Tom Honey

I first heard of Shout, a crisis text messaging service accessed by texting SHOUT to 85258, last summer. The service connects someone (who is normally experiencing a mental health crisis) by text message to a volunteer. The premise of a Shout conversation is to help a texter move from a “hot moment” to a “cool calm” in order to de-escalate a situation. As a volunteer, you are, for the majority of texters, the first person they have opened. Conversely, you may be the last hope for someone who is in a crisis who has tried every other service.

The five steps of each conversation are building rapport, exploring a texter’s issue, identifying the goal of the conversation, discovering next steps and ending the conversation. During the exploration stage (similar to history of presenting complaint) it’s important to establish how long they’ve been feeling like this and what, if anything, has triggered this. You must also perform a risk assessment as, in some instances, there may be imminent risk at which point emergency services may be required.

Identifying the goal (similar to expectations of ICE) allows you to understand what a texter would like to happen next during the conversation to help them. Discovering next steps involves making a plan to help the texter after the conversation ends. This can be varied and includes simple coping strategies such as going on a walk or listening to music or providing resources such as different therapy services offered through the NHS.

Shout has taught me how important it is to see the person beyond the patient. Everyone has a unique story that deserves to be told. Simply being there for someone over text is, for most people, more powerful than any medication will ever be. That’s what makes Shout so special - it’s based purely on the idea that being there to talk through something with someone in their time of need can provide instantaneous relief. Even though shifts can be emotionally draining, the Shout community is so supportive and everyone is there to help each other.

Being comfortable talking to people who are in a crisis is a life valuable skill for anyone, not just healthcare professionals. My journey so far with Shout has been the greatest privilege of my life. Being able to talk to others who are entrusting you with information they haven’t told anyone else is such an honour and I urge anyone interested to become a crisis volunteer :)