Call us, definitely: crisis support with Lifeline Direct's Dr Jakqui Barnfield

Our guest for this episode is Dr. Jakqui Barnfield,  Lifeline Direct's Executive Director of Service Delivery.
Jakqui is a registered nurse with a passion for mental health and suicide prevention. She tells us about the power of reaching out to Lifeline Australia's services and that you are not alone.

Helplines:
Lifeline on 13 11 14
13 YARN on 13 92 76 (24/7 crisis support for Aboriginal and Torres Strait Islander peoples)
MensLine Australia 1300 78 99 78
Suicide Call Back Service 1300 659 467
Free nationwide service providing 24/7 phone and online counselling to people affected by suicide
SuicideLine Victoria 1300 651 251
24/7 telehealth service that offers free professional phone and online counselling for people living in Victoria
MORE INFO about the Safety Plan mentioned in this episode.

CREDITS
Produced, hosted and edited by Emily Webb, ermha365 Advocacy and External Communications Advisor with Karenza Louis-Smith, CEO ermha365.
Follow ermha365 on social media:
FACEBOOK - @ermhaorg
TWITTER - @ermha365
INSTAGRAM - @ermha365

ermha365 provides mental health and disability support for people in Victoria and the Northern Territory. Find out more about our services at our website.

ermha365 acknowledges that our work in the community takes place on the Traditional Lands of many Aboriginal and Torres Strait Islander Peoples and therefore respectfully recognise their Elders, past and present, and the ongoing Custodianship of the Land and Water by all Members of these Communities.

We recognise people with lived experience who contribute to GET REAL podcast, and those who love, support and care for them. We recognise their strength, courage and unique perspective as a vital contribution so that we can learn, grow and achieve better outcomes together.

Transcript

Speaker 1: 0:00

Get Real is recorded on the unseeded lands of the Boonarong and Warungery peoples of the Kulin Nation. We acknowledge and pay our respects to their elders, past and present. We also acknowledge that the first peoples of Australia are the first storytellers, the first artists and the first creators of culture, and we celebrate their enduring connections to country, knowledge and stories.

Speaker 2: 0:28

Welcome to Get Real talking mental health and disability brought to you by the team at PURMA 365.

Speaker 3: 0:34

Join our hosts, emily Webb and Karenza Louise Smith, as we have frank and fearless conversations with special guests about all things mental health and complexity.

Speaker 4: 0:48

We recognise people with lived experience of mental health and disability, as well as their families and carers. We recognise their strength, courage and unique perspective as a vital contribution to this podcast so we can learn, grow and achieve better outcomes together.

Speaker 3: 1:10

Everyone is absolutely worthy. We're here 24-7 to help everyone. We're open to everyone. We want people to call. We don't want people to wait to learn crisis. We will offer support to people who are in crisis. We'll offer support to people who aren't in crisis, but we'll also offer support to people who are supporting people, because being a carer is tough and it's often absolutely under recognised. It's undervalued.

Speaker 5: 1:41

Our guest for this episode is Dr Jacqui Barnfield, executive Director of Service Delivery for Lifeline Direct.

Speaker 5: 1:47

You'll hear us talk about On the Line Australia during this interview, and that's because Jacqui was working with them and recently On the Line Australia amalgamated with Lifeline Australia to better address service gaps for people to access care and support around the country. Jacqui is a registered nurse whose career focus and passion has been mostly in mental health and suicide prevention. She's been a Director of Nursing and Operations in various roles, and her PhD study Therapeutic Optimism and Attitudes Among Medical and Surgical Nurses Towards Attempted Suicide explored the experiences of both nurses and consumers when faced with caring for or being the recipient of hospital admission following a suicide attempt. We're going to be finding out more about Jacqui and her work, and also about ways to look after ourselves over the Christmas, holiday and New Year period, which can be difficult for people for many reasons. And before we launch into our conversation, if you're affected by anything discussed in this episode, you can reach out to Lifeline on 13 11 14. Welcome to get real, dr Jacqui.

Speaker 3: 3:00

Thank you very much, Emily. Lovely to be here.

Speaker 5: 3:03

Now, karinza, before we start chatting with Jacqui, we explored this topic of extra focus on self care and mental health support over the Christmas New Year period for our last episode of 2022. And we're revisiting it again. I don't think we can talk about this enough. What's your general feeling at the moment about this time of year and things that you're doing to keep mentally well, because it's a hectic time, there's lots of pressure, and aspects of life like the cost of living crisis have got harder in the 12 months since we last spoke about this.

Speaker 6: 3:36

I think you're right and I think it's interesting, isn't it? We were chatting earlier offline about how Christmas seems to magnify things. You know, I think you can find ways to get through tough and difficult times sometimes, but the expectations that are set around us at Christmas are really hard. To put presents under the trees, to gift to people, to have a smile on your face, to show up, to be happy, and you know, for some people that is just too difficult, too much and too hard. And then you know there's that sense of I failed, I haven't done well enough, I'm not doing good enough If I can't do some of those things. So I think the pressure that Christmas brings is huge. And then, of course, if we look at what's going on in the world, I mean it's pretty depressing and you know, it's pretty awful when you see, I guess, some of the conflicts that are happening in the world, people dying, all of those things I think can magnify sadness for people as well too.

Speaker 6: 4:27

So I think these conversations that we have around Christmas are really important, because finding ways to recognise that but also take care of ourselves is really, really important. And you know, preparing, I think, to get yourself through the sort of festive season is really important, so I'm really looking forward to today's conversation. In particular, I like calling you Dr Jackie, so I'm thrilled that you've joined us, for, get Real, you've got a background as a clinician. You're also a registered nurse as well. Can you talk to us a bit about, I guess, your expertise and what's brought you into this area of work?

Speaker 3: 5:05

Dr. Jackie, it's so weird. I'm going to have to take you back, like to the last century really, to give you a little bit of context to how I got here. At least we're early enough in the century I can say that it doesn't feel that long ago, but it is so a really long time ago. It comes back to high school when you're picking what it is that you want to do. I had no idea Actually, originally I thought I wanted to be a park ranger and I realized that it was going to be cold at some point.

Speaker 3: 5:27

I didn't really like the cold weather, so it was like, okay, that's not for me, something that's going to be indoors. And you know, we've all got like a favorite uncle or favorite auntie. They're the fun one, the one who inspires, without actually even knowing that they inspire you. I said just cool, and I had a cool uncle. He was a mental health nurse and I thought actually I could be a mental health nurse. Would I be as cool as him? I don't know, that's irrelevant now. And it was interesting because he was, you know, in the UK, in here in Australia, the year that I was applying to become a nurse. It was my last year of high school they no longer ran the mental health nursing specific qualification, so I did my registered nursing bachelor at Monash Uni and throughout that I just I found that all of the clinical placements within the mental health sphere really resonated for me and I just felt more real being in those spaces than you know. Hospitals are really artificial places. You know people go, they're unwell, and you know that you see people when they're at the most vulnerable, when they are at the most unwell, and that's where you spend most of your time. So, irrespective of whether it be in a medical ward or a psychiatric ward or a mental health ward however you want to phrase it you see people when they're considered to be at their most unwell or at their, you know, a pinnacle of a crisis. I will come back to that in a little while and give you a little bit more context to where my thinking is now.

Speaker 3: 6:53

So I started off and, you know, really kicked off in the mental health space with an associate nurse manager really early on in my career and I remember I call it my defining moment and it really defines why I've chosen the career trajectory there's a word I can't say Trajectory that I'm here now and my defining moment is this I was working on the inpatient unit and you know I was that nurse that he think oh, that's so cool to be, you know, to answer phones could vector doctors. I was like the octopus in the mind really, as a nurse leader in that space. And then we had this lady come in and it was Joan. Now it's easy to remember Joan because, as I said, I've attached her to my defining moment and my career trajectory.

Speaker 3: 7:41

But Joan came into us from a nursing home and she was very confused, very disorientated, as she would be taking out of her natural environment. It was the old, old designs of mental health units they used to have. This was like a fishbowl glass all around the nurse's station to give a perspective or a view of the ward for safety reasons, apparently Whole other dynamic around that. But she was at the window a lot tapping and she was, you know, tapping on the window frequently and it was almost constant pretty much for three days. So she came into us on the Friday by the Monday like we're all exhausted because we were trying to reorientate Joan, get her back to her space she was safe and where she was constantly having to try and reorientate someone who was so unable to actually hear what you're actually saying. And it got to Monday and it's stopped. And I remember vividly standing in the middle of the office thinking, oh crap, we failed Joan. And I had an absolute epiphany and I went back and I had a look she was getting massive doses of medication when she was at the nursing home and she came to us and it wasn't picked up. She wasn't prescribed that high level of medication. So for three days Joan went through withdrawal that we were completely oblivious to and I call it my defining moment because I just realised that's not the nurse I want to be.

Speaker 3: 9:13

So whilst I got caught up in the hype of being able to do everything, I lost my purpose. I lost myself in that thing of what I thought was the important, and it was important to the organisation, not the important to the individual. And immediately I left the office safely. But I left the office and went around and spoke to my director of nursing and said how do I become an educator? I want to be able to be in a space where I can influence more people, to not make the area that I just made. I speeded up a little bit more now because we've done the important part of that story. So it became an educator for a period of time, became the manager of an education team, had much more influence than being able to really specialise and hone in on the delivery of education in a tertiary mental health hospital.

Speaker 3: 10:07

Then I had the opportunity to work in another organisation and there was a vacancy for a director of nursing role open. I thought how hard can it be? It's not much different to an educator. That was an interesting experience. It's one of those things that you don't know what you don't know until you find out you really don't know it. So that was a massive learning curve for me and I look back now and I think that was such an amazing opportunity. And there's something if I had known what was expected, I probably wouldn't have been brave enough to try it. Now again, being a director of nursing, you can influence, you can't necessarily mandate. So I realised that in fact, I needed to be in the operational space as well and became an operations director tagline alongside with my director of nursing role, and I had a fabulous mentor who enabled me to develop that role as it was.

Speaker 3: 10:57

Now comes to the really important part of this Now. I said before that there are lots of people in crisis that really are well when they're in hospital. During COVID, I took stock and I realised that I'd lost the joy in what it was that I was doing. In hospitals. There's no people coming in, there's no visitors, no one to engage. I wasn't allowed to go to the wards because of potential infection. So I was in my office and I'm like what am I doing? So I left and I decided to join completely different.

Speaker 3: 11:28

Get back on the tools. I became a clinician again, which really kick started. Ah, there's my true north. That's what I'm here for, and I've then since spent the last two and a half three years apologising to every single person I've come across in the primary health sector Because of that sea snobbery. Tertiary is the hardest part of the world, absolutely wrong. The people who work in the primary health sector, who work in the community sector, are the ones doing it tough. That's where I am at today. Sort of it doesn't quite give you where I am now with on the line, but I'm fairly sure we're going to meander into that sector shortly. I'll leave you with my defining moment.

Speaker 6: 12:12

Thank you and trigger warning for our listeners. We are going to talk a little bit about suicide and suicide prevention so something that you're really passionate about and services that support people as well following suicide attempts. You know full disclosure, share that passion. You know I was in a family living in a family where my grandfather took his own life and I've seen the impact that that had on my dad, who was a young boy at the time, and that long kind of term trauma and things that happen. Your PhD focused on hospital care receiving and delivering care for people who have attempted to end their lives. You know that's a huge topic to explore. What was it that kind of drew you to that and what is it that you know when you think about that that you actually want to achieve?

Speaker 3: 12:57

Thank you. Interesting, one of the actually the reason I selected that topic I was thinking about you know what do you do when you've done a lot of study? What's next? And one of my professional colleagues and a friend actually attempted suicide. So a mental health professional, an educator, highly qualified, and it was like, okay, that's her, that's her journey. And we were talking one day after about her experiences and she said you know what really got me out? Sorry, I didn't say she's also a mental health nurse, so she knew what she should have been expecting. So she was in the emergency department and she she was talking about how, you know, the nurses were engaging with her or not engaging with her, and in fact she didn't get a lot of conversation from the nurses in the emergency department. But she said what really hit her hard was when the nurse from the emergency department was doing the handover, when you're transitioning care from one part of the hospital to another, and she overheard the nurse say she's been a naughty girl and it was such a label and in fact I did a presentation on that I've. You know I interviewed her about that experience, what it really meant for her, and that he started me on the journey. Why would a nurse say such a thing? And you know, is it that nurses are judgmental or is it that nurses just don't know what to say? So that was really what I was.

Speaker 3: 14:30

I was trying to unpack in this space around. Do the people caring for anyone? Because you know, the ED is really the major front door for hospitals. Yes, now there's a whole heap of research on emergency nurses in that space. So I thought, okay, that's been done. What about general nurses? And there's little in that space. And then people go from, obviously, the emergency ward to medical wards, should it be required. So that's where I focus my research. So I was able to interview a few consumers who were very privileged to be able to interview a few consumers who are willing to share their experiences and also do some surveys and interviews with nurses who work in that space.

Speaker 3: 15:13

What was fascinating about it is the nurses really want to do the right thing. They just don't know what the right thing is. The wards themselves aren't set up to provide a safe environment and they know that. So what you often see and the consumers are saying you know, the nurses were in the room because often a four bed, because they would put people in multiple rooms so that it decreased the risk to have people around.

Speaker 3: 15:40

But they say the nurse would never come and talk to me, but that always be in the room and they'd be doing something with someone else. So I'm sitting there doing nothing and I talked to the nurse about that and what we unpacked was, in fact, the nurses are in there and they're doing this whole bunch of busyness and they're being busy because they're really anxious that whatever they're going to do or say to the person is going to be wrong. So what really connected was, in fact it's all a defence mechanism that the way in which nurses behave towards some of the people who were coming under their care, it was anxiety driven. They just did not know what to do.

Speaker 6: 16:18

They wanted to do what they could and that's probably reflective, not just nursing people listening to us. They'd be thinking I don't know what I would say. You know what do you say when someone starts to talk about having feelings of suicidal or suicidal ideations and I don't want to be here anymore. It's like one of the most scary things I think for someone to hear.

Speaker 3: 16:40

It is. You know, we focus so much on life and then when someone is actually talking about, we focus so much on wanting to prolong life and, you know, get older and have a healthy age, but then when people are thinking about ending their own life on their own volition, it's like, oh, what a really confronting thing to be posed with. It's frightening, and for me, what I think about that, people who are willing to sit and listen to someone who talks about you know their feelings about suicidality even before it even gets to that point. Someone who's willing to sit and listen to someone else's burdens is extraordinarily brave, because we know that one of the single biggest risk factors for suicide is isolation. It's loneliness. And if you've got no one to share any of that stuff with, where do you go? And if you've got nowhere to go, all it does is exacerbate that. I'm alone, I'm isolated. No one else feels like this. I've got no one else to carry my burden.

Speaker 5: 17:37

It's so interesting and important to hear. I have a 17 year old daughter who's in year 12 next year and she's quite keen on doing nursing, and I have a husband who came to nursing late when we moved back to Australia. He's from the UK and my mum was a nurse for nearly 50 years. I'm going to ask you a few questions about nursing a bit later, if I can. So, jackie, you know you changed track, got so much experience, so can you tell us more about the services that on the line deliver? Do they do some really important stuff? And also a bit about the amalgamation that happened quite recently, I think in October, with Lifeline Australia?

Speaker 3: 18:14

Thanks, emily. It's easy to talk about the amalgamation and then I can talk about the services. So Lifeline and on the line Australia amalgamated, so voluntary amalgamation, on the 1st of October of this year. So people listening, what does amalgamation mean? Oh, we've joined forces, so we're now under one combined banner Great question. Thanks, karenza. I say voluntary as well because I don't want people to think that there was a takeover or one is bigger or better than the other. We actually are very much a shared organisation. Now we came together both voluntarily, the reason being both organisations really resonate. Our purpose resonated, our mission resonated, the things that we do. We're both providing services in the digital mental health space, some clinically, some not so clinically. Absolutely the 13, 11, 14 number that you raised before. I think almost every person knows that number, which is awesome, because it just means that everyone in Australia has somewhere to go at any point in their time, irrespective of what it is.

Speaker 3: 19:19

Now the amalgamation, so prior to it, on the line Australia. So I will actually do a bit of a spree. On the line Australia, we're three years older than Lifeline, so there's a little bit of friendly banter about that. So on the line started 1960, lifeline 1963. So Lifeline now runs the on the line previous lines. So previous lines being, or as they are now, men's Line Australia Suicide Callback Service. So both of those are national helplines. I'll talk a bit about what that actually means in a second. We've got Suicide Line Victoria, which is available only to those in Victoria, and we run a couple of services for some of the primary health networks in South Australia, in Victoria and in New South Wales. Now when I say we run them, we provide it's 24 7365, it'll be 366 days next year. Happy leave here. And what I say so is it's people can pick up the phone at any time and give us a call. We've always got people there ready and able to answer your call.

Speaker 3: 20:32

I will talk a little bit about peak times. We do get peak times and sometimes it's to actually plan when they're going to be and also know when a peak is going to occur, because obviously sometimes people call in response to something that's going on in the community and you're a bit of lag behind on that. Hypoclea, peak times are between about 5 and 11pm, which makes sense. You've got people home from school, they finish work. It may be that meal times are over into the evening. Kids have gone to bed. Not to say that we're quiet during the day, but we are certainly busier in the evening. It doesn't necessarily quiet down overnight, but we tend to have some, I guess, some people who call more frequently overnight because for them that's their day, which makes sense.

Speaker 3: 21:23

We're 24-7, so we're available for shift workers, which is awesome. We're available for when people need us. It's when they decide that they need a call, which again comes back to being really brave about putting themselves out there. I need help, I need someone to talk to picking up the phone and reaching out, doing that. We've got phone availability. We've got chat availability. Both of those can be done on demand. We've also got video availability as well, and that is made by appointment. It's a little bit more complex to set up, so appointment-based.

Speaker 3: 21:58

What we offer is counselling For those people, and I know there's a lot of services out there where there are massive amounts of wait lists to get into. There's often quite high price associated with that. Certainly, there are supports with under the Medicare Benefit Scheme. What's really good about our services is they're free. Doesn't matter who you are, where you are, where you're based, they are 100% free. They're even a free call. Now we do inbound and outbound calls, so inbound pick up the phone and you're calling straight away. You will get to speak to a counsellor straight away as soon as you get through.

Speaker 3: 22:34

As I said, there are some peak times, so it might mean that the time to get onto the call might take a little bit longer, but we certainly do try to answer as many calls as quickly as we possibly can. We don't predict how long the wait list is going to be or how much time you're going to be waiting on the phone, because we don't know how much time we need to spend with someone who's on the call before you. What we do try to do, though, is pick to about a 20-minute time frame, because we don't want to delve into stuff that becomes too hard to unpack in a phone call or in a chat, and also we're not face-to-face counsellors, so there are things that we don't do in digital counselling that you would do in face-to-face, and some of that stuff is really building that relationship, getting to know someone a little bit more closely, aligned with what they want to talk about. I mean, we do talk about things like what got you here, what's going on for you right now, but it's done in a really condensed way. So there inbound, there are single sessions, so I can talk through the model that we have a solution focus, brief therapy approach.

Speaker 3: 23:38

So what we do is we ask people to identify what sets brought you to pick up the phone today. Why are you calling and no one ever rings? For one reason, but in 20 minutes we need people to focus on the one reason and it's actually a really powerful tool to get them to think about what's the one thing that is bothering you more than everything else, because it's typically that destroy, that break the camel's back. You know you've got a whole bunch of stuff that goes on in people's lives all the time, but there's one thing that made them pick up the phone today. What was it? Okay, it might not be the final thing that got them to think, oh, I need to call someone. It could be the first thing that it's really been bothering them, but it's been bubbling away and it's never really been resolved.

Speaker 3: 24:24

So we get people to think about what is that number one thing you really want to focus on right now in this call and then ask them to write a level of distress that it causes them. Right now. We call that a consumer's self-rated distress scale. What that does a really powerful tool is it gets them to think about oh, how much of an impact does this have on my life? If you've got four or five different things, then you can do a quick mental check and think, okay, is it my relationship issues? Is it my work, is it financial concerns? You go, okay, oh, that's maybe a four, that might be a five, that might be a two. Oh, that's an eight. I didn't really think about it that much until it actually you get the question.

Speaker 3: 25:08

So, with that, then that's the plan on the opportunity for the counselor and the consumer to really talk through what that issue is. And you know there's a whole bunch of counseling tools, mechanisms that are really skilled professional counselors use. Now I will just tap in. So our counselors are all professional counselors. They are either qualified in counseling psychology, they're either mental health social workers or they could be mental health nurses. Lots of experience, lots of qualifications. They are experts in delivering digital mental health service delivery.

Speaker 6: 25:46

So, jackie, I was reading an article in the Guardian. That is not unusual now for you guys to receive more than 4,000 inbound calls a day. Is that right, 4,000?

Speaker 3: 25:57

Yeah, lifeline yeah, 13, 11, 14, whether it be by phone or text.

Speaker 6: 26:03

That's a phenomenal number, that's huge, and they talked as well in the Guardian about the rising costs of living, kind of being a major driver for this. You know I was thinking I was in the supermarket the other day and doing my groceries shopping grief like you know the how much it's risen. Are you seeing a lot more people come into you with financial distress and anxiety and things that are happening as a result of that?

Speaker 3: 26:28

It waxes and wanes. I mean we've had people who've been calling around financial difficulties well before COVID, but certainly over the last little while we are seeing an increase. The other reasons people still call. They're still struggling to get over what happened during COVID as well. You know, getting back to the new normal there's still trying to work out how to reengage, still stuck in you know, that isolation, that loneliness, being able to rebuild relationships and reconnect with people. The financial stuff is absolutely how awful to have to decide whether you're gonna pay a bill or whether you're gonna eat, whether you are gonna eat or whether you're gonna give your child the last bit of food.

Speaker 6: 27:11

Or the business presence that they want. Right, that's kind of an up-down, absolutely.

Speaker 3: 27:15

Yeah, with that there's this absolute, inordinate amount of shame. And it's not anyone's fault. We say it all the time mental health, it's not your fault, but shame and guilt are emotions that we put on ourselves Again. Probably. I mean there's layers to it, but there's the comparison to you know, I'd love to be able to give my family blah, or I'd love to be in a situation to be able to provide blah, but also we don't have a. You know, we don't have the utopian society. What we have is a place where there are people who are living very far below the poverty line. You know, we've got people at the poverty line and we have people who are getting through. We've got people who are getting through a bit better and we've got people who are not struggling or needing help in any way, shape or form in a financial perspective, but that doesn't mean that they're mental health any better.

Speaker 6: 28:12

No, I'm interested when you talk about that kind of sense of shame. You know that shame, the failure, you know, but also the stigma piece, I think as well. And I think there are people perhaps that are listening to the podcast thinking I've thought about ringing, but I never have and I haven't because I feel silly. You know, if I say it it's real. All of those things. What would you say to someone that's sort of sitting in that space, that inner turmoil and battle?

Speaker 3: 28:38

I could have said before you know, I think you're really brave if you call. There's no way you would ever feel as though a councillor would never say you should feel ashamed, you should feel guilt about what's going on. We work in a strength-based approach. We want people to. You know we don't do fluff. You know we'll tell it how it is, but there's no way in which you should ever feel as though you're not worthy of picking up the phone either. That's the other thing. Everyone is absolutely worthy. We're here 24 seven to help everyone. We're open to everyone.

Speaker 3: 29:14

Again, it's shame and guilt. It's self-limiting and it comes back to and I've got this whole thing about. We're really unkind to ourselves. You know we are so unkind to ourselves and for me, when I've actually been doing some reframing about that as well, you know you do simple things, stupid things. There you go. There's a prime example. But we put labels on everything that we do and we internalise that. So you know, example being, I actually just literally had a conversation in our office about being kind to yourself and I was talking to one of the marketing ladies and I was walking back from my desk and I kicked the table and I said, oh you bloody idiot she goes.

Speaker 3: 30:00

Are you or did you just kick the table? And I went, oh nicely, played horse, because you know it wasn't a reflection on me being an idiot. I kicked the table, it was just an accident. But what first thing I did was a negative self-talk. And how do you be kind to yourself when you've got that sort of overlay going on the back of your mind? So it's interesting, because the minute you start to switch and think, let's call out what happened rather than internalise it. I kicked the table egg.

Speaker 3: 30:33

Wow, in the scheme of things, is that a big deal? Absolutely not. Does that make me an idiot? Absolutely not. I think what would make me an idiot is if I didn't continue to reflect on that and go actually it is just I kicked the table egg. I mean, there are bigger things than people talk other stuff and you know if you are in the depths of despair, you know it could be depression, it could very well be some psychotic disorders. You've got a whole heap of other elements that are going on and it's not necessarily your own negative self-spec that's going on. It's being forced by broader society and judgement, as you said, stigma. And then you've got self-stigma, you know, am I worthy of seeking help? And it's this massive self-perpetuating cycle.

Speaker 6: 31:19

It's very powerful about a telephone line. I mean just to start with telephone for starters. It's quite safe and quite anonymous, like you can pick up the phone and you can be anybody, you can have any name, you can have anything you know, and for some people you know the thought of walking into a GP and saying I'm not coping, that's going to be on my health record. Is that going to stop me getting a job later. Those things are terrifying. So there's something really powerful, I think, about a phone-based service. And it doesn't matter where you live. You know how far away you are from the nearest I don't know GP service or the nearest community-based health service. You could be in the middle of what? In the middle of nowhere, but that support is there for you, as you just said, 24 hours a day, every single day of the year. That's a really powerful thing to be able to offer people. In a way. I would think that would be quite safe.

Speaker 3: 32:11

That's a really good point, karenza. I did forget to think that we've got a lot of communities out there that are really small. How exposed do you want to feel in those communities? Now, there is some important things to know that, when you do call our lines, though, that all of our calls are recorded. They're recorded for and the usual quality and training purposes, but also for safety reasons. People can access their recordings. It's free to move information. We have them available if people do request them, but we also do ask information and, you're right, you can be completely anonymous. You could give me whatever name you chose to if I answer the phone. I wouldn't know any different, because I take everything on face value.

Speaker 3: 32:52

Some of the stuff that we do ask, though and there is some demographic things that we do ask is useful for our funders. Now, they never get any detailed information about every single caller. Everything's done as a bulk lot. So questions about postcode, things like that, because what's really important for funders is that they know where they can potentially target services if they need to be designed in certain places. We need to know if we're getting particular calls from certain members of the calls community. So are we getting people who are experiencing things right now that are relevant or specific for that community. As well, too, are we being able and responsive to our Aboriginal and Torres Strait Islander communities? So there's those as well, as we ask about gender, but, at the end of the day, we know as much about you as you're willing to share, and it doesn't necessarily have to be accurate. We just have to ask it, so we do.

Speaker 6: 33:50

I think that's just important for people listening. It can be you say it's very brave. It can also be terrifying to think. I want to take this step. I want to take this step so to know that you can do that in a safe way. I think it's huge and I would actively encourage all of our listeners. If you get to that place in space where it feels dark, where things don't feel okay and don't feel safe, but you don't know where else to go to be able to pick up the phone and ring, and we'll make sure that we have all the numbers in the show notes so we talked about.

Speaker 5: 34:21

It's a really big step to call for help or contact and it can actually start the ball rolling for people to access more services. And thinking about stigma and I was recently reading the Australian Bureau of Statistics Statistics about Suicide and you know, obviously we know that men are pretty highly represented and I was sort of shocked to see that men over the age of 85 were some of the highest people who take their own lives. But men's line is one of the services and we know that mental health awareness is getting better with men. But there's many factors in play with men's mental health and men's mental health impacts not only them but their families, women. We see this play out in society. So, jackie, what does men's line Australia do? Because I was reading a bit about it, what kind of things does it encompass?

Speaker 3: 35:17

Absolutely Anything that a man wants to talk about. We don't permit weird sexual stuff which I will put out there. We do get, and so obviously there are restrictions as to what I will actually allow our councillors to listen to. So for their safety we don't allow that. But everything else, absolutely.

Speaker 3: 35:37

Men call about relationships, they talk about issues at work, they talk about dating, they talk about kids. There's a whole bunch of stuff that you often think, oh, nothing's going to surprise me now. And then someone will ring and it could be just I'm having trouble making a decision and you don't even need to know what the decision is. But it's talking through. How do you make decisions and what does the decision have an impact on your life? Does men tend to not call us suicide sweats? Now, is that because men tend to not call out for help or seek help when they are suicidal, and maybe that's why suicide rates for men are higher? There's one of those things Again. There's the whole layers of complexity around the suicide space and help seeking.

Speaker 3: 36:29

But whatever a man wants to talk about, men's line, australia is stuffed by both men and women councillors. Now, if a man does call and specifically requests to speak to a man. We don't always have them on shift, so we will try and endeavour to facilitate a call back if that's what's required. But what's often a really great thing for men to do is speak to women, because if they are having relationship difficulties, it does sometimes provide them the opportunity to practice.

Speaker 3: 36:59

How is it that you are communicating with your loved ones? It's different ways in which you communicate. It could be your boss. There's different things, and so we don't necessarily advocate and promote men just to speak to men. But, as I said, we will certainly facilitate that if we can. The interesting stuff about the men over 85, of course, are a lot smaller cohort, so it's the rate of suicide plus. Also, you have to think. You know they tend to be more physically frail and so however they attempt might end up with an outcome that they're seeking, not necessarily one that we're wanting, but certainly it's women who certainly still attempt more often.

Speaker 5: 37:43

Oh yeah, I was going to ask about that and I should have checked my stats because I was actually quite interested to see that women in probably my age bracket. I think there's a big story. There's always stories behind statistics. That data tell the stories.

Speaker 6: 37:58

I think the thing to talk about when we talk about it is when I think people get to that place. You get to that place like you get to rock bottom, the lowest point that you can get to. There are ways that you can step forward. You know and I think for anyone listening to this podcast, there are, you know, I know that times in my life I felt like I can't go any lower than I feel now. You know there's moment and, yes, other things magnify it but you're like, can it get any worse? And you know how do I try and find a way to step forward? And I think that's the powerful thing that Lifeline and OTLA can actually help people to start to think a bit about. When everything feels like completely like shit, it's complete crap, I can take a step forward.

Speaker 3: 38:42

It's also, you know, if you think about, you know a bit of context. So you know, when you've had a really fabulous weekend and you know, you see someone you haven't seen for a while and you just want to, you're really epulent, you want to tell them about your really good news. But you're like, hi, how are you going? And they're like, great, how is your weekend? And it's like, oh, blah, blah, blah, blah, blah. Or alternatively, you go, you know, and sometimes it happens in the workplace you go to work and it's like, hi, and everyone goes hi, how are you going? And no one asks you about your weekend. You're a bit deflated. Now that's if you're feeling good, if you're already feeling in a place where you're a bit flat or a little bit. You know things aren't going great and no one asks you how you're going, how is your weekend, what about you?

Speaker 3: 39:28

Who are you as a human being? And I think some of that stuff is we've lost some of the human connection, the social nice it is. You know, how often do you do, oh, yeah, good, thanks. And then you realize, oh, actually they didn't ask me how I was, it's just an automated response. There's some of that stuff that we do on wrote without actually thinking about the impact that it might have. And you know, what we've stopped doing is making connections with people and again, you know, as wonderful as technology is, there's an element to that, however, I've got to say I speak to more people now using technology than I would in a face-to-face office. So that's been fabulous for me because it can increase your scope. But then again, meeting people face-to-face after having seen them on screen, you know I never recognize people because I never look like the person Two-dimensional is so different to a three-dimensional person. How do you re-engage with someone who is a three-dimensional person Because you realize they're actually a human being?

Speaker 6: 40:30

Thinking about that build up to Chrissy and all the things that come with that. What do you say to people? You know, like I'm okay, I'm doing great. How can I be aware of other people and what's going on for other people? You know how do we take some care to actually stop and not be caught up in them. You know the running around and all the things to actually pause and look around us a bit.

Speaker 3: 40:53

You know there's so much demand on all of this in this Christmas period. You basically say December's gone. You know we're all into January. At this stage there's so much demand on us, on our time, on our energy, on our resources, and then there's still people wanting more, because now there's a great opportunity for people saying give the gift of giving. And yet we've already talked about the financial crisis and the impact that this is actually having on people and again, that exacerbates more guilt. So there's elements of that.

Speaker 3: 41:26

It's okay to actually say no, and you know it comes back again to a little bit of that being kind to yourself, because one of the best ways of being kind to yourself is to connect with another human being. So how often do we again, as I said, those superficial greetings but really stop and talk to someone and you catch up for a coffee, but actually are you having a coffee sitting opposite someone or are you having a coffee looking forward and standing next to each other having a coffee? There's ways in which we've stopped engaging. You know we will walk side by side, but we won't look at each other, and I recently went to a forum and there was men talking about it and that was actually what they were saying.

Speaker 3: 42:16

Men go out and they sit next to each other. They don't make eye contact. That's not what men do. They get eye contact, that human connection, and you don't have to say how's your mental health or even you know how are you doing. It's the social nice of this, but a little bit more than that. You could even start the time off like, geez, I'm finding this thing, but it's really rushed and really hard Connect it. It's really hard on me. How are you going with it?

Speaker 6: 42:44

Yeah.

Speaker 3: 42:45

It's a way of then reminding people that they're not the only people to feel like this.

Speaker 5: 42:50

Yes, that's important and also thinking you know, the services that we're talking about aren't just for people who are experiencing crisis. People who are trying to support someone who are experiencing a crisis or they're concerned can call, can't they? Oh, absolutely.

Speaker 3: 43:07

We want people to call. We don't want people to wait until they're in crisis. We will offer support to people who are in crisis. We'll offer support to people who aren't in crisis, but we'll also offer support to people who are supporting people, because being a carer is tough and it's often absolutely under recognised, it's undervalued, while someone might be experiencing their own mental health crisis, their own mental health concerns. What about the family? What about their friends? How are they coping with that as well? So, yeah, all of our lines are open to have anyone access at any time.

Speaker 6: 43:45

That's interesting. I didn't know that. I did not know that. I think there's a really powerful message, isn't it? That you don't have to be in an acute crisis situation to pick up the phone.

Speaker 5: 43:54

What made me think of that, Crenzer, is Jackie. Last year we did an episode with an educator and professional who wrote a book for parents for when their children self harm, and it was interesting because she said you know, most parents will just, absolutely, you know, freak out, understandably, but the big thing the message came through is we're going to get through this together. And it made me think of that because it can exacerbate problems when you're trying to support, like a loved one or a friend, or you're just really worried about them and you're like I don't actually know what to do. And I thought, you know, calling someone, like on one of the lines we're talking about, for some practical advice would be really useful. You know that's not advice from your mom, your uncle, Bob, so on. So down the street, you know that kind of thing.

Speaker 3: 44:38

It's usually to do with pulling the socks up. What's really great about some of our lines as well is they've got some amazing internet resources on their websites, so you know they could be self help things, but it's also information as well about what happens, why people are doing this, what's really going on as well, and all of our websites have some, as I said, some amazing resources. This callback service has a safety planning tool on it as well, and you know we plan for so much stuff. We plan for holidays, because they're amazing. We plan for, you know, birthdays, parties, but we never plan for the what if.

Speaker 3: 45:18

You have your car insurance and you have your house insurance. That's a bit of a what if, but we never do the what if for ourselves. And whilst you're well and capable and able to do so, we should all think about creating our own safety plan, Because through it now rather than when you need it, because when you need it, you're not going to be able to think of where you can get the resources. I took my own advice a little while ago and did it myself. I was like it makes perfect sense to do it right now and it was a bit weird, but then it also gave me the opportunity to think about. I've identified people on my safety plan that if I need to talk to I will call them, but it gave me the opportunity to then think I'm going to give them a heads up. You're on my safety plan.

Speaker 6: 46:00

That's powerful. So the question we ask everyone that we talk to and Emily and I are just really big believers in this like self-care, which is what you're starting to talk about, but you're taking it to a whole new level. When you think about self-care, what are the things that you practice or do that takes care of you? And I think we do this because we like to encourage our listeners as well to think about always self-care. What are the things? I've never heard of think? Creating a safety plan, I'm thinking, wow, okay, that's really interesting. Who would be my people? Wow. And then I would talk to them and say that that is hugely powerful. But what other things do you do that our listeners could think about? That's something I can try.

Speaker 3: 46:39

I'm a reader and I will read. My husband says you read the Beth of Cornflakes book. It was sitting in front of you. True, he's refused to come shopping with me at the supermarket any longer, because I just love to read and I get a few information. Come on, let's go with that. But I don't read specific genres because it depends on where my mind is at. I love your crime, but you can't read that all the time because it just leaves you with. It's almost like a greasy film and you think, oh, come on, I just can't do that anymore. I'll read romance, I'll read text book, stuff that is taking my interest.

Speaker 3: 47:20

I'm your introvert's introvert. So it actually allows me time to regroup and get energy for myself. And I think what's important when you're doing self care is knowing whether you are likely to identify as an introvert or an extrovert, and by that I don't mean loud and bubbly. Where do you get your energy from? I have to regroup. There are certain times on the day when I think, oh, I'll just decompress, and that could be just sitting in the car. Well, working from home is a bit weird, but you know that's just go out to the car and sit in the car. But when I was driving places radio off. It's my time. But if I'm in a crowd of people I can get energy from other people. But sometimes that's really exhausting.

Speaker 3: 48:01

Christmas is like that for some people Exhausting. You've got to almost perform, you know. You've got to be there for your family, your relationships. Christmas as well is. I've done it this year, can I do it again? And that's what we often see. Actually, what was surprised last year is we tend to see a decrease in the number of people who call over the Christmas January period. We didn't see that last year. It was the first time we'd actually seen the numbers of people still calling out remain the same. And you know, was that because it was really the first year out of lockdown and you know back to, we can go to Christmas with great Aunty June when Uncle Bob is telling us to pull our socks up. But also there's things like work will continue. People aren't having the same sorts of holidays. So all if you are on holidays, you're with your family and it's intense and it's hard and you've got to keep giving of yourself.

Speaker 3: 48:59

Now, for people who don't get their energy from others and don't generate their energy from others, that's exhausting and you need downtime. So it's very simplistic. But whether you're an introvert or an extrovert, you can be both. There's no, no very clear delineation, but know that it is like how to take downtime for yourself. I would offend who spends time hiding in the loo from her children. For her, that's all she can do because they're young, they're toddlers, they're into everything and they're still banging on the door. But she puts her headphones in and she knows that. Okay, it's just, she's there. I just need five minutes. That's all she needs.

Speaker 6: 49:37

So we're coming to the end of our conversation, jackie. Thank you so much for your time. Are there any last kind of words or thoughts you'd like to leave with artists and there's an in particular, I think, around. You know we gave the trigger warning at the start. You know the really difficult topic, I think, of suicide and people who are feeling suicidal, in particular at this time of year. So any last thoughts that you might like to share?

Speaker 3: 49:58

Yeah, thanks, krinta. I think Cole, cole, before it gets difficult, but also be kind to yourself. If you can be there for others.

Speaker 6: 50:11

Thank you, thank you. That's terrific advice and I just can't, you know, emphasise the incredible work that you and everybody at Lifeline and Online Australia are doing. It's such a critical service, it's a fabulous piece of, I think, the mental health service system in here in Australia, and we're so lucky that we can actually pick up the phone and speak to trained workers, trained clinicians, trained people who aren't judgmental, who are going to listen and, ultimately, who are going to help. So I know there'll be lots of information in the show notes. All the phone lines will be there too, but just to remind people of that phone number for Lifeline Australia, it is 131114.

Speaker 2: 50:53

You've been listening to Get Real Talking Mental Health and Disability, brought to you by the team at Irma 365. Get Real is produced and presented by Emily Webb, with Kerenza Louis Smith and special guests. Thanks for listening and we'll see you next time.