Last line of support

Last line of support

To mark World Mental Health Day, Life talks to professionals and volunteers offering emotional help to some of society's most vulnerable people

SOCIAL & LIFESTYLE
Last line of support
Aboveā€‚A psychiatric public health officer receives a call. Photos: Chanat Katanyu

It was a drizzly Thursday afternoon, and the booths of the 1323 Mental Health Hotline were humming with the low, empathetic voices of their call operators.

Only the day before, a woman had phoned in at 1am, already on a balcony and ready to jump. Two years ago, she was raped whilst on holiday. She'd opened up to her parents, but they only told her to forget it and move on. In addition to the increasing pressure from her workplace, she just didn't have the will to live anymore. With nowhere to turn, she dialled 1323.

"The counsellor took around an hour talking to her," said Dr Mathurada Suwannapho, director of the Child and Adolescent Mental Health Rajanagarindra Institute where the hotline centre just moved two years ago. "It was a successful case as he was able to lure her out from the balcony into a safer place. She's now being treated."

Oct 10 is World Mental Health Day. Earlier this year, it was disclosed by the Ministry of Public Health that on average, more than 300 Thais commit suicide per month. That's almost 4,000 cases per year. While families and psychiatrists are central in helping the mentally or emotionally afflicted, centres like the 1323 Mental Health Hotline and volunteer groups like The Samaritans are saving thousands more from potential mental illnesses and at worst, death.

From October to July 2016, the 1323 hotline received a whopping 44,798 calls -- most from working aged people; 33.2% had called about stress and anxiety, 29.3% due to ongoing psychiatric illnesses and 0.9% due to suicidal thoughts.

The hotline, which is free and open 24 hours a day, also has a Facebook chat option from 5pm onwards. It was set up 10 years ago, seeking to help the public manage their emotional health and assisting them in analysing their problems (i.e. relationships, addiction, gender identity, behavioural problems) and solving them in a healthy and logical way. Callers talk or chat to trained psychiatric public health officers who have graduated with a degree in psychology, and have gone through a six-week intense training course before ever picking up a phone.

They work on rotation -- three shifts of eight hours, with an average of no more than 10 cases per shift, and are supervised and advised by a team of a clinical psychologist and a psychiatric nurse with backups to all 18 psychiatric hospitals in the country in case of any emergencies.

It's a gruelling and mentally draining job, but for the sake of the public's health, someone has to do it.

Chonticha Yamma, whose kind voice could brighten anyone's day, has seen and heard a lot, working at the centre for the past three years. Since calls are all voluntary, 80% end up successful, but there's also the other 20% that they have to come to terms with.

"We're here to listen to them," she said. "We have to let them know that they're worth something, that they're not alone and there is a way out. These people don't want to die, they're calling for help. But [failed cases] are frightening, especially for the new recruits.

"One day someone would call for advice, [and] the next day, their family calls us and tells us that she has hanged herself. It's a shock. What did I miss? What did I lose? I did my best, I followed the procedures, but the case failed."

In cases like these, there will be a peer review with all the staff involved with the case. They go over what went wrong in order to fix their methods to prevent anything like this from happening again.

"Most of our lost cases were because the caller already had depression," explained Chonticha. Some may have missed their medication; some may have added pressures from work and society; and in the end, they take their own life.

"For us, we have to move on, and continue helping people in order to prove that we actually can help people. There's a lot of process that goes into it [the peer review]; we talk about our guilt and how we can move past the event." Unexpectedly though, the biggest cause of stress for Chonticha isn't distressed callers, but prank callers.

"We can handle the cases that need help. We're able to de-stress from that. But we get prank calls, sex calls, obscene calls and people calling in to abuse us. This makes our mental health deteriorate. I understand that these groups of people have problems of their own, but when there's so much of it we feel like we're getting abused."

The number of prank and sex calls has been so high that the hotline had to create a blacklist, which lasts for 24 hours.

"After that they can call and abuse us again," Chonticha chuckled sadly.

Dr Mathurada, however, says that psychologists have better coping mechanisms than your average Joe.

"People sometimes ask if we're stressed out. We're not, because we're trained to learn how to listen to other people's trauma. People who have studied psychology have supervisors who act as therapists for us, so we are able to be neutral."

A different approach is undertaken by The Samaritans, where all staff members are simply kind-hearted volunteers. But being a suicide hotline, how are they qualified to put the lives of others into their own hands, and how do they cope with that amount of stress?

Currently with 80 volunteers, Samaritans -- which started in England in 1953 and came to Thailand in 1978 -- has the belief that a well-trained "layperson" can help ease people in crisis just by being there and listening to them with no judgements.

The organisation (which operates on donations alone) offers Thai and English services that unfortunately may be difficult to reach due to the very low number of volunteers -- a challenge that they're trying to fix.

Last year, the organisation received around 10,000 calls, with 50% of the triggers being relationship problems, and the rest being mentally ill patients who have nowhere else to turn. Last year, The Samaritans made a popular viral video in which celebrities come on camera to talk about the importance of listening to the distraught; it was made after the shocking suicide of singer Prachathip Musikapong.

The process of choosing and training a volunteer is long and tedious in order to have the most appropriate person for the job. Characteristics of a Samaritan are people who listen more than they talk, who are open minded, able to accept people without any conditions, generous, aren't judgemental and have a good tone of voice.

"We call it listening with your heart," said Trakarn Chensy, director of Samaritans Thailand, sitting in the organisation's small office lined with morbid suicide prevention posters. "When they call, no matter how many wrongs they have done, they are your friend. You will step into their world, and you will listen to them, not judge them, and understand them.

"We filter and select people [from our workshops]. We need people who truly have a good heart, and are able to take in all the sadness without taking it home with them."

With that, potential candidates are invited to do intense practical training once a week for four to six months. They train to master skills in listening and the psychology of suicidal people. They simulate phone calls from actual events, and are taught to let callers speak openly about death, and never use phrases like "calm down", "you're overthinking" and "think of your parents".

"It might be ironic, but the thing suicidal people need the most is to talk about suicide," said Trakarn. "We have to make sure the volunteers can handle it. We are dealing with saving people's lives. We choose people who are mentally very strong. If a person is sensitive, it's not their fault, but this won't be the right path for them."

Volunteers, who are encouraged to work four hours a week, are constantly faced with new challenges. Fon, a volunteer for four years, took a while to adjust to the constant stress and sadness.

"At first I listened to people with so many problems -- sometimes I felt uneasy. So I had to carefully adjust myself. If you are sensitive, you won't be able to work in this type of field. You go home stressed and unable to sleep. It was like that for me initially as well. But now, I have the power to be able to smile once I put down the phone when I'm able to make a person feel better. Now it's not a hard thing to do."

As The Samaritans don't have personal supervisors to help them cope, they have bi-monthly support group meetings, and are able to call the director or "day leader", a senior staff member, if they are feeling stressed.

"The support group is very important," said Trakarn. "We all meet each other to talk about how we feel, and in The Samaritans we have what we call Day Leaders, volunteers who are also psychologists. These people will take care of the volunteers and will support them."

But one thing for sure is they need more volunteers. People in society, according to both Trakarn and Dr Mathurada, are becoming more isolated. Families are more broken than ever due to rapid economic and cultural change. The elderly are lonelier, workers are stressed and teenagers have less mental immunity and emotional control.

"Areas that used to be successful in preventing suicides [like the North and East] are starting to see more suicides," said Dr Mathurada.

"Thailand needs volunteers, but they have to be able to listen with professionalism. I actually have to thank the volunteers. These hotlines really help doctors a lot."

Help At Hand

1323 Mental Health Hotline

Call 1323 for free mental health counselling and advice if you or someone you know are showing symptoms of stress or mental illness. Their chat services start from 5pm onwards at www.facebook.com/helpline1323.

The Samaritans of Thailand

Open from noon-10pm every day.Call 02-713-6793 for Thai language operators and 02-713-6791 for English language operators.To volunteer, call 02-713-6790.To donate, transfer money to The Samaritans of Thailand via Bangkok Bank account 232-0-11324-0.

Dr Mathurada Suwannapho, director of the Child and Adolescent Mental Health Rajanagarindra Institute. Chanat Katanyu

The 1323 Mental Health Hotline centre. Chanat Katanyu

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