It has been estimated that 5% of the UK population are active users of mental health helplines. Mental health helplines are close to my heart as I volunteer for one of them myself. One question has troubled me since I have worked there, as it has troubled many of my colleagues: Do they do any good? Is it really good to talk?
There are a number of problems with many helplines. First and foremost they are often staffed by unpaid volunteers. While standards of training and selection are excellent where I work, volunteers do not claim to be professional. They do what they can with the limited resources available.
Helplines are often quite isolated from the mental health services offered by the NHS. There is strength to be derived from independence, but this disconnect can be disabling in many different ways.
With these problems in mind and, understandably in our scientific age, there is a great appetite for evidence. Just as there should be. Unfortunately the way in which helplines operate does not lend themselves to easy evaluation. For one thing callers are normally assured that their confidentiality is paramount. It can be difficult to reconcile this confidentiality with the processes of research.
Despite this, Rethink, the charity concerned with serious mental ill health, recently carried out a study examining two helplines: Focusline and Lincsline. Both of these services are 24-hour helplines serving a limited geographical area, both with some degree of integration with local statutory services. The positive effects found for the helplines included users reporting a reduction in their anxiety levels, a feeling of greater control and a decrease in isolation.
Unfortunately this is not the whole story. The methods used to investigate these services do suffer some problems common to psychological research. It is cross-sectional - this means it only asks people their opinion once and relies on their memory. This is considered comparatively weak when set alongside a longitudinal study which tracks changes across time.
There are also many problems inherent in asking people who actually use a service what they think of it. At the simplest level is the tendency for people to work out what the researcher wants and give it to them. In this case the researchers, with the best of intentions, have a vested interest in showing helplines are effective and may well have biased the results accidentally.
So to return to the original question: do helplines help? There's a stack of anecdotal evidence that screams 'Yes!' but unfortunately the hard evidence is not there yet. At present it is an area where common sense prevails - people are doing what seems like the right thing. Unfortunately it's easy for wishful thinking to cloud judgement.
Note: This is based on the research summary as the full report is not yet available online.