A friend of mine went into crisis recently. Much to her surprise and distress, she was feeling unsafe and desperate. Fortunately, she called me and agreed to come over. My husband and I listened and kept her safe for a couple of days until she could settle down and start thinking more positively.
I know better than to try to be a therapist for a dear friend. I can love her. I can support her. But she needs the freedom to talk to a therapist about things she might not necessarily want to share with a friend. Once she was out of immediate crisis, I urged her to make an appointment with a local therapist to get the treatment she needs and deserves. She agreed.
Over the next two days, she called 11 therapists. Not one called back. A week later, she did get one return call from a therapist who didn’t have any openings and had no suggestions for what she should do next.
I’m dismayed by the lack of response to a call for help. I’m disappointed in my colleagues. I’m very concerned now that I’ve done some research and discovered that, in the U.S. at least, not returning calls from prospective patients is common.
The reasons are many: Not enough time; It’s not billable; No office staff; I’ll just have to say “no” so there’s no point; I only take referrals from doctors; I get so many calls, I can’t keep up. But, regardless of the reason, I think the practice of not returning calls is antithetical to the first principal we share with the medical profession: “First do no harm”. Not calling back when a person reaches for help often does do harm. It adds another layer of distress.
Therapists who do call back needn’t read further. I’m grateful. I understand that making a string of calls at the end of a long day takes energy you don’t always feel you have. I support you and I feel supported in the belief that doing some daily work free of charge is being true to our calling.
But if you’ve fallen into the habit of not returning calls, this is a friendly reminder of issues you already know but maybe have put aside because of your own stress or what I believe to be unfortunate standards in your community:
· The caller may be in significant pain, even suicidal. When that’s the case, the lack of a call back confirms their worst suspicions that their pain doesn’t matter.
· Not everyone is inclined to see a therapist. Sometimes it takes desperation to make them pick up the phone. If we don’t call back, the person may never find that willingness again. They give up on us and give up on getting help.
· Not everyone can muster the energy to make numerous calls. A depressed person is just that – depressed. An abused person may have just found the courage (or a safe place from which to call) to finally look for help. That call to you may have taken that last bit of energy for self-care the person had.
· It’s discouraging: Imagine the person who is suicidal calling 11 therapists (11!) and getting no response. Why would she try #12? I was able to refer my friend to our local Emergency Services but not everyone in crisis knows about that resource (or has a friend who does).
· It’s disrespectful. Prospective clients shouldn’t be treated like nuisance telemarketers who don’t deserve a call back.
Personally, I don’t think an outgoing message stating that we don’t have any openings is much better than not calling back for all the same reasons. We are healers. No matter how busy we are; no matter how stretched by current patients; no matter how sure we are that someone else will take care of it; a call for help deserves a call back.
When we don’t have any openings, a compassionate no, followed by suggestions of where a person can get immediate help lets the caller know that they are heard, that they are not alone or inappropriate, that they are correct to ask for help. Suggestions like these offer the caller options for doing some self-care while they wait to get an appointment.
· Have a list of emergency numbers on your desk. Include the hospitals, shelters, and services that offer immediate help for those who are addicted, abused, or desperate.
· Maintain a list of community resources and local agencies that offer support groups. Your local newspaper may provide a list of on-going groups for various issues (grieving, cancer support, parenting, families of the addicted, etc.)
· Suggest online support groups as a resource while the client waits to get into therapy. PsychCentral alone has more than 250 support groups online where people from all over the world offer each other support and practical advice.
· If the caller is a reader, bibliotherapy can get them started on a journey of self-care. Keep a list of helpful books for various diagnoses.
· If the caller belongs to a community of faith, remind them that they can talk to their clergy.
· If possible, join (or create) an email list-serve of therapists who then stay aware of who has openings so a prospective client can be referred on to someone who can offer an appointment in a reasonable amount of time.
My friend found out her workplace has an Employee Assistance Program (EAP) where she’ll get an intake and maybe some assistance in finding a therapist for follow through. Hopefully a local therapist will have the time to take on a new client.
In the meantime, she was also open to doing some reading, to talking to friends, and to making some lifestyle changes. It’s a start. But that doesn’t take away the sting of not getting one call back after leaving messages for, now, 18 area therapists. Really. We can, and should, do better than that.