More than one person a day contemplated dying by suicide in 2022 and this year, and reached out to the Richmond Foundation either by phone or chat.

Those seeking the NGO’s support were mainly dealing with depression, anxiety or relational issues.

Relational issues – whether between partners or children and their parents – have been on the increase since the COVID pandemic took the world by storm, with Richmond struggling to keep up with requests for help since.

In just three years, Richmond has had to double its therapists’ complement and quintuple its therapy space. Still, it is not enough.

“For the very first time, we now have a two- to three-month waiting list for one of our main services through which companies can provide psychological sessions to their employees while observing full confidentiality,” acting CEO Daniela Calleja Bitar told Times of Malta.

Every week, Richmond reworks its waiting list because at least 10 people need urgent therapy.

The challenges faced by Richmond are prevalent across the sector. Earlier this month, the president of the Chamber of Psychologists, Gail Debono said Malta was facing a “crisis in mental health services” with increased awareness leading more people to seek government services, where waiting lists keep getting longer and psychologists are burned out.

“This is the pandemic after the pandemic. But no one is speaking about it or is as alarmed as they were about the COVID pandemic,” Calleja Bitar said.

Her colleague, Lynn Sammut recalls that when she took over management of Richmond’s psychological support programmes, in 2020, she was faced with a “steady-flow service” offered to 75 companies through 15 therapists.

“COVID hit and everything was turned over its head. We now have 34 therapists and continuously hire more professionals. We went from having two to 10 therapy rooms… and it is still not enough.

“In 2020, we had a stable 300 sessions a month. We’re now at 750 with a demand for 900 sessions a month.”

Apart from an increasing number of people needing support, those facing mental health challenges are increasingly in need of more time with their therapists as they are coming up with more complex issues.

“While in pre-COVID times people would need, on average, six sessions with a therapist, now most are requesting extensions, with Richmond’s capacity of taking in new clients becoming very limited. Faced by this new reality, we are continuously seeking new therapists as the feedback shows that the service fosters a healthy working environment for the employers and the employees.

“Fortunately, we continue seeing companies wanting to support employees who might otherwise not afford to, resulting in a negative impact on their lives and that of their relatives.”

Richmond separately provides free or subsidised support to people from the public who do not afford therapy. The NGO has gone from very few people reaching out for this service in 2020 to €25,000 worth of therapy

in 2022, which it financed through fund raisers.

Richmond also offers a service through which people can just dial a number  or chat online with a professional.

In 2022, a total of 391 people with suicide ideation contacted Richmond on its 24/7 helpline 1770 or OLLI chat facility, both of which were partly funded by the government.

This year, although the foundation no longer affords to provide the service 24/7, projections show similar data.

Contact can remain anonymous but, according to information provided by the callers, Richmond has seen an increase in men aged in their late teens or early 20s – or their concerned relatives – who are contemplating suicide.

Casey Scicluna, head of Richmond’s programmes in the community, noted that, while no correlation could, as yet, be drawn between current mental health issues and COVID, during the pandemic people spent much more time with just one or two people and were cut off from colleagues and friends they used to meet on a daily basis.

This could have put a strain on the relationship between those two people and, once preventive measures were lifted, people had to relearn to socialise and adapt from scratch. It was especially hard for children and younger people because students went from learning social and negotiations skills at school to having their interactions limited by a screen.

Calleja Bitar and her colleagues believe that, apart from encouraging more people to enrol for psychology, psychotherapy, social work and other related courses and making the sector more attractive through financial incentives or tax reprieve incentives, early intervention services in mental health should be a priority.

“Richmond offers a service that allows school staff and older students to recognise symptoms of mental health challenges among their peers. The younger that children – especially boys – understand that it is ok to speak up, the better.

“We tell children to take care of their health, eat vegetables and remain physically healthy… we should similarly teach them how to take care of their mental health,” Calleja Bitar said.

“We all know the symptoms of a cold. If it goes on for more than three days, we know we have to seek medical attention as otherwise we risk it getting worse.

“If you don’t feel OK for more than two weeks, reach out. If you have a low mood, feel you want to isolate, low motivation to take a shower or a change in appetite, just go to your GP. They will know what to do.”

Mental health first aid steps

If you suspect someone you are in contact with is suicidal, you can help them.

Ask them directly – are you having thoughts of suicide or are you thinking of killing yourself?

If they say yes, ask if they have a plan and do not leave them alone.

Listen to them without judgement. Reassure them and let them know that suicidal thoughts may often be associated with treatable mental illness.

Always link them to professional help as soon as possible – a GP or a mental health professional if there is no urgency. GPs will then link them to appropriate professional help.

If it is urgent, call 112. The Accident and Emergency Department has a psychiatrist on call 24/7.

You can also call the Mental Health Helpline 1579, including at night.

If you are feeling depressed and need support, or if you need guidance on how to help someone who is suicidal, you can call Richmond Malta’s helpline on 1770 Monday to Friday between 8am and 8pm, and on Saturday till 4pm. Alternatively, type OLLI.Chat on your desktop, mobile or tablet browser to chat with a professional.