Friendship Line

"Give sorrow words; the grief that does not speak whispers the o'er-fraught heart and bids it break."
- William Shakespeare

While there are other organizations that respond to the needs of people who may be contemplating suicide, none provides the type of services that IOA’s Friendship Line offers to respond to the public health problem of suicide among the elderly. Knowing that older people do not contact traditional suicide prevention centers on a regular basis even if they are considering suicide, we created the only program nationwide that reaches out to lonely, depressed, isolated, frail and/or suicidal older adults, encouraging conversations rather than confrontation with depressed older people.

Traditional suicide prevention Hot Lines state that they serve the needs of all community members across the life-span. However, we are the only one that specializes in the needs of those individual 60 years of age and older. Not only do we receive calls to our 24-hour Friendship Line, the only accredited crisis line in the country for seniors and adults with disabilities, but we also make on-going outreach calls to lonely older adults.

National - 800.971.0016

Local - 415.752.3778

I feel lonely. Can I talk to you?

The toll-free, 24-hour Friendship Line (FL) – the only one of its kind in the United States – is both a crisis intervention hotline and a warmline for non-urgent calls.  Founded by Dr. Patrick Arbore, Director of IOA’s Center for Elderly Suicide Prevention, and accredited by the American Association of Suicidology, FL provides round-the-clock crisis support services, including active suicide intervention, elder abuse counseling, grief support, assistance, reassurance, and information and referrals for thousands of isolated older adults and adults with disabilities throughout the United States.

In addition to receiving incoming calls, FL also offers outreach, connecting with clients on a regular basis and helping to monitor their physical and mental health concerns. The call-out services act as an intervention to prevent suicide in the long term by improving the quality of life and connectedness of isolated older adults.   


Adults aged 65 to 84 are nearly twice as likely to commit suicide as 15- to 24-year-olds.  Beyond age 85, the risk is 70% higher.   Yet traditional suicide prevention centers do not provide age-appropriate services for seniors, creating a high level of need for appropriate mental health and suicide prevention services targeted for older adults.

As adults age, factors such as isolation and diminished physical ability can have a significant negative impact on overall health and well-being. With age, there is a natural tendency for social networks and support systems to diminish. Today, with extended families less likely to remain living in close physical proximity, older adults are increasingly at risk for isolation and loneliness.  According to the U.S. Census Bureau, 11 million, or 28%, of American citizens 65 and over lived alone in 2010.  AARP has found that slightly more than one in three adults over 45 report being chronically lonely.  

Worldwide, the proportion of people age 60 and over is growing faster than any other age group.  In California, seniors (60+ years old) make up almost 18% of the state’s population.  According to the California Department of Aging, that number is expected to grow more than twice as fast as the state’s total population. The oldest age group (85+ years old) will increase at an even faster rate. The primary demographic challenge in the 21st century will be to find ways to satisfy the demands of a rapidly aging population while assuring a high quality of life for all.


In the early 1970’s, the San Francisco Commission on the Aging (now the San Francisco Department of Aging and Adult Services) invited Dr. Patrick Arbore to find an innovative way to target lonely, depressed, frail, isolated and/or suicidal older adults. He agreed with Jo Ruffin, San Francisco’s Director of Geriatric Services, that older people were not comfortable calling traditional suicide prevention centers and that generic volunteers were not prepared to “connect” with older callers. This inspired Dr. Arbore to found Friendship Line in 1973, and to form the Center for Elderly Suicide Prevention & Grief Related Services (CESP) to address this public health problem and recruit volunteers of all ages who specifically choose to work/counsel older people. Dr. Arbore’s work in the field of mental health, depression, and suicide in older adults has been honored with the American Society on Aging’s 2013 Mental Health and Aging Award as well as the 2014 Jefferson Award for his contributions to the field of Aging and Older Adults.