Registered healthcare professionals undertake a wide range of mental health work, sometimes with little preparation and training [1]. Increasingly non-registered staff take on mental health call-handler roles, having conversations with vulnerable individuals over the phone; these staff often lack the training to effectively communicate with callers. The aim of this initiative was to design and deliver a telephone skills training program for non-registered NHS mental health call-handlers, with the hypothesis that such training would improve their communication skills and overall job performance. Studies have shown that receiving training in having supportive mental health conversations over the phone increases staff confidence and changes their attitudes [2] and has the potential to benefit staff retention.
A mixed-methods approach was used in the design, incorporating both qualitative and quantitative data collection and based on the needs and feedback of the call-handlers themselves. Evidence shows that involving simulated patients (SPs) can be effective in telephone studies [3]; leading us to train experienced SPs in their roles as members of the community phoning the help line. All was face to face, although conducted over the phone with the SP hidden. Active participants, the SP and the observing participants all became involved in the debrief. The content covered active listening, empathy, signposting and options in handling the challenging situations. Developed over a month, the programme was delivered as part of an overall training for their roles.
The evaluation of the session indicated significant self-rated confidence in having calls with members of the public. The scenarios increased in intensity, covering topics ranging from bullying, domestic violence, gambling addiction and intent to take life. Qualitative feedback from the call-handlers showed that they felt more confident and prepared in their roles, and were better equipped to handle challenging situations. The involvement of SPs was also found to be authentic and highly beneficial by the call-handlers. Participants requested frequent practice sessions, face to face or online.
Investing in providing targeted training and support for non-registered NHS mental health call-handlers, can have a positive impact on their communication skills, overall job performance and likely staff retention. This can ultimately lead to improved quality of care and patient outcomes in the mental health sector. The involvement of SPs can provide a valuable learning experience, both in role and in the debrief, for call-handlers, and help to prepare them for real-life scenarios.
Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.
1. Secker J, Pidd F, Parham A. Mental health training needs of primary health care nurses. Journal of Clinical Nursing. 1999 Nov;8(6):643–52.
2. Payne F, Harvey K, Jessopp L, Plummer S, Tylee A, Gournay K. Knowledge, confidence and attitudes towards mental health of nurses working in NHS Direct and the effects of training. Journal of Advanced Nursing. 2002 Dec;40(5):549–59.
3. Derkx HP, Rethans JJ. E, Muijtjens AM, Maiburg BH, Winkens R, van Rooij HG, et al. Quality of clinical aspects of call handling at Dutch out of hours centres: cross sectional national study. BMJ. 2008 Sep 12;337(sep12 1):a1264–4.
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