Many mental health hotlines have been forced to switch to remote work during the coronavirus crisis. (Jessica Christian/S.F. Examiner file photo)

Mental health, suicide hotlines brace for surge of crisis calls

Responders feel the weight of the coronavirus-related calls themselves

While local suicide and mental health hotlines have so far seen modest to significant bumps in calls, they’re preparing for a larger volume in the coming weeks as the coronavirus crisis continues — all while being impacted by the disruption themselves.

Call volume remains largely normal for Crisis Support Services of Alameda County and San Francisco Suicide Prevention, but the latter’s program director, Van Hedwall, has noticed a spike during evening hours. The California Peer-Run Warm Line, a non-emergency line for emotional support in San Francisco, has seen up to a 15 percent jump in calls and messages in recent weeks, said Executive Director Mark Salazar.

Suicidal ideations and self-harm are known to spike during times of crisis, like the 2008 recession and the AIDS epidemic. What’s different about the coronavirus pandemic is that everyone is isolated from one another, unable to comfort one another in person, said Crisis Support Services Executive Director Narges Zohoury Dillon. Isolation is already a significant factor in suicide and contributes to poor mental health.

“From a crisis line perspective, the larger impact is yet to come, especially as people who work for us and also our callers know someone personally impacted by the virus,” Zohoury Dillon said. “So many grief rituals require togetherness and without an ability to have togetherness, grief will just linger.”

Coronavirus isn’t necessarily the cause of the calls to San Francisco Suicide Prevention, but an additional stressor on existing issues, Hedwall added, while an HIV Nightline has seen more calls with questions about how the pandemic impacts their health. Both San Francisco and Alameda County’s hotline are just starting to log calls that mention the virus to report to the National Suicide Prevention Lifeline, but didn’t have data as of press time.

“Definitely people are talking about it, but I don’t believe it’s the cause of people calling, maybe some are,” Hedwall said. “There are folks that have anxiety issues already — this compounds those anxiety issues.”

Where mental health crises have not yet swamped suicide hotlines, mental health support is already feeling the impacts. Without additional staff, they’ve had to place people on hold or call them back — a first for the six-year-old resource.

The Warm Line is based in San Francisco but recently expanded to serve all of California in October after a state grant recouped lost funding. Salazar hopes that the mental health impacts on everyone help reduce stigma and to take it seriously for others when the world isn’t in an unprecedented crisis.

“It’s probably things people are experiencing for the first time,” Salazar said. “That’s what people with mental health issues face on a daily basis. That loss of normalcy will affect everyone.”

As hotline responders might tell people who call in, Hedwall and Zohoury Dillon advise practicing mindfulness, taking breaks from the news, video calling friends and family to check on one another, going outside for some fresh air, getting enough sleep, and generally doing things you find enjoyable.

Many staff and volunteers at the three hotlines have personal experience or brush with mental health issues, which makes it all the more important for them to maintain their sense of community virtually while serving others going through similar motions. Alameda County’s crisis support office boosted their check-ins with staff and volunteers to twice a week and The Warm Line maintains upbeat Slack channels and video coffee breaks to just hang out and overcommunicate.

“Our staff and volunteers are simultaneously impacted by the same crisis as the callers are, which is a somewhat unique dynamic,” Zhouroy Dillon said. “There’s tremendous empathy for the calls but the weight of the calls feels heavier when the concerns of the caller are concerns [for responders] too.”

San Francisco’s hotline is in the process of moving remote, though fewer people are in the office already, while The Warm Line and Crisis Support switched over before the shelter-in-place. The virtual workspace has also posed challenges for training staff and volunteers.

Peer support groups — like various hoarding workshops, dependent adult caregivers and Adult Survivors of Child Abuse — are also a valuable way to work through emotions and maintain mental health that have had to adapt to video conferences or other means. El/Las Para TransLatinas has been calling past participants of their workshops to check on them, planning to hold meditations on Facebook Live, and encouraging Latinx trans, gender non-conforming, and non-binary people to message them on Facebook to include them in the outreach.

“So far, the general feelings for our participants are anxiety, and depression,” said Nicole Santamaria, executive director of El/Las Para TransLatinas. “Some of our participants are hourly employees who were laid off from their work and are very concerned for the rent, and other living expenses. This crisis has brought a lot of instability, and opened more vulnerability layers in their already complex and challenging lives.”

While having one’s life put at a standstill is a significant stressor, Zohoury Dillon is thinking about the frontline workers and those aiding others in duress. She noted that they might be low-paid and expected to go above and beyond without the support they need themselves to stay physically and mentally healthy.

Working directly with people who have a sense of hopelessness can become contagious, Zohoury Dillon warned, and people need to intentionally address it head-on so they can keep moving forward. The crisis is a marathon, not a sprint, after all.

“They might be so busy that they’re not stopping to see the impact it’s having on them,” Zohoury Dillon said. “That’s who I’m worried about at this point.”

If you or someone you know needs help, please call the National Suicide Prevention Lifeline’s 1-800-273-TALK(8255) or text 741-741 to speak to a nearby certified crisis center and counselor. Both are free and operate 24/7.

Local crisis centers San Francisco Suicide Prevention and Crisis Support Services of Alameda County may be reached at 415-781-0500 and 1-800-309-2131, respectively. The California Peer-Run Warm Line is at 1-855-845-7415 or via online chat.

imojadad@sfexaminer.com

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