Who's Holding The Other End Of The Lifeline?

HER prejudices and pleated pallu firmly in place, Mrs Sheela Joshi is chauffeured into social work. This after long years of her samaritan spirit being smothered by the demands of growing children. But now at 43, with both kids grown up, she's unleashed her yearning to do good unto others. She's a volunteer in one of the many helplines proliferating in Delhi. The job with its limited hours and secure office makes her feel purposeful. Plus, she feels benign that she chose not to ask her influential, businessman husband to find her a job for money. So, an-over-two-decades old BA Pass course degree and a force of well-instructed domestic help backing her, Mrs Joshi picks up the phone to work. To speak to depressed, distraught people. To advise them on matters as varied as sexuality and suicide, lesbian leanings and loneliness, disease and dilemmas....

Mrs Joshi's magnanimity could cost many dear. Dangerously unqualified for the role she is playing as counsellor on a helpline, she is part of a burgeoning brigade of do-gooders who have taken to being at the receiving end of crisis calls. Rank amateurs who are convinced that their good intentions are surrogate to the professional skills that a counsellor must have. Mistakenly believing that sharing problems mostly helps solve them. Believing catharsis can be cure.

Well, the good news is, now that mental well-being is standing up to be counted as a health issue in India, the much-needed Helpline Culture has arrived here with a roaring ring. In the metros and in smaller cities, where social stigma keeps many from seeking cure on the psychiatrist's couch and agony aunts in newsdailies are too impersonal with their stock solutions, there are now phone lines dedicated to give a personal ear to your peculiar problems.

Then there's the bad news. Just about anyone could be, and often is, running a helpline. Get a phone line, insert an ad in a local daily and wait for the calls to pour in. No registration, no professional skills, no accountability required. Just a charitable feeling for humankind, some good samaritans as volunteers, some funding, grant or sponsorship—not necessarily in that order-—and the solution shop comes to a ringing start. And pronto, it becomes part of the helpline network that caters to the elderly and children, to those suffering post exam-result distress, the suicidal, those confused about their sexuality, homosexuals, those coping with cancer and those trying to raise funds for heart ailments.

Little wonder really that test calls made by Outlook to many helplines across the country revealed the dangerous inadequacies of these support services. Posing as a young woman sexually harassed by her boss in office, Outlook's test caller was offered different 'options' by different helplines: "Learning to accept nasty male attitudes is a part of maturity"; "Unclutter your mind, you might be perceiving things that aren't real"; "You should have more girlfriends whom you can discuss these problems with"; "If you stop being scared of your father, you'll learn to be less scared of your boss". Interestingly, its voyeuristic tendencies suspect, a Delhi-based helpline kept insisting on the description of the physical abuse that the caller was being subjected to by her boss: "Ghabraiyen nahin, bataiyee woh kya karte hain aapke saath (Don't fear, say what he does with you)."

Further, repeat calls made to the same helpline had different volunteers addressing the caller's problem at different times. The counselling had no continuity and hence the need to mouth the problem over and over again and begin every session afresh. And with a different "set of options" emanating from each session. Also, some of the volunteers sounded bored and short on time after they realised that our test caller really wasn't willing to stomach a first-shot solution. Could have been traumatising if our test caller's problem was real.

"This happens because volunteers at many helplines are no different from that inquisitive neighbour who'd dole out advice to everyone in the mohalla. He had a limited scope of damage but these helpline volunteers, unskilled and inexperienced, could be damaging scores of people daily in an org-anised manner," observes Dr Avdesh Sharma, neuro-psychiatrist at the capital's Batra hospital. "It's scary to think how they could affect people who may be suffering serious mental ailments—cases that need skilled diagnoses." Sharing the expert's concern, Professor Vimla Nadkarni, head of the department of Medicine and Psychiatric Social Work at Tata Institute of Social Sciences (TISS), fears that overenthusiastic and under-trained helpline personnel may do more harm than help. "Many such services are manned by unskilled volunteers—and should be stop-gap arrangements at best. Listen to the problems and refer callers to experts. Their mandate being to share problems, not cure. Amateurs can destroy already fragile minds."

 Having heard those who have been at the receiving end of this helpline horror, clinical psychologist Radhika Chandiramani of TARSHI, a sexual health helpline, fulminates at the non-professionals in the business. Her helpline employs only skilled counsellors and gives the more distraught callers codes for efficient follow-ups. "Some of these unprofessional helplines should just keep their mouths shut." TARSHI had a distressed woman calling in to relate a horrendous story of abuse at the hands of a male volunteer of a Delhi helpline. Having befriended the woman, he led her into a physical relationship and was manipulating her into continuing the affair. "In another case, a young man who'd come into Delhi fresh from the south had called us to talk about how he felt a misfit in a new city. Because we deal in another field we referred him to another helpline that claims to be dealing with those depressed, lonely and suicidal. He was furious when he called us up next. Apparently they had told him he would have to feel suicidal for them to speak to him!"

WHICH is not to undermine the importance of helplines in an urban lifestyle that is so typically ours. Where contradictions and confusion abound. Where the media reports that virginity is not in vogue and also makes mega bucks printing classifieds seeking convent-educated, non-manglik brides for men earning five-figure incomes. Where rabid alienation of the individual from society still does not guarantee anonymity enough to be beyond the pale of public judgement. Where political correctness is in being non-judgemental but social propriety demands nagging guilt.

It's tough times. And many are broken by its demands. There is so much uncertainty and so many queries. TARSHI, in just two and a half years of its being set up, has already received over 23,000 documented calls from callers between ages 10 to 70. The youngest caller, a seven-year-old, was scared that her breasts weren't growing fast enough. Maithri, a suicide helpline in Kerala's Kalamassery, has had more than 1,300 people calling in just these last 12 months. "Twenty per cent of them were severely suicidal. Family break-ups, stress, professional problems are really taking a toll on many," says P.O. George, coordinator, Maithri.

 Over 4,000 distressed people called Prerna, a Mumbai-based helpline dealing in emotional problems, just in the last one year. "Only 10 per cent are crank calls. The bulk are genuinely in an emotional mess and need not only calming but cure," says Prerna's Gopa Sarkel. Another Mumbai helpline, Sahara, now in its fifth year at helping people who are despairing and suicidal, says that not only callers but problems too have been on the increase for the stressed-out urbanite. Sahara director Reny Mahendra analyses: "Relationships are getting more and more complicated. And people have no one to talk to. What with the traditional support systems giving way. People are feeling very alone and would just like to share their frustrations with someone who helps them decide on the options that they feel are available to them."

HUNDREDS of miles away from Mahendra, Calcutta-based Lifeline's P.K. Bhattacharya reiterates the same sentiments. More phonelines are a must, he says, if he is to do justice to all his callers. "People don't know where to turn for help. We even get calls from Bangladesh. We need more volunteers—younger volunteers than we have now. Because older people might be more committed but aren't very regular," says the 62-year-old former Hindustan Motors employee. "Though age and experience really help one understand other people's problems."

True perhaps. But the experts seem reluctant to verify this unconditionally.

Psychiatrist Dr Veena Kapoor is critical of volunteers dishing out advice just because people feel comfortable about talking anonymously: "You can't say helplines do great work just because there would be no one for people to call up if they weren't there. It's an organised system of support in the area of mental health—it's serious business—and it has to have some experts looking into it, not just some person who's old and wise." Sujata Sharma, clinical psychologist trained at the National Institute of Mental Health and Science (NIMHANS), agrees: "Untrained help can mean a clash between two entirely different sets of values and subconscious structures...that's really dangerous when one is dealing with a human mind that is already stressed. And I dread to think what impact this kind of constant exposure to problems can do to the personality of an unskilled volunteer who's never learnt how to distance himself."

But many in the business defend the unskilled volunteers. Running eight hours daily and even on Sundays and holidays, Delhi-based suicide helpline Sumaitri has about 35 volunteers who are house managers, bankers, students among others. The criterion for selection, says coordinator Meena Gupta, herself a housewife, is that the person should be above 21 years of age, fluent in Hindi and English and a good listener: "We put our volunteers through a two-week intensive training course and refresher trainings to monitor their preparedness. But we do admit that we are befrienders not counsellors. We are not psychologists and they can't be friends. We deal at the feeling level, not the fact level. Our work is to help people unwind and see what their options are."

 While not quite sure that helplines, and especially those dealing with people on the verge of self-annihilation have just that function, psychologist Dr Achal Bha-gat's recently-concluded hel-pline venture Delhi-based Operation Hope for students just before and after the Board results, also employed students as volunteer counsellors. "Talking to a peer helps. But then I made sure that a three-tier system was at work: peers, then students at the 18-month counselling skill course I run, and finally a panel of skilled counsellors," says the doctor. Co-sponsored by Clinic All Clear shampoo, the helpline received 5,000 calls during the 17 days it was on, convincing the doctor of the desperate need for such a service. So new plans are afoot and Bhagat has already blueprinted four helpline ventures in the coming year: on schizophrenia, depression, marital relationships (all three for seven days each), till the Board results herald in Operation Hope again.

And why not? The 6,000 calls that Chennai-based helpline Sneha receives every year from people of varied ages and societal classes has its director Ram utterly certain about how rootless and confused the urbanite has become and how he is scouring around for help. Hardly surprising then that Aruna Nair, coordinator of Mumbai-based Dignity Dialogue, a helpline for the elderly, says that it received 100 calls in two days after an article in a local daily published its numbers. "Ignored, alone, lonely—our old are crying for help."

 So are our children, it seems. Director of Mumbai-based Childline, Jeroo Billimoria from TISS, says calls from desperate children to the helpline's four-digit number are more than pouring in. Complaints of sickness, physical abuse, suffering and loneliness have been on the increase since the two years that the line has been operational. The ministry of Social Justice and Empowerment has now sanctioned similar Childlines in all cities with a population of over 10 lakh. They will be run by local NGOs and professional social workers.

TISS' Melita Vaz who held a seminar with personnel from various helplines last year, however, cautions that NGOs and others often get into helplines because it is currently the 'in-thing' to do. "There are many fly-by-night operators and NGOs who set up a helpline on issues that they are working on. Sometimes, just knowing an issue is not the same as counselling on it. It's unfortunate enough that none of our Institutes run a separate course on helpline cou-nselling which is quite different from face-to-face interviews that our psychologists conduct. There's a lot to be done in the field if it is to be efficient and meaningful."

Certainly. And, while on the subject of bettering services helplines, our Outlook test caller has a request to make to volunteers manning the crisis lines: Please don't address callers as betis and betas while enquiring after their problems. It made her feel like she was speaking to mom!