A lifeline under threat

For thousands affected by mental illness, Saneline provides a listening ear and a mine of information. But now, as it celebrates its 10th birthday, it is threatened by cuts, writes Virginia Ironside

I conducted a little experiment on my way from Shepherd's Bush, in west London, to the offices of Saneline in Whitechapel, in the east. How many obviously disturbed people would I encounter on the way – people who might welcome the support of the only nationwide phone-line that helps those affected by mental illness? I counted 23 characters who looked distinctly unstable – not including the dozens of normal-looking people who were doubtless suffering inside, or those whose friends or relations are suffering.

Saneline is celebrating its 10th birthday. It was started by the award-winning journalist Marjorie Wallace, founder of the mental-health charity Sane, after the phone lines to the BBC became jammed following a televised debate on mental health.

"At the time, there wasn't a national helpline for individuals and families affected by mental illness, and there was a desperate need for one," says Marjorie Wallace. "When we opened, we had so many calls that we had BT outside, drilling, to put in more lines." Now, Saneline, with centres in London, Macclesfield and Bristol, answers around 1,000 calls a week. Seventy-five per cent of the calls are from mentally ill people themselves, and 18 per cent are from carers. Just under half of the calls are from people under the age of 35. Their concerns range from depression, suicide, anxiety, schizophrenia, psychosis, to self-harm.

While I was visiting, a young woman rang. She had been self-harming. She used to stub cigarettes out on her arms, but had progressed to using her lighter. Casualty was fed up with her. There were times when she felt the pressure building up, with memories of childhood abuse and flashbacks of people hurting her. It had become overwhelming, to explosion point, but when she hurt herself there was an immediate release of tension. She said that when she'd rung a week ago, the volunteer had suggested that when she wanted to harm herself, she ring up, instead. She had managed this successfully for a week, and hadn't self-harmed. Would the volunteer on duty mind talking her through the crisis this time?

Saneline lets people ring when they feel helpless, and talk for as long as they like. "Sometimes, we talk for half an hour or longer. It's often the first time anyone has allowed them the time and space devoted to them alone," says Marjorie Wallace.

Their calls are answered by one of 200 volunteers, each of whom has been trained on a course endorsed by the Royal College of Psychiatrists. They also give callers information – which makes the service different from, say, the Samaritans. Saneline's database is the most comprehensive source of local and national information on mental-health services in the UK, containing over 16,000 records. Not only that but, if they're asked, the volunteers can give descriptions of symptoms of mental illness, the side-effects of specific drugs, details of therapies, and they can even explain mental-health law.

Gerry W, an insurance accountant, joined as a volunteer 10 years ago. His wife had suffered a breakdown and he had felt completely at sea. He realised how helpful it would have been to have had somewhere to ring for help. "I get calls from parents whose children have had breakdowns at university, distraught, and from suicidal youngsters," he says.

Those calls are difficult for the volunteers to bear. One had to listen to a young man who said he didn't want to go on living. He was walking to a bridge from which he intended to jump. He had already made five suicide attempts. He had been in and out of the mental-health system for 30 years. He had no family, friends, romantic relationships, no dreams. He didn't know why he had called but he stayed on the line until he got to the bridge. He said he felt like he was living on a desert island, alone, despite being on a very busy street. There was lots of noise and people, but he said he couldn't see or hear them. Then he hung up.

One of Saneline's most radical services is a callback system, which means that the caller may be asked if they want to be rung back at an agreed time. Sometimes, they don't even answer the phone when Saneline calls back, but write to say that just to hear the phone ringing was a comfort. Judy Wilson, the psychiatric nurse who is the head of the callback service, says: "Some people we ring back two or three times, and some we ring frequently over a period of years. I've rung someone back and they've just cried and cried. No one had ever rung them to ask how they were."

One of the many anxieties they hear is from parents of mentally ill children. Because their offspring are over 16, they have no say in how they are treated by the medical profession or social services. Unless the young people are sectioned, they are deemed to be capable of looking after themselves – and the families are left out in the cold. The service is also the last resort for children who are looking after parents who are mentally ill. One 11-year-old rang, worried not only because her mother hadn't taken her medication but because she had threatened to kill her. But she didn't dare to ring the social services because she neither wanted her mother to be sectioned nor to go into care herself. Saneline talked to her mother the next day, persuaded her to go back to her doctor, found a self-help group for children in similar circumstances, and keeps in touch with the child. She knows there is always someone to talk to.

In a world in which one in four people will experience some kind of mental-health problem in the course of a year, in which one person in the UK kills themselves every 79 minutes, and in which the World Health Organisation predicts that depression will be the second-biggest burden of disease by 2020, you'd think that a phone-line such as Saneline was essential. And yet, although it costs only £1m a year to run, it is, in its 10th year, struggling to survive.

The Government seems to imagine that NHS Direct can deal with callers such as those who ring Saneline, and, as a result, the funding for Saneline is drying up. But as anyone who has rung NHS Direct knows, there is no way that you could get from them a sympathetic listener with no time constraints, a list of local resources, and an offer of a call-back. "People ring us", says Marjorie Wallace, "precisely because they have already been let down by the health service. We planned to go 24 hours because there's a need, but now our very existence is under threat. If we were a donkey sanctuary, we'd have money coming out of our ears. Sick donkeys are far better treated than most of our callers."

Saneline: 0845 767 8000 (low-call rates), midday to 2am every day of the year. Donations can be sent to Sane, Freepost WD528, London E1 1BR

Some details in this piece have been changed slightly to protect anonymity