All helplines have their own policies about contacting Emergency Services to assist helpline users who either declare themselves to be in need of such services or who the helpline feels cannot be left without assistance being summonsed. Leaving aside the debate to be had about policies and procedures let us consider the change in response that seems to be evident from emergency services, and how, as helpline managers, we should manage the effect of that response on our helpline workers and the people they are in communication with.
Of course we know the emergency services do a very hard job very well. We all must be aware of how good the Police are in working with people with mental health issues who they are called out to for instance. Paramedics also do a fantastic job. The problems come in trying to get to the right service in the right place. For national helplines this is a particular issue. Emergency calls now seem to be first received in central call centres – the one I most usually get connected to is in Scotland, whilst we are based in England. Only when there is a very switched on operator will they connect to the locality that is required (or perhaps they don’t know the protocol). Most usually they say they can only connect to the services in the county or area that you are calling from. We won’t dwell now on the delays when the queue is too long for the chosen service so we try another one. …You reach the service of choice, no longer can they also connect you to another area as used to be the case. So you give all the details and they say they will pass them on. You don’t know if they will, you don’t know when they will, you don’t know if they will pass on all the information as you have provided it. We have even had situations where the first call handler has despaired and offered to take the details themselves and pass them on. It is a time consuming recipe for disaster and a cause of great unease for the helpline manager. We are unable to give the reassurance that is so needed by the worker and the helpline user. This surely must be one of the highest factors for vicarious trauma in helpline work at the moment.
The next problem, if we leave aside the issue of getting the accurate information to the right service in the right locality is when will help arrive? Most helplines will offer to stay with the helpline user until help arrives, in the same way as emergency services often will (used to) and not so long ago this would be within about 20 minutes – quite a time in terms of comparison with call lengths perhaps but in the circumstances surely the right use of the helpline workers time. Now however it is taking hours for assistance to arrive. We know that this is because of the extreme pressure services are under and we understand that often issues of self harm are not considered high priority on the whole and we agree that RTAs need immediate attention as do other sorts of woundings to one person by another.
But how to manage this new set of circumstances? We can let helpline workers know to reassure that help has been summonsed but recently we were contacted five hours after we made the referral – when the helpline was closed, to be told the suicidal overdose we had reported for assistance was not viewed as a high priority and was the patient still breathing, was help still needed?
Now we need to reassure the worker that they have done the right thing, the helpline has done the right thing in report the situation, the helpline user has done the right thing in asking for help. Can we say help with come? We can no longer say we will wait with them until help arrives, unless in certain extreme circumstances as when the 999 operator is in communication with the referee and the emergency response team at the same time. We need now to reassure the helpline user that help has been requested, rather than state it is coming. Can we do more than to try to make them comfortable, to give basic first aid advice where applicable and ask them to contact us again the next day? That really now seems to be the most honest offer we can make. But for a person in desperate straights, will they not feel more of the rejection that has brought them to this?
This is surely a situation that needs to be highlighted?
Can we not come together and share case studies, anonymised and everything of course, which we could collate and pass on? Not sure who to! But putting our heads together can we not work this out? Between us can we share good practice on how to support helpline users and helpline workers, please do!