Robin Rombach, Post-Gazette John Traficante talks to Peer Support and Advocacy Networ operators, who understand his condition. Click photo for larger image. Warm line In Allegheny County, the toll-free warm line operates seven days a week from 2 p.m. to 10 p.m. To contact the warm line, call 1-866-661-WARM (9276).

Ever since his recent release from a hospital, John Traficante has made daily calls to a free telephone service that provides him with direction and emotional support.

Mr. Traficante, who was hospitalized for depression, discusses his problems or just talks about how his day is going with operators from the Peer Support and Advocacy Network.

Sometimes, the operators refer him to other people who can help. But often, they simply listen, said Mr. Traficante, 42, of Bridgeville.

The telephone service targets adults in Allegheny County who have mental illnesses. Known as a warm line, it caters to different needs than a crisis hot line.

Many people call just because they are lonely, said Shirlee Hopper-Scherch, the advocacy network's executive director.

While the program also provides information and referral services, the majority of people "call just to have someone listen to them," said Thomas Devereaux, the group's program manager who, like Ms. Hopper-Scherch, is a licensed social worker.

Warm lines are used in many communities. They were developed years ago "to support people before they reach the point of crisis," said James Radack, a senior vice president for the National Mental Health Association. Many, like the Allegheny County warm line, are staffed by people who also have mental health problems.

Mental illness "causes a lot of people to feel isolated," Mr. Radack said. "By having access to a warm line, they're able to reach out to someone who has walked in their shoes before and been able to come out well on the other side."

While his brother Michael and other family members have been supportive, Mr. Traficante, who once had a successful career in the pharmaceutical industry, said people unfamiliar with mental illness often have trouble understanding why he or others don't simply shake off their problems.

"It doesn't occur to them why a normal person who was so vibrant and had so much going for them is suddenly stuck."

Warm line operators understand, he said, that the depression can be so great that he sometimes can barely get out of bed, and that the medications he takes do not always work well.

The Peer Support and Advocacy Network, which provides a variety of programs and services for people with mental illness, operates the warm line in partnership with the county's Office of Behavioral Health. The Community Care Behavioral Health Organization funded the warm line with a three-year, $600,000 grant.

The service began in November and received 217 calls in May, a 52 percent increase over the previous month.

Overall, the median age of callers is 54 and a majority are women. Most callers find out about the service from therapists, though some, including Mr. Traficante, learned about it through promotional materials.

While calls typically come from neighborhoods in and around Pittsburgh, officials also are testing the program at a unit at Mayview State Hospital in Bridgeville.

The service may expand to other units at the hospital, said James Nelson, the advocacy network's director of operations.

In general, callers are asked to limit their calls to about 20 minutes and to call no more than once a day.

Those in crisis can be immediately linked to a hotline operated by Allegheny Crisis Emergency Services. Others can talk through their problems with warm line operators or be referred to other staffers who can provide additional help.

Among other issues, Mr. Traficante, who receives federal disability payments, has called about being unable to keep his cat, Baby, at his apartment and about his challenges with the new Medicare prescription drug program.

He quickly went through the initial drug coverage available through his Medicare Advantage plan and now is in a coverage gap known as the doughnut hole. Just one of his medications, he said, is $177 for a five-day supply, so he is working to find samples from his doctor and the drug's manufacturer.

The warm line's operators use pseudonyms with their callers. One of them, a 54-year-old with bipolar disorder known as Elizabeth, said that some callers recount their personal histories, including relationships they have lost to death or divorce.

If callers are depressed, she often tries to get them to write down positive developments in their lives. If they need to make a decision, she suggests listing pros and cons.

"But a lot of what I do is praise and encourage people because they had the strength and courage to call," she said.

When callers phone back repeatedly with the same problems, another operator known as Rose said she will ask them what they can do to improve their circumstances.

"I let them talk," she said, "but I also try to do some redirecting to help the caller understand there are options."

Some callers become angry "because they feel they have more problems than we can handle," said Rose, 53, who supervises seven part-time operators and has struggled herself with anxiety and depression. Still others don't want to be referred to other services, afraid that they will be involuntarily committed to the hospital.

"But for the most part, I think we're able to help people," she said. "And that's what we're all about."

In developing the program in Allegheny County, officials looked toward other warm lines, including some operating locally.

Lynne Loresch, executive director of the Mental Health Association of Washington County, said the agency's program, which began about 10 years ago, currently serves Washington, Greene and Fayette counties.

Butler County has operated a warm line for several years, said Pamela Grabe, executive director of the county's Mental Health Association.

Besides taking calls, the program, operated by the Grapevine drop-in center, also will make "reassurance calls," contacting regular callers who haven't been in touch, Ms. Grabe said.

Many calls come from people who are lonely or depressed, feelings that may be exacerbated for people who are returning to the community after a hospital stay, she said.

Though he doesn't want to be back in the hospital, Mr. Traficante said returning to his apartment has seemed overwhelming at times, a concern he has shared with the warm line.

A friend helped him shop for groceries and otherwise get settled, and Mr. Traficante called about that, too, just to share his gratitude for having someone who would lend a hand.

He plans to tell others about the warm line and to continue to touch base regularly.

"When I hang up," he said, "I feel connected."