This is what it's like to work for a mental health crisis line
image Ildar Imashev / Getty with additional design by Team Woo
words Sahar Esfandiari
Being in a state of mental health ‘crisis’ means something different for each individual. It might look like struggling with overwhelming anxiety in the face of eviction or homelessness and not knowing who to turn to. It might be difficulty navigating the psychological side of being a victim of domestic or sexual abuse, or suffering with feelings of loneliness and depression as a result of social isolation.
Many people experience periods of time where they struggle with their mental health to a point they no longer feel able to keep themselves safe, and reach out to a crisis service for help.
For me, the realities of working as a support worker in a community crisis service can vary drastically day by day. There’s no ‘typical’ shift or client.
Whilst no two people walking through the service doors have the same story, many do have experience of shared struggles. Many people at crisis are in the depths of navigating major life changes, bereavements, breakups, terminal or life altering health diagnoses. In these periods of change and adjustment many of us need extra support to help carry us through.
Similarly, many of those accessing the service have struggled with mental health illness for some time and need extra support in that particular moment. For others this may be the first time they have ever reached out for help.
My job is to provide immediate, urgent support for anyone walking in the door or calling the phone lines for help. This can look like emotional support and de-escalation of high intensity situations involving self harm and suicide, or practical support in the form of referrals to help with finances, housing, therapy, and peer support groups.
There are also workshops and groups that take place at sites within the community, from chair yoga to creative writing.
The service I currently work for functions alongside, and often works in collaboration with different NHS services. It is a community mental health service originally set up to help alleviate pressures on emergency services during the Covid 19 pandemic. In the face of crisis, services like this offer a more personalised, flexible approach to mental health than formal avenues such as A&E or your GP.
Referrals might be made from individuals through the website or phone, or on behalf of clients through GP’s, nurses, other mental health services in the NHS, as well as other organisations and charities.
The flexibility of community mental health allows more focus on person centred care and we work with clients to empower them and ensure people are supported within the community, through their personal networks as well as peers and local organisations.
In the aftermath of the Covid 19 pandemic, the pressures on health services remain high and in some cases this has manifested in longer waiting times to access therapy through the NHS.
On top of this, due to current inflation and the rapidly rising cost of living, many people who were previously accessing private therapy are also now pushed towards NHS routes.
In a recent study by the British Association for Counselling and Psychotherapy 60% of therapists questioned in a survey reported clients cutting back on therapy as a result of financial concerns, with 49% pausing or cancelling altogether.
On top of that, 49% of therapists interviewed said their clients were also pushed to cut back on activities that benefit their mental health such as gym memberships and taking exercise classes.
It is within this context community-based mental health services are growing in importance. They fill an often wide gap of support between asking for help and receiving it, where people are often in their lowest, darkest moments. Such services are often a much better suited approach than police or A&E emergency services at times of crisis.
My personal career journey to working in mental health is an unconventional one. After five years of working in journalism, what I wanted from a career since my early twenties started to change. Through personal experiences with mental health in my own life, I witnessed first hand the difference that professional support can make. It can be the difference between life and death for many.
Changing careers and going back to University aged 29 was not a decision I took lightly and one that I am now very proud of.
My service is very on the ball and supportive when it comes to training and there are always opportunities to develop skills and knowledge. I recently completed a 3-day training course with the NHS on counselling for crises and covered topics such as psychosis, personality disorders, and suicide prevention.
Alongside training provided by my company, I’m currently also studying for an MSc Psychology Conversion, which is demanding but complements practical work in the field very well.
The job can be emotionally demanding some days, and working late and often unsociable hours is a challenge, however it is also undeniably fulfilling.
I often reflect on how special it is to be in a position where you are given the opportunity to speak to so many different people on a very personal level about the events that have shaped their lives, and explore their deepest desires and biggest fears with them.
Through holding space and providing a listening ear for others, I have gained so much knowledge and perspective about life myself. I learn something new from each client I speak to.
It’s also encouraging to see clients on the other side of their crises. Although not every story has a fairytale ending, many do receive the support they need by way of the service, and some come back to tell us that we played an important role in their journey to recovery.
If you’re interested in finding out more about crisis services or want to know how you can help check out the links below to donate or find out how to volunteer at your local service.
Are you or someone you know struggling and need to talk to someone? See below for numbers to call.
Crisis help services:
Samaritans 116 123 (freephone) firstname.lastname@example.org Chris, Freepost RSRB-KKBY-CYJK PO Box 90 90 Stirling FK8 2SA samaritans.org
Shout 85258 (text SHOUT) giveusashout.org Confidential 24/7 text service offering support if you are in crisis and need immediate help.
Papyrus HOPELINEUK 0800 068 41 41 07786 209697 (text) email@example.com papyrus-uk.org Confidential support for under-35s at risk of suicide and others who are concerned about them. Open daily from 9am–midnight.
Mind 0300 123 3393 firstname.lastname@example.org
The Mind Infoline provides an information and signposting service. We're open 9am to 6pm, Monday to Friday (except for bank holidays) NHS 111 (England) 111 111.nhs.uk Non-emergency medical help and advice for people in England.