to better understand the communication processes of telephone help lines dedicated to crisis intervention and suicide prevention. Whereas prior research primarily considers these issues in terms of psychological predispositions and call outcomes, this study shows how many of the core considerations of crisis and suicide prevention are interactionally negotiated and managed. Callers and call takers are shown to utilize a range of interactional practices and actions in order to jointly construct and negotiate institutionally-relevant identities, stages of the call (e.g., opening, problem presentation, questioning), and larger institutional missions. The study uses the methodology of Conversation Analysis to examine audio- recorded naturally-occurring calls made to a mid-size crisis call center, HelpNow (pseudonym), located in the northeastern United States. Several findings emerged from the study. First, in call openings, a set of institutionally-significant ii identity categories (first-time caller, repeat caller, and regular caller) were revealed to be established and managed through particular interactional practices. Second, a range of sequential environments and interactional practices through which callers present their focal problem on the crisis help line were documented. Third, call takers’ uptake of callers’ problem presentations via rising-intoned repetitions were analyzed and shown to fall short of their institutional job to pursue elaboration. Overall, the dissertation contributes to scholarship related to crisis intervention and suicide prevention, communication studies, and language and social interaction. iii Dedication In memory of Tyler Clementi (1991 – 2010) and Segrio de Biasi (1972 – 2011) iv Acknowledgements It would have been impossible to write this dissertation without the help and support of many different people. First and foremost, I would like to thank my outstanding advisor, Galina Bolden, for her tireless help and world-class mentorship throughout my doctoral program. I am so grateful for the countless hours – including more face-to-face and skype meetings in the past three years than I can count - discussing each stage of this project. Thank you to the members of my dissertation committee (Jenny Mandelbaum, Lisa Mikesell, Hartmut Mokros, and Alexa Hepburn) who provided many helpful comments that strengthened the manuscript. Also, thank you to Beth Angel, Madeline Gould, David Lester, and Chris Pudlinski for their extra assistance with aspects of this research. I would also like to thank the leadership of the Department of Communication including James Katz and Hui Min Kuo and (more recently) Laurie Lewis and Brian Householder. Thanks also to the other Communication faculty I have learned from including Mark Aakhus, Marya Doerfel, Jenn Gibbs, Keith Hampton, Vikki Katz, Nikolaos Lindardopoulos, Craig Scott, Jen Theiss, and Matt Weber. Also, thanks to members of the SC&I Dean’s Office & Student Services: Claire McInerny, Karen Novick, Diana Bell, Linda Dondoro, Megan Ludlow, Kevin Ewell, and of course, the amazing Joan Chabrak. Special thanks to Steve Garwood for being such an incredible source of inspiration for all things teaching and always being there to listen. Also, special thanks to Barbara Bender for giving me such v fantastic opportunities with the Teaching Assistant Project and the Rutgers Academy for the Scholarship of Teaching and Learning. Thank you to my fellow faculty colleagues/family in the Department of Communication and Rhetorical Studies at Syracuse University, including Diane Grimes, Brad Vivian, Ann Demo, Erin Rand, Lynn Greenky, Amos Kiewe, and Joanne Balduzzi. Special thanks to Cynthia Gordon and Chuck Morris for giving me the opportunity of a lifetime and being the best departmental leaders and mentors a Visiting Assistant Professor could ask for. Also, thank you to Richard Buttny and Jeffrey Good for taking me under their wing this year and involving me with the stellar LSI working group and lecture series. Also, a huge thank you and bear hug goes out to all of the other wonderful people I have met during my time in Syracuse: Katie Carroll, Carla Cesare, William Volterman, Bryan Semaan, Emily Stokes-Rees, Becky Schewe, Perry Singleton, Will Sudderth, and many, many others I’m probably forgetting. I’m so honored to have gotten to know each of you during this past year. Here’s to many more years of friendship and fabulous cocktails. Thank you to all of my fellow doctoral students in the School of Communication and Information PhD program, especially Maggie Boyraz, Frank Bridges, Danielle Catona, Christine Goldthwaite, Heewon Kim, Weixu Lu, Nik Rashid, and Surahbi Sahay. Special thanks to Katie McCullough, Jonathan Bullinger, and Andrew Salvati for their wonderful company and all the times we reunited as a group for dinner. Also, thank you to Bryce Renninger (as well as the other film vi makers, Lauren Ashley Belfer and Tony Shaff) for inviting me to provide research support for the documentary, Hotline. Thank you as well to those PhD students who, despite being a few years ahead of me in the program, were always willing to share their wisdom about each new PhD life hurtle. This includes Leon Laureij, Alena Vasilyeva, Roi Estlein, Sunny Lee, Emily Knox, Annie Gilbert, and Marianne Martens. Special thanks to Emily Knox and Annie Gilbert for always having time to give me job market advice this year despite being so busy with your own academic careers. Also, an extra special thank you to Leon Laureij for mentoring me in all aspects of life (and, of course, indoctrinating me into the COM 101 regime). I also want to thank my family – including my extended DiDomenico and Ringler families - for their love, support, and lots of patience throughout my 6 year PhD journey. A colossal thank you to the most amazing cat in the world, my little (Princess) Violet DiDomenico. I adopted her during my first week in New Jersey and she has been with me ever sense. Special thanks to my little nephew, Grant, and little niece, Londyn, for being the absolute coolest kiddos on the planet. Special thanks also goes out to Guy Ringler and Mark Rios for being so supportive of my graduate studies and being the most fabulous “guncles” one could ever ask for. Last but not least I would like to thank my parents, Mary and Ralph DiDomenico. Mom, thank you for always being there when I needed you most. Dad, thank you for inspiring me through your teaching. I am so grateful to vii have had an entire childhood worth of opportunities to shadow one of the most dedicated and fearless teachers the world will ever know. I would also like to acknowledge Hope May, my life mentor early on in my undergraduate studies at CMU. You inspired me in so many ways, whether it was first getting hooked on your exquisite writings on the ancient philosophers or witnessing your drive for making a difference on campus and in the world. I am certain I would not be at this point if it weren’t for you seeing my potential at a time when I thought I had little to live for. Knowing what a profound impact you have had on my life will always push me to try to do the same for my own students. Finally, I want to acknowledge the lives of Tyler Clementi and Sergio de Biasi, both of whom lost their lives to suicide. Their deaths have impacted my life in significant ways and this dissertation is dedicated to their memory. viii Table of Contents ! Abstract of the Dissertation!...............................................................................................!ii! Dedication!.................................................................................................................................!iv! Acknowledgements!.................................................................................................................!v! List of Figures!......................................................................................................................!xiv! Chapter 1: Introduction........................................................................................................!1! Preview of chapters!........................................................................................................................!4! Chapter 2: Review of Previous Literature!....................................................................!7! Defining crisis and suicide!..........................................................................................................!8! Conceptualizing crisis!..................................................................................................................................!9! Conceptualizing suicide!...........................................................................................................................!11!