Saving lives, one call at a time: Behind the scenes in suicide helplines

From listening to callers for hours to going beyond the call of duty to help them, those working in suicide prevention do it all and more.
Saving lives, one call at a time: Behind the scenes in suicide helplines
Saving lives, one call at a time: Behind the scenes in suicide helplines
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Two months ago, Patrick Vaz was on his regular shift, volunteering at Bengaluru-based Sahai Helpline for Suicide Prevention and Emotional Distress. He received a call and the voice on the other end was completely hysterical. “The way she was crying, I thought someone had beaten her up,” Patrick recounts.

The woman, an MNC employee, was standing next to a window from which she planned to jump. “She was shouting, cursing and crying. Her best friend was not speaking to her and had poisoned her other friends against her too she said,” Patrick recalled. “I don’t know what made her call, but I’m glad she did.”

Fifteen minutes later, Patrick noticed that she was able to talk more coherently. “That’s when I started asking her questions related to her problem. And after some time, I was able to convince her that even if she loves a person, it is not necessary for her feelings to be reciprocated. And she could walk away if she was unhappy,” the 55-year-old narrates. “She called again in the two weeks after that. After that she stopped. I assume that she felt better.”

This is just one of the many cases that Patrick, who has been volunteering for nine years, seven of them at Sahai, has dealt with on his weekly shifts there. Sahai was set up in 2002 by NIMHANS, Rotary East and Medico Pastoral Association (MPA).

And like Patrick, the people who work in suicide prevention must often leave all judgment and advice behind, only to listen and do their best to help people in emotional distress. TNM spoke to various people who work in suicide prevention to gain insight into their work, and why they do it.

What it means to work in suicide prevention

Rajesh Pillai (46), an advocate, has been volunteering for 18 years. He presently volunteers at Maithri, a helpline set up for suicide prevention in Kochi by Befrienders India.

“Helplines like these don’t just receive calls from people who are suicidal or have mental health issues. Anyone can call us, and we listen. We cannot and do not judge them, cannot chide them even if their concern appears inconsequential,” he tells TNM.

Maithri volunteers with Prof Sylvia Lappeire from Canada, who was visiting to study the volunteer model for suicide prevention

“Maithri receives 6-7 calls per day. On an average, a volunteer spends a minimum of 45 minutes on one call,” he says. That may seem like an excessive amount to speak to one person but it’s necessary to establish a rapport and trust with the caller, he adds.

Though their shift is four-hours-long, often a call may go beyond the volunteer’s check out time. And if it’s a critical case, the volunteers generally continue speaking to the person. For instance, Patrick once spoke to a 22-year-old who was facing violence at home and wanted to self-harm. “That call went on till 12.30 am in the night,” he shares.

Who needs help

Those working in suicide prevention say that most of the callers tend to be youngsters (as young as 12), and many are women. There are also a few calls from trans persons, those facing or fearing stigma due to their sexual health, preferences and/or their sexuality. 

Both Rajesh and Patrick observe that the most common issues are relationship-related – romantic, familial or even friendships. The second most common issues are education-related, which, Rajesh says, increases in the first half of the year with a number of people awaiting results.

With teen mental health being an issue of growing concern, it’s essential to validate their feelings no matter how trivial they seem, says Sharan Pradeep Naik, who has helped 13 teens in Hubbali, Karnataka, seek the mental health care they required. “There are several who consider extreme steps because of restrictions parents impose on phone usage, talking to the opposite sex and so on,” he notes.

Sharan Naik conducting a workshop

Having gone through depression and suicidal thoughts when he was 19, the Hubbali-based 24-year-old decided to do something to help others. So, under the guidance and mentorship of Dr Shivanand Hiremath of KIMS hospital, Sharan started a project with the Deshpande Foundation. He began conducting workshops at schools about mental health and suicide prevention.

“A lot of students approached me after these workshops and talked about their problems,” Sharan says. “There was one boy who had decided to kill himself after his exams because he could not see his mother, a single parent, being beaten and mistreated by their relatives. His decision was a cry for help. I was able to dissuade him and put him in touch with a professional,” he narrates.

Limitations of suicide prevention helplines

While helplines and speaking to volunteers like Sharan does help a lot of people, there are limitations to this. Though not all those who consider self-harm and suicide may be depressed or mentally ill, there are those who the volunteers ascertain need help from a mental health professional. But when the suggestion is made, it is not always taken well or carried through.

Dr U Vivek, a consulting psychiatrist at Renai Medicity in Kochi, also consults with Maithri and another helpline, Chaitram. He says that people sometimes exploit the fact that helplines are free. “If you were to go to a counsellor or psychologist for those two hours, you would have to pay for their services, right? Also, most people just think talking is enough. But in some cases, it really isn’t. Medication and therapy are required. But the stigma dissuades people from going forward,” he says.

This is something Rajesh and Sharan have observed too. “Our job as volunteers at the helpline is to listen and help the callers vent. Only towards the end, in cases where we feel it’s required, we suggest people to seek professional help. But that does not go down well with everyone,” Rajesh says.

With teens, it is a matter of convincing parents as well. Sharan has not spoken to as many parents, but he knows the bias against going to a professional therapist is very real. “My own cousin’s mother began doubting me when I told her that her daughter needs help. So even if you convince the students, their parents may not agree,” he says.

The need for more volunteers

Dr Vivek observes that most people who volunteer in helplines are retired people, who have spare time, or those who are 40 and above. Rajesh and Patrick corroborate the same. They agree that there need to be more young people in the field.

The most important thing for a volunteer is to be emotionally and psychologically stable. “If a volunteer is not emotionally and psychologically strong themselves, they cannot handle the callers or those who need help,” Dr Vivek says.

Both Maithri and Sahai have a three-day training period for volunteers where experts tell them about basic mental illnesses, how to make a person vent, how to be good listeners without judgment, how to handle critical callers and also do role play. After that, in Sahai, a volunteer is assigned to a more experienced counsellor-volunteer for 4-6 weeks, who guides them.

Sexual harassment, hoax calls

It’s not all about helping those in emotional distress. People who volunteer at helplines are often faced with hoax callers and even those who attempt to sexually harass them. It’s also one of the major reasons for volunteers to drop out, Rajesh says.

Nandini, who has been volunteering with Sahai for four years now, says they have learnt to differentiate between those who have genuine problems, which may relate to sex or sexual health, and those who just want to be inappropriate. “For example, when a person goes into graphic details of sexual acts or the anatomy, without rhyme or reason. I usually tell such a person firmly that this is not a helpline where we can help them in this matter. And if they want, they can go to a specialist. Then, if they do not have a genuine problem, they hang up.”

Volunteers at Sahai 

These calls are so common that volunteers are trained to handle them. In Sahai for instance, if a woman volunteer gets uncomfortable, she suggests handing over the call to a male volunteer. “The miscreants generally tend to hang up,” Patrick says.

Further, they maintain a register with callers’ details that only volunteers can access. “Repeat offenders can be warned with police action, and that is usually enough to make them stop,” he adds.

What keeps volunteers going

The job of working in suicide prevention is by no means easy. The people TNM spoke to admitted that it can get emotionally taxing, especially when the people who need help are very young.

For this reason, they have their own mechanisms to maintain their own emotional stability. Dr Vivek and Patrick emphasise on having their own hobbies and recreational activities to rejuvenate. There are also mechanisms within the organisations to ensure the emotional health of volunteers.

Maithri for instance has a system of co-volunteering, where a person outgoing from their shift is made to speak to another volunteer. In Sahai, they have monthly meetings with a guest speaker, where new observations as well as issues of concern are discussed.

But what keeps these workers going is their own motivation. For Sharan and Nandini, it comes from their own experiences of having been in emotionally distressing situations and wishing for someone to vent to.

But it is perhaps Patrick who sums it up best. “Initially, my motivation, like many volunteers, was simply to give back to the society. But now that I have been doing counselling also, it is the difference I see in people. Whether it’s the smile that a person leaves with, or relieved laughter of a person who was on the brink of self-harm on the phone – that gives me the most happiness.”

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