With rising rates of anxiety, depression, and other mental health illnesses, the United States is in the grip of a mental health crisis. At the same time, there is a severe lack of mental health specialists, ranging from psychiatrists to social workers, to meet the increased demand for care. When the two are combined, the crisis becomes a disaster.
Some patients suffering from mental illnesses require the intense care that only trained nurses, physicians, and social workers can offer. However, such positions need a significant investment of time and money to complete the appropriate training and certification, which contributes to the shortage.
Others in need of mental health treatment might find it through community-based groups staffed by people who share an important trait: compassionate involvement.
Empathetic engagement is a listening and questioning strategy that allows the person on the receiving end to get a better knowledge on both an intellectual and emotional level. It is active listening with a greater emphasis on understanding and validating the emotional experience of another person. Anyone who has dealt with a good mental health care practitioner understands the value of this expertise. Some people are lucky to have friends and relatives that are gifted in this area.
The capacity to listen to people in an emotionally affirming manner is essentially an intrinsic trait that cannot be taught. So, rather than formal degrees and qualifications, one option to broaden the pool of possible mental health professionals is to hire people based on their capacity for compassionate involvement.
Based on early testing my colleagues and I did, it’s a successful strategy to relieving mental health difficulties in communities.
In the early days of the epidemic, we wanted to see if compassionate participation might have a significant impact on a community’s mental health. We and others had been seeing many older persons who, who were already at risk for a variety of health issues owing to medical and social factors, become even more isolated as the pandemic progressed. Our hypothesis was that we might minimize loneliness in these folks by outreach by people who were both skilled and trained in sympathetic listening.
We looked for people who were genuine, sympathetic, and mission-driven. Before reaching out to anyone in the community, these folks went through a two-hour mock-call training. A New York Times documentary focusing on a comparable empathic engagement technique in Montreal provided an example of what this process looks like.
Our research was conducted over the period of one month. It began with 240 participants from central Texas sent to us by Meals on Wheels of Central Texas: 120 in the intervention group and 120 in the control group. Participants in both groups were administered the UCLA 3-item loneliness measure and the 8-item Patient Health Questionnaire (PHQ-8) at the outset of the trial to determine baseline levels of loneliness and depression.
For the first week, each participant in the intervention arm received a call once a day. Those answering the phones were instructed to prioritize listening and stimulate dialogue from the participants on themes of their choosing. The callers did not utilize any conversational suggestions, therefore the early discussions were occasionally filled with awkward silences. However, when participants became more at ease with the chats, they expressed anything was on their minds — a neighbor, the cost of food, a recent dispute with a daughter or son, or being pleased about a grandchild’s visit.
Individuals in the control arm did not receive any research calls.
While around 60% of participants preferred to continue getting one call per day, some preferred to receive two or three calls per week. Each call lasted an average of 10 minutes.
Self-reported loneliness as judged by the UCLA 3-Item Loneliness Scale had dropped by 30% by the end of the month, verifying our hypothesis of the usefulness of sympathetic listening. Even more striking, according to the PHQ-8, depression symptoms were dropped by 24%. We were able to determine that the mental health benefits were caused by the sympathetic calls since individuals who did not get them did not improve, as these findings came from a randomized clinical trial.
It is not new; it simply appears different.
This strategy of tackling workforce difficulties in mental health is not new.
Community-based groups today give a significant amount of mental health and logistical assistance to their members’ lives. To mention a few, they provide peer-support groups for children in schools, programs for individuals with substance-abuse issues, church programs that pair teenagers with elderly, and food banks. What they all have in common is that they are virtually all run by volunteers and are subject to fluctuating finances. These sorts of services are morally valuable in our society, but not financially.
There is a huge potential to not just address a rising mental health issue, but to do it in a way that uses the intrinsic knowledge and talents of community people who understand compassionate involvement while also providing meaningful, flexible, and well-paying employment. Communities cannot afford to rely on volunteer or underfunded initiatives to create these answers. They are entitled to the financial and logistical assistance required to meet critical demands.
To be clear, lay caregivers do not serve as a substitute for properly educated and accredited mental health specialists. They do, however, represent an effective and accessible strategy to addressing the mental health challenges that plague every community while allowing formally educated professionals to focus on the individuals who require their full services and skill sets the most.
It is worth emphasizing that empathic listening is already a part of medical education. Current medical education recognizes the need of sympathetic listening in giving treatment; I believe, however, that few grasp how crucial it is. The finest element of the strategy I’ve detailed here is that it is easy to swiftly recruit and train lay caregivers with intrinsic sympathetic aptitude, allowing communities to avoid the scarcity of mental health care professionals today rather than years in the future.
Erin Balsa is a highly skilled and knowledgeable health journalist with a passion for educating the public on important health and wellness topics. With extensive experience in both traditional and digital media, Erin has established herself as a trusted voice in the field.