52% increase in emotional crisis calls during the pandemic

In a particularly overwhelming year, the Ajuda i Esperança Foundation has been sensitive to the discomfort and suffering of people who need to be heard in a framework of security, confidentiality and anonymity. The Foundation offers guidance and emotional support through the Telephone of Hope (operational since 1969) and the Suicide Prevention Telephone number, which has been active since 6 October 2020 in agreement with Barcelona City Council (900 92 55 55).

This experience led to the creation of the Observatory of Hope project, initiated with the support of the "la Caixa" Foundation in 2020, with the aim of analysing the information collected by the services of the Telephone of Hope and the Suicide Prevention Helpline on the people attended to and their problems in order to contrast it with the analysis of current social phenomena and generate a source of knowledge that provides reflection and proposals to improve care for vulnerable people.

The publication is the first result of the Observatory, which is committed to becoming a meeting point for reflection and proposals on how to deal with the emotional tensions of the population generated by the social, economic and cultural transformations of our times, and in this way establish the bases for the development of a welfare society for all citizens.

The anonymous stories collected on the telephone numbers of Hope and Suicide Prevention reveal the profound unease of social groups who seek a friendly voice in order to be heard.

The high number of calls received during 2020 on the two helplines (55,948 calls), more than 150 a day, mostly from Barcelona city and its surroundings, but going beyond the city limits, shows that the problem is not a minor one. Even more so when, surely, the two telephone numbers only detect the tip of an iceberg of much more extensive malaise.

The personal and social problems expressed through the two telephones revolve around six main themes: suicidal ideation, mental illness, relational problems, unwanted loneliness, physical health and economic poverty. Each has its own dynamic, but they are very often interrelated and feed into each other. All of them are characterised by personal suffering that each person faces with his or her personal capacities and with the resources that he or she obtains from the people around him or her and from those that society makes available. The experience accumulated in the two telephones shows that these resources are not enough or are not sufficient to contain the tensions of discomfort to bearable levels. In fact, the services of the two telephones generate a new resource of an anonymous friendly voice that has proven its validity in calming emotional tensions and avoiding extreme situations.

The anonymity on which the telephone methodology is based does not allow us to know in depth the characteristics of the callers, but in broad outlines they draw clear profiles: in the case of the Telephone of Hope, women are in the majority, especially among the elderly. The majority group is adults, but with two significant age groups, the youngest (18-39 years) and those over 65. The two extreme age groups, those under 18 years of age and those over 80 years of age, are in the minority, which does not mean that their problems are less important, but rather that they are less likely to use this service.

They are people from all social levels, so almost half of them have a basic level of education. In most cases they are people who live alone, although a third of them live with a partner or other family members. The vast majority are not active in the labour market, either because they are on sick leave, retired or do not have a paid job. Almost all of them have been or are in the care of health or social services, although in some cases, the telephone service is the first point of contact that may later lead to medical or social services care.

In the Suicide Prevention Hotline, the profiles are similar. A majority of calls correspond to women and this majority increases in the case of women with suicidal behaviour. In reference to age, the majority are also of middle age, but the proportion of young people under 29 years of age is higher in this case, almost a third, than in the Telephone of Hope. They are mostly single people, half of whom live alone and the other half with family or other formulas. Physical loneliness is not as prevalent as in the case of the Telephone of Hope. Most do not work, although people with a paid job are more abundant among the calls to the Suicide Prevention Hotline than in the calls to the Telephone of Hope. The territorial influence is similar.

In the case of suicide prevention, mental health issues are much more prevalent than in the Telephone of Hope.

If this is the anonymous profile of the people who use the telephone of the two services, the exact dimension of the whole iceberg is more difficult to draw. The problems that the listeners and the counsellors of the services pick up in their conversations have a common denominator, which is the personal discomfort that they do not find in their personal or social environment, the necessary confidence to express themselves and find comfort and that they do find it in the telephone communication with a person they only know by voice and who offers understanding and companionship. A personal discomfort, which can be of varying degrees of intensity, but which is always experienced by the person in a sufficiently problematic way to pick up the phone and explain their worries to another person who does not know them personally, even if only, as the volunteers tell us very well, to listen to their own voice and soothe their lack of communication. "When they call us, they know perfectly well that we are anonymous people, that they will never know what we are like, nor we what they are like. But what really acts as a balm is to listen to their own voice, to verbalise what is distressing them, and this same distress wells up, they see it, they almost touch it, because they can feel it, and precisely because of this, because we are anonymous, they can go deeper, even deeper than they would in a conversation with a friend or with any other person closer to them. And of course, it is loneliness, a lot of loneliness", comments Alicia, a participant in the focus group as a listener and counsellor.

In this way, the experience of the services of the Telephone of Hope and the Suicide Prevention Service provide five elements for reflection:

- They value the transforming power of conversation, even if only to help visualise the tensions and anxieties of the person who expresses him/herself under the pressure of discomfort, and even more so when it contributes to its rational elaboration, as expressed with great lucidity by the volunteers who participate.

- The voluntary nature of the relationship between individuals and the service, both users and providers, provides a highly constructive and enriching climate of freedom for the conversations to be established. It is a relationship in which both parties gain personally, some because they release tensions and others because they receive more than they give, to paraphrase the statements of some volunteers.

- In the case of the Telephone of Hope, the civil society initiative through the Help and Hope Foundation contributes to generating patterns and spreading alternative behaviours of community involvement among people. And in the case of the Suicide Prevention Helpline, the public initiative to establish a public-private partnership between Barcelona City Council and the Foundation materialises one of the most promising lines of action for tackling the challenges of advanced societies, now widely recognised but still incipiently materialising.

- The need for a high degree of professionalism among listening volunteers, based on a rigorous methodological control of the conversation processes that facilitates the incorporation of all the accumulated knowledge and collective intelligence developed by the human and social sciences.

- The anonymity between the user and the listener or counsellor contributes to generating a climate of trust in a very short space of time, which is absolutely necessary to facilitate the rapid manifestation of internal discomfort. The challenge posed by this emergency resource is its articulation in a set of resources that facilitate the resolution of the factors that trigger the discomfort.