Digital services: How to connect in a time of crisis

This is a guest blog by Dr Ariele Noble, Dr Lia Maragkou and Sarah Kendrick of Mental Health Innovations, a digital mental health charity which runs Shout. Shout is the UK’s first 24/7 mental health text service and they have been uninterrupted in their ability to connect with users throughout this crisis due to the nature of their services and the way they operate.

Very little has prepared mental health services for how to provide support in times of global crisis, when uncertainty and isolation become unavoidable experiences. Technology has become an essential tool for connecting us with others and it offers us ways to be listened to, to be understood, and to meet our true need to be cared for. This has become increasingly important as we all endure the outbreak of Covid-19.

As a digital service, Shout volunteers, currently based at home, have been able to continue to offer support 24/7 throughout the UK lockdown. We have been a leading form of support throughout the coronavirus crisis, including to young people and frontline staff, and we continue to offer a vital degree of digital connection and assistance to individuals in this period of uncertainty.

Flexibility in uncertain times

Shout is the UK’s first, 24/7, free and fully confidential text line service, which supports people across the UK who are in need of urgent emotional and mental health support. Since launching a year ago, our trained volunteers have had over 300,000 conversations. Nearly 35% of those conversations have been with young people aged 17 and under. The teenagers that we speak to, tend to want to access support as and when they need it and often prefer services that are flexibly available to them, as Shout is.

In the context of the Covid-19 crisis, there is a level of uncertainty in relation to the duration of this crisis and whether we will ever return to a familiar sense of normality. It is therefore essential to offer confidential emotional support, as people feel the need for human connection more in uncertain times. However, simultaneously, a number of charitable support services are also struggling to keep up with demand. Shout has been helping to fill this gap by being able to operate undisrupted. By nature, Shout is virtual and so the majority of our organisation and all of our volunteers work remotely. We have also been able to expand and offer much-needed emotional support to those working on the frontline of this crisis, as well as, to those whose usual support services have been interrupted.

Combating loneliness

Thoughts of suicide are the main difficulty for which young people contact Shout. Suicide is talked about in nearly 35% of the conversations we have; closely followed by depression (30%), anxiety (30%), relationships (25%), self-harm (20%), and loneliness (15%). Young people are also the age group most likely to discuss self-harm and bullying with us.

Loneliness is often what underlies other difficulties, and is a significant cause of anxiety and depression. Feelings of loneliness happen when we feel like no one is there for us and when we don’t feel cared for—not necessarily because of physical absence but because of a sense that we are not sharing meaningful thoughts and feelings with others. We can be surrounded by people and still lack meaningful contact. The disruption to everyone’s daily activities has actually given our volunteers greater flexibility to offer more time to connect with people in need. Perhaps now more than ever, we are all benefiting from more opportunities to engage meaningfully with people virtually.

For many, Shout is a first point of meaningful contact for people in need. Almost half of those who text Shout tell us that they felt they had no one else to talk to, and four out of ten tell us that they have never asked for help elsewhere before. In the context of Covid-19, we have been available to support those most affected, such as people who are without food, grieving, experiencing domestic abuse, struggling with the loss of their school environment, and challenged by their relationships.

Through texting, people in need (particularly young people) are able to talk in a safe and structured environment that allows for privacy. Texting also ensures that our services can be accessed from anywhere. Feedback confirms that people who use Shout most appreciate being listened to and feeling understood. It is vital that we all continue to give young people the opportunity to talk, as by doing so, we are encouraging help-seeking behaviour which will increase their resilience as they develop into adulthood.

Easing anxiety

By the end of March, around 25% of our conversations concerned Covid-19 and around 60% of these conversations also mentioned anxiety as an issue, which is twice the rate we usually see. Covid-19 has intensified the challenges we face. Because of this, Shout continues to be open to everyone and anyone, offering an instant source of caring human contact, which enables us to help tackle loneliness, isolation, and anxiety in this difficult period.

We listen empathically without judgement, we invite you to reflect on what can be helpful to you in the present moment, and offer coping and relaxation skills. We strongly believe that innovative and easily accessible ways of support can be viable and sustainable even in the most absurd circumstances—such as a global pandemic. Perhaps now more than ever, we must continue to connect.