Suicidal ideation in callers to a crisis hotline in Mumbai, India

Abstract

Suicide is a worldwide public health problem. The stigma associated with suicide often deters people from seeking help. Although, helplines are not rated as very effective therapeutically, they offer an opportunity for intervention for people in crisis. The present study examined the characteristics of people attending an outpatient service after establishing an initial contact during an emotional crisis with a helpline in Mumbai, India. A total of 15,169 clients called the service during the first five years of operation, of whom 9.2% reported suicidal ideation. About half (51.6%) of the callers who were given a referral to the affiliated outpatient clinic kept their appointments. While 38% of the outpatient clients did not have an Axis I or Axis II psychiatric disorder, 25% were diagnosed with schizophrenia and 17% with depression. In addition, 13% had a personality disorder and 7% substance abuse disorders. Female clients more often reported stress arising from financial problems, conflict with their in-laws, and pre-marital relationships than did male clients; male clients more often reported stress arising from employment, loss of reputation, and education than did female clients. The availability of a 24/7 mental health helpline, staffed by mental health professionals with back-up support from an outpatient psychiatric facility, can enhance community mental health services. Some of the problems encountered were mentioned and needed improvements were discussed. Key words: helplines, suicidal ideation, referrals