Research has found that 50% of mental health crises happen outside of normal community mental health team opening hours (Ellis, D., & Lewes, S., 1997). Certitude’s Solidarity in a Crisis service supports people in distress by providing out of hours emotional support over the phone and in person. Launched in April 2012, it is available in the London boroughs of Lambeth, Southwark and Lewisham.
The service was co-designed by service users and carers and is run by Peer Supporters who have their own experience of facing and overcoming crisis. By sharing life experiences, Peer Supporters can promote recovery and enhance feelings of belonging, especially for those who feel isolated.
To prepare them for their role, Peer Supporters take part in a four-week induction and training programme covering peer support, person centred care, confidentiality and boundaries, as well as Mental Health First Aid, and Mindfulness. Some peer supporters also require additional support to help them make the transition from having been out of work for many years to being formally employed and paid for their work: for example a benefits advisor has been invited in to talk to people about the implications to their individual financial circumstances.
Once they start their role, peer supporters may also require support in getting used to the formal structures associated with working in an organisation, from policies and procedures, to the use of forms and adherence to the on-call rota. As they are dealing with distressing calls one-to-one support to debrief and reassure them that what they said to callers was appropriate and sensitive is also essential. Peer supporters have monthly team meetings and one-to-one supervision with the project manager for individual support and development requirements. The team also attend clinical group supervision with a clinical psychologist every 6 weeks.
The Solidarity in a Crisis service operates from 6.00pm – midnight on weekdays and from midday to midnight at weekends. There are two peer supporters on call during each shift to ensure that the phone is always answered and that they can discuss difficult calls and support each other. Peer supporters do their work from home, taking calls in their own house which helps to reduce the time and cost of sitting in an office waiting for the phone to ring. They log the calls on a database following the shift. Peer supporters have an on-call bag containing a phone which they exchange with each other before the next shift. Peer supporters also have a resource manual which contains useful resources on dealing with callers who are presenting with suicidal thoughts or intent and a service directory across Lambeth, Southwark and Lewisham. Peer supporters can, if required, arrange a meeting in the community with the person they are supporting. Two peer supporters attend this meeting.
Solidarity in a Crisis receives calls from people who have a variety of different issues, including social isolation, relationship breakdown, bereavement, self-harming, overdose, and suicidal thoughts. The service has also been contacted by people looking for advice about how to support a loved one, and by people seeking information about local services or support with benefit applications. The majority of contacts are self referrals, but community mental health teams and other services have been welcoming of Solidarity in a Crisis when it has been promoted to them.
What most callers have in common is that they just want to be listened to or to have someone to talk to, or to put them at ease or to guide them to a safe place where they can approach their crisis in a different way. This is where peer supporters’ own experiences of facing and overcoming crisis can be really valuable:
I shared something to let her know I understood when you’re overwhelmed the simplest things often do not occur to you.
An initial evaluation of the project one year in found that those supported peers who took part reported that being able to talk to someone had had a positive effect on their wellbeing. The service also had a positive and meaningful impact on the peer supporters. They had managed the calls excellently, the confidence of the team had gone from strength to strength, and some peer supporters had got other work, including with the Social Work Occupational Therapy team, supporting people to move to more independent living, as well as having input into the collaborative prototyping of a crisis house. On 18 December 2015, SLAM launched its 24-hour mental health telephone support line and is working collaboratively with Solidarity in a Crisis to provide the widest range of options to help those in distress.
Engaging with others through peer work connects me to the side of myself that is hopeful, which does believe things change. I get a great sense of self-worth and truly value what I do, it helps me to feel I can give to others in whichever small ways - which feels healthy and is Health.