Crisis support services like Lifeline receive more than a million calls from Australians each year and play a crucial role in suicide prevention. This need is particularly pronounced at the end-of-year, with services receiving the most calls on holidays like Christmas or New Year’s Day.

A new paper led by researchers at the University of Sydney’s Matilda Centre in the Faculty of Medicine and Health looked at the wellbeing of crisis workers and volunteers who answer the phones, finding that while most find their roles fulfilling, about one in three experiences psychological distress – a rate three times higher than the general population.

"Crisis lines are an incredibly important service, providing essential support at critical and vulnerable times in people’s lives. But it’s important that we also help the helpers. There are strategies support providers can use to cope with the work and ultimately, most find it incredibly rewarding,” said lead author and PhD candidate Jayden Sercombe.

Wellbeing was highest among crisis workers who provided support over the phone (as opposed to online chat services and from a helpline office (as opposed to working from home).

“Online chat volunteering is often more urgent and comes with a higher risk of suicide and distress. It's also more likely to be used by people from under-served groups – such as those with anxiety or for whom English is a second language,” said Mr Sercombe.

Challenges that affected workers’ wellbeing included speaking with verbally abusive callers, repeat callers and those with a sexual motive. Interactions ending in uncertainty about the caller’s safety were particularly distressing for support workers.

“You may have spent time on the phone or in a chat with someone who has expressed a desire or made plans to end their life, only for them to abruptly hang up. Not knowing what has happened to that person can be deeply distressing,” he said.

The study found that support workers who used problem-focused coping (such as reframing a problem and outlining steps to solve it) coped best. Those who were avoidant (engaging with self-distraction or substance abuse) experienced the most distress.

“This insight could be used to help train workers to better deal with distress that may come from providing crisis support,” Mr Sercombe said.

While one in five crisis support workers experienced a high level of compassion fatigue, a third said the work gave them high levels of compassion satisfaction.

“The silver lining is that a third experience a high feeling of satisfaction from helping others. They also felt they gained skills and become better listeners. This is something I felt when I volunteered at Lifeline. It was intrinsically rewarding, and as a result I also became a better supporter of family and friends,” he said.

The study has been published as part of Mr Sercombe’s PhD thesis. His interest in the wellbeing of crisis support workers stemmed from his own volunteering at Lifeline during the COVID-19 pandemic.

The study comes as Lifeline General Manager Adam Miller recently announced that of the 10 busiest days in Lifeline’s history, five have been in the last six months.

Dr Anna Brooks, Chief Research Officer, Lifeline Research Office said: "Lifeline acknowledges the emotional and psychological hazards our incredible crisis supporters encounter as they provide connection and support for individuals seeking help at varying levels of distress.”

“This is front of mind when Lifeline develops and continuously refines both proactive and reactive supports which are in place before, during and after shifts for each individual crisis supporter, no matter their role.”

“We welcome this paper as it is research like this which enables us to continually refine our approach to training and supervision, ensuring that we safeguard, support, and nurture our crisis supporters in the most effective ways possible, according to the latest evidence base.”

The study involved a survey with 422 paid workers (working up to 30 hours a week) and volunteers (typically working two hours a week) across 38 crisis lines. 

Research: Sercombe, et al, ‘Holding the line: mental well-being, stressors and coping in crisis supporters’, (Research Trends 2024). DOI: https://doi.org/10.1027/0227-5910/a000985

Declaration: Jayden Sercombe and Mark Deady have previously volunteered for crisis support services. Mark Deady receives funding from iCare and Katherine Mills is supported by NHMRC funding.