From early 2020, concerns were raised about the impact of the pandemic on mental health. The stresses of lockdown, social isolation, financial precarity, and widespread grief were all considered to be potential triggers for poor mental health, along with issues such as increased domestic violence.
A new study, published in Nature, looks at what helpline calls can reveal about mental health during this period. It finds an increase in calls to helplines during the early days of the pandemic, largely driven by fear, loneliness, and worries about physical health.
Marius Brülhart from the University of Lausanne and colleagues used data from both general crisis lines and specific suicide prevention lines, as well as those focusing on children, parents, and immigrants. Data was collected from January 2019 to the most recent available date in order to cover the period before and during the pandemic, with 8 million calls from 19 countries included in the dataset.
First, the team looked at call volumes, before zooming in on the conversational topics raised by callers. For each helpline, calls were categorised based on topic, including loneliness, fear, suicidality, addiction, violence, physical health, work situation, and relationships. Demographic data was collected here if possible, including marital status, living situation, and work situation. Government responses of helpline countries were also measured, including how stringent restrictions were and how much governments were supporting people financially.
The team found an increase in calls during the pandemic, in particular in the six weeks after the first outbreak. A significant increase began at week three and this peaked at week six, at which point the volume of calls exceeded pre-pandemic levels by 35%.
In terms of conversational topics, most pre-COVID calls were made because of relationship issues, loneliness, or anxiety; 61% of calls were from women and 63% placed by people between the ages of 30 and 60. However, during the pandemic, conversational topics shifted. The biggest increase in calls placed during the pandemic period were those related to fear — whether of COVID-19 itself or of the ramifications of lockdown.
Calls related to loneliness also increased, with other conversational topics coming up less frequently during the first wave of the pandemic. Compared to pre-COVID, callers were less likely to seek help for relationship issues, economic worries, and addiction, though there was no significant change in the percentage of calls related to suicidal ideation.
Demographically speaking, the increase in calls related to fear was driven almost entirely by those over the age of 30, which tracks with the increasing level of risk of contracting COVID with age. Women under the age of 30 were more likely to call because of violence than they were before the pandemic. But overall, the increase in call volume was driven by fears of the virus and of loneliness rather than by these other factors.
Many of these figures could be underestimates in terms of who was struggling and with what — during strict lockdowns, it may have been difficult for people to access helplines, particularly if they were subject to domestic violence or had no privacy in talking through their suicidal ideation. There will also have been many who didn’t call crisis lines but who were nonetheless experiencing distress. The results, therefore, do not contradict those other pieces of research that detected an increase in domestic violence.
The results offer a unique insight into people’s mental health over the period of the pandemic. Many people will have been experiencing distress; not all of them will meet thresholds to be assessed by mental health professionals, nor may even want to visit them in the first place. Helpline calls, therefore, could give greater access to feelings people found hard, painting a more accurate picture of how we experienced the pandemic.