Crisis Identification and Initial Response

  • How much time does a mental health crisis typically last?

    Training Helpie Crisis Line Responders for a role that involves handling crisis calls demands a nuanced understanding of the duration and evolution of a mental health crisis. In a crisis call scenario, the duration of the crisis for the caller can be categorized into several phases:

    Phases of Crisis During the Call:

    • Immediate Crisis Phase: The first few minutes of the call are crucial for assessing the situation, establishing rapport, and calming the caller.
    • Stabilization Phase: The next 10-15 minutes may be sfocused on helping the caller to stabilize emotionally, gather their thoughts, and consider immediate next steps.
    • Information and Referral Phase: The last part of the call may involve providing the caller with resources or referrals for longer-term assistance.

    General Duration Estimates:

    • Short-Term Crisis: May last for the duration of the call and possibly a few hours afterward. These are often situations where the immediate crisis can be diffused relatively quickly, such as panic attacks.
    • Ongoing Crisis: May last for days or weeks. These may require additional follow-up and more intensive long-term care.
    • Chronic Crisis: In cases of chronic mental health conditions, a crisis could potentially last for weeks to months and may require hospitalization or more intense forms of intervention. 
  • What is the one thing you should never say when someone reaches out to you in a crisis?

    The science of mental health crisis intervention highlights the importance of empathy, active listening, and non-judgmental support. What can be especially harmful to mention to a caller reaching out in a crisis is anything that minimizes, dismisses, or invalidates their feelings or experience. The exact wrong thing to say may vary based on context and individual needs, but generally, mental health professionals agree that dismissive or judgmental statements can be extremely harmful. A statement that is scientifically recognized as harmful might be something like:

    “You shouldn’t feel that way.”

    This statement invalidates the caller’s feelings and experiences, potentially making them feel misunderstood or judged. It disregards the complexity of mental health and the real pain or fear the caller may be experiencing. It can build a barrier between the caller and the responder, hindering the establishment of trust and open communication.

    Research in psychology and mental health emphasizes the importance of validating emotions, showing empathy, and avoiding assumptions or oversimplifications of complex emotional states. Statements that undermine these principles can escalate a crisis or shut down communication, hindering effective intervention.

    It’s important for Helpie crisis responders to approach each caller’s unique situation with respect and avoid to quickly “fix” the problem without truly understanding it. 

  • What is the first thing you say when someone contacts you in a crisis?

    When someone contacts the Helpie Mental Health Crisis Line in a state of crisis, the initial interaction is crucial. Establishing a connection, ensuring the caller feels heard and safe should be the priority. A common initial response might be:

    “Hello, I am Helpie and I’m here to help you”

    While there may not be a “one-size-fits-all” magical phrase, as each caller’s situation and feelings are unique, a compassionate and thoughtful opening can indeed set a comforting tone. A phrase that could make a caller feel special and heard might be:

    “Your call is very important, and I’m here to listen. Can you tell me what’s on your mind?”

    This statement combines gratitude for the caller’s trust, emphasizes the importance of their call, and assures them of the responder’s willingness to listen. It helps create a safe space for the caller to begin sharing their concerns.

    However, it’s essential to recognize that the effectiveness of a particular phrase depends on the specific situation, the caller’s emotional state, and the genuine empathy and attentiveness of the responder. Trained professionals like Helpie Responders will likely tailor their approach to each individual to create the most supportive and validating experience. 

  • As a Helpline Responder, where do you step in during a crisis, and how?

    As a volunteer for the crisis helpline, you offer support and guidance to individuals in crisis. The level of intervention required will depend on the severity and nature of the crisis. Here are some general guidelines for how you can step in during a crisis:

    1. Listen actively:  Active listening means paying attention to what someone is saying and showing that you understand and care about what they’re going through. When you’re on a crisis helpline, and someone calls in, they might be feeling upset or scared, so it’s important to listen to them carefully and be kind and patient. Here are some tips for active listening:
    • Pay attention to the person’s words: When someone calls in, try to focus on what they’re saying. Listen to their words and try to understand their feelings.
    • Be patient: It’s important to be patient with the person on the other end of the line, even if they’re upset or talking a lot. Let them take their time,, and don’t interrupt them.
    • Show that you’re listening: You can show that you’re listening by saying things like “I understand” or “That must be really hard.” This will let the person know that you’re there for them and that you care.
    • Ask questions: Sometimes, it can be helpful to ask questions to better understand what the person is going through. But be careful not to pry or make them uncomfortable.
    • Be supportive: Let the person know that you’re there for them and that you want to help. You can offer words of encouragement or just let them know that you’re there to listen.

    Remember, being a good listener can be really helpful for someone in a crisis. It shows that you care and that they’re not alone. Encourage the person to talk about their feelings and experiences and to listen without judgment or interruption. Let them express themselves fully, and validate their emotions.

    1. Establish rapport: Build trust with the caller by creating a safe and supportive environment. Establishing rapport with a caller on a crisis helpline means building a connection with them so that they feel comfortable talking to you and sharing their thoughts and feelings.  Remember, the most important thing is to be kind, patient, and understanding. Here are some tips for establishing rapport:
    • Start with a friendly greeting – When you answer the phone, say hello in a friendly and warm tone. Mention that you are a Helpie and you are here to help.  This will help the caller feel welcome and at ease.
    • Listen carefully – It’s important to listen carefully to what the caller says. Ensure you give them your full attention and don’t interrupt them while they’re speaking.
    • Show empathy – Try to put yourself in the caller’s shoes and understand what they’re going through. You can say things like, “I’m sorry to hear that you’re going through a tough time” or “That sounds difficult; I’m here to help you.”
    • Be patient – Sometimes, it takes a little while for callers to open up and start talking. Don’t rush them or try to force them to talk about things they’re not ready to discuss.
    • Respect their feelings – Whatever the caller feels, it’s important to respect their emotions and not judge them. Let them know their feelings are valid and you’re there to support them.
    1. Assess the situation:

    Ask open-ended questions to understand the severity of the crisis and any risk factors that may be present.

    • Can you tell me a little about what led you to reach out to the mental health crisis helpline today?
    • How are you feeling now, and has your mood been consistent or fluctuating lately?
    • What kind of support system do you currently have in your life, such as friends or family members you can talk to?
    • Have you been struggling with any mental health issues or symptoms, such as anxiety or depression, for a prolonged period of time?
    • Have you had any past experiences with mental health crises or seeking mental health support? If so, can you share what those experiences were like?
    • Are you currently experiencing any suicidal thoughts or urges, or have you in the past?
    • Have you been using any substances or engaging in any behaviors that may be affecting your mental health or well-being?
    • Are there any current stressors or difficult situations in your life that may contribute to your current mental health crisis?
    • What kind of help or support would you receive at this time, and what would be most helpful for you?
    • Have you been able to access any other mental health resources or services recently? If so, how have those experiences been for you?

    Identify if the caller is in immediate danger (some sample conversation starters here include)

    • Are you currently in a safe place?
    • Have you taken any medications or substances that may harm you?
    • Is anyone else with you who may be causing harm or making you feel unsafe?
    • Are you experiencing any physical injuries or medical emergencies?
    • Have you attempted suicide or self-harm?
    • Are you feeling overwhelmed or out of control?
    • Have you been experiencing anything different that may be putting you at risk?
    • Do you have access to weapons or harmful objects?
    • Have you taken any medication or drugs recently?
    • Do you feel like you cannot control your thoughts or actions?
    • Are you experiencing any physical symptoms, such as chest pain or difficulty breathing?
    • Have you reached out for help? And if so, what happened?

    Ask the person if they are having suicidal thoughts or have a plan to harm themselves or others. If the answer is yes, take the necessary steps to ensure their safety. This may involve contacting emergency services or guiding them through steps to keep themselves safe.

    • Do you feel like you are in a life-threatening situation?
    • Have you attempted suicide or self-harm, and if so, how recently?
    • Do you feel like you want to hurt yourself or someone else right now?
    • Are you feeling suicidal or thinking about hurting yourself?
    1. Offer support: Provide emotional support, reassurance, and practical advice to help the caller cope with the crisis. Let the person know that you are there for them and offer support.  Help them explore their options and connect them with resources that may be helpful. Provide the person with resources such as helplines, mental health services, and support groups. In cases where the caller requires specialized help, such as medical or legal assistance, refer them to the appropriate resource. Provide them with contact information and help them navigate the system if needed. Encourage them to seek professional help.
    • How are you feeling right now, and how can I best support you at this moment?
    • What’s been going on that led you to reach out for help today?
    • It’s great that you reached out for support. What are some things that have helped you cope in the past?
    • What are some things you can do right now to take care of yourself?
    • Have you considered seeking professional help or counselling to address what you’re going through?
    • It’s important to remember that you’re not alone in this, and resources are available to help you get through this crisis. Have you thought about contacting any local mental health services or support groups?
    • It’s okay to take some time for yourself and prioritise your mental health. What activities or hobbies bring you joy or help you feel more grounded?
    • Remember that recovery is a journey, and taking things one step at a time is okay. What small goals can you work towards to improve your mental health and well-being?
    • Have you considered reaching out to your support network, whether that be friends, family, or a therapist?
    • It takes a lot of courage to ask for help, and I’m here to listen and support you in any way I can. What can I do to help you feel more comfortable or supported right now?
    1. Safety planning: If the caller is at risk of harm, help them develop a safety plan that outlines steps to protect themselves.
    2. Follow up: Follow up with the person after the crisis to see how they are doing and offer ongoing support. This can help them feel less alone and reinforce that they have someone to turn to if they experience another crisis.

    Overall, it’s important to remember that every crisis is unique, and that there is no one-size-fits-all approach. As a crisis helpline volunteer, you should approach each situation with empathy, patience, and an open mind and do your best to support the caller through their crisis. Remember to prioritize the person’s safety and well-being at all times and maintain professional boundaries. If you are unsure of how to handle a specific situation, seek guidance from your supervisor or a mental health professional. 

  • How can you tell if someone is in a crisis or has been having mental health problems for a long time and needs help?

    Differentiating between someone experiencing a sudden mental health breakdown or “meltdown” and someone struggling with mental health problems for a long time can be challenging. However, there are some signs and symptoms that can help to distinguish between the two:

    1. Acute onset of symptoms: A mental health breakdown often occurs suddenly and may be triggered by a particular event or stressor. On the other hand, someone with long-term mental health problems typically experiences symptoms over an extended period.
    2. Severity of symptoms: In a mental health breakdown, symptoms are usually more severe and can cause significant distress or impairment in functioning. Long-term mental health problems may also cause distress and impairment, but the severity may be more manageable.
    3. Changes in behavior: During a mental health breakdown, a person may exhibit noticeable changes in their behavior, such as sudden mood swings, withdrawing from social activities, experiencing difficulty concentrating, engaging in self-destructive behaviours, and exhibiting aggressive behaviours. Those with long-term mental health problems may exhibit similar behaviors, but the changes may be less dramatic.
    4. Duration of symptoms: The duration of symptoms is another factor that can help distinguish between a mental health breakdown and long-term mental health problems. Symptoms of a breakdown are typically acute and may subside within a few days or weeks with appropriate treatment, whereas symptoms of long-term mental health problems may persist for months or even years.

    It’s important to note that everyone’s experiences with mental health are unique, and there is no one-size-fits-all approach to identifying mental health concerns. Remember that the person is probably in a vulnerable state and looking for help, whether they have a diagnosed mental illness or a mental health breakdown. Help them seek professional advice from a mental health provider. Remember to approach the situation with empathy, without judging them, and to actively understand and listen to what they have to say.  Ask open-ended questions to understand their situation better.

    Remember, it’s also possible for a person to experience a mental health crisis without having a diagnosed mental illness. Regardless of the person’s diagnosis, the most important thing you can do is listen to and support them as they navigate their situation. 

  • When do you say someone is in a crisis?

    Several indicators may suggest that someone is in a crisis:

    1. Changes in behaviour: A sudden change in behavior, such as increased anxiety, agitation, restlessness, or withdrawal from social activities, may indicate a crisis.
    2. Emotional distress: The person may express hopelessness, helplessness, despair, or intense emotional pain.
    3. Suicidal thoughts or actions: If the person expresses thoughts of suicide or self-harm, it is important to take this seriously and seek immediate help.
    4. Substance abuse: A sudden increase in substance use, such as alcohol or drugs, maybe a sign that the person is in crisis.
    5. Physical symptoms: Physical symptoms, such as rapid heartbeat, chest pain, or difficulty breathing, may indicate a crisis.
    6. Disorientation or confusion: The person may seem disoriented or confused, indicating a crisis.
    7. Recent traumatic event: A recent traumatic event, such as the death of a loved one, a divorce, or a serious illness, may trigger a crisis.

    Recognizing someone in a mental health crisis during a phone call can be challenging because you cannot see the person’s body language or facial expressions. However, some signs you can listen for may indicate that the person is struggling with their mental health:

    1. Rapid speech or talking incoherently
    2. Heavy breathing or gasping for air
    3. Crying, screaming or yelling
    4. Expressing feelings of hopelessness, helplessness or worthlessness (“there’s no point” or “it’s never going to get better”)
    5. Talking about suicide or self-harm (feeling like a burden, being trapped, or not wanting to go on living)
    6. Expressing intense emotions such as anger, sadness or anxiety, being paranoid or withdrawn
    7. Avoiding questions or changing the subject frequently
    8. Expressing thoughts of hurting others
    9. Feeling overwhelmed or feeling like they are losing control
    10. Asking for help or expressing a need for assistance

    If you notice any of these signs or behaviors during a phone call, it is important to take them seriously and try to assess the level of risk the person may be at. It is important to be empathetic and non-judgmental while listening to the person and offering support and resources that may be helpful to them.

    Also, if the person is having trouble communicating and remains silent, this could be a sign of a mental health crisis. 

  • When do people typically seek assistance from mental health crisis helplines?

    People call crisis helplines when they need immediate emotional support, guidance, and resources to help them through hard times, such as, but not limited to:

    1. During a mental health crisis: People may reach out to mental health crisis helplines when they or someone they know is experiencing a mental health crisis, including suicidal thoughts, a severe depressive episode, self-harm urges, overwhelming anxiety or panic, psychosis, trauma like from domestic violence or sexual assault, or other mental health problems.
    2. When feeling overwhelmed or stressed: People frequently call mental health crisis helplines when they require emotional support or guidance during times of high stress or uncertainty, such as during a relationship or family crisis, a financial crisis, a job crisis, a natural disaster, or a major life transition.
    3. To seek advice or guidance: People can also call helplines when they need advice or direction about not only mental health issues but also taboo topics like sexual health issues and sexuality-related issues, which they may feel more comfortable discussing anonymously. Also, when they feel like they can’t handle their problems on their own and need help right away from trained professionals who can give them advice, support, and resources.
    4. To access mental health resources: People looking for information on nearby support groups, therapists, or mental health clinics may also contact helplines.
    5. Other related challenges: Those battling an addiction (not limited to drugs or alcohol) or coping with physical health issues, such as chronic pain, disease, or disability that interfere with their capacity to function on a day-to-day basis.

    Remember that they need help immediately, and the helpline gives them the impression that help is just a phone call away and can provide confidential and non-judgmental support. 

Crisis Management and Intervention Techniques

  • What to say to someone calling and claiming they want to die right now?

    In situations where someone claims they want to die immediately, generally accepted guidelines for a trained crisis responder may involve the following steps:

    Immediate Actions

    • Prioritize the Call: Any mention of immediate suicidal intent jumps to the top of the priority list. All other concerns are secondary at this point.
    • Stay Calm: Maintain a calm and composed demeanor. Your voice and tone can have a stabilizing effect on the caller. It’s crucial not to argue, or threaten the caller.
    • Direct Questions: Quickly assess the situation by asking direct, non-judgmental questions. Is the caller in immediate danger? Do they have a plan? Are the means readily available? These are crucial details that can guide the next steps.

    Risk Assessment and Intervention

    • Immediate Safety: If the caller indicates immediate intent and means to carry out suicide, your priority becomes keeping them safe. This may involve redirecting to emergency services if you have that capability.
    • Involve Third Parties: In some cases, it may be necessary to involve a third party for immediate intervention.

    Emotional Support

    • Validate Emotions: Express empathy and understanding without reinforcing the suicidal thoughts.
    • Short-Term Coping: Offer suggestions for immediate coping mechanisms, like talking to a trusted friend, sitting with a family member, or going to a safe public place.

    Refer to Professionals: Remind the caller that only a qualified healthcare provider can properly diagnose and treat medical or psychological conditions.

    After the Call

    • Document: Maintain thorough records of the interaction for accountability and potential follow-up.
    • Self-Care: Given that such calls are emotionally draining, follow self-care and debriefing after handling crisis calls. 
  • How to quickly but accurately assess the situation to decide whether immediate medical attention is required, especially for high-risk cases such as suicide ideation?

    Quickly but accurately assessing a crisis situation to determine the need for immediate medical attention is a crucial skill for HelpieCrisis Line Responders, particularly when dealing with high-risk cases such as suicidal ideation.

    Initial Screening Questions:

    1. Immediate Danger: Start by asking if the person is in immediate physical danger or has already inflicted harm upon themselves or others.

    2. Means and Plan: Assess whether the person has a specific plan to commit suicide and has access to the means (like weapons or pills) to carry it out.

    High-Risk Indicators:

    1. Previous Attempts: A history of previous suicide attempts significantly increases risk.

    2. Substance Abuse: Alcohol or drug use can impair judgment and increase impulsivity, thus elevating risk.

    3. Immediate Crisis: A recent life-changing event (e.g., loss of a loved one, divorce, legal issues) can intensify the risk.

    Risk Assessment Tools:

    Simple tools can often yield essential information to guide immediate action. Here are some that can be administered over the phone in a brief duration:

    SAD PERSONAS Scale A quick 10-item scale to assess suicide risk.

    S: Sex (male)

    A: Age (<19 or >45 years)

    D: Depression or hopelessness

    P: Previous suicide attempts or psychiatric care

    E: Excessive alcohol or drug use

    R: Rational thinking loss (psychosis or mood disturbance)

    S: Social support lacking or recent loss

    O: Organized plan to commit suicide

    N: No spouse or significant other

    A: Anxiety or agitation

    S: Self-harm history

    Each factor earns one point. A score of 0-4 suggests low risk, 5-6 suggests moderate risk, and 7-10 indicates severe risk. Higher scores necessitate immediate action.

    SAFE ERS (Suicide Assessment Five-Step Evaluation and Triage for Emergency Room Screen)- This is useful for very quick assessments.

    S: Suicidal ideation?

    A: A plan to enact it?

    F: Frequency of these thoughts?

    E: Emotional indicators? (hopelessness, desperation)

    E: Exit plan? (How would they do it?)

    R: Resources? (social support, mental health treatment)

    S: Severity? (history, preparatory actions)

    • Ask Direct Questions
    • Sometimes simplicity is key. Questions like:
    • Are you thinking about hurting yourself?
    • Do you have a plan?
    • Do you have the means to carry out this plan?
    • Have you attempted to harm yourself before?

    SLAP Risk Assessment

    SLAP stands for Specificity, Lethality, Accessibility, and Proximity. It’s used to evaluate the level of danger associated with a suicidal thought or plan.

    S: How Specific is the plan?

    L: How Lethal is the method?

    A: Is the Accessibility to the method immediate?

    P: What is the Proximity to medical services?

    Each of these questions can be followed by sub-questions to refine the risk level.

    Two-Question Screen

    For cases where you have very limited time:

    • During the past month, have you often been bothered by feeling down, depressed, or hopeless?
    • During the past month, have you often been bothered by having little interest or pleasure in doing things?

    A “yes” to either question suggests further screening is needed.

    Decision-Making Guidelines:

    1. High Risk, Immediate Action: If the person has a plan, means, and intent to commit suicide imminently, involve emergency medical services immediately. This often involves a breach of confidentiality for the safety of the individual.

    2. Moderate Risk, Urgent Referral: If the person has ideation but no immediate plan, refer them to emergency psychiatric services for an urgent assessment.

    3. Low Risk, Non-Urgent Referral: If the person has suicidal thoughts but no plan or immediate intent, they should still receive mental health support but may not require immediate medical intervention.

    Legal and Ethical Guidelines:

    1. Mandatory Reporting: Know the jurisdiction’s laws about when you must report a case to authorities.

    2. Confidentiality: Clearly communicate the limitations of confidentiality when immediate risk is identified.

    Team Support:

    1. Consult a Supervisor: For complex or borderline cases, consult with a medical advisor or a senior crisis responder.

    2. Coordinate: Ensure a smooth handover if you must involve emergency services, so there’s no gap in care.

    Given the complexity and sensitivity of these assessments, continual training and real-time supervision are strongly advised. 

  • What are some immediate response techniques to manage the information and referral crisis phase effectively?

    Managing the stabilization phase in a crisis call is a critical step in supporting someone who’s experiencing acute emotional distress. This phase aims to move the caller from a heightened state of emotional turmoil to a more manageable level of distress, setting the stage for problem-solving or longer-term support. Here are some evidence-based techniques commonly used:

    Cognitive Interventions:

    1. Reality Orientation: Gently remind the caller about time, place, and their surroundings to ground them back to reality.

    2. Cognitive Restructuring: Help the caller identify distorted thought patterns and reframe them into more balanced and constructive thoughts.

    Emotional Regulation:

    1. Guided Visualization: Use guided imagery to help the caller visualize a calm and safe space.

    2. Emotion Labeling: Encourage the caller to name their feelings as a first step in emotional regulation.

    Coping Strategies:

    1. Problem-Solving: Engage in basic problem-solving for immediate concerns, keeping the caller’s emotional state in mind.

    2. Coping Mechanism Identification: Help the caller identify existing coping mechanisms that have worked for them in the past.

    Safety Planning:

    1. Immediate Safety Measures: Outline concrete steps for ensuring the caller’s immediate safety, especially if there is a high risk of self-harm or harm to others.

    2. Long-Term Safety Plan: Begin to implement the Helpie Ring, the safety plan that can be used after the call.

    Social Support:

    1. Resource Identification: Identify social supports in the caller’s life that they can turn to once the call ends.

    2.Follow-Up Plan: Provide a framework for what steps the caller should take following the call.

    Escalation Protocols:

    1. Medical Triage: Know the protocol for situations requiring immediate medical intervention, including how to facilitate emergency services.

    2. Legal and Ethical Guidelines: Be well-versed in your obligations concerning confidentiality and mandated reporting, especially when the crisis involves potential harm.

    Self-Care for the Responder:

    1. Emotional Check-In: Quickly assess your emotional state to ensure that you remain effective in your role.

    2. Tag-Team Approach: Understand when to involve other professionals or pass the call to a more specialized responder. 

  • What are some immediate response techniques to manage the stabilization crisis phase effectively?

    Managing the stabilization phase in a crisis call is a critical step in supporting someone who’s experiencing acute emotional distress. This phase aims to move the caller from a heightened state of emotional turmoil to a more manageable level of distress, setting the stage for problem-solving or longer-term support. Here are some evidence-based techniques commonly used:

    Cognitive Interventions:

    1. Reality Orientation: Gently remind the caller about time, place, and their surroundings to ground them back to reality.

    2. Cognitive Restructuring: Help the caller identify distorted thought patterns and reframe them into more balanced and constructive thoughts.

    Emotional Regulation:

    1. Guided Visualization: Use guided imagery to help the caller visualize a calm and safe space.

    2. Emotion Labeling: Encourage the caller to name their feelings as a first step in emotional regulation.

    Coping Strategies:

    1. Problem-Solving: Engage in basic problem-solving for immediate concerns, keeping the caller’s emotional state in mind.

    2. Coping Mechanism Identification: Help the caller identify existing coping mechanisms that have worked for them in the past.

    Safety Planning:

    1. Immediate Safety Measures: Outline concrete steps for ensuring the caller’s immediate safety, especially if there is a high risk of self-harm or harm to others.

    2. Long-Term Safety Plan: Begin to develop a more comprehensive safety plan, Helpie Ring that can be used after the call.

    Social Support:

    1. Resource Identification: Identify social supports in the caller’s life that they can turn to once the call ends.

    2. Follow-Up Plan: Provide a framework for what steps the caller should take following the call.

    Escalation Protocols:

    1. Medical Triage: Know the protocol for situations requiring immediate medical intervention, including how to facilitate emergency services.

    2. Legal and Ethical Guidelines: Be well-versed in your obligations concerning confidentiality and mandated reporting, especially when the crisis involves potential harm.

    Self-Care for the Helpie Responder:

    1. Emotional Check-In: Quickly assess your emotional state to ensure that you remain effective in your role.

    2. Tag-Team Approach: Understand when to involve other professionals or pass the call to the Lead Helpie responder. 

  • What are some immediate response techniques to manage the immediate crisis phase effectively?

    Immediate response techniques are critical for managing the initial moments of a crisis situation effectively, especially for roles like Crisis Line Responders. These techniques aim to stabilize the individual emotionally, assess the severity of the situation, and provide appropriate resources or interventions. Below are some evidence-based immediate response techniques commonly used:

    Active Listening:

    • Reflective Listening: Echo back what the caller is saying to show that you understand and are paying attention.
    • Summarizing: Periodically summarize what has been said to ensure that you have a comprehensive understanding of the situation.

    Verbal De-escalation:

    1. Calm Tone: Use a calm, steady tone of voice to help reduce the emotional intensity of the situation.

    2. Short Sentences: Use simple, concise language, as people in crisis may have difficulty processing complex information.

    Emotional Validation:

    1. Empathetic Statements: Use empathetic language to validate their feelings and experiences.

    2. Non-Judgmental Approach: Convey an attitude of understanding and acceptance.

    Risk Assessment:

    1. Ask Direct Questions: It’s essential to ask clear, direct questions about the caller’s intentions, plans, and means if the crisis involves suicidal thoughts or other types of harm.

    2. Safety Check: If the situation is high-risk, inquire about the person’s immediate environment to ensure they are not in immediate physical danger.

    Crisis Diffusion:

    1. Grounding Techniques: Encourage the use of sensory grounding techniques like deep breathing or tactile engagement (holding onto a cold object, etc.) to bring the caller’s focus back to the present.

    2. Immediate Coping Strategies: Discuss basic coping strategies that the caller can implement immediately, such as talking to someone they trust, moving to a safe location, or diverting their thoughts through activity.

    Resource Provision:

    1. Immediate Referral: Provide contacts for immediate medical or psychological help if necessary.

    2. Future Resources: Share information for long-term resources that may be applicable to their situation.


     Additional Tips:

    1. Confidentiality: Be clear about the boundaries of confidentiality and mandated reporting.

    2. Team Consultation: Consult with the available Lead Helpie Responder (s) who are on a supervisory role for high-risk or complicated cases. 

Responder Self-Care and Emotional Boundaries

  • What are some burnout indicators of Helpie Responders?

    Recognizing burnout indicators early can be crucial for Helpie Crisis Line responders, especially given the emotionally taxing nature of crisis intervention work. Here are some signs that yourself, supervisors and peers should be alert to:

    Emotional Signs

    • Increased Irritability: A short temper, low tolerance for frustration, or becoming quickly irritated with callers or colleagues.
    • Emotional Exhaustion: Feelings of emotional depletion, emptiness, or being “drained” at the end of a shift.
    • Decreased Empathy: A reduced capacity to empathize with callers, possibly manifesting as an uncaring or detached attitude.
    • Increased Cynicism: Negative or cynical comments about callers, the efficacy of the help being offered, or the job itself.

    Physical Signs

    • Fatigue: Consistently feeling tired, even after a good night’s sleep.
    • Frequent Sickness: Increased susceptibility to illness, which could be a sign of a weakened immune system due to stress.

    Cognitive Indicators

    • Decreased Concentration: Trouble focusing during calls, missing important details, or making errors that are uncharacteristic.
    • Indecisiveness: Difficulty making routine decisions, which may lead to delays in providing effective crisis intervention.

    Behavioral Signs

    • Reduced Productivity: A noticeable decrease in the effectiveness or productivity, despite long hours.
    • Avoidance: Avoiding certain types of calls, responsibilities, or even avoiding logging in to the dashboard.
    • Isolation: Withdrawal from colleagues, avoiding social interactions, or team meetings.

    Professional Indicators

    • Lower Job Satisfaction: Expressing dissatisfaction with the volunteering, questioning its meaningfulness or considering quitting.
    • Increased Absenteeism: Frequent unexplained absences, prolonged absence from taking calls on the dashboard.
    • Reduced Commitment: Lack of interest in additional training, reluctance to adapt to new procedures, or avoiding extra responsibilities.

    Performance Indicators

    • Quality of Service: A decline in the quality of service, as indicated by feedback from callers, peers, or supervisors.
    • Failure to Follow SOP: Not adhering to established procedures, leading to compromised caller care. 
  • How to set emotional boundaries to ensure that the crisis of the caller does not adversely affect the responder’s well-being.

    Maintaining emotional boundaries is essential for Helpie Crisis Line responders. Striking the right balance between empathy and emotional detachment is crucial to ensure both effective crisis management and well-being of the responders. Here are some strategies:


    1. Recognize your emotions and those of the callers, allowing you to maintain a level of detachment.
    2. Identify personal emotional triggers.
    3. Practice setting boundaries during emotionally charged calls.

    During the Call

    1. Time Limits: Set reasonable time limits for calls when appropriate, as extended exposure can contribute to emotional fatigue.
    2. Structured Approach: Follow a structured framework or script that keeps the focus on resolving the crisis and providing resources rather than becoming emotionally enmeshed.
    3. Tag-Out System: Implement a system where a second, equally trained responder can take over a call if the first responder feels overwhelmed.
    4. Phrases for Emotional Boundaries: Equip yourself with phrases like “I understand this is a difficult time, but it’s crucial for us to focus on solutions,” which empathize but redirect the conversation.

    After the Call

    1.Immediate Debrief: Have an immediate, confidential debriefing with supervisors or peers where Helpie responders can process the call and their feelings about it.

    2. Journaling: Write down their experiences and feelings, which can help in emotional unloading without breaking confidentiality rules.

    3. Respite: After an intense call, it might be advisable to take a short break before the you take another call.

    Ongoing Support

    1. Have regular check-ins
    2. Get access to mental health professionals for periodic assessments and emotional well-being workshops.
    3. Join Peer Support Groups: Create a support group within the Helpie Platform where responders can share experiences and coping strategies.
    4. Look for Burnout Indicators: Recognize early signs of emotional fatigue or burnout and take immediate action (Refer question 13)
    5. Crisis Support for Responders: Have a separate, confidential crisis support system for responders themselves.

    Technological Support Use technology to monitor the length and emotional tone of calls, alerting supervisors when a responder might be at risk of emotional fatigue. 

Documentation and Data Management

  • What needs to be included in the “Note to other responders” section?

    The “Note to other Responder(s)” section is crucial for ensuring continuity of care, maintaining quality, and improving team communication. Given the range of topics you might be dealing with, from mental health crises to complex medical or social issues, this part of the documentation can be a lifeline for those who handle the same caller in the future. Here’s what should generally be included:


    1. Summary of Interaction: Provide a concise yet informative summary that gives the essence of the call. This enables the next responder to grasp the context without having to dig through all previous notes.

    2. Pending Actions: Mention any tasks or follow-ups that were promised to the caller or that remain pending, so the next responder knows what to pick up on.

    3. Risk Assessment: If the caller is at high risk for self-harm, suicide, or other dangerous behaviors, note this clearly for the immediate attention of future responders.

    4. Triggers or Sensitive Topics: Point out any triggers or topics that should be avoided in future interactions to prevent re-traumatizing the caller.

    5. Key Insights: Share any valuable insights gained during the call that could inform future interactions. For example, if you’ve noticed that the caller responds well to a specific communication style or set of coping mechanisms.

    6.Referrals Made: Include details about any referrals given, whether to emergency services, mental health professionals, or other organizations. This will prevent redundancy in future calls.

    7. Legal/Ethical Concerns: Highlight any legal or ethical issues that have been identified, so that future responders are aware and can act accordingly.

    8. Personal Preferences: If the caller had any preferences, such as being called by a specific name or pronoun, include this information for the comfort and personalization of future interactions.

    9. Upcoming Milestones: If the caller has mentioned any significant upcoming events like court dates, medical appointments, or anniversaries of traumatic events, note these so that future responders can inquire or prepare accordingly.


    1. Continuity of Care: Ensures a seamless experience for the caller, even if they interact with multiple responders over time.

    2. Quality Assurance: Helps in maintaining a uniform quality of service and ensures that critical information is not lost between shifts or responders.

    3. Efficiency: Saves time for the next responder, who can quickly get up to speed on the caller’s history and needs.

    4. Team Cohesion: Enhances team coordination and allows responders to learn from each other’s experiences and insights.

    This kind of thorough documentation can greatly assist in the complex and often sensitive work of a mental health crisis helpline. It respects the caller’s unique needs while also facilitating better teamwork among responders. 

Special Cases and Ethical Considerations

  • When and how should a caller be put on a blacklist?

    Blacklisting a caller is a significant and sensitive action that impacts a person’s ability to access services. This should be done cautiously and only after due consideration. The protocols may vary between helplines, but generally, a caller might be blacklisted for the following reasons:

    Reasons for Blacklisting:

    1. Abusive Behavior: Consistent abusive or aggressive behavior towards the helpline staff.

    2. Fraudulent Activity: Misrepresentation, impersonation, or fraudulent misuse of services.

    3. Non-compliance with Guidelines: Repeated violation of the terms and conditions or rules set by the helpline service.

    4. Harassment: Any form of harassment, including sexual, emotional, or psychological towards helpline staff.

    5. Illegal Activities: If the caller uses the service for illegal activities or endorses them.

    6. Resource Drain: Continuous calls without a genuine need, leading to other callers not getting timely help.


    1. Documentation: Record each instance of the behavior that might necessitate blacklisting, complete with the date, time, and the responder involved.

    2. Team Consultation: Discuss the case with a team of supervisor responder, core team, to ensure the decision is fair and justified.

    3. Warning: Depending on the severity of the offense, issue a formal warning to the caller explaining what behaviors are unacceptable.

    4. Final Decision: After a designated period or following multiple warnings, make the final decision to blacklist, consulting SOP as necessary.

    5. Implement: Blacklist the caller

    6. Review: Periodically review the blacklist to ensure that it remains accurate and relevant.

    Ethical Considerations:

    1. Right to Appeal: Offer an avenue for the caller to appeal the decision or a process for removal from the blacklist under extenuating circumstances.

    2. Data Privacy: Ensure the blacklisted data is stored securely to maintain confidentiality and compliance with data protection laws.

    Remember, the goal of the helpline is to assist those in need, but this must be balanced with the well-being and safety of the staff, as well as the effective allocation of resources. Always consult with the team and follow helpline’s specific procedures and ethical guidelines when making such a significant decision. 

  • If a caller’s consent status is “no” on the helpline dashboard, should I still call back to see how they’re doing?

    If the helpline dashboard indicates that the caller’s consent status is “no,” it is crucial to respect that decision and not initiate a callback. Doing otherwise could violate ethical guidelines, trust, and potentially even legal requirements related to privacy and consent.

    Guidelines for Helpie Responders: Handling “No Consent” Status on Dashboard

    1. Respect Consent: Always respect the caller’s wishes. If they have indicated “no” for consent to be contacted again, do not override this choice.
    2. Documentation: Update any logs or systems to indicate that the caller has declined consent for a callback. This ensures that other responders are also aware of this status.
    3. No Intrusiveness: Remember that unsolicited contact could be perceived as intrusive or unwelcome, potentially exacerbating a crisis situation or causing emotional distress.
    4. Available for Future Contact: Even if the caller has opted not to be contacted, the Helpie Crisis line allows them to initiate contact again should they change their mind.
    5. Review and Move On: After ensuring that you’ve complied with the consent status and documented it, move on to assisting other callers.

    Following these guidelines will help maintain the integrity of our service and uphold the privacy and choices of the Helpie Crisis Helpline callers. 

  • As a responder, how do I differentiate between genuine and fake calls?

    Discerning between genuine and fake calls is a vital skill for Helpie Crisis Line responders. Fake or “prank” calls can divert resources from those who genuinely need help. However, it’s also crucial to approach. this cautiously; making a mistake in judgment could have serious consequences. Here are some pointers to differentiate:

    Vocal Indicators

    • Inconsistency in Tone and Content: If the caller’s emotional tone doesn’t match the severity of the situation they describe, it could be a red flag.
    • Inappropriate Laughter or Giggling: Although some individuals may laugh nervously in serious situations, excessive laughter or snickering might indicate a fake call.

    Content Red Flags

    • Changing Stories: If the caller changes the narrative or the sequence of events frequently, that may indicate fabrication. Check on the call notes tab on the Helpie Crisis Response Platform for previous call details.
    • Exaggerated Scenarios: Scenarios that seem overly dramatized, improbable, or inconsistent with common sense or medical knowledge may be suspect.
    • Overuse of Stereotypes or Clichés: Descriptions that seem to mimic a stereotypical crisis situation could be a sign of a fake call.
    • Avoidance of Direct Questions: An unwillingness to answer straightforward questions about the situation may indicate lack of authenticity.

    Behavioral Signs

    • Background Noise: Listen for incongruous background noise (e.g., party noises during a claimed crisis).
    • Multiple Voices: If you hear multiple voices instructing the caller on what to say, that’s a strong red flag.
    • Hesitation in Urgent Scenarios: If someone is portraying an urgent situation but seems unconcerned or lacks urgency, be cautious.


    • Clarifying Questions: Use open-ended questions to ask for more detail. A genuine caller is more likely to offer specifics, while someone faking might falter.
    • Cross-Check Information: If possible and appropriate, validate the information provided with existing Notes from the previous call.

    Safeguard Protocols

    • Document: Keep records of suspected fake calls, noting specific inconsistencies or red flags.
    • Supervisory Consult: When in doubt, consult a supervisor or experienced colleague for a second opinion.
    • Brief Hold: Placing the caller on a brief hold can sometimes discourage non-serious callers. 
  • What is the point at which callers are redirected to seek further professional help?

    Determining when to redirect callers to seek further professional help is a critical decision-point for Helpie Crisis Line responders. Here are some situations where redirection to more specialized care would be appropriate:

    Immediate Safety Concerns

    • Active Suicide Ideation: Explicit statements or strong hints about attempting suicide imminently.
    • Threats to Others: Clear intentions or plans to harm someone else.
    • Severe Self-Harm: Indications that the caller is currently engaging in or planning severe self-harm.
    • Medical Emergency: Symptoms of a severe medical problem that require immediate medical attention.

    Severity of Symptoms

    • Extreme Emotional Distress: Inability to communicate, extreme agitation, or dissociation, signaling an acute crisis that is beyond the scope of telephonic intervention.
    • Psychotic Symptoms: Delusions, hallucinations, or severe disorientation.

    Capacity and Consent

    • Lack of Capacity: If the caller is unable to understand the advice given or to make informed decisions.
    • Minors Without Guardian Consent: If minors are calling without parental or guardian awareness and the issue is severe.

    Ongoing Needs

    • Chronic Issues: Repeat callers who show no sign of improvement and have persistent issues that are beyond the scope of crisis intervention.
    • Need for Medication or Medical Tests: When the nature of the crisis indicates a likely need for medication, medical tests, or physical healthcare services.

    Other Indicators

    Specialized Care Required: Issues that need specialized therapeutic or medical intervention like eating disorders, severe PTSD, etc.

    Legal Issues: Situations involving imminent legal consequences that need specialized legal advice.


    Documentation: Document the reasons for redirection according to your set protocols for future reference and quality control.

    Warm Transfers: Whenever possible, facilitate a “warm transfer” where you stay on the line with the caller until the other service picks up.

    Follow-Up: Depending on your guidelines, a follow-up might be in order to ensure that the transition to a higher level of care was smooth. 

Communication Skills and Challenges

  • How to engage with a caller who is receiving treatment for mental illness but reports that the treatment is not working for them?

    Engaging with a caller who reports that their mental health treatment is not effective can be a sensitive and complex situation. Here are some guidelines on how to proceed:

    Establish Rapport and Trust

    • Acknowledge the Caller’s Experience: Start by recognizing the frustration and difficulty they may be feeling because their treatment hasn’t been effective. This validates their experience.
    • Express Limitations: Make it clear that while you’re not a healthcare provider, you are here to listen and guide them to the right resources.

    Gather Information

    • Duration and Type of Treatment: Ask how long they’ve been on this treatment and what type (medication, therapy, etc.).
    • Symptom Status: Without going into diagnostic territory, inquire generally about the persistence or worsening of symptoms.

    Time and Adjustment

    • Patience with the Process: Mention to the caller that mental health treatments, particularly medications, often require time to become fully effective. It’s not uncommon to experience a delay before noticing substantial improvements.
    • Ongoing Communication: Stress the importance of maintaining an open dialogue with their healthcare provider. Treatment for mental health conditions often involves a period of dosage adjustments and “fine-tuning” to find the most effective and safe therapeutic window. This process typically requires multiple follow-ups with the treating doctor.

    Recommendations and Referral

    • Consult Their Healthcare Provider: Strongly advise the caller to consult with their treating physician or mental health professional for a thorough evaluation of their treatment plan. Stress the importance of honest communication with healthcare providers.
    • Second Opinion: Suggest that getting a second opinion could offer additional insights into their condition and treatment options.
    • Additional Support: Offer resources for support groups or alternative treatments that they can discuss with their healthcare provider.

    Crisis Resources: If the caller indicates severe symptoms or urgent distress, recommend immediate medical attention or crisis intervention services.

    Emotional Support

    • Encourage Hope: Remind them that treatment for mental health is often a trial-and-error process and that it’s normal to seek adjustments.
    • Non-Judgmental Listening: Sometimes, callers just need a compassionate ear. Offer that space for them to share their concerns. 
  • What should be done if the caller cites multiple concerns?

    When a caller cites multiple concerns, it’s important to manage the situation in a structured, compassionate manner. Given Helpie Platforms expertise in evidence-based mental health care interventions, problem-solving prompts, and patient management strategies, the following evidence-based approach may be valuable for Helpie Crisis Line responders:

    Initial Steps

    • Acknowledge Complexity: Start by acknowledging that the caller is dealing with multiple issues, which understandably can feel overwhelming.
    • Clarify Role and Limitations: Inform the caller that while you’re not a healthcare provider, you are trained to offer immediate support and guide them to appropriate resources.

    Prioritizing Concerns

    • Risk Assessment: If one of the concerns involves immediate danger, such as suicidal ideation, address that first. Immediate risks should always take precedence.
    • Urgency vs. Importance: After immediate risks are addressed, try to differentiate between what’s urgent and what’s important to tackle next.

    Structured Conversation

    • Issue Segmentation: Break down the multiple concerns into individual segments. Use open-ended questions to understand the nuances of each issue.
    • Summarize and Confirm: After listening, summarize each concern briefly and ask the caller to confirm or clarify.

    Providing Support and Guidance

    • Targeted Resource Allocation: Offer resources and recommendations specific to each concern, ensuring that they are evidence-based and reputable.
    • Action Plan: Develop a simplified, immediate action plan that the caller can follow after the call.

    Emotional Support

    • Validation: Reiterate that it’s okay to seek help and commend them for taking the first step by calling the helpline.
    • Empowerment: Empower the caller to take control by making informed decisions based on the resources and information provided.


    • Wrap-up: Summarize the conversation, the resources provided, and the action steps recommended.
    • Follow-up: Discuss the possibility of follow-up to ensure they’ve been able to access the resources or help needed. 
  • What happens if the person who calls you is more knowledgeable than you are on the subject at hand?

    When a caller appears to be more knowledgeable than the Helpie Crisis Line responder on the subject at hand, it can present a unique challenge but also an opportunity for constructive engagement. Here’s how you might handle it.

    Acknowledge Expertise

    1. Be Transparent: Honesty builds credibility. Acknowledge that you’re learning from the conversation as well, and clarify the limits of your expertise if necessary.

    2. Focus on Your Role: Remember, as a Helpie crisis line responder, your primary role isn’t to be the foremost expert on mental health issues but to provide immediate emotional support and appropriate referrals.

    Active Listening

    1. Validating: Even if the caller has more knowledge, it doesn’t invalidate their need for emotional support. Listening empathetically can offer immense value.
    2. Non-judgmental Engagement: Create a safe space for the caller to share their thoughts and feelings, even if they express viewpoints that are different from mainstream understandings.

    Leverage their Knowledge

    1. Ask for Their Opinion: Encourage them to share what they know, as it can be empowering and therapeutic to teach someone else.
    2. Utilize Their Suggestions: If they offer evidence-based strategies or resources that align with the scope of the Helpie Mental Health Crisis Helpline, consider incorporating their suggestions into the conversation.

    Emotional Support and Guidance

    1. Be Supportive: Offer emotional support as needed, focusing on the caller’s immediate needs.
    2. Referrals and Resources: Since they are knowledgeable, they may appreciate more specialized resources or referrals you can offer.

    End of Call

    1. Express Gratitude: Thank them for educating you, ensuring to maintain an empathetic and supportive tone.
    2. Follow Protocol: Complete any documentation or follow-up procedures according to your helpline’s protocols.

    Disclaimer: It’s crucial to remember that even if a caller is more knowledgeable on a subject, the information they provide should not replace the Helpie Mental Health crisis line’s best practice guidelines or SOP. 

  • How to talk to a caller who has a lot going on in the background, like loud music or people talking?

    Handling a call with a lot of background noise can be challenging, especially when your primary goal is to provide focused, evidence-based crisis support. Here are some guidelines to help Helpie Crisis Line responders manage such scenarios effectively:

    Initial Assessment

    1. Quickly Gauge the Situation: Attempt to discern if the background noise is temporary or likely to continue throughout the call.
    2. Prioritize the Call: If it’s a crisis situation, the background noise becomes a secondary concern, but it still needs to be addressed to ensure clear communication.

    Addressing the Noise

    1. Be Direct but Tactful: Politely ask the caller if it’s possible to move to a quieter environment or to lower the background noise.
    2. Explain the Importance: Stress that a quieter environment allows you to focus better on helping them, and that it’s crucial in a crisis situation to have clear communication.

    Maintaining Focus

    1. Active Listening: Despite the background noise, try to maintain an attentive posture. Use verbal nods like “I see,” “Go on,” etc., to indicate you’re listening.
    2. Clarification: If you can’t hear them properly, don’t hesitate to ask them to repeat what they said.

    Technical Assistance

    Use Headphones: If possible, use noise cancellation headphones to minimize the impact of background noise on your end.

    Emotional Support

    1. Be Calm and Steady: Your calm voice can be a beacon of stability in a chaotic environment. Stick to that demeanor to offer the best support.
    2. Express Understanding: Acknowledge that dealing with a crisis in a noisy environment can be overwhelming, showing empathy toward their situation.

    Wrapping Up

    1. Summary and Next Steps: Briefly recap what was discussed and offer the next steps, including referrals if applicable.
    2. End on a Positive Note: Thank them for taking the time to call despite their challenging environment, reinforcing that you’re there to help. 
  • What if the caller’s friend or family member needs help and wants to talk to you during the call?

    When a caller’s friend or family member expresses a desire to talk to a Helpie Crisis Line responder during the same call, it presents both a challenge and an opportunity to provide broader support. Here’s a structured approach to handle such situations, aligned with evidence-based practice and ethical guidelines:

    Initial Response

    • Establish Caller’s Consent: Before speaking to the friend or family member, make sure to get the original caller’s explicit consent. This ensures confidentiality and trust are maintained.
    • Prioritize Safety: Make a quick assessment to determine if the situation is a crisis requiring immediate attention. If so, proceed according to emergency protocols.


    • Clarify Roles: Make it clear that you’re available to help but are not a replacement for professional medical advice or emergency services.
    • Set Expectations: Briefly outline what the friend or family member can expect from the conversation, such as emotional support, information, or referrals.

    During the Conversation

    • Active Listening: Give the new speaker your undivided attention, allowing them to share their concerns or questions.
    • Objective Assessment: Use brief risk assessment tools to understand the gravity of the situation, particularly if the subject is high-risk like suicide ideation.

    Providing Support

    • Evidence-based Advice: Offer recommendations or advice based on scientific evidence and clinical guidelines, focusing on immediate emotional support and next steps.
    • Resource Sharing: If appropriate, provide referrals to local resources or services that could be of further help to the friend or family member.

    Transition Back

    • Summarize: Before handing the phone back to the original caller, summarize the key points discussed with the friend or family member.
    • Check-In: Once you’re back with the original caller, make sure to do a quick check-in to ensure they’re comfortable with how the conversation went.

    Post-Call Protocol

    • Documentation: Document the conversation according to your helpline’s guidelines, including any unique scenarios that occurred due to the inclusion of the friend or family member.
    • Self-Care: Given that interacting with multiple people in a single call can be emotionally taxing, make sure to follow self-care to prevent burnout.

    Guidelines for When the friend or family has a different problem of their own to discuss

    • Obtain Original Caller’s Consent: Before shifting the focus to the third party, ask the original caller for their consent for a brief diversion.
    • Define Your Role: Make it clear to the third party that while you can provide some immediate support, you can’t offer specialized medical advice for their separate issue.
    • Provide Resource-Based Advice: Suggest immediate next steps or resources they can utilize based on their particular situation.
    • Manage Time Efficiently: Given that the original call was intended for a different crisis, keep your engagement with the friend or family member brief and directed towards appropriate resources or a separate, more detailed call.
    • Transition Back to Original Caller: Always return the focus to the original caller to ensure their crisis remains the primary concern of the call. 
  • What to do when a caller insists on speaking to the same person they spoke to the previous time they called? The Helpline SOP does not allow the same.

    When a caller insists on speaking to the same Helpie Crisis Line responder they interacted with previously, it can be a challenging situation. Since Helpie Mental Health Crisis Helpline Standard Operating Procedure (SOP) does not allow this, here’s how to handle it:

    • Acknowledge the Request: Start by acknowledging the caller’s request in a compassionate manner. Understand that their previous interaction may have built a sense of trust and rapport, making them more comfortable with that particular responder.
    • Clarify SOP Policy: Clearly but gently inform the caller about the Helpline’s policy that does not allow them to speak to the same responder they spoke with previously.
    • Assure Quality Service: Assure them that all Helpie Mental Health Crisis Line responders are trained professionals, capable of providing consistent, high-quality assistance. Your goal is to make them feel as comfortable as possible with the current conversation.
    • Offer Immediate Support: Transition smoothly from policy clarification to addressing the caller’s immediate needs or concerns. The quicker you can refocus the conversation on their crisis, the better.
    • Escalation Protocol: If the caller becomes agitated, distressed, or uncooperative, follow your escalation protocols to manage the situation effectively.
    • Document the Interaction: Finally, make sure to document the caller’s request to speak to a specific responder. This information could be useful for future training and SOP reviews. 
  • What should be done if the caller discusses sexual matters or problems linked to sexual wants and needs?

    Handling discussions about sexual matters requires a delicate balance of professionalism, sensitivity, and adherence to ethical boundaries. Here’s a step-by-step guideline for Helpie Crisis Line responders:

    Set Boundaries Clearly: At the beginning of the call, make it clear that while you can provide emotional support and general advice, you are not a substitute for specialized medical or psychological guidance on sexual matters.

    Stay Non-Judgmental: Maintain a non-judgmental tone to ensure the caller feels heard and understood, encouraging open communication.

    Adherence to SOP: Follow your SOP for handling sensitive or adult content. Ensure that you are in a setting that maintains the caller’s confidentiality.

    Safety Assessment: If the discussion relates to sexual abuse, violence, or any form of exploitation, immediately adhere to your specific safety and reporting procdedures.

    Provide Information and Referrals: Offer information about specialized services, resources, or professionals who can provide more tailored support for sexual concerns. ( )

    Check For Consent: Before discussing sexual matters, ask for explicit consent to continue with the topic, ensuring the caller is comfortable discussing such sensitive issues.

    Guard Your Own Boundaries: If the conversation becomes inappropriate, you are entitled to assert your own boundaries and end the call if necessary.

    Document Thoroughly: Maintain a comprehensive record of the call, adhering to helpline’s guidelines for documentation. This is particularly important for calls of a sensitive nature, as they may be useful for future Helpline responders handling to the same call.

    Criteria for Blacklisting Callers Discussing Sexual Matters Inappropriately

    Blacklisting a caller is a serious decision and should only be made under specific, documented circumstances that are deemed inappropriate or harmful. Below are some criteria that may warrant blacklisting a caller who discusses sexual matters:

    Explicit Inappropriateness: If the caller makes explicitly sexual comments that are meant to harass, intimidate, or exploit the Helpie Crisis Line responder.

    Harassment or Stalking: If the caller consistently harasses multiple responders over several calls, especially after being warned.

    Lewd or Offensive Behavior: If the caller engages in lewd or offensive behavior, sharing unsolicited explicit content, or making inappropriate advances.

    Non-Cooperation with Protocols: If the caller persistently refuses to follow guidelines after they have been communicated clearly.

    Illegal Activity: Any caller discussing illegal sexual activities, such as child exploitation, should not only be blacklisted but also reported to the appropriate authorities, following the helpline’s reporting protocol.

    Safety Threat: If the caller threatens the physical or emotional safety of the responder or themselves.

    False Reporting: If the caller makes false reports or false allegations against the service or its responders.

    Misuse of Service: If it is evident that the caller is using the helpline services for purposes other than seeking help, such as for their own sexual gratification.

    Multiple Warnings: If the caller has already received multiple warnings about the inappropriate conduct but continues to behave in the same manner.

    Procedure for Blacklisting:

    • All blacklisting actions should be documented thoroughly, including the incidents leading to such a decision.
    • Before taking the action, consult with a responder supervisor to review the case.
    • Follow the helpline’s specific protocols for blacklisting a number, including the duration of the blacklist and the review process. 
  • How to respond when a caller requests that you speak with a third party, such as a family member or close friend, on their behalf.

    When a Helpie Crisis Line responder receives a request from a caller to speak with a third party like a family member or close friend, it’s crucial to tread carefully while ensuring that the service’s ethical and procedural protocols are upheld. Here are some guidelines to help manage these requests:

    Clarify the Need: Ask the caller why they want you to speak to a third party. Is it to explain the nature of the crisis, to seek consent for a certain action, or another reason?

    Adherence to Protocol: Remind the caller that, as per your helpline’s standard operating procedure, you cannot speak directly with a third party on their behalf unless it’s part of a pre-defined emergency protocol.

    Offer Alternatives: Suggest alternative ways to address the situation. For example, you can offer to guide the caller in having a more effective conversation with the third party, or provide general information that the caller can pass on.

    Supervisory Consultation: If the situation is complex or unclear, consult with a supervisor responder for guidance on how to proceed.

    Safety Measures: If there’s a risk to the caller’s immediate safety and they can’t speak for themselves, follow specific emergency protocols which might include notifying appropriate authorities or medical personnel.

    Documentation: Keep thorough records of the call, documenting the request and the steps taken to address it.

    Referral Information: If appropriate, provide the caller with referral information for services that might be more equipped to handle their specific needs, including liaising with family members or friends if needed. 

  • What should you do when a child calls, whether intentionally or not?

    Managing a call from a child, intentional or accidental, presents unique challenges and responsibilities. Here are some guidelines tailored for such circumstances:

    Identifying the Child Caller

    1. Initial Identification: If the voice sounds youthful or the conversation seems child-like, gently ask the caller’s age to confirm you’re speaking with a child.
    2. Consent and Parental Involvement: Depending on your protocols and local laws, you may need parental consent to offer advice to a minor. Clarify this in the beginning.

    Handling Intentional Calls

    1. Assess Urgency: Determine if the child is in immediate danger or experiencing a crisis. Use simplified language appropriate for their age to gauge the severity of the situation.
    2. Tailored Communication: Speak in a calm, reassuring tone using age-appropriate language. Keep questions simple and to the point.
    3. Contact Adults: If the situation warrants it, try to get in contact with a responsible adult in the child’s life. This could be parents, guardians, or even school officials.
    4. Follow Safety Protocols: If the child is in immediate danger, follow emergency protocols, which might involve contacting child protective services or emergency services.
    5. Document Thoroughly: Keep detailed notes of the conversation for future reference and potential legal requirements.

    Handling Accidental Calls

    1. Quick Assessment: Politely ask if they meant to call the helpline and whether they are okay.
    2. Disconnect If Appropriate: If it’s clearly an accidental call and there is no risk, it may be appropriate to end the call after ensuring the child is safe.
    3. Parental Notification: If possible, inform parents or guardians about the call to ensure that they are aware of the situation.

    General Procedures

    1. Supervisory Consultation: Always consult a supervisor or team lead when dealing with a potentially sensitive or high-risk situation, especially when it involves minors.
    2. Legal Compliance: Be fully aware of, and compliant with, any laws related to interacting with minors in your jurisdiction.
    3. Follow-Up: Schedule a follow-up call or make a note for future reference to ensure the child’s ongoing safety. 
  • How do you handle a caller with physical health problems that make it hard for them to go about their daily lives?

    When a caller reaches out to the Helpie Mental Health Crisis Helpline with physical health issues that make daily life difficult, your role as a responder is multi-faceted. Here are guidelines to navigate such complex interactions effectively:

    Initial Assessment

    Clarify the Situation: Ask for details about their physical condition, ensuring you understand how it affects their daily life and mental health.

    Emergency Signs: Quickly assess if the physical health problem needs immediate medical attention. If so, inform them to reach out to the nearest emergency healthcare service.

    Addressing Mental Health Concerns

    Emotional Support: Acknowledge the emotional toll that chronic or acute physical health issues can have. Provide empathetic and supportive listening.

    Anxiety and Depression: Many individuals with physical health issues may also suffer from anxiety or depression. Make sure to assess for these mental health conditions as well, using validated screening tools when appropriate.

    One of the widely recognized and validated tools that could be suitable for the Helpie Crisis Line is the Patient Health Questionnaire-2 (PHQ-2), which is a shorter version of the PHQ-9. This tool specifically assesses for depression but can also indicate the presence of other mood disorders like anxiety, especially if followed by more comprehensive assessment. The tool consists of two questions:

    1. Over the past two weeks, how often have you been bothered by little interest or pleasure in doing things?
    2. Over the past two weeks, how often have you been bothered by feeling down, depressed, or hopeless?

    For each question, the caller can answer:

    • Not at all (0 points)
    • Several days (1 point)
    • More than half the days (2 points)
    • Nearly every day (3 points)

    If the score is 3 or higher, it may be indicative of a mood disorder, and the individual should be referred for a more comprehensive mental health evaluation.

    Similarly, the Generalized Anxiety Disorder-2 (GAD-2) questionnaire is a 2-item version of the GAD-7 and focuses on anxiety. It asks:

    1. Over the last two weeks, how often have you been bothered by feeling nervous, anxious, or on edge?
    2. Over the last two weeks, how often have you been bothered by not being able to stop or control worrying?

    The scoring is the same as for the PHQ-2.

    Both tools are brief, straightforward, and can be administered over the phone, which could make them particularly useful for the
    Helpie Mental Health Crisis Line setting.

    Motivational Support: Encourage them to discuss their feelings and fears about their physical health condition. Reinforce that although physical conditions can be debilitating, mental well-being can positively influence their quality of life.

    Providing Information and Resources

    Interdisciplinary Approach: Recommend an interdisciplinary approach involving medical doctors, mental health professionals, and physical therapists, if not already in place.

    Resource Directories: Be well-versed in available resources and referrals for different types of physical health issues, and share them as appropriate.

    Setting Boundaries and Limitations

    Role Clarification: Make it clear that while you can offer mental health support, you cannot diagnose or treat physical health conditions.

    Further Evaluation: Urge the caller to consult their healthcare provider for a comprehensive assessment and treatment plan.

    Concluding the Call

    Wrap-Up: Summarize key points of the conversation and ensure the caller has a clear understanding of the next steps.

    Follow-Up: Need be, schedule a follow-up call to check on their mental and emotional well-being. 

  • How to respond when a caller states they have previously tried to receive assistance from MHPs but need something to work for them?

    When dealing with a caller who expresses frustration due to previously unsuccessful interactions with mental health professionals (MHPs), it’s crucial to acknowledge their feelings and concerns empathetically. You might say something like:

    “I can hear that you’re feeling frustrated and discouraged by your past experiences with mental healthcare. I’m really sorry you’re going through this, but I’m glad you reached out. While I can’t offer a medical diagnosis or treatment, I can help guide you towards the resources or professionals who may be able to assist you more effectively.”

    Here are some guidelines for managing such conversations:

    Validate their Feelings

    Ensure you validate the caller’s feelings. This may help lower their defenses and make them more receptive to seeking help again.

    Assess Current Crisis Level

    Use a validated tool like the PHQ-2 or SAD PERSONAS scale to quickly assess the immediate risk and crisis level. This will guide your subsequent actions.

    Suggest Second Opinions or Alternative Therapies

    Sometimes different professionals have varying perspectives on diagnosis and treatment. Also, suggest looking into alternative or supplementary treatments like psychotherapy if they’ve only tried medication and vice versa.

    Encourage Persistence

    Remind them that mental health treatment is often a trial-and-error process that can require changes in healthcare providers, therapies, or medications. This does not mean that effective treatment is unattainable; it often takes time to find the right approach.

    Provide Referrals

    Be prepared to offer specific referrals to different types of mental health professionals, support groups, or other resources, perhaps some that offer a different therapeutic approach.

    Reiterate Support

    Conclude by expressing support and encouraging them to reach out again if they need to talk, while also emphasizing the importance of professional assistance for an accurate diagnosis and treatment plan. 

  • The caller is uncomfortable seeking treatment from a psychiatrist or psychologist. How can we best assist this individual?

    In cases where a caller is hesitant or uncomfortable seeking help from a psychiatrist or psychologist, you have an opportunity to offer alternatives while still emphasizing the importance of professional care. Here are some guidelines:

    Validate Their Concerns

    Start by validating their concerns: “I understand that the idea of seeking help from a psychiatrist or psychologist feels uncomfortable for you. That’s okay; you’re not alone in feeling this way.”

    Suggest Alternative Mental Health Professionals

    Mention other types of mental health professionals like licensed counselors, social workers, or psychotherapists who are also qualified to provide mental health treatment. “There are other healthcare professionals trained in mental health support. Have you considered speaking to a licensed counselor or a social worker?”

    Offer Information on Different Therapies

    You could talk about the array of therapies available that don’t necessarily involve medication, such as Cognitive Behavioral Therapy (CBT), Interpersonal Therapy (IPT), or Mindfulness-Based Stress Reduction (MBSR). “Some therapies focus on coping strategies, skills building, and are not medication-based. Would something like that be more in line with what you’re looking for?”

    Discuss Support Groups or Peer Support

    Suggest local or online support groups or peer support communities. These spaces can sometimes serve as an intermediate step for people uncomfortable with formal medical settings. “There are also peer-led groups where people share experiences and coping strategies. Would you be interested in something like that?”

    Telemedicine or Online Consultations

    Given their hesitation, they might be more comfortable with the anonymity provided by telemedicine services. “Online consultations are also available, which might provide the initial level of anonymity you might be comfortable with.”

    Recommend Self-Help Resources

    Share high-quality self-help books, apps, or free online courses on mental health. Make sure to let them know that while these resources are valuable, they should not replace professional advice.

    Encourage Primary Care Consultation

    For some people, talking to their primary care physician about their mental health symptoms is a less intimidating first step. “Sometimes, a general physician can also guide you initially and may provide a referral based on your comfort level.” 

  • The caller is discussing the medicines they are presently taking. Should I proceed with this discussion?

    Discussing medications over a helpline can be a sensitive issue. Even if you are a qualified healthcare professional, as a Helpie Responder, it’s generally not advisable to give medical or pharmacological advice on the Helpline. However, you can still provide support and guidance in a responsible manner. Here are some guidelines:

    Do Not Provide Medical Advice

    Clarify at the outset that you are Helpie Crisis Responder and can’t provide medical or pharmacological advice: “I need to clarify that I’m a Helpie Crisis Line Responder, I cannot offer medical advice.”

    Validate and Listen

    Offer a listening ear and validate their concerns, but reiterate the importance of consulting a healthcare provider for any medication-related queries: “I understand that you have concerns about your medication, but it’s crucial to consult your healthcare provider for accurate advice.”

    Suggest Consultation

    Recommend that they consult their healthcare provider for accurate, personalized advice. “Your healthcare provider is the best person to discuss any medication questions or concerns you may have.”

    Offer General Information

    If the caller is asking about general knowledge regarding types of medication or their purpose, you may offer this information only if you are certain it is accurate. Always qualify this by stating that they need to consult their healthcare provider for personalized advice.

    Note Down Information

    Make a detailed note of this discussion for future reference or for supervisors to evaluate or other responders to refer to. This can be especially useful if the caller is a repeat caller, as it helps to maintain continuity. 

  • The caller is hesitant to speak since they know the call is being recorded and fear the information could be used to blackmail them. How should I respond?

    Navigating a situation like this requires a balance of empathy, professionalism, and strict adherence to confidentiality protocols. Here’s how you could manage this delicate circumstance:

    Reiterate Confidentiality and Ethical Guidelines

    Assure the caller that the organization strictly adheres to confidentiality norms and ethical guidelines. Emphasize that the primary purpose of the call is to provide immediate assistance and support. “I understand your concerns about confidentiality. Please know that these calls are recorded to ensure we’re providing the highest quality care and support. Our organization has stringent ethical and confidentiality guidelines to protect your privacy.”

    Acknowledge Their Concerns

    Let them know you understand why this situation might make them uncomfortable. “Your worries about privacy are completely understandable. It takes courage to reach out for help, and we want to make this process as comfortable as possible for you.”

    State the Scope and Limitations

    Explain the extent to which the information will be kept confidential and the scenarios in which information may have to be disclosed, such as immediate life-threatening situations or as mandated by law. “While we strive to maintain your confidentiality, there are specific legal limits to this, especially if someone’s immediate safety is at risk.”

    Offer Alternatives

    Suggest other ways they can receive support if they are uncomfortable continuing the phone call. This could include using other helplines. “If you’re concerned about the call being recorded, you can take support through [____], where you can remain anonymous.” 

  • The caller is in legal trouble, extremely distressed, and requires assistance. What should be done?

    Navigating a call involving legal trouble is a sensitive and complex situation. Here are some steps to guide your response:

    Clarify Your Role

    Make it clear at the beginning of the conversation that you are not a legal advisor but crisis helpline responder. “I’m not qualified to give you legal advice, but I can certainly help you find some emotional balance and think through your next steps.”

    Acknowledge Emotional State

    Acknowledge the caller’s emotional distress without dwelling on the details of the legal trouble. “It sounds like you’re going through an incredibly stressful time right now, and that’s why I’m here to support you.”

    Assess Immediate Risk

    Evaluate if there is an immediate risk to the caller or others. If yes, escalate as per the protocols for immediate danger. Given our key work area in suicide prevention, you may need to swiftly assess suicidality or immediate risk.

    Offer Emotional Support

    Your primary goal is to help the caller reach a state of emotional stabilization. Use techniques like active listening, empathy, and validation to offer emotional support.

    Provide Resource Information

    Offer to guide them toward the appropriate services such as legal aid, counsellors who specialize in legal stress, or other local resources. “While I can’t offer legal advice, there are professionals who can. Would you like some help in finding those resources?”

    Encourage Professional Help

    Recommend they consult with legal and medical professionals for their situation. “For the situation you’re describing, it’s crucial to speak with a qualified legal advisor as well as a healthcare provider for comprehensive support.”

    Set Boundaries Make sure to define your limitations clearly. “I can provide emotional support and general advice on stress management, but for legal issues, it’s essential to consult with the appropriate professionals.” 

  • The caller has financial difficulties and requests assistance. What should I suggest?

    Addressing a caller facing financial difficulties requires a careful approach that blends emotional support with information and resources. Here’s how you can navigate this scenario:

    Acknowledge the Stress

    Firstly, acknowledge the emotional burden that financial difficulties can bring. “I understand that financial difficulties can be incredibly stressful, and it’s okay to ask for help.”

    Clarify Your Role

    Let them know that while you can offer emotional support and general guidance, you’re not a financial advisor. “I can’t provide specific financial advice, but I can help you look at your options for next steps.”

    Emotional Support

    Provide emotional support, focusing on the feelings and stresses the caller is experiencing rather than on the financial problem itself.

    Assess Immediate Needs

    Try to understand if their financial difficulties are leading to immediate risks, like lack of food or shelter. In such cases, provide immediate referral information for emergency financial aid or shelters.

    Offer Resource Guidance

    Suggest resources where they can get professional financial advice or aid. “There are organizations and professionals specialized in financial difficulties. Would you like me to help you find some resources?”

    Encourage Practical Steps

    Although you can’t offer financial advice, you can encourage them to take practical steps like creating a budget or contacting financial help centers. “Sometimes, breaking down the problem into smaller tasks can make it more manageable.”

    Reinforce Resilience

    Remind the caller that many people go through financial difficulties and come out stronger. “This is a tough phase, but it’s not the end of the road. Taking one step at a time can lead to a better situation.”

    Close with a Follow-Up Plan

    Provide a sense of direction for them to follow after the call, whether it’s looking into resources you’ve provided or consulting with a financial advisor.

    What if the caller is in huge debt and is thinking of ending their life or considering harming the family?

    Crisis situations like these require immediate, professional intervention.

    Immediate Risk Assessment: Evaluate the immediacy of the risk. If the person indicates a specific plan or means to end their life or harm others, this is an emergency requiring immediate action.

    Call for Help: If the situation is assessed as life-threatening, follow the emergency protocol to ensure immediate medical attention. This could involve notifying local authorities or emergency medical services.

    Build Rapport: Attempt to build a connection with the caller to encourage communication and better assess the situation. Your tone should be empathetic, compassionate, and calm.

    Validation: Validate their feelings without validating their suicidal ideation. For example, “It sounds like you’re going through an incredibly tough time, but I can’t provide the help you need. It’s important to talk to someone who can, though.”

    Encourage Professional Help: Steer the caller toward immediate, qualified assistance. Provide local emergency numbers, helpline numbers, or legal numbers who can offer immediate assistance.

    No Secrets: Make it clear that if you believe their life is at immediate risk, you will have to break confidentiality and seek emergency help.

    Referrals for Ongoing Support: Once the immediate crisis has passed, refer the caller to financial advisors or counselors who specialize in debt management, along with mental health support.

    Follow-Up: Arrange for a follow-up to ensure that the caller has accessed the required services and is no longer at immediate risk.

    Self-Care: After the call, it’s essential for the responder to engage in self-care and possibly debrief with a supervisor to process the event. 

  • The caller needs assistance with queer issues, but I do not have the training to provide it. How to proceed?

    When encountering a caller who needs specialized assistance that falls outside the scope of your training, it’s important to be both honest and helpful. Below are some guidelines on how to handle such a situation:

    Acknowledge the Limits: Politely acknowledge that while you’re there to support them, you are not an expert in queer issues. Transparency is key.

    Express Empathy: Make sure to express empathy and validate the caller’s feelings and concerns.

    Consult Resources: Utilize Helpie directory  to identify specialized services that can more appropriately assist the caller with queer-specific issues.

    Refer and Guide: Give the caller the contact information for specialized services, hotlines, or counselors trained in queer issues.

    Document for Training: Make a note of this experience so that it may be used in future training sessions or as a case for more extensive training in this area for the Helpie Mental Health Crisis Helpline.

    Follow Up: Follow up to see if they were able to connect with the specialized service and found it helpful.

    Self-Review: After the call, take some time to consult with a supervisor and review the guidelines on how to deal with topics outside your expertise. This is a good time to identify gaps in your training and seek additional information for future interactions. 

  • The caller has requested that you connect them with a licenced mental health professional (MHP). To whom should I make this referral?

    Referring a caller to a licensed mental health professional (MHP) is a critical step and should be executed with precision and care. Below are some guidelines:

    Check SOP: Always adhere to helpline’s standard operating procedures regarding referrals. Helpie Mental Health Crisis Helpline doesn’t have partnerships with MHPs, consider appropriate and relevant external referrals.

    Utilize Resources: Utilize internal database of vetted MHPs, which includes psychiatrists, psychologists, counselors, or social workers. These professionals should be credentialed and specialize in the type of care the caller is seeking.

    Consider Special Needs: If the caller has specified a particular type of therapy or specialization (like CBT, DBT, or queer-friendly services, for instance), make sure to refer them to an MHP who can meet those specific needs.

    Local or Remote: Depending on the caller’s location and your service capabilities, you may also need to consider whether they require an in-person visit or if telemedicine is adequate.

    Contact Information: Provide the caller with complete contact information for the MHP, including phone numbers, email addresses, and physical locations, if applicable.

    Confirm Understanding: Before ending the call, confirm that the caller understands the next steps and knows how to reach the MHP.

    Documentation: Make sure to document the call and the referral for internal tracking and quality assurance.

    Caution: If the caller is in immediate danger or experiencing a severe mental health crisis, emergency services should be contacted according to your helpline’s crisis intervention protocols.

    Avoiding conflict of interest is crucial for maintaining the integrity and trustworthiness of the Helpie Crisis Line. Here are some guidelines that could help:

    Disclosure Requirements: It is important to disclose any potential conflicts of interest, either with service providers, callers, or within the team.

    Neutral Referrals: Make sure to refer callers to a list of verified and neutral service providers. Avoid referring to any services or practitioners where there might be a financial or personal gain involved.

    Transparency: If for some reason there could be a perception of a conflict of interest (e.g., if the helpline has sponsorship from a particular organization), this should be transparently communicated to the caller.

    Multiple Options: Provide the caller with multiple options for additional help, so they do not feel funneled into a decision that might not be in their best interest.

    The Helpie Crisis Response team can feel comfortable discussing potential conflicts of interest without fear of repercussions. 

  • Can someone call a Helpline outside of an emergency or non-crisis situation, and if so, how should the responder respond?

    Yes, Helpie Mental Health Crisis Helpline often receive calls from individuals who are not in immediate crisis or emergency situations. These callers may be seeking information, validation, a listening ear, or preventive measures for potential future crises. It’s essential to handle these calls with the same level of professionalism and empathy as crisis calls. Here are some guidelines for responders:

    1. Initial Assessment: Quickly assess the caller’s situation to determine the level of urgency. If it’s a non-emergency, proceed accordingly without neglecting the caller’s concerns.

    2. Active Listening: Give the caller your full attention. Non-emergency calls can sometimes evolve into emergencies, and it’s crucial to pick up on any signs or cues that might indicate escalating distress.

    3.Information and Referral: Provide accurate and up-to-date information based on what the caller is seeking. Direct them to appropriate resources or organizations that might further assist them.

    TeleArogya Inquiries: If a caller has queries specifically related to TeleArogya, kindly inform them that they can reach out to Farica for more information. The contact number is 7899109887.

    Augmenta Health Inquiries: For calls that are specifically about Augmenta Health services, please guide the caller to contact our front office at 9980740344 for comprehensive support and information.

    Spandana Hospital Inquiries: If the caller is inquiring about Spandana Hospital, they should be directed to contact the hospital’s front desk at 9036670000 for detailed information and support.

    In-Patient Referral Centers in Bangalore: For those looking for in-patient referral centers in Bangalore, please refer them to our directory. Make sure the directory is kept updated.

    Other Counseling or Long-Term Help: If the caller requires counseling or long-term mental health assistance, suggest that they reach out to Tele-Manas at either 14416 or 18008914416.

    Note: Always ensure you confirm that the caller has noted down the information correctly, and ask if they need any more help before concluding this segment of the call.

    4. Boundaries: Make sure to establish the limits of the service you can offer. The helpline is not a substitute for long-term care or professional medical advice.

    5. Validation: Even if the situation is not an emergency, validating the caller’s feelings can be crucial for their mental well-being.

    6. Follow Standard Protocols: Stick to the helpline’s standard operating procedures, ensuring confidentiality and offering evidence-based guidance or resources.

    7. Encourage Proactive Measures: For individuals seeking preventive help, encourage them to take proactive steps for their mental health, like consulting a mental health professional, joining a support group, or using reliable self-help resources.

    8. Documentation: Document the call accurately and impartially for record-keeping, following the helpline’s guidelines.

    9. Closure: As with crisis calls, close the conversation by summarizing the steps the caller can take and confirming that they have understood the information or resources you’ve provided.

    10. Self-Care: After the call, take a moment to decompress, especially if the call was emotionally taxing. This helps in maintaining your own well-being and effectiveness in handling future calls.

    By following these guidelines, responders can ensure that even non-emergency callers receive the attention, care, and resources they need. 

  • The caller is currently perched on the roof of a building, close to a train bridge or the edge of a mountain precipice, and is preparing to leap at any moment. How to approach this situation with care?

    Scenario: Caller in Immediate Physical Danger

    1. Immediate Action: If the caller is in a life-threatening situation and reveals their location, contact emergency services immediately while trying to keep the caller on the line. If the helpline’s protocol allows it, you may need to initiate a trace or request emergency intervention.

    2. Be Direct and Clear: Clearly ask the caller to step back from the edge and to move to a safer place. Use a direct and authoritative tone: “I’m really concerned for your safety right now. Can you please step back from the edge?”

    3. Maintain Connection: If possible, try to establish and maintain a human connection. Use their name if you know it and remind them that you are there to listen and provide immediate emotional support.

    4. Avoid Philosophical or Moral Arguments: Stick to the immediate situation and the person’s feelings; avoid diving into ethical or philosophical considerations about life and death.

    5. Tactical Empathy: Display empathy but try to divert focus away from the action they are contemplating. Ask them to talk about what has led them to this point, which may distract from the immediate crisis.

    6. Professional Guidance: Consult with Responder Supervisors and SOP to determine additional steps, such as contacting next-of-kin, using emergency geo-location tools, or other procedures.

    • Consult the Airtel Dashboard to ascertain their location. This should be done in conjunction with keeping the caller engaged in conversation to maintain their focus away from the harmful action they are contemplating.
    • With location data available, immediately contact emergency services to intervene. Provide them with the most accurate and current location information available.
    • If appropriate and without escalating the situation, inform the caller that help is on the way. This can sometimes act as a deterrent for them to carry through with their plans, knowing that someone is actively working to prevent it.
    • While waiting for emergency services, attempt to confirm the location data with the caller to ensure accuracy. However, be cautious in how this is approached to avoid alarming the caller or triggering a negative reaction.
    • Keep the caller engaged, using their name if known, and continue to provide emotional support until you can confirm that emergency services have reached them.
    • Simultaneously, remain in touch with your core team who are monitoring the Airtel Dashboard. They can update emergency services if the caller changes location or provide additional data that might aid in the intervention.
    • Make sure there’s clear communication between you, the core team monitoring the Airtel Dashboard, and emergency services. Effective coordination can save critical seconds and improve the chances of a positive outcome.

    The Airtel Dashboard can be a vital tool in these high-risk scenarios. The ability to quickly locate a caller in a life-threatening situation enhances the opportunity for a successful emergency intervention, giving emergency services a head start and reducing response time.

    7. Don’t Disconnect: Stay on the line until emergency services arrive, or until you’re certain that the immediate threat has been alleviated.

    8. Post-Call Actions: After the call, immediately document the incident in detail and consult with your supervisory team for debriefing and any additional actions that may need to be taken.

    Remember that while you can offer immediate emotional support, the objective is to facilitate emergency assistance as quickly as possible to prevent any physical harm. 

  • The person who called does not want to discuss any specifics of their problem, but they are in immediate need of assistance. What options do I have?

    Context: Caller in immediate need of assistance but unwilling to discuss specifics.

    Immediate Acknowledgment: Let the caller know you are there to help even if they’re not comfortable sharing details. This builds rapport and offers a modicum of immediate relief. “I understand you’re going through a tough time right now and it’s okay if you’re not ready to talk about it. I’m here to support you.”

    General Support and Assurance: Offer general emotional support. Be empathetic, non-judgmental, and soothing. “You don’t have to go through this alone. Even if we don’t get into specifics, I’m here to listen and offer some level of support.”

    Encourage for Future Disclosure: While maintaining sensitivity to their current comfort level, indicate that more specific information can help you provide more targeted assistance. “Whenever you’re ready to share, we’re here to help in a more specific way. But take your time; there’s no rush.”

    Introduce Resources: Even without specifics, you can guide them toward general resources or coping mechanisms that might be useful. “While I can’t offer specialized help without knowing more, there are some general resources and strategies that could be helpful. Would you like to know about those?”

    Safety Assessment: Although it’s challenging without specifics, try to gauge their immediate safety. Use open-ended questions that allow them to reveal as much or as little as they choose. “Can you help me understand how urgent your situation is, even if you don’t want to discuss the details?”

    Non-Verbal Cues: Listen for background noises or changes in the tone of voice. This can sometimes offer clues when verbal information is lacking.

    Confidentiality Assurance: Reiterate the confidentiality of the helpline to encourage more openness. “Everything we discuss here is confidential within the bounds of law. You’re in a safe space.”

    Documentation: Keep a record of the call as per the protocols, highlighting the caller’s unwillingness to share specifics but marking it as a crisis call.

    Consult Supervisors: After the call, consult with supervisors and team members for further actions, especially if you felt that the caller was at a high risk but did not disclose information.

    The key is to offer as much support as you can within the bounds of what the caller is willing to share, while keeping all available options open for immediate or future assistance. 

  • The caller doesn’t tell me much about why they’re upset, but they insist that I give them advice and talk to them to make them feel better. What should I do?

    Context: Caller seeks advice but provides limited information.

    1. Clarify Limitations: Initially, it’s essential to clarify the limitations of the support you can provide without specific information about their situation. – “I’m here to help and support you, but it’s challenging to offer targeted advice without understanding the details of what you’re going through.”

    2. Offer General Support: While you can’t provide specialized advice, you can offer general emotional support, which can still be valuable. – “Even if you don’t want to get into specifics, I can still listen and offer some general emotional support. Sometimes just talking it out can help.”

    3. Empathy and Active Listening: Use empathetic statements and active listening techniques. This can sometimes encourage them to open up more. – “I can hear that you’re going through a tough time. You’re not alone; I’m here to listen.”

    4. Open-Ended Questions: Pose questions that allow them to reveal as much or as little as they want.  – “Can you share how you’re feeling right now, in a word or a sentence, perhaps?”

    5. Introduce Coping Strategies: Share general coping mechanisms, such as deep breathing, mindfulness, or grounding techniques.  – “Some people find breathing exercises helpful in moments of stress. Would you like to try one together?”

    6. Resource Redirection: Mention that there are resources and professionals who can provide more targeted help if they’re willing to engage. – “We also have other resources and professionals who can assist you more specifically when you’re ready.”

    7. Assessment of Risk: Even with limited information, try to assess whether the caller is in immediate danger.- “I understand you may not wish to discuss details, but it’s important for me to ask if you’re safe right now.”

    8. Maintain Confidentiality: Reinforce the confidential nature of the conversation to assure them they’re in a safe space.- “Remember, this is a confidential space. You’re welcome to share as much or as little as you like.”

    9. End on a Positive Note: Conclude the call with encouragement for the future.- “I’m glad you reached out today. Whenever you’re ready to share more, we’re here to help.”

    10. Documentation: Note the general context of the conversation for future reference, adhering to the helpline’s privacy policies.

    Your goal in this challenging situation is to offer a balance of support, general advice, and openness to future discussions when the caller is more willing to share details. 

  • The caller has read or saw some triggering information and has sought out to the helpline because they were triggered after seeing the helpline number provided in the media report? Could you please share some practical strategies for dealing with the immediate triggers?

    Context: Caller has been triggered by media content and seeks immediate assistance.

    1. Acknowledge the Trigger: Open by acknowledging that the caller has been triggered and express empathy. – “I understand you’re feeling overwhelmed right now after reading or seeing something triggering. I’m here to help.”

    2. Safety First: Before diving into the conversation, make a quick assessment to ensure the caller is not in immediate danger. – “Can you confirm that you’re in a safe place right now?”

    3. Clarify Your Role: Make sure to clarify your role and the limitations of the support you can offer – “I can provide immediate emotional support, but if you’re in a crisis, it’s essential to consult with a healthcare professional.”

    4. Grounding Techniques: Recommend some grounding techniques to bring the caller back to the present moment- “You may find it helpful to ground yourself by touching something physical, like a wall or table, or focusing on your breathing for a few seconds.”

    5. Disengage from Trigger: Suggest that they remove themselves from the triggering content and environment if possible. – “If you’re still exposed to the triggering content, it might be helpful to step away from it for now.”

    6. Divert Attention: Provide suggestions to shift their focus to less distressing thoughts or activities. – “Some people find it helpful to divert their thoughts by focusing on a neutral or positive topic, like a favorite hobby.”

    7. Coping Mechanisms: Introduce coping strategies to help them manage emotional spikes.   – “You may also try a brief mindfulness exercise, like taking deep breaths or counting backward from 100.”

    8.Resource Redirection: Recommend longer-term resources for managing triggers. – “For ongoing challenges with triggers, you may benefit from speaking with a therapist or counselor who specializes in trauma.”

    9. Documentation and Follow-Up: Document the interaction in the notes tab of the “Helpie Dashboard” noting any potential need for follow-up. – “Your well-being is important to us, and we have additional resources for more specialized help if you need it.”

    10. Conclude Positively: End the call with a reassurance that support is available. – “I’m glad you reached out, and I hope our conversation has been helpful for you. Remember, support is available when you’re ready.”

    Your primary objective in such situations is to offer immediate emotional support while encouraging the caller to seek professional help for long-term solutions. Always follow your helpline’s specific guidelines and protocols. 

  • How do I handle a rambling caller (who keeps talking and talking)?

    Managing a caller who rambles can be challenging but is crucial for effective crisis intervention. Rambling can sometimes indicate a heightened emotional state, anxiety, or a need for validation, and therefore needs to be addressed thoughtfully. Here are some strategies tailored for Helpie Crisis Line responders:

    Initial Approach

    Active Listening: Initially, allow the caller to speak to understand the core issue or concern they have. You can use active listening cues like “Uh-huh,” “I see,” to let them know you are attentive.

    Take Notes: Make concise notes to track significant points the caller makes, which will help you in focusing the conversation later.

    Redirecting the Conversation

    Interject Politely: Find a natural break in the caller’s speech to interject softly but assertively. You could say something like, “I apologize for interrupting, but I want to make sure I fully understand the main issue you’re facing. Is it okay if we focus on that?”

    Utilize Closed-ended Questions: Transition from open-ended to more closed-ended questions to guide the conversation. For example, “Are you currently feeling safe?” instead of “How are you feeling?”

    Summarize and Reflect: Periodically summarize what you’ve understood and reflect it back to the caller. This serves two purposes: it demonstrates that you are engaged and listening, and it can help narrow down the conversation to the most crucial elements.

    Manage Time Respectfully

    Time Check: If the conversation continues to stray, a time check can be useful. For example, “I have about 10 more minutes to speak with you. Can we focus on the most important thing you’d like help with?”

    Resource Transition: If the caller still continues to ramble without addressing a particular crisis, consider transitioning to offering resources they can utilize, with a phrase like, “It sounds like you have a lot to consider. Would it help if I provide some resources or avenues for further support?”


    Next Steps: Reiterate any action steps or resources that have been agreed upon.

    Invite for Follow-up: Let them know they are welcome to call back and further discuss the issue, especially if the call could not cover everything due to the rambling. 

  • How should I respond to a caller whose crying can be heard over the phone?

    Addressing a caller who is audibly crying requires a nuanced approach.This situation is particularly sensitive, requiring tact, understanding, and appropriate emotional boundaries. Here are some guidelines tailored for Helpie Crisis Line responders:

    Prioritize Emotional Safety

    Pause: Give them a moment; don’t rush to fill the silence. Crying is an emotional release, and sometimes silence is supportive.

    Acknowledge the Emotion: Use empathetic phrases like, “It sounds like you’re going through a really tough time right now. I’m here to listen and support you.”

    Be Calm and Reassuring

    Maintain a Calm Tone: Your calm demeanor can help stabilize the emotional state of the caller.

    Affirmative Statements: Use reassuring phrases such as, “You’re not alone,” or “I’m here for you.”

    Gentle Query

    Open-Ended Questions: After the initial emotional surge, ask gentle questions like, “Would you like to talk about what’s causing you to feel this way?”

    Permission-Based Guidance: Ask for permission before offering any kind of advice or resources, “Is it okay if we discuss some steps you might consider taking?”

    Establishing Further Contact

    Resource Sharing: Offer to share resources that may be relevant to the caller’s situation. However, be sure to gauge their readiness to receive this information.

    Follow-Up Option: Let them know that they have the option to call back and that ongoing support is available.

    Close with Respect and Care

    Thank the Caller: Show gratitude for their trust in sharing their struggles.

    Signpost Next Steps: Whether it’s a recommendation to seek professional help or a reminder that your line is always open, offer a clear next step for continued support. 

  • What should I say to a caller whose voice is cracking while they are on the helpline?

    Communicating with a caller whose voice is cracking poses a delicate challenge. A cracking voice often indicates emotional distress, and addressing this in a sensitive manner is crucial. Here are some suggestions for Helpie Crisis Line responders:

    Start with Empathy

    1. Acknowledge the Emotion: Begin by acknowledging the emotional difficulty the caller seems to be experiencing. You could say something like, “I can hear that this is really hard for you, and I’m here to help.”

    2. Affirm their Courage: Let them know that reaching out is a courageous step. “I understand that speaking about this might be difficult, but you’ve done a brave thing by calling us today.”

    Be Calm and Reassuring

    1.Steady Tone: Keep your voice calm and even. This can have a soothing effect and may help the caller feel safer.

    2. Reassurance: Use phrases like “You’re not alone” or “I’m here to listen and provide support.”

    Clarification and Summarization

    1. Ask to Repeat: Politely ask them to repeat what they said if you’re having difficulty understanding them due to the cracking voice. “I apologize, I’m having a bit of trouble hearing you clearly. Could you please repeat that?”

    2. Summarize: Occasionally summarize what you’ve understood to let them know you are engaged and to clarify any misunderstandings.

    Open Door to Resources

    1. Guidance: If appropriate, offer guidance on resources or next steps, but don’t rush into this. Make sure you’ve fully understood the situation first.

    2. Additional Support: You might say, “When you’re ready, we can discuss some resources that might be helpful for you.”

    Close on a Positive Note

    1. Thank Them: Thank the caller for sharing and trusting you.
    2. Provide Follow-up Options: Make them aware that they can call back anytime they need support. 

  • How do I respond to a caller whose voice is difficult to hear?

    Responding to a caller whose voice is difficult to hear can present a challenge, especially when the stakes are high in situations involving crisis intervention. It’s crucial to manage such cases effectively. Here are some practical guidelines for Helpie Crisis Line responders:

    Technical Checks

    • Volume Adjustment: Make sure your headset or phone volume is turned up to the maximum level that is comfortable for you.
    • Connection Quality: Politely ask the caller if they can improve their phone’s signal strength or move to an area with better reception.

    Communication Techniques

    • Speak Clearly: Clearly state that you are having difficulty hearing them and ask them to speak louder or more clearly.
    • Repetition: Politely ask the caller to repeat what they’ve said or confirm your understanding by summarizing what you think you’ve heard.
    • Spelling: For critical pieces of information like names or addresses, you can ask the caller to spell them out.

    Advanced Strategies

    • Closed Questions: If you’re still having trouble, resort to yes/no or multiple-choice questions to glean as much information as possible.
    • Code Words: Use code words or numbers for common scenarios or key pieces of information, which might be easier to distinguish than open-ended speech.

    Utilizing code words or numbers can be an effective way to streamline communication, especially when voice clarity is compromised. Here are some examples tailored for Helpie Crisis Line responders:

    Code Words for Common Scenarios

    Suicidal Ideation: Use the code “S-1” to indicate a caller is experiencing suicidal thoughts.

    Self-Harm: Use “S-2” for callers engaging in self-harm but not expressing suicidal ideation.

    Domestic Violence: Use “DV” to discreetly indicate a situation involves domestic violence.

    Medical Emergency: “MED” could indicate a need for immediate medical attention.

    Code Words for Key Information

    Safety Check: Use “Check-1” to signify that a safety check has been completed.

    Resource Allocation: Use “R-1” to indicate that you’ll be giving the caller resources for mental health support, and “R-2” for medical resources.

    Supervisor Needed: “SUP” could be used internally to indicate that the case needs a supervisor’s attention.

    Follow-Up Required: “F-UP” could signify that the call requires a follow-up interaction.

    Code Numbers for Levels of Urgency

    • Level 1: For situations requiring immediate emergency intervention.
    • Level 2: For urgent but not life-threatening situations.
    • Level 3: For non-urgent cases that still require attention.

    Usage Example:

    If you’re struggling to hear a caller but manage to discern that they are talking about self-harm and needing medical resources, you could communicate with your team by simply noting “S-2, R-2” in the call log or via internal messaging. This would allow for quick understanding and action, such as readying medical resource lists for dissemination.

    Disclaimer: These codes are hypothetical examples and should be tailored to fit the Helpie Platform as it evolves. Always ensure all team members are thoroughly trained in the use of any coded language to minimize misunderstandings.

    Third-Party Assistance: If available, involve a colleague to listen in and assist in understanding the caller better. This could be especially helpful in situations that may require quick decision-making.

    Safety Protocols

    • Safety First: If you still cannot understand the caller but sense that it is a crisis situation, consider defaulting to the most conservative safety measures, such as initiating emergency services.
    • Documentation: Keep detailed notes of the call, stating that the voice was difficult to hear, to provide a comprehensive record of why certain decisions were made.


    • Caller Feedback: After resolving the immediate issue, ask for feedback on how to improve the communication for future calls.

    Internal Review: Use these instances for quality checks and training sessions for better handling similar situations in the future. 

  • How do you pick up on subtle signs of problems with mental health during a phone call?

    Detecting subtle signs of mental health problems during a phone call, especially in a crisis situation, is an invaluable skill for Helpie Crisis Line responders. It’s critical to equip yourself with the tools and techniques to pick up on these nuanced signals. Here’s how:

    Voice and Tone

    Flat Affect: Listen for a monotonous, flat tone which can indicate emotional numbness or depression.

    Speech Rate: Rapid or pressured speech may signify mania or anxiety, while slow speech might indicate depression or possible substance abuse.

    Volume: Lowered volume might indicate low mood, lack of energy, or withdrawn behavior, while elevated volume may suggest heightened emotional states.

    Verbal Cues

    Indirect Statements: Phrases like “I can’t go on,” “I’m tired of everything,” or “What’s the point?” could be veiled expressions of despair or suicidal thoughts.

    Ambiguity: Vague or ambiguous statements can be a red flag for confusion, disorientation, or cognitive issues.

    Contradictions: Contradictory statements might indicate inner turmoil or a conflicted mental state.


    • Repetition: Repeating phrases or questions could indicate cognitive problems or high anxiety levels.
    • Inconsistency: Inconsistent narratives might point to confusion, disorientation, or fabrication which could stem from various mental health issues.

    Non-Specific Complaints: General complaints about physical discomfort (“I don’t feel good,” “I’m just tired all the time”) may mask underlying mental health conditions.

    Behavioral Cues

    • Hesitation: Excessive hesitation before answering could be a sign of anxiety, depression, or fear of judgment.
    • Frequent Pauses: Frequent, unexplained pauses during conversation may signal thought process disturbances.

    Emotional Language

    • Disproportionate Emotions: Excessive laughter or crying can be signs of emotional instability.
    • Negative Self-Referencing: Frequent self-deprecating comments may indicate low self-esteem or depressive thoughts. 

Call Logistics and Technical Issues

  • Is there a recommended minimum number of attempts to make before giving up on an unanswered call?

    Handling Unanswered Calls

    1. Urgency Assessment: The number of callback attempts might depend on the perceived urgency of the caller’s situation. For life-threatening situations, multiple attempts within a short span may be appropriate.
    2. Consult Documentation: Always refer back to any documentation or notes about the caller. If the situation was assessed as high-risk or urgent, the number of attempts should reflect that urgency.
    3. Time Interval: Leave reasonable intervals between each call attempt. The intervals may vary depending on the urgency of the situation.
    • Log Each Attempt: Log each one meticulously in the system, including the time, the wait duration, and any actions taken after.
    • Review and Redirect: Redirect your focus to other callers while remaining vigilant in case the original caller returns.

    Caveat: Excessive callbacks might also be interpreted as intrusive or stressful for the caller, so always act in the best interest of the caller 

  • There was no answer when I attempted to contact the caller. How should I proceed?

    Guidelines for Helpie Responders: Handling Unanswered Callbacks

    1. Log the Attempt: Document your attempt to reach the caller in the helpline’s call log. Include details like the time of the call and any other pertinent information.
    2. Consult SOP: Refer to Helpie Helpline standard operating procedures for how to handle unanswered calls. Follow these steps meticulously to ensure you’re acting within the framework of established guidelines.
    3. Wait and Observe: In keeping with Helpie Helpline’s SOP, you cannot repeatedly attempt to contact the caller. Instead, remain available for when they choose to call back.
    4. Continue Monitoring: Keep an eye on the incoming call queue to check if the caller returns. If they do, promptly attend to their needs, while taking into account the context from their previous calls if available.
    5. Documentation: Ensure that all actions, observations, and follow-ups are properly documented in your system. This helps in maintaining a transparent and accountable service.
    6. Post-Shift Briefing: Share your experience and the steps you took in the regular team briefing. This may help to improve the procedures for the entire team.

    Remember that the effectiveness of the Helpie helpline service not only depends on answering calls but also on the quality of follow-up actions. 

  • No push notification was delivered to my phone regarding the call. I missed answering the call. What do I do?
    • Remain alert to your notifications. Make sure all technical aspects like volume, vibration, and other notification settings are optimized for immediate response.
    • Before taking any action, ensure that you understand why the push notification was not delivered. It could be due to various reasons, such as software glitches, data connectivity issues, or updates pending on your device.
    • If you suspect a technical problem, contact Sim Service provider Support for immediate resolution. They may require specific information, so be prepared to describe the issue in detail.  – “Hi, this is [Your Name]. I did not receive a push notification for an incoming helpline call. Could you please look into the issue?”
    • Report the missed call to supervisor responder. Include all pertinent details so that they can investigate and ensure you receive timely assistance.  – “I have missed a helpline call due to a lack of push notifications. What steps should I take to ensure the caller gets help?”
    • The helpline dashboard has a log of incoming calls, ensure if the caller was assisted by another responder or if they’ve left a message.
    • According to the Helpie helpline’s policies regarding missed calls you are allowed to follow-up with the caller if the call duration is less than 30 minutes. If it is above 30 minutes, the caller must callback themselves when they are available.
    • Make sure you’re available for the next call and that all technical issues have been resolved. It’s crucial to ensure that such lapses are minimized in the future.
    • Make sure to document the missed call and the steps you took to rectify the situation, adhering to your organization’s policies for documentation.
    • this as an opportunity to learn and improve. Are there preventive measures you can put in place to avoid missing future calls?
    • Ensure helpline’s dashboard and your phone’s operating system up to date to minimize the chances of such technical issues reoccurring.

    Remember, even in a mission-critical service like a helpline, technical issues can arise. The key is to resolve them promptly and take steps to prevent them in the future. 

  • What should you do if there are problems with the network while you are on the call?

    Technical issues like network problems can pose significant challenges, especially in a crisis helpline setting where timely assistance is crucial. It’s essential to have contingency plans for such scenarios. Here’s how you can handle network issues during a call:

    Initial Recognition

    • Acknowledge the Issue: As soon as you notice network issues like voice breaking, lag, or disconnection, promptly acknowledge the problem. For example, “It seems like we’re experiencing some network issues. Can you still hear me clearly?”
    • Check Alternate Connection: If possible, see if switching to a different network or using a landline can improve call quality.

    During the Call

    • Quick Summary: Quickly summarize the key points discussed so far. This ensures that if the call gets disconnected, the most important information has been covered.
    • Immediate Next Steps: Briefly outline the immediate next steps the caller should take, particularly if the situation is high-risk.

    If the network is highly unstable, provide information that someone else from the team will callback earliest.

    If abruptly disconnected

    • Attempt to Reconnect: Try calling back the caller once
    • Documentation: Make sure to document the disruption and any steps taken during this period for quality assurance and follow-up.
    • Technical Support: Report the issue to your internal tech team for resolution to avoid recurring issues.

    Future Preparedness

    • Regular Check-Ups: Periodically test your network and phone systems for robustness, especially during high-traffic times.
    • Team Briefing: Ensure that the team is well-informed about the SOP for handling network issues to ensure a standardized approach. 
  • What should you do if the caller starts talking about an issue that is completely irrelevant to you and you do not wish to continue the call?

    Managing calls that veer into irrelevant or inappropriate topics is a common challenge in crisis helpline settings. It’s essential to handle such calls tactfully while staying focused on the helpline’s core purpose. Here’s how:

    Initial Steps:

    Start grateful. Thank them for contacting the Mental Health Crisis Helpline.

    Gently Redirect: Politely bring the conversation back to the primary purpose of the crisis line. For instance, you could say, “I understand this topic is important to you, but our primary focus here is to assist with immediate mental health crises. How can I assist you with that today?”

    Set Boundaries: Clearly but kindly set boundaries for the call, reiterating the helpline’s primary focus. Example: “Our main goal here is to help with immediate mental health concerns. Is there something specific troubling you that you’d like to talk about?”

    If Redirection Fails:

    Be Direct but Diplomatic: If gentle cues don’t work, use simple direct language in stating the service’s limitations. “ Sorry, I wont be able to help you with this” “I need to focus on calls related to immediate mental health crises. I would have to end this call to be available for others who are in urgent need.”

    Provide Alternatives: Offer to direct them to a more suitable resource or service that aligns with their concerns. (softens the blow)

    Conclude Gracefully: End the call by saying, “Thank you for calling. I hope you find the help or information you’re looking for through the appropriate channels.”

    Ethical Considerations:

    Supervisory Consult: If a call feels particularly challenging or falls into an ethical gray area, consult with a supervisor either during or after the call for guidance.

    Documentation: Document the nature of the call and the steps taken for future reference and quality assurance. 

  • How do you respond to a caller who speaks a language you cannot comprehend?

    Navigating a call with a language barrier is particularly challenging in a crisis intervention setting, where effective communication is crucial.

    Knowing the language of the caller in advance via the Helpie helpline dashboard is a significant advantage for effective crisis management. This feature allows Helpie Crisis Line responders to prepare themselves better before even picking up the phone, aligning with the requirements of the caller.

    Suggested Tip

    Dashboard Alert Pre-Call Prep:

    Before answering a call, take a moment to note the indicated language on the dashboard. If you are proficient in that language, you can prepare yourself mentally to switch to that language as soon as the call begins. This immediate linguistic alignment can provide a sense of comfort and understanding to the caller right from the outset, which is crucial in crisis situations.

    If you aren’t proficient in the indicated language, consider the following steps:

    Acknowledge the Barrier: Politely inform the caller that you’re having trouble understanding them due to the language difference. Keep your tone empathetic and regretful.

    Quickly Identify Language: If possible, try to identify which language the caller is speaking. You might use phrases like, “I’m sorry, I don’t speak [language]. Do you speak English?”

    Immediate Transfer: If someone on your team is proficient in the indicated language, immediately transfer the call to them before picking it up.

    Use Simple Phrases: If the language barrier is only partial, use simple, universally understood phrases to communicate essential points, especially regarding immediate safety.

    Translation Services: Have your translation service tool ready to go, if you have access to such technology.

    Language Database: Keep a list of verified local language helplines handy to redirect the caller right away  [].

    Resource Sheet: Keep a resource sheet or quick-access guide to essential phrases or questions in the indicated language to help guide the conversation as you wait for a more proficient responder or translation service to assist. 

  • How to gracefully wind down and end a lengthy call?

    Winding down a lengthy crisis call is a skill that requires both tact and precision, Here are some steps that Helpie Crisis Line responders can follow to close such calls in a graceful and effective manner:

    Pre-Closure Indicators

    • Time Check: Gently indicate that the call will need to come to a close soon. For example, “I want to let you know we have about five more minutes to chat. Let’s focus on the most crucial steps you can take next.”
    • Summarize: Briefly summarize the key points of the conversation and any agreed-upon action steps. This clarifies any lingering ambiguities and ensures both parties are on the same page.

    The Graceful Exit

    • Resource Offer: Present the caller with additional resources or referrals that they can utilize. This provides them with a next step and shows that you are still thinking about their well-being even as the call comes to an end.
    • Empathetic Farewell: Acknowledge the emotional gravity of the situation one last time. “I know this is a challenging time for you, and I’m glad you reached out. Remember, we’re here 24/7 if you need to talk again.”
    • Permission to End: Ask for their acknowledgment or permission to close the conversation, “Is there anything immediate that you feel we haven’t yet covered?”
    • Positive Closure: End on a positive, hopeful note, reinforcing any strengths or coping mechanisms that the caller has. “You’ve shown a lot of courage today by talking about this. I hope you’ll take the next steps we discussed.”
    • Final Confirmation: Confirm that they have noted down any resources or next steps, and remind them they can always call back.

    Additional Tips

    • Tone Matters: Maintain a calm, empathetic tone throughout, especially during the closing phase, to avoid making the caller feel rushed or unimportant.
    • Be Direct but Gentle: If a caller is resistant to ending the conversation, be direct but gentle, “I need to end our call to be available for others who are also in need of support. I encourage you to use the resources we discussed.”
    • Avoid Abruptness: Never end the call abruptly, especially if the individual is in crisis, unless there is a direct threat to you as the responder. 
  • How long should a crisis call duration last ideally? (both minimum and maximum)

    Determining the ideal duration of a crisis call is a nuanced matter. The length of a call can vary widely depending on the severity of the crisis, the caller’s emotional state, and the complexity of the issues being discussed. However, there are some general guidelines to consider:

    Minimum Duration

    Quick Assessment: A minimum of around 5-10 minutes is generally required to adequately assess the caller’s situation, especially in cases involving immediate risk like suicide ideation.

    Resource Allocation: In some situations, the minimum time could be spent providing immediate resources or referrals, particularly if the caller’s needs are straightforward and not life-threatening.

    Maximum Duration

    Case Complexity: In very complex or severe cases, a call may last up to an hour or more. This would give the responder enough time to perform an in-depth assessment, provide emotional support, and discuss various resources or next steps.

    Responder Fatigue: Keep in mind that lengthy calls can contribute to responder fatigue. Ideally, no single call should be so long that it impairs the responder’s ability to assist other callers effectively.

    Escalation Protocols: After a certain point, it might be more beneficial to escalate the call to a Helpie Responder Supervisor (s)

    Factors to Consider

    Organizational Policy: Your organization’s guidelines may have specific recommendations for call duration, based on staffing levels, call volumes, and other operational factors.

    Quality over Quantity: The focus should be on the quality of support provided, not merely the duration of the call. Effective, evidence-based support can sometimes be provided relatively quickly.

    Follow-Up: Consider offering the option of a follow-up call or other resources, which may help in effectively resolving the crisis without extending the initial call’s duration unnecessarily.

    In crisis Helpline settings, there’s a delicate balance to maintain between providing quality care and managing resources effectively. Call duration can be influenced by several industry-specific factors such as staffing levels, call volumes, and other operational considerations. Here’s a general look at some industry recommendations:

    Based on Staffing Levels:

    • Low Staffing: During low-staff periods, the recommendation might be to keep calls brief but effective, typically within 15-20 minutes, so that other callers are not kept waiting for extended periods.
    • Adequate Staffing: When staffing levels are adequate, calls may go up to 30-45 minutes, especially if the situation requires a more detailed intervention or assessment.

    Based on Call Volume:

    • High Volume: During peak hours or high-volume periods, shortening call duration (ideally, 15-20 minutes) may be necessary to manage the influx.
    • Low Volume: During quieter periods, calls can afford to be longer (up to 45 minutes to an hour) to offer in-depth support and assessment.

    Other Operational Factors:

    • Shift Change: Calls should ideally not extend into shift changeovers to ensure continuity and quality of care. If a long call is anticipated, it’s best initiated at the start of a new shift.
    • Specialization: Based on the future needs, we can consider specialized staff who handle more complicated or severe cases. These calls may naturally take longer, potentially an hour or more.
    • Technology: We can consider incorporating advanced systems that can predict call durations based on historical data and can adjust staffing levels in real-time.
    • Quality Assurance: Regardless of these factors, each call should meet a minimum quality standard, following evidence-based best practices.
    • Call-back Services: We can offer scheduled call-back services for cases that need ongoing support but do not require immediate crisis intervention. This allows for better resource allocation. 

Follow-up and Miscellaneous

  • I could see from the notes on the dashboard that the caller had called the helpline before. Can I look at the notes and use what’s in them on this call?

    The use of past call notes when dealing with a repeat caller depends on your helpline’s protocols, data protection guidelines, and ethical considerations. Here’s how you can generally approach it, while staying in compliance with standard practices:


    1. Consistency: Looking at past notes can offer consistency in advice and support.

    2. Efficiency: Knowing the background can save time and make the call more efficient.

    3. Personalization: Past notes can help in providing more personalized and relevant help.

    Steps to Consider:

    1. Confidentiality: Ensure that the notes are confidential and that you’re authorized to access them.

    2. Discretion: Use your professional judgment on whether and how to use this information. For example, don’t make the caller feel like they’re under surveillance or that their privacy has been compromised.

    3. Verification: Always verify the information. Circumstances, feelings, and attitudes change, and what was relevant in a previous call might not be applicable now.

    4. Acknowledge: If you do use past information, acknowledge this to the caller transparently. For example: “I see in my notes from a previous conversation we discussed X. Is that still a concern for you?”

    5. Documentation: Make a note in the current call log that you’ve accessed past call notes and how they influenced the current interaction.

    Ethical Considerations:

    1. Consent: You may want to inform the caller that you have access to their previous calls and ask for consent to refer to them.

    2. Avoid Assumptions: Even if you see past notes, each call should be treated as unique. Emotional states and circumstances can change rapidly, especially in a crisis.

    So, while past notes can be a useful resource, they should be used cautiously, ethically, and in line with your helpline’s specific guidelines. 

  • Elaborate on the details regarding the documentation of the responder’s suggestions

    Documenting the responder’s suggestions during or after the call serves multiple important purposes, from quality assurance to legal protection and enhanced continuity of care. Below are the key aspects that should be considered when documenting the suggestions:

    What to Include in the Documentation of Responder’s Suggestions:

    Immediate Safety Measures: If the call involved a crisis situation or immediate threat to life, document any immediate safety measures suggested, such as contacting emergency services or a trusted family member.

    Crisis-Related Coping Strategies: Note down the specific coping mechanisms or stress-reduction techniques that were suggested to the caller for immediate relief.

    Resource Referrals: List any resources or agencies that were recommended to the caller for further assistance, such as hospitals, specific professionals, or support organizations.

    Next Steps: Provide a clear outline of any immediate or future steps that were advised for the caller to take, including seeking professional help, contacting family, or accessing community resources.

    Follow-Up Suggestions: If applicable, note suggestions regarding when and how to follow up, whether it’s a recommendation for the caller to call back, seek emergency care, or schedule an appointment with a mental health professional.

    Potential Drug Interactions or Side Effects: If the caller was already on medication and this topic came up, note any general advice given, like speaking to a healthcare provider about side effects (but make sure to add a disclaimer that you are not a healthcare provider if that is the case).

    Emotional Support Measures: Document any emotional support measures that were offered, whether they were listening techniques, validation, or empathy statements.

    Legal or Ethical Considerations: If the caller was in a situation involving legal concerns or ethical dilemmas, note any suggestions made regarding seeking legal counsel or ethical consultation.

    Why Documentation of Responder’s Suggestions is Important:

    Legal Safeguard: Detailed documentation serves as a record that can protect the helpline and the responder in case of any legal scrutiny.

    Quality Control: The documentation allows for quality checks, audits, and supervision, ensuring that the helpline maintains a high standard of care.

    Training: Detailed notes can serve as educational material for training new responders.

    Continuity of Care: Documented suggestions provide a roadmap for future interactions, helping other responders or mental health professionals understand the guidance that has already been provided.

    Analysis and Improvement: Over time, the aggregated data can help in assessing the effectiveness of the helpline’s intervention strategies, thus aiding in continuous improvement.

    Accountability: It ensures that responders are accountable for the advice they provide, which can be critical in maintaining professional standards.

    By meticulously documenting suggestions, the helpline can achieve a greater level of professionalism, effectiveness, and safeguarding, both for the callers and Helpie Mental Health Crisis Helpline 

  • Which insights from the responder should be documented?

    For a mental health crisis helpline like Helpie, documentation is crucial for both immediate response and future reference. Responder insights can offer an invaluable perspective for subsequent interactions and treatment planning. Here’s what should typically be documented:

    Types of Responder Insights to Include:

    1. Risk Level: Make an assessment of the caller’s immediate risk level for self-harm, harm to others, or suicide. This is vital for determining next steps and the level of emergency intervention required.

    2. Engagement Level: Note how cooperative, open, or responsive the caller was during the interaction. Did they engage willingly, or were they hesitant?

    3.Coping Mechanisms: Observe any existing coping strategies the caller seems to be using, whether effective or not. This can provide a base for recommending more adaptive coping skills.

    4. Emotional State: Although the caller’s emotions will be separately noted, the responder should provide insights into how these emotions evolved during the call. For instance, did the caller appear to calm down or become more agitated?

    5. Complexity of Issues: Comment on the complexity or multiplicity of issues the caller is facing, like co-occurring mental and physical health issues, or compounded stressors like financial and relationship issues.

    6. Resource Availability: Does the caller have a support system or access to immediate help? This can be crucial for formulating a safety plan.

    7. Readiness for Change: Does the caller appear willing to take steps to improve their situation, or do they seem resigned?

    8. Cultural, Gender, or Age-related Factors: Mention any factors like these that could influence the approach to treatment or that came up as significant during the call.

    9. Anomalies or Unique Factors: Document anything unusual or distinctive about the interaction that doesn’t fit into standard categories but might be relevant for future interactions or treatments.

    10. Responder’s Own Reactions: Sometimes, the responder’s own emotional or intuitive reactions can provide important contextual clues. For instance, if the responder felt unusually concerned or alarmed, this could be noteworthy.

    Importance of Capturing These Insights:

    1. Continuity of Care: These insights help in building a more rounded understanding of the caller for future interactions or subsequent healthcare professionals involved.

    2. Quality Assurance: Periodic reviews of these insights can also serve as a quality check for the helpline services.

    3. Training: These records can also serve as case studies for training new responders, helping them understand the range and complexity of calls they might encounter.

    4. Refinement of Services: Over time, these insights can contribute to the data pool that can be analyzed to refine and enhance the services offered by the helpline.

    By documenting these aspects, the responder not only aids in immediate problem-solving but also contributes to the long-term efficacy and improvement of the crisis helpline services. 

  • What emotions of the callers should be assessed and included?

    When assessing and documenting a caller’s emotional state, it’s crucial to focus on capturing both the breadth and depth of their emotional experiences. Here are some key emotional aspects to include:

    Types of Emotions to Include:

    1. Despair/Hopelessness: Feelings that things will never improve or that they are stuck in their current situation.

    2. Anxiety: Heightened emotional state characterized by worry, nervousness, or panic.

    3. Anger: Any feelings of rage, irritation, or annoyance.

    4. Sadness: Prolonged feelings of unhappiness or sorrow.

    5. Shame/Guilt: Feelings related to personal failings or actions that the caller regrets.

    6. Fear: Distinct from anxiety in that it may relate to specific triggers or perceived threats.

    7. Overwhelm: Feeling overloaded or incapable of dealing with current issues.

    8. Isolation/Loneliness: Feeling disconnected from others or lacking a support network.

    9. Confusion: Inability to think clearly or make decisions.

    10. Numbness: Lack of feeling or emotional response, often a symptom of extreme distress.

    11. Relief: Some callers may feel a temporary sense of relief after sharing their concerns, and this is also noteworthy.

    Importance of Capturing These Emotions:

    1. Immediate Support: Understanding the caller’s primary emotional states will guide the approach for immediate emotional support and stabilization.

    2. Risk Assessment: Certain emotional states like despair, extreme anxiety, or anger could indicate an immediate risk to the caller or others.

    3. Building Rapport: Acknowledging and validating the caller’s emotions can help in establishing trust and rapport.

    4. Tailored Advice: Knowing the emotional context can help tailor advice or coping strategies that will be most effective for the caller’s specific emotional state.

    5. Referral Context: For healthcare professionals who may take over the case, a detailed emotional profile provides a richer context for continued care.

    6. Data Collection: In the longer term, tracking prevalent emotional states in callers may provide data that can be used to improve helpline services and interventions.

    Ensure that you approach the emotional assessment with sensitivity, taking care not to make the caller feel judged or labeled. The goal is to make them feel heard and understood while gathering critical information to assist effectively. 

  • What aspects of the caller’s thoughts should I include?

    When documenting a caller’s thoughts, the aim is to capture key aspects that give an insightful understanding of the caller’s cognitive and emotional state, as well as any indicators that could guide your intervention strategy. Here are some aspects to consider:

    Types of Thoughts to Include:

    1.Suicidal Ideation: Whether the caller is having thoughts of suicide, self-harm, or harming others. If yes, how frequent and intense are these thoughts?

    2.Hopelessness: Any thoughts that convey a sense of despair, e.g., “Things will never get better.”

    3. Anxiety-Driven Thoughts: Thoughts that fuel the caller’s anxious state, e.g., “I will lose my job,” or “I can’t handle this.”

    4. Intrusive Thoughts: Unwanted thoughts that are bothering the caller, often observed in conditions like OCD or PTSD.

    5. Distorted Thoughts: Cognitive distortions like catastrophizing, overgeneralizing, or black-and-white thinking.

    6. Repetitive Thoughts: Thoughts that keep circulating in the caller’s mind and may be contributing to their distress.

    7. Coping Thoughts: Any positive thoughts or mantras the caller is using to try and cope with their situation.

    8. Triggering Thoughts: Thoughts that are tied directly to the initial trigger for calling.

    Importance of Capturing These Aspects:

    1.Intervention Strategy: Knowing the types of thoughts the caller is experiencing helps you select an appropriate intervention method, whether it’s grounding techniques, coping strategies, or immediate emergency intervention.

    2. Safety Assessment: Certain thoughts, especially suicidal ideation or thoughts of harming others, are immediate red flags that warrant rapid action, possibly involving emergency services.

    3. Building Rapport: Validating the caller’s thoughts can establish trust and rapport, making them more receptive to your support and suggestions.

    4. Long-Term Care: These notes can be invaluable for mental health professionals who may provide long-term care to the caller, giving them an initial understanding of the cognitive landscape they are working with.

    Remember, it’s crucial to approach this sensitive information-gathering process with tact, empathy, and without judgment to ensure the caller feels safe and supported. 

  • What exactly does it imply when it says “callers trigger to connect”?

    The term “caller’s trigger to connect” refers to the specific event, situation, or emotion that prompted the individual to reach out to the crisis helpline. Understanding the trigger can offer crucial insights into the immediate needs and emotional state of the caller, helping responders offer more targeted support.

    Importance of Identifying the Trigger to Connect

    1. Assessment: Understanding the trigger helps in quickly assessing the severity of the caller’s situation and prioritizing the call.

    2. Tailored Support: Recognizing what specifically led the caller to reach out allows for a more personalized and effective set of recommendations or interventions.

    3. Context: The trigger may provide critical context to understand the caller’s history or current circumstances, which might not be immediately apparent.

    4. Trust Building: Demonstrating an understanding of the caller’s specific trigger can help in building trust and rapport, crucial elements in a crisis intervention setting.

    5. Data Collection: For the purpose of data analysis and improving services, it’s beneficial to know what kinds of triggers are most often leading people to use the helpline.

    Examples of Triggers to Connect

    – A recent loss or bereavement

    – A traumatic event

    – A sudden change in mental state (e.g., an acute episode of anxiety or depression)

    – A conflict with family or friends

    – Witnessing or experiencing violence

    – Reaching a “breaking point” in the ability to cope with chronic issues

    – Experiencing withdrawal or substance abuse issues

    – Witnessing triggering information in the media or social media

    Understanding the trigger for making the call can greatly aid the quality and efficacy of the support provided. Therefore, it should be a priority to understand this as early as possible in the conversation, without making the caller uncomfortable 

  • What specific information should be entered into the caller details section?

    Collecting accurate and relevant information about the caller is crucial for various reasons, including establishing rapport, providing tailored support, and ensuring continuity of care. Here’s how each component of the caller details can help:

    What to Include in the Caller Details

    Ensure you have the caller’s consent before collecting personal information.


    What: The date and time of the call initiation and termination.

    Why: To track the frequency and duration of calls for both administrative purposes and for gauging the ongoing severity or change in the caller’s situation.

    Caller ID:

    What: A unique identifier for the caller, or note if it’s a new or repeat caller.

    Why: Helps in quickly accessing previous call records to understand the caller’s history and issues, thereby providing a more personalized and efficient service.


    What: Age, gender, employment status, marital status, and potentially ethnicity, education level, and more.

    Why: Demographic details can inform the types of issues the caller might be facing and the appropriate resources to suggest. For example, resources for adolescents may differ from those for seniors.


    What: General geographic location of the caller.

    Why: Vital for directing the caller to nearby services and for understanding cultural or regional factors that may be relevant. In emergencies, this could be critical.

    Anonymity Status:

    What: Note if the caller wishes to remain anonymous.

    Why: Respecting anonymity can affect how much detail can be collected and used in future interactions. It is crucial for building trust.

    Contact Details:

    What: Emergency contact details, if the caller is comfortable sharing.

    Why: Useful for any necessary follow-ups, but also can be critical in emergency situations where immediate intervention may be required.

    Special Notes:

    What: Any additional notes such as language preferences, disabilities, or other specific needs.

    Why: To tailor the support provided and ensure it’s as accessible and effective as possible.

    Priority Flag:

    What: A categorization or flagging system to note the urgency or severity of the caller’s situation.

    Why: Helps in triaging calls and may guide how quickly a responder should follow up.


    What: A note indicating that the caller has consented to the collection and use of their information for the purpose of the call.

    Why: Legally necessary and ethically important to ensure that the caller’s privacy is respected and protected.

    Each of these details not only aids the current call but also equips any future responders with the information needed to provide high-quality, individualized care. It also helps in the compilation of data for quality assurance, research, and program development. 

  • What information needs to be asked for during the call so it can be documented on the call notes?

    Thorough and accurate documentation is critical for providing consistent and high-quality support. It’s essential to adhere to data protection guidelines and secure consent when applicable. Here are the key components to document:

    What to Document in the Call Notes

    Caller Details:

    1. Timestamp: The date and time the call was made and ended.

    2. Caller ID: If applicable, noting whether the caller is new or a repeat caller.

    3. Demographics: As permissible, record gender, age, employment status, marital status, location, and other relevant demographic information. Confirm how the caller identifies themselves especially in terms of gender and sexual orientation, without making assumptions.

    4. Anonymity Status: Note if the caller wishes to remain anonymous.

    Caller’s Trigger to Connect:

    1. Initial Concern: The primary issue the caller presents.

    2. Trigger Event: If applicable, the specific event or situation that triggered the crisis or need to call.

    3. Urgency Level: Assess and note the level of urgency or risk.

    Caller’s Thoughts:

    1. Thoughts: Document any disclosed thoughts the caller has, especially if they involve self-harm, harm to others, or are delusional in nature.

    2. Plans or Intent: If relevant and safe to ask, document any plans or intentions the caller reveals.

    Caller’s Emotions:

    1. Emotional State: Document the caller’s emotional state at the beginning, during, and end of the call.

    2. Changes in Emotion: Note any significant shifts in emotion throughout the call.

    Responder’s Insights:

    1. Assessment: Your professional assessment of the caller’s mental and emotional state.

    2. Risk Level: A summary of any immediate risks identified, such as suicide risk.

    3. Other Observations: Any additional observations that may be pertinent for future interactions with the caller.

    Responder’s Suggestions:

    1. Immediate Actions: Any immediate steps taken during the call (e.g., emergency services contacted).

    2. Suggestions: Advice or coping strategies suggested to the caller, based on evidence-based practices.

    3. Resource Referrals: List any external resources or organizations you referred the caller to for further support.

    Note to Other Responder(s):

    1. Continuity of Care: Provide a summary that would be helpful for other responders who may interact with the caller in the future.

    2. Follow-up Needed: Indicate if a follow-up is recommended and, if so, what kind.

    3. Alerts: Any specific alerts that the next responder should be aware of, such as a particular trigger or risk level.

    This documentation will provide valuable context and continuity of care for any future interactions with the caller. 

  • At what point must the call notes be entered into the dashboard?

    The timing for entering call notes into the dashboard may vary depending on the organization’s protocols and the nature of the call. Below are some general guidelines that could be useful for Helpie Responders:

    1. Immediate Risk Situations: In situations that present immediate risk or emergency, prioritize action steps over entering notes. Enter the notes after the situation has been stabilized and/or emergency services have been alerted.

    2. During Idle Time: For non-critical calls, it is advisable to enter notes during idle time when the caller is reflecting or when you’re waiting for them to answer a question. This practice helps in keeping real-time information flow.

    3. Post-Call: We recommend entering call notes immediately following the conclusion of the call to ensure accuracy and completeness. Memory is freshest at this point, and important details are less likely to be forgotten.

    4. End of the day: If it is not possible to enter notes immediately after the call, aim to complete this task by the end of your day. This minimizes the risk of forgetting key details.

    5. Consult Supervision for Sensitive Cases: In cases involving severe ethical dilemmas or legal complications, it may be beneficial to consult a responder supervisor before entering notes into the dashboard.

    6. Check for Completeness and Accuracy: Before finalizing, review your notes to ensure they are complete and accurately represent the events of the call.

    7. Confidentiality: Ensure that the notes maintain the anonymity and confidentiality of the caller, in line with your Helpie data protection guidelines.

    8. Escalation: For calls that may need to be escalated or reviewed by a supervisor, timely and accurate entry of notes is critical.

    9. Updates: If the caller contacts the helpline again and there is a significant update or change in their situation, it’s crucial to update the dashboard as soon as possible.

    10. Data Quality: Ensure you follow Helpie SOP on data quality, which may include using standardized language, specific formats, or approved abbreviations.

    Following these guidelines helps maintain the quality and reliability of the data being collected, which is crucial for effective follow-ups and long-term case management. 

  • As soon as the call was returned, the person who called hung up. Should another call be made right away?

    In the realm of mental health crisis helplines, every action can have significant implications. The approach to handling a situation where a caller hangs up immediately after the call is returned should be guided by Helpie Helpline SOP. Below are some general guidelines that might help a Helpie Responder in this situation.

    Guidelines for Helpie Responders: Handling Immediate Hang-Ups

    1. Check Helpie Helpline SOP: First and foremost, refer to your helpline’s SOP on how to handle hang-ups.

    2. Attempt a Callback: A callback is often recommended. The person might have hung up accidentally, or they could be assessing the safety of the call.

    3. Delay the Callback: It might be beneficial to wait a couple of minutes before calling back. Immediate callbacks may sometimes be seen as invasive.

    4. Check Dashboard Notes: Review any available notes or background information on the caller. Understanding the context could guide how you proceed.

    5. Supervisory Input: Consult with a responder supervisor for their opinion if you are unsure.

    6. One More Try: You may try calling back one more time after a reasonable delay, if the first immediate callback goes unanswered.

    7. Document Everything: Note down the events in the dashboard for the benefit of future interactions and to ensure quality control.

    8. Do Not Persist: Overcalling could be seen as harassment and can exacerbate the person’s crisis.

    9. Seek Supervisory Review: In case of multiple hang-ups, it might be useful to have a supervisory review to assess whether different actions should be taken or if the case should be escalated.

    10.Ethical Considerations: As always, ensure that your actions are in line with the ethical guidelines set forth by your organization.

    Remember, the primary objective is to ensure the caller’s safety and well-being, while also adhering to the helpline’s standard operating procedures and ethical guidelines. 

  • The caller had phoned quite some time ago. However, their call has yet to be returned. Is it appropriate to return the call at this time or not?

    In the context of a mental health crisis helpline, the protocol for returning calls that were made some time ago would depend on your organization’s specific guidelines. However, here are some general points to consider:

    Guidelines for Helpie Responders: Handling Delayed Call Returns

    1.Review Documentation: Check the dashboard for any notes or information left about the caller’s situation. Try to gauge the urgency and nature of the call.

    2. Time-Sensitivity: If the caller had been in a crisis situation, consider the time that has passed. For older calls, the situation may have already been resolved or escalated without your intervention.

    3. Prioritize: If there are more recent calls that are of high risk or urgency, these should likely be addressed first.

    4. Check the SOP: The helpline SOP has specific rules about the time frame for returning calls. Always adhere to these guidelines.

    5. Consult a Responder Supervisor: If in doubt, consult your supervisor or senior team members to make a judgment about returning an older call.

    6. Consider Sensitivity: Calling back after a long period could re-open emotional wounds or be seen as an intrusion. Carefully consider the potential implications.

    7. Your Opening Script: If you do return the call, make sure to explain the delay in your response and ensure the caller is still in a position to talk.

    8. Record the Outcome: Whatever the decision, make sure to document it in the dashboard for future reference and for possible quality assurance evaluations.

    9. Public Relations Aspect: Keep in mind that failing to return a call, particularly if it was urgent, can have implications for the reputation of the helpline service.

    10. Ethical Considerations: Always weigh the ethical implications of delaying a response to a potentially critical call.

    Deciding whether to return a call that was made quite some time ago is a nuanced judgment that involves several considerations, including ethical, practical, and organizational factors. 

  • What is the relevance of the dashboard’s call counts?

    The dashboard’s call counts can serve multiple important functions in the operation and management of a mental health crisis helpline. Below are some key points to consider:

    Guidelines for Helpie Responders: Understanding the Relevance of Dashboard’s Call Counts

    1. User Engagement: Frequent calls from the same number may indicate a higher level of engagement or a more severe issue. This can inform the type and level of care or intervention needed.

    2. Risk Assessment: Multiple calls within a short period could signify a crisis situation requiring immediate attention.

    3. Quality Control: A high call count can also be a quality metric. If many calls are coming in but not lasting long, it might indicate an issue with the service being provided, requiring further investigation.

    4. Resource Allocation: Understanding call volume can help with staff allocation. For example, if call counts typically spike at certain times, additional resources can be directed accordingly.

    5. Follow-Up Actions: A sudden drop in calls from a frequent caller could indicate a change in their condition and may necessitate a follow-up, in accordance with the Helpie Helpline SOP.

    6. Monitoring and Evaluation: For administrative purposes, call counts are essential data points for evaluating the service’s reach and impact. They can also be valuable for securing funding or other resources.

    7. Case Management: Keeping track of how many times a specific individual has called can assist in case management, potentially indicating whether escalation to a more intensive level of care is appropriate.

    8. Training and Development: Patterns in call counts can serve as case studies for training new responders and for professional development activities.

    9. Trend Analysis: Over the long term, call count data can indicate trends, whether they are seasonal, related to external events, or otherwise. This can be valuable for planning and strategic development. In summary, the dashboard’s call counts are not merely numbers; they offer multi-dimensional insights that can aid in real-time decision-making, long-term planning, risk assessment, and overall service improvement.

    ‘s generally best practice to review all relevant dashboard notes before making a call. This ensures that you have the most up-to-date information on the caller, previous interactions, any special instructions, or identified concerns.

    Importance of Dashboard Review

    1. Context Matters: Notes can provide crucial context about a caller’s history, their state of mind during previous calls, and any specific issues that have been discussed. This context can be invaluable for guiding the current interaction effectively.

    2. Continuity of Care: Even though you might not be the same responder the caller spoke with before, having background knowledge helps to provide a level of continuity in the support and guidance offered.

    3. Efficiency: Knowing the history can save precious time, enabling you to get to the heart of the matter more quickly, especially in a crisis situation.

    4. Prevent Repetition: A review can prevent unnecessary repetition of questions or suggestions, which can be frustrating for the caller and could erode their trust in the service.

    5. Risk Assessment: Previous notes might contain information vital for risk assessment, which can be crucial in a crisis situation.

    6. Quality Assurance: Familiarizing yourself with the case ensures that you are meeting organizational standards for quality of care.

    7. Preparation: Lastly, having as much information as possible can only aid in your preparation and effectiveness in managing the call.

    In summary, always review the dashboard notes before making the call unless there is an exception to so. Doing so equips you to provide the most informed, empathetic, and effective assistance possible. 

  • Is it suggested that I review the relevant dashboard notes before making the call, or should I only do so if necessary?

    It’s generally best practice to review all relevant dashboard notes before making a call. This ensures that you have the most up-to-date information on the caller, previous interactions, any special instructions, or identified concerns.

    Importance of Dashboard Review

    1. Context Matters: Notes can provide crucial context about a caller’s history, their state of mind during previous calls, and any specific issues that have been discussed. This context can be invaluable for guiding the current interaction effectively.

    2. Continuity of Care: Even though you might not be the same responder the caller spoke with before, having background knowledge helps to provide a level of continuity in the support and guidance offered.

    3. Efficiency: Knowing the history can save precious time, enabling you to get to the heart of the matter more quickly, especially in a crisis situation.

    4. Prevent Repetition: A review can prevent unnecessary repetition of questions or suggestions, which can be frustrating for the caller and could erode their trust in the service.

    5. Risk Assessment: Previous notes might contain information vital for risk assessment, which can be crucial in a crisis situation.

    6. Quality Assurance: Familiarizing yourself with the case ensures that you are meeting organizational standards for quality of care.

    7. Preparation: Lastly, having as much information as possible can only aid in your preparation and effectiveness in managing the call.

    In summary, always review the dashboard notes before making the call unless there is an exception to so. Doing so equips you to provide the most informed, empathetic, and effective assistance possible. 

  • The caller calls several times in a short time and expresses a desire to continue chatting because they believe it would help. How to handle this moment compassionately?

    Scenario: Frequent Caller Expressing Desire for Continued Conversation

    1. Acknowledge the Caller’s Feelings: First and foremost, acknowledge the caller’s emotional state and their need for support. A simple statement like, “I can hear that you’re going through a difficult time and I’m glad you reached out” can be affirming.

    2. Clarify Helpie Helpline Policies: Gently explain that while you understand their need for continued support, the helpline is intended for immediate crisis intervention and it’s essential to keep the lines open for others who may also be in immediate need.

    3. Encourage Scheduled Professional Help: Suggest that for ongoing, regular conversations, a scheduled session with a licensed mental health professional is more appropriate and beneficial in the long term.

    4. Offer Alternatives: Provide information about alternative services, like ongoing counseling or support groups, that may be more suited to offer the continued support they seek.

    5. Information and Referral: Direct them to appropriate resources. For example, for long-term counseling suggest they reach out to Tele-Manas @ 14416 or 18008914416.

    6. Wrap-Up: Let the caller know that it’s important for them to find the long-term support they need and that the Helpie Helpline is always there for immediate crises. Thank them for reaching out and encourage them to seek specialized, ongoing help.

    7. Post-Call Documentation: Once the call is completed, document the frequency of the caller’s contacts and any recommended next steps. This will help other Helpie Responders if the individual calls again.

    Being compassionate yet clear about helpline policies can ensure that the caller understands the limitations of the service while still feeling heard and supported. 

  • The caller hangs up while still talking because they have something to attend to. Tells the person who answered to call back later. How should I handle this?

    Scenario: Caller Hangs Up and Requests Callback

    Documentation: Immediately document the call specifics up to the point where the caller hung up. Ensure that all relevant information and context are meticulously recorded in the system.

    Protocol Reminder: If the caller requests a callback, gently inform them that as per Helpie Helpline protocol, they will need to call back themselves when they are available, and the next available Helpie responder will assist them.

    Privacy and Sensitivity: Express understanding and reassure the caller that their information will be kept confidential. Let them know that Helpie is always available to provide support when they are ready to talk.

    Resource Availability: Briefly inform the caller about the working of the helpline and the availability of Helpie responders.

    Follow-Up Information: If the call is of a particularly sensitive nature (e.g., involving a high level of crisis), re-emphasize the importance of calling back as soon as they are able to or need be reach out to another helpline.

    End the Call: If the caller needs to hang up abruptly, ensure you end the conversation on a positive, reassuring note, reinforcing that Helpie is here for them whenever they choose to call back.

    Post-Call Actions: Update the internal records and make a note of the request for a callback, even though the policy does not permit you to initiate one. This is crucial for future interactions if the caller should contact Helpie Helpline again. 

In Mental Health Crisis

Maybe it’s time to seek help…