These are truly unprecedented, extraordinary times. With a pandemic, global lockdowns and growing uncertainty, it’s important to keep a check on our mental health too.
On Sunday, 5 April, Lav Agarwal, Joint Secretary of the Ministry of Health urged Indians to “ fight unitedly against this disease” and keep an eye out for “any mental health issues.”
In doing so, he also suggested a mental health helpline number, the National Institute of Mental Health and Neuro-Sciences (NIMHANS)'s toll-free number 08046110007.
Across India, several other helplines have sprung up to met the crisis head-on. Among the many I called to check on were,
NIMHANS: 08046110007
Mumbai-based mental health organisation mPower and the government of Maharasthra and BMC: 1800-120-820050
Poddar Foundation and Rotary Club of Bombay: 1800-121-0980
Assam Police and the Department of Psychiatry, GMCH and Clinical Psychologists/psychiatric Social Workers: 6026901053/54/55 or 6026901056/57/58.
Are these helplines effective? And can they help plug the budding anxiety?
I dialled each of the numbers to test them out and the response pattern was similar: an automated voice welcoming me and describing the organisation, options for regional languages and after just a little while (a few seconds or 1-2 tries) I was connected to a human voice on the other end - with similar advice on stress-busting during COVID-19 times.
Why Are People Calling?
FIT reached out to counsellors and representatives from all 4 helplines; some offered quick stress-busting and well-being focussed advice while some dealt with more serious anxieties.
They all agreed that most calls were around anxieties related to COVID-19 and the lockdown.
“Mostly, a lot of people calling in for work-related apprehensions and job insecurity. This preempts a lot of PTSD. A lot of the youth are calling about this. The elderly have a lot of fear. A lot of home-makers are calling about stress and the lack of space because of the lockdown,” says Dr Prakriti Poddar, the managing trustee of the Poddar Foundation.
Psychiatrist Dr Soumitra Pathare, in a previous article for FIT, also added that mental health concerns are closely linked to our socio-economic situation. And financial stress is a huge factor in these trying times.
With have over 20 organisations on board and the Goa government and Maharasthra State Commission using the Poddar helpline, Dr Poddar says the idea is to create “a collective to address this problem area and break the silence.”
Poddar Helpline works on a graded system with 570 trained volunteers and government recognised clinal psychologists and psychiatric team.
“Critical calls from people who are hallucinating or suicidal are escalated to the nine doctors of the psychiatric team.”
Another Mumbai-based helpline is Neerja Birla’s mental health organisation MPower collaborating with the government of Maharashtra and BMC.
Dr Ambrish Dharmadhikari, Psychiatrist at Mpower says, “Mpower counsellors run this 24/7 helpline. We focus on mental health issues but also look at queries outside of this domain.”
The helpline has gotten over 2000 calls since they launched, mostly from Maharashtra - Mumbai and Pune in particular.
“This could be as these are COVID-19 hotspots,” muses Dr Dharmadhikari.
In Assam, the Assam Police and Department of Psychiatry from Guwahati Medical College (GMCH) have created 6 toll-free numbers.
Dr Mythili Hazarika, Associate Professor at GMCH told FIT that “The helpline is for psychiatric care and services - only for counselling - as a crisis call to this COVID-19 situation.”
The Poddar, mPower and Assam helpline were started on Monday, 6 April, while the NIHMANS one started last week.
Murshid Thayyil, an Mphil in psychiatric social work and counsellor on the NIHMANS Helpline, says “In the initial phase, in the first and second day, we were getting 1 call per 3-4 minutes! Then we included the Central Institute of Psychiatry, Ranchi and the Lokopriya Gopinath Bordoloi Regional Institute of Mental Health in Assam to spread the load.”
COVID-19 Stress On Top of Existing Mental Health Problems
Each helpline has a separate protocol on how to deal with callers with pre-existing mental health issues, which involves either escalating them to senior professionals from within their teams (Poddar, NIMHANS) or asking them to schedule regular counselling sessions (mPower).
“ We got a call from a mother whose daughter is getting treated for schizophrenia, she was worried about her daughter being locked home all day. It’s already hard to handle her, but we gave her tips on how to engage her in the house, help with chores and feel involved and occupied,” says Murshid.
At the Mpower helpline, Dr Dharmadhikari said that this situation is exacerbating existing issues like bipolar disorders, depression, anxiety and more.
How Are Callers Trained?
For mPower, NIHMANS and the Assam helpline, mental health professionals were employed as counsellors, but how did the Poddar foundation train their volunteers?
Arun Varma, a Poddar Foundation Helpline Volunteer, answered the helpline when I called. A retired engineer, he told me he felt like he needed to pitch in this crisis and volunteered for the helpline for 4 hours every day.
Mental health is often delicate and requires emotional intelligence, skills like empathising, listening and reassuring that often aren't inherent to us.
Dr Poddar says they rely heavily on their volunteers and have trained them with a volunteer caller form that takes them through certain questions they can ask to gauge a person’s mental health, appropriate responses and more.
“It is very important to normalise conversations so the focus is on inculcating habits of listening, emphasizing, encouraging purpose-driven solutions and using a time and action calendar. Whether the caller is calling for depression or a lack of purpose, we want to find out - what are they really feeling and when is that feeling most magnified? Have they had skills in the past to lessen that load for themselves?"
She adds, “So we train our volunteers to ask these questions. We train them to help callers build the memory of their skills and help them utilise it now.”
Varma added that he had a group zoom call and a mock call to train him.
It’s interesting to note that the Poddar helpline is the only one with such a large volunteer pool and a voice message that says they do not take any liability.
All helplines also operate in several regional languages, and their strengths lie in the geographical area they are based in - but extend to the entire state. Each of them has gotten callers from different states, underlining the need for such helplines in lending a helping hand.
Migrants, Domestic Violence Survivors Calling for Help
Murshid tells me that he gets varied calls, although approximately half are related to physical health or lockdown concerns. He says they mainly get calls from lower-economic groups looking for answers.
“At midnight, someone from rural West Bengal called me to ask about his neighbour who had respiratory difficulties and symptoms of COVID-19 he thought. So the person wanted to take him to the hospital and wanted help. I gave him West Bengal COVID helpline number.”
Even Dr Hazarika tells me that they get calls from outside of Assam asking about the closing of the borders, and on procuring essentials. They help direct them to regional specific numbers.
Then there are calls which require more expertise. Across the globe and in India, the lockdown is causing domestic cases to surge. Domestic violence is one of the leading causes of women’s mental health stress, but are these helplines equipped to deal?
“There are reports of increased violence and we are seeing calls - from couples too - about increased anger and irritation but no one has called about violence so far,” says Dr Poddar.
But Murshid says the NIHMANS counsellors have a group to discuss such calls, and although he hasn't encountered any, another counsellor did receive them. “We discussed it on Whatsapp and sent the caller specific domestic violence helpline numbers. If the cases are severe we have an in-house woman’s cell we can transfer the call to as well.”
Dr Dharmadhikari adds that they have received a lot of calls regarding domestic violence. They even received calls from people in the LGBTQ community, and distress mainly stems from being forced to live with toxic families - and the lack of freedom to get external support from their friends. For such cases, Dr Dharmadhikari suggests they look up Mpower’s online counselling and set up regular sessions.
Meanwhile, Dr Hazarika in Assam says that they got a call from someone, “He didn't say he hit someone but he was very angry. We helped him with anger management.”
A Drop in the Number of Calls, for Now
“The calls are dwindling, I spoke to the NIMHANS director too, who agreed that maybe people are dealing with the new normal better now,” says Dr Poddar.
Murshid agreed that perhaps state and central governments were getting better at disseminating information.
But this could stem from a lack of conversation about our feelings. “Yes, we have started a ‘mask your face not your feelings,” campaign.
Dr Dharmadhikari, however, felt that we would see a continuous stream of calls, “The mental health effects of this situation will continue and we are prepared to deal with them.”
Maybe the ebb and flow of the calls need further scrutiny, but what can be said for sure is that these helplines form a vital support system in our unprecedented times.
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