Crisis services

This is a really great conversation to have @avant-garde

Just a quick reminder to anyone who joins that we can't specify crisis services in discussions such as these, due to our community guideline regarding complaints about named services.

I know that this has already been a part of the conversation, but it is important to provide feedback to these services where able. While these services should have their own processes of auditing calls and ensuring quality of service, providing feedback can help to make sure that any problematic interactions are looked into and can help them spot holes in the service they're providing or the training of staff.

I'm really interested to see input and ideas from others on here.

I'm also wondering, if you were to build an ideal crisis service what would that look like?

@Ru-bee

• Change the distress scale to a colour scale "what colour are you seeing/feeling"
• Have peer support workers leading different groups of volunteers
• Have a comments section in the feedback form
• For the demographic questions in the chat services to build in an AI to ask them slowly and provide CBT/DBT guidance in the waiting time before interacting with a human
• Follow up in 24 hours to provide resources for more local help, once the crisis period is over, even if it's just an automated email, they have our location from the demographic information
• Have focus groups of survivors to address different issues as they arise

Good discussion @avant-garde

I agree with changing the assessment distress scale from numbers, tends to make it heartless and mechanical. I agree with the importance of Lived Experience in groups and co-design etc. Follow up within 24 hours and later also would be great protocols. As an older person I am reluctant about AI use when I might be in crisis.

I am not sure many people are in the frame to give feedback a lot of the time. @Ru-bee

I hear you @Appleblossom, especially after having a distressing interaction with a service I know that submitting a complaints or feedback form just is not possible for a lot of people. I wonder if there are things that could make that more accessible too?

I love these ideas @avant-garde and they do seem to be potentially achievable ones to implement into services

I am very reluctant to reach out to some services cause they are just not helpful.

but I will say I actually like the number distress scale because it’s very simple and straightforward, and it’s used across a broad spectrum of services. I know what to expect.

I would really like for them to talk to me like a person, and for them to not sound like robots. I hate all that repeating back to me what I have said to them junk. It’s time consuming when I’m in a place of crisis. JUST TALK WITH ME! that’s what I really liked about the sane chat line. People need connection and that is missing greatly when they are so rehearsed and robotic.

while some kind of follow up after a contact would be ideal, can you imagine how time consuming it would be. Some services receive hundreds of calls a day. Perhaps an automated text or email where you have the option to receive follow up instead of it being automatic?

Thanks for thread @avant-garde good topic for discussion

• I agree with @Appleblossom especially after the robodebt scheme that many people (not just us "golden oldies") would be wary of an AI system.
• I think I might find a colour system difficult to use in times of distress and I am comfortable with a number system, however perhaps both could be offered, as I know some people definitely get anxious with numbers. It depends I think on your natural predilection for numbers or not. Also colour system hard for colour visin impaired people.
• Definitely people with lived experience to be included in design (remembering as above, everyone has their own experiences)
• Feedback at the time is often difficult depending on level of distress, also on outcome of crisis intervention
• Re-contact after 24hrs (or some time period) would be difficult for some people, especially if you are using a text based support system. Some people do not like talking on phone, some people like to be in control of their contact with services. On the other hand some people would feel comfortable and perhaps appreciate it.
• Of course it will all come down to funding - there is a lot of replication and therefore financial wastage in the system. However, if the system does not work that is a financial waste to start with.
• The problem of funding is already evident in the wait times on the phone and text services. I was once on a text based service and it was quite obvious that the person on other end was handling more that one conversation at once.
• Remote contact crisis services are especially important for rural and remote areas because access to other services is very difficult in some places with extended wait times, sometimes fly in fly out, so sometimes the personnel changes regularly, you might have to drive for hours to make face-to-face contact.

@Bow that repeating back what you have just said to them drives me absolutely nuts. Like I know what I just said and I don't need it said back to me. Especially when it's via chat, it's right there in front of them and yet they still repeat it back.

For me as part of my own profession I sometimes deal with people in crisis or in altered mental states that I need to manage and refer to crisis support lines.

as someone that is currently struggling with my mental health and trying to do all the right things I have been so distressed that I have reached out to crisis support 3 times.

Unfortunately most of these occasions have been in the very early hrs of the morning when I am awake and extremely anxious and agitated.

the first experience was ok but they had not other recommendations but to go back to my dr as I was not an immediate threat to myself but at least having some one to talk to at that moment calmed me down at this time it was helpful as I was in a remote location 8 hrs away from my medical team. Their recommendations were already things I had tried before getting so anxious that i reached out to them as a last resort.

second experience was horrible I was extremely distressed but was told to go wash my face and watch tv.

third experience was wonderful took the time to calm me down actually listened and taught me a new thing to try. told me to go back to my dr did that was sent to Ed sat in Ed for a while and then was told cause I don’t seem like a danger to myself go home and wait to see my psychology appointment.

i feel mental health is still taboo and not supported I would like to see help earlier to prevent people getting to stage when they are a threat to themselves.

To access mental health services has a huge wait list I have managed to get faster appointments with Psycologists ect based on the simple fact that I am willing to pay to try and get better and fund the treatment privately.

im one of the lucky ones but i also now remain very enlightened that we need to do better and it should not be this hard

@avant-garde I've literally just had one of the worst experiences possible with a crisis line. I can't even type it out right now cos I'm in such a state. Something really needs to change with these services cos it's honestly getting worse with some of the experiences I've had. 3 services tonight let me down when I was in a crisis, do they not realise how hard it is to be vulnerable and open up about how you are feeling, telling them your thoughts and sharing the traumas you have been through. Then to feel completely dismissed, like your feelings aren't valid, you don't matter, you'll be fine, you just have to let this moment pass.

Anyway right now all my energy is going to be put into trying to make it through the night, alone. Not sure how it's possible to feel so many emotions all at once.