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Redding mental-health hotline helps those in need, but needs its own help, too

Record Searchlight (Redding, CA) - 7/28/2014

July 28--REDDING, California -- When the phone rings at Help, Inc., workers answer with a sense of urgency, the callers on the other end people in emotional crisis, sometimes to the point of considering suicide.

"There's an awful lot of lonely people out there who don't think they have any worth," said Steve Smith, the organization's director.

The free, Redding-based hotline has been around since 1971, giving people a chance to talk through their dark thoughts when they either can't get to a mental health professional or can't afford one in the first place.

"There's a whole heck of a lot of people around here who can't pay $100 an hour," Smith said. "I like to just ask them, 'What can I do to help you? How can I help you feel better?'"

Smith and the handful of other volunteers who take turns staffing the phone lines say that while the job can be incredibly fulfilling, it can also present an emotional challenge for the workers trying to help people in their darkest moments.

"What do you do if a particular call is too much?" said Dr. Sanjay Nath, an associate professor of clinical psychology and the director of the Institute for Graduate Clinical Psychology at Widener University. "It's difficult taking in that information; it can be very emotional. So I think there's a piece of, how are you going to address people's care without burning out?"

And with no steady financial support, the formerly county-funded organization now relies solely on volunteers, bringing it a share of operational challenges to navigate in a county that already has more suicides per capita than just about any other in California.

"At present, there's not enough volunteers," Smith said. "Every time the budgets are cut, everyone looks at mental health."

Offering a friendly ear

Help, Inc. has evolved quite a bit over the four decades since its inception.

Starting out of someone's home as a line meant mostly for suicidal people, the bulk of the organization's calls today are actually for the "emotional support warm line" -- the industry term for the sort of mental-health equivalent of preventive medicine, where callers who aren't in a full-blown crisis get that little emotional boost they need to remain stable.

"Having this kind of community-based resource is one of the most helpful things that's available," Nath said. "It's really a testament of this closer-knit community."

While suicide intervention is obviously important, Smith said, the hope with the warm line is that it'll stop people from needing it in the first place.

"If we can get people to call us for the warm line, maybe they'll never get to the crisis calls," Smith said.

And for some people, the warm line is actually so crucial that they call in just about every day.

"We used to have a lady who called every shift," Smith recalled, for "at least 25 years."

The woman, who died earlier this year, didn't have any family left, and ended up using Help, Inc. to maintain the fulfillment of human relationships.

"With her, it was kind of like we were an outlet so that hopefully she didn't end up in the emergency room," Smith said. "I think kind of we were a surrogate that helped her get through the day."

And that kind of everyday connection is not to be overlooked, mental health professionals say.

"It can serve a very valuable function, of being the first line of defense for somebody who doesn't have access to a support group, to family, to friends, a psychiatrist," said Dr. Prakash Masand, a former consulting professor of psychiatry and behavioral sciences and president of Global Medical Education, an online psychiatry resource for healthcare professionals. "It can probably be the most meaningful relationship that a caller has in their life."

A compassionate listener

While there are plenty of callers who can't afford psychiatric treatment -- or as much as they need -- for some, the hotline saves them from the shame or frustration of talking to someone they know.

Indeed, even friends and family members -- while good confidants in theory -- sometimes employ a hurtful, tough-love approach, Smith said.

"I think one reason people call these hotlines or may call them back ... is often, when we tell our family about these things or even our friends, the response is, 'Get over it,'" Nath said. "Those are the responses you're trying to work against, and just sort of be with people and say, 'Wow, it sounds like it's pretty bad.'"

Others are just too embarrassed to express their pain to someone who knows them, Masand said.

"Unfortunately, even today, the stigma of having a psychiatric illness is greater than the consequences of an untreated psychiatric illness," he said. "It's very sad, in this day and age and this society, psychiatric illnesses are not looked upon at the same depth as heart disease, cancer. That's what it is -- they're a medical illness. The only difference is they affect the brain."

While volunteers aren't professionals, they do undergo 25 hours of training and shadowing to make sure they're versed in that balance of sensitivity, listening and being proactive when need be.

"What we try to do is listen to them, but try to empower them, too," said one volunteer, who uses the name "Mitch" for calls, since volunteers aren't allowed to talk to callers outside of work. "We try to let them discover themselves -- that empowers them."

Another lesson -- one that can be counterintuitive -- is being upfront with callers who sound suicidal.

"One of the biggest fallacies out there is, with suicide, you don't talk about it, because that makes it worse," Smith said. "Actually, that is the 180-degree wrong thing. The bottom line is, if it's on their mind at all and you see one of the signs, you talk about it."

Indeed, Nath said just admitting that you're suicidal can begin to help.

"If you do ask people whether they think about hurting themselves, it's actually helpful, and sometimes people actually have a tremendous amount of relief just to say, 'I'm having that thought,'" he said. "Just having passing thoughts of this is common, and often they think they can't tell anyone because it would alarm people too much."

But truly listening is one of the most important -- and hardest -- things to learn, Smith said.

"I would have been a lot better at what I did (before retiring) if I used some of the skills I learned here," he said. "You're thinking of all these things you can suggest to them, and you're not really listening to them."

Finding that balance, though, just may be the biggest challenge.

'Some people you can't help'

Samantha, a volunteer, recalled the time when she was new and thought the best thing she could do was simply listen, without factoring in the caller's extreme fragility. The woman ended up hanging up after she determined that Samantha's silence meant she didn't care.

"I always wondered (what happened to her)," she said.

Those occasional emotional side effects of the job are a sad reality, volunteers say.

"We don't know if they're ever going to be better after we talk to them," Mitch said. "There's some people you can't help. Every call that comes in here isn't going to be a winner."

Smith said he can only think of one caller he's fairly certain ended up committing suicide -- a former regular from Nevada who matched the description of someone he later found out had killed himself.

But other callers go on to overcome their battles with mental illness, including Ripley Wolf, of Redding.

"I know the experience of sitting in the dark, rocking back and forth in the night in so much agony," she said. "It was just this terrible blackness. ... I knew it was my brain and not my mind."

Wolf had called hotlines four or five times throughout her life before dialing up Help, Inc.

Though dark thoughts were normal, given her "black, often suicidal depression," Wolf said "extreme loneliness" is what usually propelled her to actually pick up a phone.

"This is someone who just talked me through it," she said. "The reason it helps is because it gives you a sense of connection to another human being. ... The suicide hotlines were so important. People who are suicidally depressed need love. (The volunteers) are not judging you; they care. They're there because they care."

Now, Wolf considers herself freed from her decades of mental illness, finding peace through a sort of Christian-Buddhist-hybrid faith and promoting mental health advocacy through the county's Brave Faces initiative, a project that aims to destigmatize mental illness through portraits and storytelling.

"It's just so cool to wake up and have a nice, steady mind and have this mission to accomplish," she said. "I absolutely believe we can stop this epidemic. I know we can. It just takes the willingness to listen to the agony."

Shortage of help

The willingness to listen is one thing -- finding the workforce to be there for an entire community without any outside funding is another.

Help, Inc. used to be funded through Shasta County, but budget cuts led to the termination of that contract in 2009.

Donnell Ewert, the Shasta County Health and Human Services Agency's director, said the county has its own all-hours hotline for people in a mental health crisis, but it's essentially a crisis-response service, not a chance for counseling or the figurative shoulder to cry on.

"It isn't exactly the same, that's for sure," Ewert said. "I know Help's running on a shoestring, and we very much appreciate the work they're doing. They're all volunteers, and they've been great partners, so I'm hoping that could continue."

The hotline is especially valuable because of Shasta County's high suicide rate, which Ewert said was most recently pegged at ninth of the state's 58 counties, though recent years have put it as high as second place.

"One's too many. When you stop and think about it, these are 48 deaths that didn't need to happen," Smith said of the county's general suicide rate.

But it's unlikely Help, Inc. will get any help of its own from the county in the near future, Ewert said.

"I don't see that, I'm afraid," he said. "I don't foresee that money becoming available ... it's hard for me to see in the near future how that might fit into the budget."

One of the biggest issues presented by the current shoestring budget is the organization's inability to operate fulltime. Hours have been cut back to only 12 a day, though calls roll over to a national hotline when no one's in the office.

Still, that's a real frustration, Smith said, since some people face their loneliest hours in the middle of the night.

That was the case with one volunteer, who spent an entire night on the phone with a suicidal man who seemed inconsolable until she thought of one last resort.

"She looked up and saw that the sky was getting lighter," Mitch recalled. So, the volunteer suggested the man go outside and look at the sunrise. "He came back in and said, 'Well, I guess I'll take a shower and get some breakfast going," Mitch said. "You just never know."

In fact, some studies have shown talking literally changes what's going on in the brain, Smith said.

"The very act of talking causes changes in brain chemistry," he said. "At some point, you are no longer as susceptible to taking your own life as you were 20 minutes ago."

But besides those immediate interventions that hotlines can offer, they can also be a very important first step in getting outside help, Nath said.

"I think often it's an initial step," he said.

And even one good experience with a hotline can have a ripple effect that could lead to others getting the help they need, Nath said.

"There is a higher no-show rate for first sessions than later sessions; I think sometimes people will make up rationalizations for why they don't want to (get help)," Nath said. "But most problems are remediable, and ... I think when people get a taste of how it works, it's very effective. They are so much more likely to tell other people (to get help)."

If you need to talk to someone at Help, Inc., call 530-244-2222. Volunteers are there from 8 a.m. to 8 p.m., seven days a week.

If you're interested in volunteering with Help, Inc., call 530-244-2211, or email helpshasta@yahoo.com.

Or, to participate in the county's suicide workgroup, go to shastasuicideprevention.com.

"You get a lot of personal satisfaction," Smith said. "If you make them feel a little better, it's all worth it."

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