Helpline data used to monitor population distress in a pandemic

Alexander Tsai in Nature: “An important challenge in addressing mental-health problems is that trends can be difficult to detect because detection relies heavily on self-disclosure. As such, helplines — telephone services that provide crisis intervention to callers seeking help — might serve as a particularly useful source of anonymized data regarding the mental health of a population. This profiling could be especially useful during the COVID-19 pandemic, given the potential emergence or exacerbation of mental-health problems. Together, the threat of disease to oneself and others that is associated with a local epidemic, the restrictiveness of local non-pharmaceutical interventions (such as stay-at-home orders) and the potential associated loss of income could have contributed to a decline in the mental health of a population while at the same time inhibiting or delaying people’s search for help for problems. Writing in Nature, Brülhart et al. present evidence suggesting that helpline-call data can be used to monitor real-time changes in the mental health of a population — including over the course of the COVID-19 pandemic.

More so than in other areas of medicine, the stigma that can be associated with mental illness often prevents people from fully disclosing their experiences and feelings to those in their social networks, or even to licensed mental-health-care professionals. Furthermore, although mental illness contributes immensely to the global disease burden, primary health-care providers are overburdened, mental-health systems are underfunded and access to evidence-based treatment remains poor. For these reasons, helplines have, since their introduction in the United Kingdom by Samaritans in 1953, played a key part in providing low- or no-cost, anonymous support to people with unmet acute and chronic mental-health needs around the world.

Brülhart and colleagues updated and expanded on their previous work looking at helpline calls in one country by assembling data on more than 7 million helpline calls in 19 countries over the course of 2019, 2020 and part of 2021. They found that, within 6 weeks of the start of a country’s initial outbreak (defined as the week in which the cumulative number of reported SARS-CoV-2 infections was higher than 1 in 100,000 inhabitants), call volumes to helplines peaked at 35% higher than pre-pandemic levels (Fig. 1). By examining the changes in the proportion of calls relating to different categories, Brülhart and co-workers attribute these increases to fear, loneliness and concerns about health. The authors also found that suicide-related calls increased in the wake of more-stringent, non-pharmaceutical interventions, but that such calls decreased when income-support policies were introduced. The latter finding is perhaps unsurprising, but is a welcome addition to the evidence base that supports ongoing appeals for financial and other support to mitigate the adverse effects of non-pharmaceutical interventions on uncertainties over employment, income and housing security…(More)”.