She hangs up. We did our best, we tell each other. We wonder about her all evening

“I intend to take my own life tonight,” she informs me, flatly. We’ve been trained for several scenarios, including and especially this one. But there’s something about this woman’s tone that immediately puts me off guard.

Seconds before, I had been in the kitchen of the helpline where I volunteer, making a cup of tea and discussing my weekend plans with my helpline “buddy”. Now I feel like I’ve rounded a corner at night to find someone standing on the lip of a bridge. Which, in a way, I suppose I have.

But I’m in a Dublin office of a helpline for people dealing with mental health challenges. And this caller could be anywhere.

I volunteered on the helpline for four years, after finding out first-hand how lonely and isolating a condition like depression could be. I wanted to understand it better. I could never have foretold all that I was about to learn.

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I attempt to get more information out of the caller, mainly to keep her on the line. Has she felt like this for a while? Is there anyone else in the house with her? How can we keep her safe for tonight? Though the helpline is a non-directive listening service, I feel I need to press the point that there are other options. That hers isn’t the answer.

It's the loneliest place; the most complex and most unknowable place

There is no anguish in her tone, so I suspect she doesn’t believe me. Despite the quietude of the call, it’s the most terrifying conversation I’ve ever had. The caller promptly hangs up, leaving the air in our office heavy. We did our best, we tell each other. We will wonder about her all evening, and long after the volunteering shift is over.

Stigma

Conversations around mental health, we are constantly being told, are happening all the time. People are finally opening up about their difficulties; those around them are reaching in to them, and better know how to. The stigma around mental health has been lifted.

I hate to be the bearer of dispiriting news, but this is far from the reality of it.

It’s only when you work on a helpline like this – where people call confidentially, knowing they can offload without judgment and reveal their utmost truths – that you truly know how far we are from where we should be with conversations around depression and suicide ideation. It’s the loneliest place; the most complex and most unknowable place. Still shrouded in shame and mystery, despite our many strides. Often married or living within family, the callers who ring our service feel they don’t have anyone to talk to about this. Terrifyingly, some family members are none the wiser about this person’s torment.

That said, the concerns of the callers run a bewilderingly long gamut. Some people call for the uncomplicated balm of company; a conversation with another person. We’re all aware, in some way, that there are Irish people living in real isolation, whether psychological, geographical, accidental, self-imposed. Yet to be made aware of their muted desperation, or their resignation, is quite something.

“What will you do for the evening when we finish this call?” I ask one man.

He sighs. “Go to bed and wait for more of the same tomorrow, I suppose,” he answers.

The friends and family of those with these conditions also regularly call the helpline

Other callers want to unburden themselves of problems – from the intensely personal to the financial – to an impartial, non-judgmental party. Some might seem trivial to an outsider, but cause them genuine torment. To talk to their loved ones about it might risk upset, or hurt, or judgment.

Some callers have lives that seem perfect to others, yet their interiority is overwhelming and malevolent to them. That there is no obvious, tangible reason for their depression is frightening to them.

Black dog

The friends and family of those with these conditions also regularly call the helpline. There is a monstrous black dog in their house, and they are scared of it.  They want to help, desperately. They are concerned parents, partners, siblings or friends worrying about erratic behaviour. The son that has suddenly turned uncommunicative, a sister that can’t get out of bed, a spouse spending with wild abandon.

There was never really a “good” call to receive on the helpline. Occasionally, there might be a call from a person who rings up, utterly at a loss as to what to do, and then leaves the conversation with something resembling a roadmap to recovery; these are among the most gratifying. There’s the faint possibility that, if they can attempt to manage their symptoms on an ongoing basis, a good day after another good day makes for a good week, and just maybe, a good life.

Where can the mental health “conversation” go from here? It’s pointless asking people to “reach in” sometimes. They don’t know how. Sometimes, they don’t know that they even have to. Ask any of these callers what they might like to see happen, and almost all of them wish for a health system that took their respective conditions more seriously.

A few weeks after she first rang, I got a call from the woman who had called before. The paracetamol is still there in a secret stash, she says. How comforting it was, on one hand, to realise that she was still alive. Quite another thing to know that her torment was still ongoing.

• Samaritans: Freephone 116 123; Email jo@samaritans.ie; samaritans.ie
• ChildLine: Freephone 1800 66 66 66; Free text the word Talk to 50101
• Text 50808: A free 24/7 text service, providing everything from a calming chat to immediate support for people going through a mental health or emotional crisis.Text HELLO to 50808, anytime day or night. text50808.ie