Photo: RNZ / Rebekah Parsons-King
Telehealth providers are dealing with increasingly complex and serious mental health issues, as dire workforce shortages make it difficult to see a psychologist or psychiatrist in person.
The services were originally designed for people with mild-to-moderate health needs.
But the number of people reaching out via text or phone for help who were at risk of harming themselves jumped to 15 percent - double the amount five years ago.
Telehealth providers were confident they could do their part in meeting the increased need, while other mental health professionals worried about how much could be achieved without face-to-face therapy.
Dr David Codyre is the lead psychiatrist at Whakarongorau, a social enterprise which runs several mental health hotlines.
Dr David Codyre Photo: RNZ / Luka Forman
He was concerned about the increasingly serious calls they were getting, but not surprised.
"I think it reflects increasing numbers of people experiencing distress out there in the community ... the services here were set up really as a response to more mild-to-moderate need. That's reflected in the way we staff our services. What we're seeing though is increased need and complexity. So we've had a big task on our hands."
The advantage of telehealth services was that a person could talk to someone at any time and from any place, Codyre said.
"Being available 24/7 and also without the kind of tyranny of geography, it means that rural communities, people who reach us out of hours, all of those kinds of areas of need are better met."
But the service was focused on short-term interventions, and they often directed people to in-person health professionals for further help, he said.
Their phone and text lines were anonymous, and callers or texters would not talk to the same person each time they got in contact.
Telehealth dealing with increasing serious mental health issues
New Zealand College of Clinical Psychologists strategic advisor Paul Skirrow said with lengthy waiting lists to see their members, many people did not know where to turn.
"There's not a lot of help available. So crisis hotlines are for people in crisis, and we're seeing and hearing that people are in much greater need."
It was positive to see people reaching out to talk to someone, but telehealth providers would only ever be part of the picture, he said.
"They can never meet the needs of complex people. They can do a small part of it. A little bit like a GP can say 'I can do my part but I can never offer the full range of treatment'."
Youthline, a telehealth charity aimed at young people, was also seeing an increase in complex and serious mental health calls.
General manager of services Megan Grimwood said the shortage of mental health specialists was not helping, but it was hard to say for sure what the cause was.
"I think there is a lot of complexity, and there doesn't seem to be any one clear answer on what is driving the increase in complexity. There's been a hypothesis around social media and around the economic challenges that young people are facing all playing into that."
The service was originally designed for mild to moderate mental health needs, and they had had to train staff to deal with more serious calls, Grimwood said.
Those taking calls at Youthline included psychology interns, volunteers, and clinically trained staff.
Where to get help:
Need to Talk? Free call or text 1737 any time to speak to a trained counsellor, for any reason.
Lifeline: 0800 543 354 or text HELP to 4357
Suicide Crisis Helpline: 0508 828 865 / 0508 TAUTOKO (24/7). This is a service for people who may be thinking about suicide, or those who are concerned about family or friends.
Depression Helpline: 0800 111 757 (24/7) or text 4202
Samaritans: 0800 726 666 (24/7)
Youthline: 0800 376 633 (24/7) or free text 234 (8am-12am), or email talk@youthline.co.nz
What's Up: free counselling for 5 to 19 years old, online chat 11am-10.30pm 7days/week or free phone 0800 WHATSUP / 0800 9428 787 11am-11pm Asian Family Services: 0800 862 342 Monday to Friday 9am to 8pm or text 832 Monday to Friday 9am - 5pm. Languages spoken: Mandarin, Cantonese, Korean, Vietnamese, Thai, Japanese, Hindi, Gujarati, Marathi and English.
Rural Support Trust Helpline: 0800 787 254
Healthline: 0800 611 116
Rainbow Youth: (09) 376 4155
OUTLine: 0800 688 5463 (6pm-9pm)
If it is an emergency and you feel like you or someone else is at risk, call 111.