Crisis Hotlines have been around for over 40 years, and so have individuals that call regularly. These types of repeat calls are often referred to as exhausting, challenging and frustrating. Viewing these calls as such can introduce the danger that someone in actual need may not receive the full benefit of the services offered. Though the caller may not be presenting a crisis at the moment, your support and empathic listening can aid in the prevention of escalating into a crisis. Often times, the callers are utilizing the same unsuccessful maladaptive coping skills to try to resolve their situation. They have most likely burned many bridges, have very little or no support from family and friends, and feel lonely and isolated. They are often turned away and told no or that nothing more can be done. It is important to remember that these callers can also experience crises.
As many centers are adopting a trauma informed care approach, the use of recovery oriented language and care is emerging. The term Frequent or Chronic caller is being replaced with Familiar or Experienced caller, to name a few.
Some centers or crisis workers struggle with setting limits and boundaries. Callers can benefit from the structure and learn to develop and rely on their own strengths. The callers are the experts on what helps them and it varies for every person.
Challenge yourself and your center to create a thoughtful approach to handling these calls, while maintaining boundaries, consistency, and setting limitations. Establish firm and consistent boundaries in a respectful manner. Some centers have time limits per call, others have limits on how many times an individual can call. Once you decide on a limit, it is important for all crisis workers to remain consistent. Create a clear guideline for crisis workers to follow. Example below:
Initial call of the day:
Listen, reflect feelings
What has changed since your last call?
What was your plan when your last call ended? Have you tried…?
Have you followed through with your plan?
What else can you try?
When speaking with someone who has been contacting your center several times per day, it is okay to ask the individual:
To restate their crisis plan
Who else can they call besides the crisis hotline?
Be cautious of providing the same intervention techniques each time, it can be beneficial to treat each call like a brand new call every time. Perhaps something has changed and what didn’t work yesterday may work today. Remember there is value in listening and acknowledging their reality. Consider what it must feel like to live with this every day.
1. Help the individual identify the precipitating event that caused them to call/chat/text. “What has happened/changed since your last call?”
2. Help the individual prioritize and stay focused. Acknowledge that it seems there has been a lot that has affected their lives. “I’m wondering, which situation is most important for you to resolve.” “What can I help you with today?” “From what you have shared, there seems to be a lot going on for you. Which one is the most worrisome for you today?”
3. It is better to interact than react. Validate that they are doing the best they can. “It sounds like you are doing the best you can. What can you try differently to cope with this?”
4. Identify coping skills. “What has helped you in the past? Have you tried that today?”
5. Help them explore new, healthy coping skills. “I’m wondering if you have thought of new ways of coping.”
6. Explore the importance of retelling their story repeatedly, “How is this helpful for you?” “What are you hoping to get from this conversation today?”
7. Empower them to work toward recovery.
8. Limit exploration of the situation and problem solving.
9. Help the caller focus on what he/she can do to help him or herself today.
10. Support the caller in developing a reasonable, specific and attainable plan. Provide additional resources, such as a warm line for support.
Other helpful statements:
“You really seem comfortable doing what you have always done, that’s more familiar to you. How would it be for you to try…”
“It sounds like you feel scared to make any changes.”
“It sounds like you have a sense of what it is going to take to change and you’re not sure you want to do that.”
“It seems discussing your past experiences are more comfortable for you than trying to make changes.”
For research on Familiar callers, please use link below for information:
Depressive disorders are extremely common — 15.7 million American adults experienced a major depressive episode in 2014. It’s much more than simply feeling sad, it’s a medical condition with physical symptoms. Check out the infographic by Mental Health America to learn more as we continue our recognition of Mental Health Month, and be sure to visit their website for lots of great materials to help you spread the word to your community.
We’ll be bringing you some of these resources on the blog throughout the month. Starting with Mental Health America’s Infographic about Anxiety. Anxiety disorders are some of the most common mental health conditions — experienced by an estimated 21% of American adults. People living with anxiety describe it as, “Being so scared you’re paralyzed” and “Being powerless against your own mind.” Check out the infographic below for more information on what anxiety is, how it feels to those who experience it, and tips for tackling it.
Since 1949, May is recognized as Mental Health Month, thanks to efforts spearheaded by Mental Health America. In preparation for this year’s Mental Health Month, MHA has released its 2016 Mental Health Toolkit for download. It includes things like:
Media Materials including key messages, drop-in article, sample press release, and MHM Sample Proclamation
Infographic Fact Sheets that incorporate plain language explanations of diagnostic criteria for mental illnesses, first person accounts about how it feels, a breakdown of common myths and misperceptions, screening data from mhascreening.org and coping skills on the topics of Depression, Anxiety, Bipolar Disorder, Psychosis and Recovery
Worksheets that individuals can use to make a mental health plan to help them work through symptoms and challenge intrusive thoughts
Social media materials including sample posts and images
Banner images for your website or Facebook and Twitter accounts
Being a web-based software means we make regular updates to iCarol with each of our ongoing releases. In these releases we do some general maintenance and apply updates or fixes, but most exciting of all we add new tools and features.
In recent weeks we’ve added three new features that I’d like to tell you about. If you’re an iCarol user you may have already read about these in the release notes available on your dashboard, but in case you haven’t, here’s some information for you:
Receive feedback from Public Resource Directory visitors
You can now enable a setting on your Public Resource Directory (PRD) that allows visitors to submit comments. This will empower the public to alert you of errors in your record, or other troubles they may encounter with a resource. In order to submit their comment, they will need to enter their name, email address, and captcha code. This is not a comment for public view that will be there for all to see, but rather once submitted, the resulting comment goes directly to your resource staff as a resource flagged for review. Your resource manager will simply open and edit the record to view the comment. When they are satisfied that any reported issues are resolved, they can clear the comment to remove it from the record, thus removing it from the “flagged for review” list as well.
You simply need to follow a few steps to turn on this setting:
Click the Resources button on the left hand menu
Click ‘Manage Resources’ and then on the next page click ‘Public Resource Directory’
Scroll to “Page to show for details view” and ensure that “Combined view (blends Agency, Program, Sites and ProgramAtSite)” is selected (this feature will not work if the setting is “Simple view”)
Check the setting for “Allow people in the public to provide comments on resource records”
Scroll to the bottom of the page and click the “Save” button
Then, users will be able to submit their comments when they view a record on your PRD.
Resulting comments will be similar to when resources are flagged internally within your organization, appearing on the main Manage Resources page and within the record itself.
Remove a user’s ability to post to the chatboard
Depending on the practices at your individual helpline, you may wish to restrict volunteer and staff access to the Chatboard. Previously you could restrict a user’s ability to see or use the Chatboard at all. Now you can more specifically allow your users to see and read Chatboard posts, but then decide whether or not any non-Admin user can post messages or replies to the Chatboard via a separate setting. This is available in the Advanced Security Settings of each volunteer or staff member’s profile.
Customize the list of resources marked as “Flagged for review.”
You can now choose to have a single, drop-down style Custom Field appear with a record that is Flagged for Review. When you enable this setting you additionally will see the date it was flagged along with the reason when you first go to the Manage Resources page.
To use this new tool you’ll first need to make sure you have at least one drop-down style Custom Field set up in your system, with choices assigned to the drop-down. Custom Field creation and editing can be found by clicking on Resources, then clicking Manage Resources, and then clicking Custom fields from the leftmost column.
Once a Custom Field is set up, you’d take the following steps to enable this field choice as visible within the list of flagged resources:
Click Admin Tools and click the Resources tab
Scroll down to Other settings, and click the drop down box for “On the Flagged for review list on the Manage Resources page, include a column for this single-select custom resource field”
Select the custom field that you would like to display in the list of resources that have been flagged for review
Scroll back to the top of the page and click “Save all settings”
Now flagged resources will appear on the Manage Resources page, along with the flagged date, reason, and the information contained in that chosen Custom Field as it exists in the record.
This has multiple potential uses that could help streamline processing of your flagged records. You could use this Custom Field to assign a priority level to your records, so that Higher priority records could be investigated and cleared more quickly. Another potential use would be to identify which staff person or position, or center if managing resources across a network, is responsible for management of the resource and thus should be the one to investigate the flagged record.
We hope that you’ll try out these new features if you think they may be helpful to you in your daily work. Set up and other information can also be found via the Help Articles posted within the Help section of iCarol, but please contact our support team if you have questions or need additional assistance.
Peer Supports for Transition-Aged YouthDate: Wednesday April 6, 2016
Time: 2pm EDT
Transition-Aged Youth(TAY), including foster youth, youth who have been through the juvenile justice system, and youth with mental health diagnoses, have unique needs that are often unaddressed. At this crucial stage . . . Read more and register
Peer-Run Respite ProgramsDate: Thursday, April 14, 2016
Time: 2pm EDT
Peer-Run Respite Programs serve as successful alternatives to hospitalization or other traditional crisis services with focuses on support, hope, and . . . Read more and register
Best Practices in the Use of Self-Directed Care to Support Recovery in WomenDate: Thursday, April 21, 2016
Time: 2pm EDT
Building relationships and support systems is an important part of recovery. Mental Health America’s highly innovative It’s My Life: Social Self-Directed Care program combined . . . Read more and register
We’d like to congratulate our friends at Karma Nirvana as they recently announced that they are the recipients of a grant award.
This funding will go to assist the Honour Network helpline, the first national line of its kind, which serves victims and others concerned about forced marriages and honour-based abuse, as well as professionals who need guidance on these issues. Helpline counselors have experience in risk assessing situations of honour based abuse or forced marriage, and some can provide peer-based support from their unique perspective as survivors.
According to the organization, they currently serve a volume of approximately 700 calls per month from within the UK. They state that over 200 additional calls per month go unanswered, the majority of which ring to the center during evenings or weekends when the call center is closed. Thanks to this grant, Karma Nirvana will be able to extend their service hours, so they can help more people in need and fewer calls will go unanswered.
We’re so pleased by this wonderful news and wish all the best to Karma Nirvana as they extend their service offerings and save even more lives. To find out more about their service, please visit their website.
We’ve talked before about how sometimes the need for silence will influence people to use texting instead of a voice call. Sometimes silence isn’t preferred, but necessary, such as in this recent instance of a deaf woman who texted 9-1-1 after she noticed some children left unattended at a shopping mall. Luckily texting to 9-1-1 was enabled in her area.
Texting to 9-1-1 is continuing its expansion throughout the United States and Canada. The Canadian Wireless Telecommunication Association has set up an extensive and detailed website giving overview of the Text-to-911 process in Canada.
In the United States, it seems like each month more and more jurisdictions are adding on texting capabilities. A quick scan of recent news articles about texting 9-1-1 in the US produces alerts about the greater Kansas City area, Minnesota, areas in Texas, and northern California. Note that each of those articles was published this week. It all points to rapid expansion of that technology.
Just another sign of the times as we continue to see just how convenient, efficient, and often necessary texting can be when reaching out for help. We hope helplines will take note as this capability expands and explore texting for the helpline service to follow suit. If you want to learn how Texting works in iCarol, please join me for a Messaging webinar sometime!
With stories about the Zika virus beginning to appear in North American news media, some non-profit helplines and information and referral centers are already receiving inquiries about the illness. Though there have been no confirmed cases in the continental US* or Canada, confirmed cases in nearby countries south of the US and in the US territory of Puerto Rico have many beginning to ask questions about the virus, especially since these areas are popular travel destinations.
The Centers for Disease Control and Prevention (CDC) has released information about the virus which could be shared with those who are concerned. This information includes:
While unpleasant, symptoms are typically mild and becoming severely ill to the point of hospitalization is uncommon, and death resulting from the illness is rare.
For the full contents of information from the CDC which may be helpful to your constituents, visit the CDC’s Zika Virus webpage.
*Since originally posting this blog, confirmed cases have begun to emerge in the US. Authorities have confirmed a case where the Zika virus was contracted sexually, and others who contracted the virus, likely from a mosquito, while traveling.
Today’s a big day for Canadian mental health initiatives: It’s Bell Let’s Talk Day!
This annual event draws attention to mental health, particularly the stigma attached to mental illness that prevents many from seeking help. The idea is that if we all talk more openly about mental health and are open to conversations about it, it will lessen the shame attached to mental illness. Bell also champions access to care, workplace mental health, and research.
On Bell Let’s Talk Day, people are encouraged to take to social media and discuss the topics of mental health and mental illness, and use the hashtag #BellLetsTalk on Twitter. They can also share the Bell Let’s Talk image via Bell’s Facebook page. For each share of this image, and each Tweet using the hashtag, Bell donates $.05 to mental health initiatives and programs across Canada (including many services that are part of the iCarol family!).
To learn more, check out the video below which summarizes five years of Bell Let’s Talk. We hope you’ll follow us on Twitter and Tweet along with us to raise awareness and remove the stigma from the conversation about mental health!