Caring contacts: a compassionate grassroots response to COVID-19 that is based on science

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Canadians are writing letters, sharing family stories and pet pictures in cheerful dispatches to lonely seniors at nursing homes. Others are making regular calls to people they have never met, just to check in.

In the midst of a pandemic, a grassroots movement of compassionate contacts has emerged – the very approach advocated by many experts as an essential part of mental health care.

Even before COVID-19 further isolated people, “caring contacts” were seen as an important touchstone to the outside world for people struggling with depression and loneliness. In suicide prevention research, these brief check-ins have been found to save lives.

Versions of caring contacts have been successfully tested in countries around the world; a new mental health program in France aims to provide a caring contact to every person, young and old, who visits an emergency department after a suicide attempt. In Canada, a few pilot projects have also been under way, most geared toward those deemed at high risk of suicide.

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Zena Samaan, a psychiatrist and suicide researcher at McMaster University who has been running a small pilot that makes regular calls to 50 people hospitalized for suicidal behaviour, said people need to feel connected, to know they haven’t been abandoned. “It’s a simple, common-sense intervention that keeps people well.”

The spontaneous initiatives expanding now are prompted more by what we instinctively know: Human contact motivated purely by compassion is essential to our well-being.

“She is my lifeline,” says Gorka Ancic, 69, who receives a call every other day from Gabrielle McMillan, one of the volunteers with the senior’s association, Life After 50, in Windsor, Ont. The non-profit is one of the many groups, including churches, with people making caring contacts – expanding on existing programs or adding phone check-ins as their members or clients have been forced to stay home, and give up their usual activities.

Family Services of the North Shore in British Columbia, for example, has volunteers reaching out to 300 seniors in North and West Vancouver. Many are low income and with chronic illnesses, said Laurie Kohl, director of community and provincial programs. The volunteers offer emotional support, but also find out if they need groceries or medication. “Social isolation has a really big impact on everyone’s health, but for seniors it’s even worse," Ms. Kohl said. “We wanted to reach out to let them know they’re not alone.”

Ms. Ancic, who takes oxygen for a lung condition, is especially vulnerable to COVID-19. The seniors in her apartment building are all self-isolating, and before her regular chats with Ms. McMillan, with her family living on the other side of Toronto, she worried about dying alone, with her Chihuahua mix, Moe, left to fend for himself. Now, she has Ms. McMillan checking in. They talk about the day, their shared habit of buying too much toilet paper, how Ms. Ancic is careful to only walk Moe when the other residents are eating and the elevator will be empty. “I sleep better knowing she is calling,” she said.

For Ms. McMillan, the calls she makes to a rotation of eight seniors are also spirit-lifting, even though some of them may only last a few minutes. Mostly, she listens. “It is really about letting them talk.” But Ms. McMillan, 64, benefits as well. “I get off the phone and I am always smiling.”

The original idea for caring contacts is credited to an American psychiatrist named Jerome Motto, who was inspired by the letters he received in the trenches during the Second World War. Between 1969 and 1974, Dr. Motto and his team started sending typed letters to patients at risk of suicide who had turned down treatment, and compared their outcomes with a control group of similar patients. In all five years of the study, the group receiving the letter had significantly lower rates of suicide.

In 2001, Dr. Motto published his work, and, since then, variations of that first trial have replicated around the world. Researchers are still sorting out the finer points: how often and what form of contact works best for which kind of patients. But different projects using caring contacts have since been developed in countries such as Norway, Denmark and Australia.

In Halifax, Alexis Blake, a 20-year-old university student, hadn’t heard of Dr. Motto’s work. But she said that being able to self-isolate with her family “made me realize how I would feel if I was actually home alone.”

Wanting to make a difference, she and a group of friends they recently started a project called Letters Against Loneliness.

So far, Ms. Blake said, they have received more than 50 letters e-mailed from several provinces and even overseas, some from relatives and friends, in both French and English. They will send them to long-term care homes where they can be handed out to residents. In the letters, people have described favorite meals, included poems and described the antics of their pets. Ms. Blake says her favourite letters have come from children, who usually writing run-on paragraphs describing what they did that day. Some authors have volunteered for their names to be included so the seniors who receive them can write back.

One of those writers was Deseray Jensen, a 26-year-old administrative assistant in Halifax, who read about the project on Facebook. “It will be all of us some day,” she said. “I hope someone will write me a letter.” She said she wanted her message to be forward-looking so she penned an ode to summer. “I hope you know that the sunshine will feel warm on your skin, and the comforting breeze will smell of sweet, fresh lawn clippings," she wrote.

That’s the message she figured everyone needs to hear right now: “It will be okay again, this won’t be forever." Until then, she hopes her letter lets someone know that they haven’t been forgotten.

If you would like to participate in Letters Against Loneliness, you can send your letter to: LettersAgainstLoneliness.can+submissions@gmail.com