Helplines Can Lead to Shortened Duration of Untreated Psychosis

When someone experiences an episode of psychosis, it could be a sign that he or she is at risk for developing a serious psychological issue, such as schizophrenia or borderline personality disorder. Sadly, many people, especially those from certain cultures, delay seeking treatment because of the stigma associated with mental illness. Research has shown that the longer an illness goes untreated, the worse the outcome. Therefore, it is crucial that treatment avenues be made available to people at the earliest stages of symptom onset. A mental health helpline, a telephonic hotline staffed with trained mental health professionals, is one such avenue of care. This type of program allows individuals to access help 24 hours a day, seven days a week, and ensures anonymity. Most helplines are free of cost, making them accessible to people of every socioeconomic status. They open the door to treatment and diagnosis.

To date, few studies have explored how helplines increase treatment enrollment for people with symptoms of psychosis. Many individuals attribute their first psychotic episode to other problems, such as life stressors, depression, anxiety, or substance use, not realizing that they may be at risk for clinical psychotic conditions such as schizophrenia. To determine how well helplines serve individuals at risk, Yves Bureau of the Silver Mind Hospital in India analyzed telephonic traffic from a community helpline in Mumbai over a five-year period. The data revealed that more than 15,000 people used the helpline during that period. Of those, 66% chose to use the services of a mental health professional, but only 33% made an appointment with a psychiatrist. Of those who called after their first psychotic episode, just over one-third saw a psychiatrist immediately, while more than one-third chose one year of therapy followed by a clinical assessment.

“It is clear that in the early phase of illness, patients and relatives prefer to see a mental health professional other than a psychiatrist,” Bureau said. People seeking help may be worried that they will receive a diagnosis of schizophrenia and consequently delay assessment. In fact, because many first-contact clients had symptoms of psychosis, depression, or anxiety rather than substance use or personality disorders, this suggests that clients in Mumbai tend to wait until they are in a mental health crisis before they reach out for help. Bureau also found that the first-time callers had a much shorter duration of symptoms than those with a history of psychotic issues. This finding underscores the importance of mental health helplines and demonstrates that this type of program could provide early care to individuals most at risk for psychological problems.

Bureau, Yves, et al. Reducing treatment delay for early intervention: Evaluation of a community based crisis helpline. Annals of General Psychiatry 11 (2012): 20. Health Reference Center Academic. Web. 28 Sep. 2012.

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The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

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  • reese

    October 16th, 2012 at 3:36 PM

    Is there anything that proves that most people who experience a psychotic episode really know that they are in mental health danger and they need to reach out for help?

    I guess I was of the understanding that people like this really don’t know that what they are experiencing is abnormal and therefore would not tend to ask for help because they wouldn’t necessarily think that there was anything that they need help with. Just curious.

  • Mary

    October 16th, 2012 at 4:35 PM

    This is a fine treatment option IF someone is willing to seek it out and use it. But that can be a mighty big “if” sometimes.

  • Lorna s

    October 17th, 2012 at 3:53 AM

    I have always felt that the whole concept of helplines can be a good one, like, If what Mary said, people are willing to actually take advantage of the resources that are available to them. I have noticed that no matter what area you are talking about, people are often unwilling to use the tools that are actually out there and ready for them to use. Are they afriad to take that next step or do they kind of get lost along the way and become convinced that either they don’t need help or that there is nothing out there for them? I’m not sure where that kind of disconnect comes from, because if you are willing to do a little leg work and research I think that you will find that there is help for pretty much anything that plagues you; you just have to sometimes be willing to go get it.

  • Kim

    October 17th, 2012 at 9:49 AM

    Never easy to identify a problem yourself.And for those that are unwilling to see a professional it can get even tougher.Talking to someone on the phone anonymously could be a little easier for such people and hopefully any advice from the other end to see a professional is taken seriously and these people hopefully seek the required help.Ignoring a problem is not going to make it go away.The problem is only going to get bigger.

  • marcia d

    October 17th, 2012 at 1:04 PM

    if this is something that is caught early, and helplines give someone this option then i am all for it. what i don’t like though is the implication that someone with a serious disorder like psychosis could use this as a primary treatment tool. i don’t think that there is any reputable clinician around who would say that this would be an appropriate resource for long term care and dealing with psychotic episodes in one’s life. this should instead be looked upon as a perfect way to begin the treatment and intervention process for someone who is indeed showing signs of this in their lives, and a s away of then helping them to get to a provider who can stay with them and give them the long term care that is most likely going to be required for healing.

  • S.D

    October 17th, 2012 at 11:50 PM

    Its always nice to have someone to talk to when you have a problem.I cannot be thankful enough to my sister who stood by me through my battle with lung cancer years ago.And for other issues like loneliness and suicidal ideation,talking to someone and someone trained in fact can be the route to seeking help and maybe even preventing suicide!

  • wendy

    October 24th, 2012 at 7:18 PM

    I have a personality disorder and called a distress line when I was in a very bad state. They told me they would not speak to me until I gave my name and address. This distressed me even more but after briefly resisting, I did. They sent the police to my house, who put me in handcuffs and took me to the psych ward against my will, where I was stripped of my rights and admitted. Even after a psychiatrist assessed me and said I could leave if I chose, I was not allowed to go. What I said in my statement was recorded incorrectly and the misinformation used against me. I managed to get out and clearly would never look to that hospital, the only one where I live, for help. I am still desperate and unable to access therapy or treatment. But obviously, I will never call a help line ever again.

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