Everytime an emergency telephone rings, the telephone worker may be faced with a life-threatening situation. An important decision facing the worker is whether to handle any given crisis call over the telephone, or to opt for a face-to-face contact. An inaccurate assessment or evaluation of a high-risk situation could contribute to serious consequences. Overreacting to what is actually a low-risk situation could result in the misuse of services and could create a dependency in the client. Emergency telephone staff are expected to make these critical assessments and evaluations without the benefit of physically viewing the patient or having control over his/her physical environment. Staff must rely totally on what they hear on the phone to evaluate, calm, motivate, plan and move the patient through the crisis toward stability. This decision-making process is examined and alternative strategies are considered in which factors such as risk assessment, resources, client responsiveness and articulateness, availability of staff, new vs. previous contact, and source of the request for contact are taken into account. (Author/JLL)