Configuring the caller in ambiguous encounters: Volunteer handling of calls to Samaritans emotional support services

Abstract

This paper discusses volunteer strategies for handling and assessing calls to Samaritans emotional support services for the suicidal and despairing. It presents findings from the qualitative components of a twoyear mixed methods study based on an online caller survey, branch observations and interviews with volunteers and callers throughout the UK. A thematic analysis of the qualitative data analysis was undertaken using the principle of constant comparison. Many calls fell beyond the primary remit of a crisis service, and called for rapid attribution and assessment. Uncertainty about identifying 'good' calls and recognizing those which were not caused difficulty, frustration and negative attribution towards some callers. This paper presents our analysis of volunteers' accounts of how they configure the caller in intrinsically uncertain and ambiguous encounters, and how such strategies relate to the formal principles of unconditional support and non-judgemental active listening espoused by the organization.Keywords: active listening; helplines; negative attribution; Samaritans; self-protection; suicide; volunteering IntroductionSamaritans is a volunteer-based charity established in the UK in 1953 as a crisis support service for the despairing and suicidal (Varah 1988;Armson 1997). In 2011, 15,516 volunteers in 202 branches throughout the UK responded to 2,868,899 dialogue 1 contacts from callers (Samaritans 2012). The majority (83%) of dialogue contacts are by phone, but email and SMS text messages are increasing and callers may also make contact by letter or by visiting a branch. Volunteers aim to provide a confidential, anonymous, nondirective, active listening service which offers callers the opportunity to reflectively explore their feelings of emotional distress and so, ideally, gain insight into how they may start to address their difficulties and 'move on' in their lives. Samaritans hope that their emotional support will help callers to identify options other than suicide, and a core aim of the service is to work towards a reduction in deaths by suicide.However, another key principle is respect for self determination. Only the caller has the authority and responsibility to make decisions about his own life, including the judgement that his best interests are to end it. Unlike many suicide crisis helplines (de Anda and Smith 1993;Mishara 1997;King et al. 2003;Barber et al. 2004;Kalafat et al. 2007;Ingram et al. 2008), Samaritans will not advise or actively intervene to deflect a caller who declares intent to die by suicide. Volunteers aim to offer the caller unconditional, nonjudgemental acceptance and support. However, the caller remains in charge of his/her life, both in defining the nature of their problems, and taking responsibility for decisions about how best to deal with these (Nelson and Armson 2004;Samaritans 2009).In view of the anonymous and confidential nature of the service the information available to Samaritans about individual callers is very limited. National statistics are co...

Callers’ Experiences of Contacting a National Suicide Prevention Helpline

“…The present study is in line with previous findings that callers fall broadly into two categories – acute and regular – and that regular callers are more often women and frequently suffer mental ill-health (Fakhoury, 2002; Hall & Schlosar, 1995; Holding, 1974; Mishara et al, 2007; Pollock et al, 2010; Samaritans, 2004). Analysis of the survey responses did not reveal any substantial differences between the reported experiences of male and female callers.…”

“…In addition, over half of the survey respondents had contacted Samaritans more than once. In line with other findings – and at variance with the stated aims and mission of the organization – this indicates that many callers value Samaritans as a source of ongoing support, rather than as a refuge in times of crisis (Hall & Schlosar, 1995; Mishara, 1997; Pollock et al, 2010). …”

“…The reason for this discrepancy is not clear. However, as was evident from the qualitative data sets collected alongside this survey data (Pollock et al, 2010), caller reports of “feeling” or even “being” suicidal referred to a very diverse spectrum of meaning and significance. “Feeling” suicidal bore very little relationship to a state of “being suicidal,” and even “being suicidal” did not necessarily relate to committed action to self-harm or suicide (Fairbairn, 1995; Holding, 1974; Mishara, 1997; Pollock et al, 2010).…”

Impact of Crisis Line Volunteering on Mental Wellbeing and the Associated Factors: A Systematic Review

“…Only thirteen studies, published between 1973 and 2018, were included in the current review: eight quantitative surveys [27][28][29][30][31][32][33][34] and five qualitative studies (observation, participation, document study, and interviews) [35][36][37][38][39]. No clinical trials or longitudinal studies were found.…”

“…The other four surveys used a single item to measure subjective mental wellbeing [27,29,31,32]. Of the qualitative studies, four presented a clear research goal or question [35][36][37][38], for example "What positive or negative experiences have volunteers had as a helpline volunteer?" [38].…”