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HomeOn the Frontlines'Emotional paramedics' deal with rising number of crisis calls

'Emotional paramedics' deal with rising number of crisis calls

The staff and volunteers manning the South African Depression and Anxiety Group’s (Sadag) helplines are “emotional paramedics”, responding to the 3 000 daily callers with compassion and efficiency, their efforts making a difference in the lives of vulnerable South Africans, including teenagers in crisis.

Tracy Feinstein, call centre manager for Sadag, says two things are crucial: that callers are helped with speed, compassion and effectiveness, and that the counsellors assisting them receive support and a safe space in which to grow.

Feinstein has been involved with Sadag for about 10 years, having started as a call centre volunteer with a 4pm-to-8pm shift every Thursday. Today, she manages and supports the call centre’s more than 200 volunteers.

“I know we make a difference to people’s lives, just by taking one call a day,” she said. “Of course, it’s not one call that we handle now, it’s thousands.”

Sadag provides mental health and suicide crisis helplines, among others. Speaking to Maverick Citizen during Teen Suicide Prevention Week, Feinstein said there had been a rise in the volume and intensity of teenagers calling for help since the Covid-19 lockdowns fell away.

“It really is, in many ways, wonderful that these teens are brave enough to reach out for support. On the other side, it is incredibly concerning that they are that desperate… they are hopeless, feeling overwhelmed,” she said.

“There has been a massive increase in the number of calls from kids, and they are younger every year… now we’re getting calls from 12- and 13-year-olds, even 11-year-olds.”

Academic stress, relationship issues and parental conflict are some of the primary reasons they call the helplines, says Lara Ellwood, training co-ordinator at Sadag. Ellwood first started at Sadag as a volunteer in 2016, driven by the role the organisation plays in breaking down stigma around mental illness.

“I also think (teenagers are) just generally finding their fit and their space in the world. They’re at that point where they’re identifying and figuring out who they are,” she said.

Kia Cordeiro, a social worker and Sadag’s Cape Town co-ordinator, identified an increase in self-harm among young people, as well as higher levels of anxiety and family issues.

“There are a lot of child-headed households in South Africa. So, kids who are maybe 15, 16, are now looking after siblings four, five, six-years-old – making dinner, making lunches, needing to come home and still study and do homework, and still fill the role of a parental figure… there’s a lot of stress around that,” she said.

People should be more open to investigating mental health struggles in younger children, says Lilah Davies (13), an anti-bullying and mental health activist. Having been bullied about her hair when she was younger, Davies has been engaging in school talks and other programmes against bullying for the past few years.

“(Child mental health struggles are) actually a lot more common than you think, and especially mental health around social media because… at a younger age, children are given access to social media,” she said.

“Cyberbullying is very prominent, even in things that aren’t supposed to be dangerous like online games….” Davies encouraged young people to look after their mental health by putting their well-being first, and surrounding themselves with positive people who support them.

Sadag counsellors encourage teenage helpline callers to approach an adult in their lives and share their situation, according to Cordeiro. However, counsellors also provide self-help techniques.

“We teach them a lot of grounding techniques, breathing techniques around anxiety… (and) also equip them with that language to be able to go to someone and ask for support or ask for advice,” she said.

Responding to crisis callers

In a crisis situation, helpline counsellors constantly navigate between gathering information about a caller – where they are, if they are alone – and ensuring the caller feels heard, said Feinstein.

“Especially if perhaps they have overdosed, they may have cut themselves, they may have swallowed a concoction that is not going to be good for them, we need to get them to a place of safety, and medical intervention is always paramount.”

No two crisis situations were the same, and counsellors often needed to “think outside the box” to ensure a caller was helped.

Sometimes the callers’ addresses were unclear because they lived in informal settlements, and counsellors needed to coordinate with emergency services to get them to the right places.

“We have even encouraged callers to call an Uber if that’s going to be quicker than waiting for an ambulance,” said Feinstein.

Cordeiro described the counsellors as “emotional paramedics”, responding to emotional crises.

Counsellor support

Sadag has a support team of supervisors working with helpline counsellors while they are on calls, to ensure there is a network of support in crisis situations, Feinstein added.

Each counsellor has his or her own reason for volunteering and face their own challenges, Ellwood said. At times, they must deal with extreme calls, or even health system failures – an ambulance arriving late or a clinic rejecting a referral.

“We offer debriefing to our counsellors. We also have a weekly support group meeting where our counsellors have an opportunity to… discuss these kinds of cases,” she said.

“There’s always an ear to listen or a shoulder to lean on…always a team behind them, supporting and guiding them.”


Daily Maverick article – Meet the ‘emotional paramedics’, heroes on the frontline of mental health support in SA (Open access)


See more from MedicalBrief archives:


Young women’s mental health worst hit by COVID – UCT and MRC


SA has higher suicide mortality that most of Africa – IRR


Drugs, alcohol and violence as much a suicide risk as self-harm in adolescents


Suicide risk rises after surviving self-poisoning


Stock-outs: A ‘shadow epidemic’ of psychiatric illness looms in SA


Is it abuse when a parent ignores a child's depression?








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