Lambeth & Southwark MIND Information Service: Responding to COVID 19.
Lambeth and Southwark MIND’s Information Helpline is one of the charity’s core services. It is a popular resource, averaging 1200 enquiries per year. Under normal circumstances the Information Service Adviser works with her manager and Information Service volunteers to answer telephone and e-mail queries, research and update entries for the on-line directory and disseminate information about community opportunities to service users, families, professionals and the community generally.
However, the event of COVID – 19 significantly changed the type and volume of calls the Information Line would normally receive at this time of year. It also structurally changed how the service was provided.
The team responded quickly to the lockdown, diverting calls from the publicised number to the Information Service Adviser’s work mobile mobile, who began working from home at the beginning of March.  Remote access to e-mails was already possible, and this communication method continued.
The Information service Adviser is Venus Caesar and what follows is a short account of her experiences answering callers over the last three to four months. Sarah Mc Donald from Vocational Services Lambeth kindly offered to do the interview and the write-up.
Almost immediately the telephone line was dominated by calls from people anxious and distressed about the virus. It had a profound effect on those already struggling with their mental health. Venus received a number of requests for help from family members worried about their children and partners who were showing signs of poor mental health.
‘We had people calling saying a relative had started to hear voices. Where it had been under control before, now voices were re-emerging. The families were in a state of panic. The lockdown meant people were not allowed to leave, yet people were acting erratically which was frightening for everyone’
‘We had lots of calls from people on wards wanting to find an advocacy service to appeal their section. People were very distressed thinking they were detained in order to be given the virus in hospital.’
A group that asked for a lot of help were those working on the front line.  In just 3 months, 53 calls were received from nurses, doctors, care workers, bus drivers, funeral directors, police and fire officers. Although the helpline is experienced in answering enquiries from a diverse range of individuals, this was a significant new development of need. The calls were very emotional and people called in great distress.  It was not unusual for people to call in tears and continue to cry during the lengthy conversations. Venus had to provide a huge amount of empathy and insightful active listening
People were feeling very vulnerable about their health and catching the virus whilst at work with insufficient PPE. A number of clinicians had separated from their families to prevent the spread of the virus, and were feeling isolated, scared and lonely. For frontline workers the pandemic was a huge toll on their mental health, feeling distressed from what they had seen and what they feared could happen to them. Police officers who had been spat at didn’t want to carry on working.
‘I had nurses crying on the phone. One described walking onto the ward like walking into a war zone’
‘A Doctor called for help, saying – I ‘ve never had a problem with my mental health until now – Its completely changed me’
Venus was able to provide practical support (signposting to Trade Unions, counselling services information, mediation Services, housing assistance) but it was validating the fear and trauma people were experiencing that appeared to help the most.
The calls would be quite long, people want to share their story, when I asked them what else they wanted they’d say ‘Just talking to you makes me feel better’
‘Sometimes I felt like I was an emergency service to the emergency services’
The helpline was consistently busy from April onwards as the pandemic began to cause social as well as health problems. Venus responded to requests for information about support for domestic violence, child abuse, debt, relationship problems, welfare benefits, medication issues and housing problems. One distressed nurse called as she was asked to leave by her housemates who were scared she could pass on the virus.
Each day the enquiries would range from the complex (liaising with homeless teams to ensure people were sleeping on the streets got accommodation, chasing food deliveries for people shielding) to the surreal (How do I make a mask? My homemade bread isn’t right, do you have a better recipe? When will my hairdresser open?)
‘I can’t think of anyone who hasn’t been affected by this. There is no normal anymore’
There was a large number of calls from people looking for services to provide emotional support. Bereavement, isolation, and family problems meant therapy services were in great demand. For many, regular coping strategies had been removed during lockdown and their mental health was suffering. It was not unusual for people to call asking for support with suicidal thoughts, and the Venus worked closely with crisis services and suicide organisations to ensure individuals were kept safe and supported.
The Information Services has an extensive database of organisations, services and resources to signpost people to.  During these exceptional times however, signposting was often difficult as many organisations’ services had ceased or halted during the lockdown. Given the vulnerable position that callers were in it was important that the signposting was as accurate and relevant as possible.
For Venus this meant liaising more closely with the recommended organisations to ensure the most appropriate help was offered, and following up to ensure people’s needs were met.  A positive outcome from this crisis is that partnerships with other local organisations have strengthened (e.g. Street Link, Papyrus).
One particularly successful example of partnership working involved contacting and liaising with a local MP for a person whose son had sadly passed away in hospital. The caller was in great distress as they were being pressured by the hospital to make funeral arrangements and more specifically to have the body removed to the funeral premises. However, the person did not have the funds to be able to do so. The MP was able to support the person to apply for funding for the funeral, and a very traumatic time was eased slightly by the communication between MIND and the constituency office.
Reflecting on the extra responsibilities, Venus commented:
‘This Is an unusual time.  If we all just said only do normal work, people would not have been helped.  Everybody has had to stretch the boundaries of what they do –we have had to be flexible and creative’
Monitoring data shows the information Service has been substantially busier during this period than in previous years. Phone calls to the service particularly escalated to more than twice what they would normally be.  The Adviser estimates over 80% of these calls were related to COVID.
When exploring with the Manager and Venus as to why the service had been so busy and received such a diverse range of queries, it was explained that there is great trust placed in and high expectations of Lambeth & Southwark Mind as a mental health organisation especially by those needing support with mental health issues. The telephone line has been particularly important to those who do not have access or use the internet.
‘Sometimes people ring for information they may have been able to get on an NHS website, but people feel safe with us’
For the team, being as accessible and supportive as is possible is a fundamental value.
We never say ‘we don’t help with that’ always try to give something.  Someone asked me to stay on the line and help her cook. I couldn’t do that, but did send her links to recipes on You-Tube
 A lot of people are so vulnerable, I know from my own experience that a little bit of help can make all the difference, the right help can be a pathway to begin their recovery
Not only was the Information Service receiving more calls than usual, they were also lengthier and more complex. Venus explained that it was not as simple as just signposting to the relevant service.  People were calling in despair and distress, and needed to share their experiences and difficulties before asking for a specific service. There was a strong therapeutic value to being heard and supported as well as receiving the right information.
‘They need to tell you their whole story, and once they have told you their whole story then they want to know how you are going to help them. And if you try to signpost them to something they have already been to – their anxiety level goes completely up.  I can spend 15 – 20 minutes on a call just talking to people, building a picture before giving any information. But once you have listened, if you are able to signpost – they are more likely to take the information in, as they are more relaxed. If you give the information too early, they are too anxious to be able to listen’
This high demand and complex nature of the calls put a lot of pressure on the service, particularly on Venus who was working from home. The usual camaraderie in the office, and the opportunity to walk away at the end of the day was greatly missed. Strong and effective support and supervision from the service manager was incredibly valued. External supervision and training was offered too as an extra layer of support.
To mitigate the pressure on Venus, and to try and meet the increasing demand for emotional support, a Befriending scheme was piloted. Phones were bought and posted to the volunteers. This cost was covered from a very small IT grant.
Three volunteers were recruited and they offer weekly 30-minute telephone calls to vulnerable people identified by the Adviser.  It has proven a success, with high satisfaction from people who are isolated and unable to currently access peer support or talking therapy or activity groups. It also provides opportunities for local volunteers who have keenly expressed an interest in helping more during the pandemic.
Below is a quote from one of the telephone befriending volunteers that Venus manages.
 
“When COVID-19 hit, I felt desperate to engage in some form of activity that would allow me to support others in such an uncertain time. Becoming a Befriender with Mind has given me such an opportunity. Over the past few months, I’ve called two individuals weekly and have been able to develop real bonds. From serious conversations about COVID-related anxieties and daily struggles, to light-hearted ones about beach vacations, I’ve really enjoyed providing a listening ear. In a time that can be extremely isolating, Befriending has given me the chance to grow human connection.”
Expanding services and identifying resources for innovative developments such as incorporating some out-reach work alongside the signposting, and developing the telephone befriending pilot could prove valuable as requests to the Information Service continue to remain high as the COVID situation evolves.  The aftermath of the pandemic means the organisation and its services will continue to receive much higher than normal requests from people struggling with grief and bereavement, anxiety with the lifting of lockdown, unemployment and financial stress.
The nature of the Information Service, like many other helpline services is that the work never ends. Now more than ever during this pandemic there are distressed people out there needing support and information either via phone or email. Many people particularly rely on the phone as they have limited or no IT resources.
For Lambeth and Southwark Mind and many other mental health organisations, returning to face-to-face contact is still a bit of an unknown.
 
 
Sarah McDonald
Lambeth Vocational Services (SLaM)