Sue-Ann Siegel wasn’t used to working in the sunlight. She usually answered the phone from a dim corner office in the Maryland suburbs, illuminated by small desk lamps and a blinking dashboard that showed how many callers were left in the queue.
Siegel readied the tone she had perfected over five years of talking to strangers about their divorces and affairs, bankruptcies and unemployment, panic attacks and thoughts of suicide.
“Hello,” she said, her voice soft like a late-night radio host’s. “Lifeline — how are you doing today?”
The young man on the line sounded strained. He had just moved from New York to Maryland, he said. His girlfriend was developing flu-like symptoms, and they got into a big fight when he asked whether she might have the novel coronavirus spreading across the United States. He was also growing worried about his elderly parents — especially his father, whom he is close to.
The man paused, then added: It felt like his anxiety was returning.
“Mm,” Siegel said. “I hear that life is hurting you right now. . . . These are confusing, confusing times. For all of us.”
Crisis center hotlines emerged in the United States in the 1960s, and for decades they have measured the pulse of the communities they serve.
In the year after the terrorist attacks of Sept. 11, 2001, more than 80,000 people called the New York City Mental Health Association hotline. In the hours immediately after the 2016 presidential election, calls to the National Suicide Prevention Lifeline nearly tripled. And during the 2018 hearings on the sexual assault allegations against Supreme Court Justice Brett M. Kavanaugh, the number of people who called the National Sexual Assault Hotline spiked by 201 percent.
Now, amid a global pandemic that has brought regular life in parts of the United States to a halt, crisis hotlines face an unprecedented need, experts say.
Government officials have imposed drastic social distancing measures to stem the spread of the virus, closing schools and churches and banning unnecessary travel. The disruption of in-person support systems has left crisis hotlines — and the people who run them — at the front lines of what doctors warn may be devastating psychological fallout from the coronavirus crisis.
Since Maryland’s first reported cases of the virus three weeks ago, the nonprofit EveryMind, for which Siegel works, has seen a sharp uptick in people reaching out to its 24/7 mental health support hotline and online chat service.
Rachel Larkin, who oversees the group’s crisis-prevention services, said that in the month of March, the hotline’s average wait time has gone from about 20 seconds to a minute, suggesting a growing need. Staff members like Siegel have had to double up on shifts, sometimes staying “online” for as long as eight hours at a time. Because of the number of people calling to talk about the pandemic, “virus” has been added as a category for employees to tag calls.
At the Montgomery County Crisis Center, a government agency that also runs a 24/7 call center, lines have been so busy that manager Dorne Hill said she has had to pick up shifts herself. Last year, the center had 2,996 calls in the month of March; this year, the center logged 2,581 calls in just the first two weeks of the month.
“What [people] are describing,” Hill said, “is a feeling of overwhelmed-ness.”
For those with preexisting anxiety disorders, the virus — and the near-constant news cycle surrounding it — has become a potent trigger, sometimes causing debilitating spirals, doctors say. Orders to shutter museums and restaurants, close public schools, and ban gatherings can introduce another layer of distress.
And with in-person therapy visits becoming increasingly unlikely under directives to stay home, a hotline may be the only place to which some people can turn.
“No matter where you were functioning before, this is hard,” Larkin said. “And for the people struggling before, they’re really struggling now.”
Siegel recounted the story of a caller who was devastated that her therapist had stopped hugging her or patting her on the back — often her only form of physical contact each week.
“She lost her hug,” Siegel said. “Her once-a-week hug.”
“There are so many other stories,” she added, shaking her head. “Things, problems I couldn’t even imagine.”
There was the young man, a regular caller with paranoid schizophrenia, who started to spiral when he was asked to download the video conferencing app Zoom to talk to his therapist. He was convinced that government spies were planning to infiltrate his calls.
There was the homemaker with severe depression who said that without museums or movie theaters, she had little to fill her day — and little distraction from her recurring thoughts of suicide.
There was the man from a nursing home who said he was “losing hope” because his girlfriend could not visit him, and the middle-schooler who told Siegel they identified as gender non-binary and could fully feel like themself only at school — not at home.
“Simple things,” Siegel said between calls one recent afternoon. “Simple, simple things, but for someone, they really matter.”
EveryMind is recruiting volunteers to help staff its hotline and text services and has ordered eight more landline phones for employees to connect to their laptops, allowing them to take calls and file call reports from home.
With the mass layoffs that have already begun in the retail, food and hospitality industries, the nonprofit is preparing for an even bigger surge in calls, Larkin said.
“It’s not just the people losing their jobs, it’s their families, those around them. . . . There is going to be some sort of massive traumatic element to this,” she added.
Siegel said that in recent weeks, she has gone back and forth on whether to “normalize” feelings of coronavirus-related anxiety by discussing her own experiences living and working in Montgomery County, a suburb of 1 million where 107 cases had been reported as of Tuesday afternoon.
Call specialists are typically urged not to share details about their personal lives, and many, including Siegel, use an alias.
“Do you say, ‘Oh, I’m anxious too’ or ‘We’re all anxious’? I think so, because that’s true,” she said. “These aren’t ordinary times for any of us.”
One recent afternoon, Siegel settled into a chair in her home office for two back-to-back shifts spanning eight hours. With each stranger who called, she tried to persuade them to focus on the realm of things they had within their control.
“Your dad,” she said to the young man who called feeling anxious about the virus, “you’re going to see him today? Good, that’s good.”
When the phone clicked off, she swiveled her chair around and leaned back. There is a line she and her colleagues like to share, she said.
“We say that we don’t save lives — that’s for first responders, cops, doctors. What we do is give folks another day.”
EveryMind hotline: 301-738-2255
Montgomery County Crisis Center hotline: 240-777-4000
National Suicide Prevention Lifeline: 800-273-8255
National Suicide Prevention chat service: suicidepreventionlifeline.org/chat