26 April 2024

Developing and delivering powerful telephone skills training

In the realm of mental health care, phone-based support is a lifeline for countless individuals in need of immediate assistance and emotional support. Registered healthcare professionals have traditionally shouldered the responsibility of handling these calls, but in recent times, non-registered staff have taken on these roles, often with inadequate training and preparation (Seeker, et al., 1999). Recognising the importance of effective communication in such roles, an initiative was launched to design and deliver a comprehensive telephone skills training program for non-registered NHS mental health call-handlers. This initiative aimed to enhance their communication skills, job performance, and ultimately, the quality of care provided to callers.

The Need for Training in Mental Health Call-Handling

Mental health call-handlers play a pivotal role in the healthcare system by being the first point of contact for individuals experiencing emotional distress, anxiety, or crisis. These call-handlers must possess the ability to provide empathetic, supportive, and non-judgmental assistance over the phone. However, many non-registered staff members who take on these roles lack the necessary training to engage effectively with callers. This training deficit can lead to misunderstandings, increased distress for callers, and job dissatisfaction among call-handlers.

The Hypothesis: Training for Improved Communication

The central hypothesis behind the initiative was that providing tailored training in telephone communication skills to non-registered NHS mental health call-handlers would result in a substantial improvement in their performance. Existing research has consistently shown that training in conducting supportive mental health conversations over the phone boosts staff confidence and positively influences their attitudes (Payne et al., 2002). Additionally, such training has the potential to enhance staff retention, which is crucial for maintaining a stable and competent workforce in mental health services.

Simulated Patients (SPs) as a Training Tool

To achieve these objectives, the initiative adopted an innovative approach by incorporating simulated patients into the training process. This decision was rooted in evidence suggesting that involving SPs in telephone-based training programs can be highly effective (Derkx et al., 2008). Experienced SPs were trained to assume the role of members of the community seeking assistance through the helpline. This allowed trainees to engage in realistic and immersive scenarios, simulating the challenges they would encounter while handling actual calls.

Benefits of Simulated Patient Training

Realism: The use of SPs in training brings a sense of authenticity to the learning process. Trainees are exposed to a variety of caller scenarios, which prepares them for the diverse range of calls they may receive in their role.

Safe Environment: SPs provide a safe and controlled environment for trainees to practice their skills without the pressure of handling real calls. Mistakes made during training can be valuable learning experiences.

Immediate Feedback: SPs can provide immediate feedback on the trainee’s communication style, allowing for continuous improvement. This feedback loop is essential for honing the skills necessary for effective call-handling.

Confidence Building: Through interaction with SPs, trainees build confidence in their ability to navigate challenging conversations and provide meaningful support to callers.

Empathy Development: Interacting with SPs helps trainees develop and enhance their empathetic skills, a critical component of effective mental health call-handling.


The initiative to design and deliver a telephone skills training program for non-registered NHS mental health call-handlers underscores the importance of effective communication in providing quality mental health support over the phone. By utilising simulated patients as a training tool, the program aims to improve communication skills, boost job performance, and ultimately enhance the care provided to vulnerable individuals in need. This innovative approach acknowledges the evolving landscape of mental health services and seeks to equip non-registered staff with the tools they need to make a meaningful difference in the lives of those they serve.

As we continue to adapt to the changing demands of mental health care, investing in the training and development of call-handlers is a crucial step in ensuring that individuals in distress receive the compassionate and effective support they deserve.


Secker J, Pidd F, Parham A. Mental health training needs of primary health care nurses. Journal of Clinical Nursing. 1999 Nov;8(6):643–52.

‌Payne F, Harvey K, Jessopp L, Plummer S, Tylee A, Gournay K. Knowledge, confidence and attitudes towards mental health of nurses working in NHS Direct and the effects of training. Journal of Advanced Nursing. 2002 Dec;40(5):549–59.

Derkx HP, Rethans JJ . E, Muijtjens AM, Maiburg BH, Winkens R, van Rooij HG, et al. Quality of clinical aspects of call handling at Dutch out of hours centres: cross sectional national study. BMJ. 2008 Sep 12;337(sep12 1):a1264–4.