OBJECTIVES: To analyse the calls received at a 24-hour helpline service at the Institute of Psychiatry during the first wave of the COVID-19 pandemic for the demographics of the service users, the reasons for calling, and the guidance provided. STUDY DESIGN: Descriptive retrospective clinical audit PLACE AND DURATION OF STUDY: The Institute of Psychiatry, Rawalpindi Medical University from June 2020 and February 2021. METHOD: The call records by psychiatry residents managing the helpline were analysed. Data regarding age, area of residence, and reasons for calling by the service users of the helpline, as well as the advice given by the resident on call were extracted. The findings were evaluated in terms of age, geographical distribution, reasons for seeking assistance, and the type of guidance provided. For data, compilation descriptive statistics were employed. RESULTS: Of the 102 calls analysed, most of the callers were between 30 to 39 years of age (33.3%), and hailed from Rawalpindi (78.4%), followed by Kashmir (5.9%), Chakwal (4.9%) and Murree (3.9%). The most frequently stated reasons for calling were to ask about availability of out-patient services (36.3%), to have medication revised (23.5%), and to enquire about the side effects of medication (11.8%). The responses to the callers were invitation to come to the hospital (44.1%), provision of relevant information about the particular questions asked (36.3%), adjustment of medications (11.8%), and prescribing medication with advice of physical follow-up (7.8%). CONCLUSION: There is a need to incorporate the use of technology in the delivery of psychiatric services to enhance accessibility and allow convenience. Future research should optimize interventions, assess long-term outcomes, and address challenges like privacy and access.