Let’s Keep Talking: re-imagining mental health service delivery post-pandemic

Telemental health, already an emergent model of mental health service delivery, has been rolled out at an unprecedented rate since the onset of COVID-19. In this project we evaluate one such service, ‘Let’s Keep Talking’, a telephone support service delivered by volunteers, for free, through the work of a Liverpool based mental health service provider.

Background

Before society became fixated on COVID-19 we were already struggling to manage what had previously been described as epidemic levels of mental distress. COVID-19 compounded this distress in multiple ways.

Those receiving support, through different forms of mental health intervention, saw this altered, with much of in-person support becoming remote, whilst Covid induced lifestyle changes exacerbated societal vulnerability and created a new population of people needing support. With existing models of mental health service delivery under pressure, the opportunity to disrupt the status quo and trial new forms of service delivery was ripe. One organisation set about doing this through the introduction of a new ‘Let’s Keep Talking’ telephone support service.

Objectives

This project evaluates this telephone support service. It was introduced specifically in response to the first Covid-19 lockdown in the UK, from March 2020, and the mental health trauma experienced by people unable to access support. The service is operated on a voluntary basis, is staffed by trained volunteers and is accessible via self-referral or referral through other organisations. In this project we examine two key objectives:

• We explore the utility of the service in the current context from the perspectives of both clients and volunteers.
• We explore the possible long-term viability of the service, establishing if clients and volunteers believe there is a place for the service in their post-pandemic lives.

Methods

Interview data has been collected from both clients and volunteers by researchers based in the Marketing Subject Group (ULMS), a group which has a track record of conducting related research.

Findings & recommendations

Ultimately, some of the key strengths of Let’s Keep Talking (accessibility, immediacy, and collaborative / client-centred approach) may be able to contribute towards improving clients’ experiences not only of individual mental health services but also of broader mental health systems.

Clients and volunteers identified a number of benefits from engaging with the service, from which four overriding themes can be identified:

• accessibility and immediacy,
• collaboration and flexibility,
• the mitigation of isolation
• trust

The solution-focused approach underpinning the service was associated with various benefits, with clients describing how this:

• helped to alter their perspectives,
• enabled them to think more optimistically or proactively,
• to recognise their strengths or resilience, and focus on their desired futures.

The ‘Let’s Keep Talking’ service model has a number of specific features which make is particularly inclusive and innovative:

• It has the flexibility to be responsive to client needs in an all-important timely fashion.
• It is entirely free
• It does not operate an eligibility assessment process.
• It is open to all
• There are no long waiting lists
• There is no limit to the number of calls a client can receive
• Call length is dependent upon individual needs and preferences
• Calls are structured to enable client-centred conversations
• Clients receive calls from the same volunteer, unless they choose otherwise
• No other mental health service model in the geographical footprint covered by the service offers this agility.

Recommendations

Let’s Keep Talking has an important post-pandemic role to play, particularly in light of the lengthy waiting lists of most mainstream mental health services (e.g. Royal College of Psychiatrists, 2020).

It offers an important service model:

• In its own right – able to respond to people with low mood with speed and agility
• As an intervention which provides support whilst clients are awaiting further specialist help.

Such is the impact of the service, three recommendations for moving this work forward warrant attention and support:

1. Seeking funding
2. Exploring opportunities for blended care
3. Revisiting the service communications strategy

Download the full Evaluation of the Let's Keep Talking' Service (PDF 0.2MB)

If you would like to hear more about the work, do get in touch with the team via phj@liverpool.ac.uk

The 'Let's Keep Talking' project and evaluation was also covered in The Psychologist' magazine.

Partners & Funding

Chloe Spence is completing an ESRC Case Studentship funded by the North West Doctoral Colloquium.

Professor Philippa Hunter-Jones and Dr Rachel Spence are undertaking this work on a pro bono basis.