When Carolyn Levitan answered the phone, she heard the voice of a man having a full-blown anxiety attack about possibly having contracted coronavirus.

He was speaking rapidly. He was worried he had it, and feared giving it to family members. He wondered if it would be alright for him to pet his dog. And then he worried about dying and leaving behind family because he knew others who had died from the virus.

These are the types of panic-stricken calls Levitan has been taking as crisis line director at Didi Hirsch Mental Health Services in Los Angeles. Didi Hirsch is one of three centers in the nation that takes calls on the suicide hotline as well the national Disaster Distress Helpline that operates around the clock to help victims of natural and man-made disasters deal with emotional and mental health issues.

In February, Levitan and her colleagues — 70 full-time staff members and 215 volunteers — took 22 calls on the suicide and disaster helplines related to coronavirus. In March, that number soared to 1,800 calls — more than an 8,000% increase.

Losing hope during the pandemic

What’s even more concerning is that a lot of the callers were already having suicidal thoughts, Levitan said.

“Suicidal thoughts stem from a sense of hopelessness, helplessness, or lack of plans or goals for the future,” she said. “The coronavirus pandemic has exacerbated those feelings in people. If things felt bad before, they can really feel hopeless in today’s environment.”

Levitan said she was able to calm down the anxious man who called about a week ago by getting him to “focus on the here and now,” as she does with others in a similar predicament. Like the woman in her 90s who hadn’t eaten or drank water all day because she was upset about not being able to go to church on Easter Sunday or see her friends and family.

“I talk to them about what they can do today to take care of themselves,” she said. “Do you want to lie down and take a nap? Do you want to watch a YouTube video? When we take little steps, it can make what feels like an insurmountable situation more manageable.”

The man Levitan talked to decided he would take some time to himself to calm down, and the elderly woman agreed to get something to eat and talk to a few friends over the phone.

Levitan says that while a lot of these people who call in crisis mode don’t talk about suicidal thoughts, they could become suicidal if they don’t get timely support.

Ramping up for worse

Didi Hirsch, which operates 10 locations in Los Angeles and Orange counties, is hiring and training more staff members to take these hotline calls from remote locations because of social distancing measures.

Other agencies also are ramping up for a significant increase in the volume of calls to suicide and mental health hotlines.

Riverside County’s crisis and suicide helpline also has experienced an increase in virus-related calls, said Rebecca Antillon, a program coordinator with the county Public Health Department who also runs its teen suicide awareness and prevention program.

“We’ve also seen a complexity of calls — individuals experiencing economic stress, social isolation and increases in domestic violence or abuse. At the same time, there is a decrease in access to community and religious support.”

Antillon said she expects the call volumes to increase as the response to COVID-19 continues and social distancing mandates remain in place.

“We’re certainly looking for ways to ramp up resources and preparation,” she said.

With school campuses closed, the county has moved its teen suicide awareness and prevention efforts online, Antillon said. In addition, the county has opened up a dedicated support line (951-955-7015) for front-line health-care workers, essential workers such as grocery store employees and first-responders who may be struggling emotionally and need help.

The county’s mental health helpline (CARES) currently has 12 staff members to answer phones and refer callers for care to the Riverside University Health System’s contracted community provider outpatient clinics, said Thomas Peterson, a spokesman for the health system’s behavioral health division.

During the pandemic, the CARES line has as many as eight additional clinicians on site to help with increases in call volumes, he said.The call system also allows some staff members to work at home.

Helping vulnerable populations

While people in all age groups are struggling, this can be a tough time for teenagers in particular, said Michelle Carlson, executive director of Teen Line, a Los Angeles-based national and international helpline for teens.

“In this environment, family relationships is the number one reason youth are contacting us,” she said. “Young people are experiencing huge increases in stress, anxiety and loneliness. We’re also seeing a significant increase in child abuse reports. It’s very concerning.”

Teen Line is manned by 145 trained youth volunteers who are now taking calls, under supervision, remotely through Zoom, Carlson said. The majority of the call volume consists of texts and emails from countries as far away as India, Australia and South Africa, she said.

“The most important thing right now is to approach your kids with empathy,” Carlson said. “They are dealing with their own losses — not being able to see friends or participate in school events like sports, prom or graduation. This time is not normal and it’s OK to acknowledge that.”

Parents can be more relaxed when it comes to schedules and engage youth in fun activities such as having a family dance party, watching a movie or playing board games, she said.

“And really, the best thing you can do for your kids in these challenging times is to listen to them.”

The Trevor Project, a national organization based in Los Angeles that serves the LGBTQ community, says the volume of youth reaching out to their crisis services programs has more than doubled since the pandemic began, spokesman Rob Todaro said. Mentions of the coronavirus have increased by more than 60 times over the past month, now comprising a quarter of crisis services conversations with LGBTQ youth, he said.

An unintended consequence of physical distancing is the potential loss of the social connections that protect LGBTQ youth from suicidal tendencies, Todaro said.

Coping with the crisis

When people are faced with a change that is unrelenting, monumental and affecting different aspects of their lives, it is natural for them to become stressed and anxious, said Jay Kumar, director of contemplative practices and well-being at the Fish Interfaith Center at Chapman University in Orange.

Kumar said there are steps everyone can take to overcome such anxieties.

“Take comfort in routine and regularity,” he said. “Stick to the time when you wake up. Keep your lunch break. Make your gym time your workout time.”

It’s also important to connect to friends and family by harnessing technology, Kumar said.

“One thing I do for my colleagues is have a weekly check-in,” he said. “It can certainly help to hit the pause button because we’re constantly bombarded with information and news from the media. Finally, be compassionate to yourself and others — be it grocery store clerks or your loved ones.”

On Thursday, April 16, Kumar kicked off a free, weekly webinar series titled “Healthy Brain, Healthy Mind,” offering advice and tools to promote emotional and mental well-being in the time of COVID-19. The next webinar, from 3-4 p.m. April 23, will focus on ways to manage work, family and life while self-isolating.

Adjusting and adapting

While there is no current data indicating a rise in suicides, suicide rates historically have increased after economic downturns in the last century, said Kita Curry, president and CEO of Didi Hirsch Mental Health Services.

“In a crisis, people are focused on basic needs like toilet paper, groceries and staying healthy,” she said. “So they might not be thinking about ending their lives. But as the economic struggles persist and long after we start going to concerts and the movies, high suicide risk factors remain because a lot of people would have suffered significant losses during the pandemic. When you don’t know how to get your job back or house back, it’s erosive in terms of your mental health.”

The coronavirus pandemic is different from almost all other natural disasters because the counselors who are handling calls are experiencing the same kinds of worries and anxieties as their callers, Levitan said.

“We always debrief after calls and take care of our staff,” she said. “We tell people if they feel unsafe, they shouldn’t come in. I feel blessed to be able to go in to the office and having that social connection with one another while maintaining the physical distance. We turn to one another a lot for support. This is the first time we’re all taking calls about what we’re experiencing as well.”

Employees who do come in to the office take their temperatures before entering their workplace, wear masks and sanitize their work stations.

“We have emergency plans for when our buildings burn down,” Levitan said. “But, we never foresaw a situation where you would not be able to take calls anywhere except your home. We’re adapting quickly, even training people remotely.”

They are ready for increases in call volumes, she said.

“We see people are burning through their savings, losing jobs and becoming more isolated,” Levitan said. “We are taking the necessary steps to make sure we’re there for people when they need us the most.”

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Crisis lines and resources

Teen Line: 1-800-852-8336 or text “TEEN” to 839863

The Trevor Project: 1-866-488-7386, via chat every day at TheTrevorProject.org/Help, or by texting “START” to 678678

Didi Hirsch crisis counselor: 1-800-273-8255

National Suicide Prevention Lifeline: 1-800-273-8255

National Disaster Distress Helpline: 1-800-985-5990

Riverside County Suicide Helpline: 951-686-HELP (4357)

Riverside University Health System Behavioral Health: CARES Line (1-800-706-7500); Substance Use CARES Line (1-800-499-3008); dedicated crisis line for health-care workers, essential workers and first-responders (951-955-7015).