How do frequent users of crisis helplines differ from other users regarding their reasons for calling? Results from a survey with callers to Lifeline, Australia’s national crisis helpline service

Crisis helplines are designed to provide short-term support to people in an immediate crisis. However, there is a group of users who call crisis helplines frequently over an extended period of time. The reasons for their ongoing use remain unclear. The aim of this study was to investigate the differences in the reasons for calling […]

Frequent callers to crisis helplines: Who are they and why do they call?

Objective: Frequent callers present a challenge for crisis helplines, which strive to achieve optimal outcomes for all callers within finite resources. This study aimed to describe frequent callers to Lifeline (the largest crisis helpline in Australia) and compare them with non-frequent callers, with a view to furthering knowledge about models of service delivery that might meet […]

Predicting suicide risk in real-time crisis hotline chats integrating machine learning with psychological factors: Exploring the black box

Background This study addresses the suicide risk predicting challenge by exploring the predictive ability of machine learning (ML) models integrated with theory-driven psychological risk factors in real-time crisis hotline chats. More importantly, we aimed to understand the specific theory-driven factors contributing to the ML prediction of suicide risk. Method The dataset consisted of 17,654 crisis […]

A machine learning approach to identifying suicide risk among text-based crisis counseling encounters

Introduction: With the increasing utilization of text-based suicide crisis counseling, new means of identifying at risk clients must be explored. Natural language processing (NLP) holds promise for evaluating the content of crisis counseling; here we use a data-driven approach to evaluate NLP methods in identifying client suicide risk. Methods: De-identified crisis counseling data from a regional text-based […]

Bridging the gap: A qualitative study of providers’ perceptions of a partnered crisis follow‑up program for suicidal patients post‑emergency department discharge

Background Effective interventions are needed to address suicide risk following discharge from the hospital emergency department or inpatient setting. Studies that examine follow-up contact methods show promise, but little is known about how follow-up programs are implemented in the real world and who is benefitting. The purpose of this formative evaluation and analysis was to […]

988 suicide & crisis lifeline: Messaging and communications to people at higher risk for or disproportionately impacted by suicide

In July 2022, the U.S. transitioned the 10-digit National Suicide Prevention Lifeline to 988, an easy-to-remember three-digit number for 24/7 crisis care. Since its launch (using data from July 2022 to July 2023), reports show 988 “has received almost 5 million contacts, of which nearly 1 million are from the Veterans Crisis Line—a part of […]

Mental wellbeing and resilience in suicide prevention crisis line volunteers

Crisis line volunteers are critical to nationwide suicide prevention efforts as they provide free support services to those experiencing emotional distress or suicidality. Most crisis lines rely on volunteers for call-taking, however, the experiences of these volunteers and the impact of call-taking on their mental wellbeing remains understudied. The current study aimed to explore mental […]

The impact of the COVID-19 pandemic on calls to a national suicide prevention hotline in Taiwan: An analysis of time trend and characteristics of calls

We investigated the impact of the COVID-19 pandemic on call volumes and call characteristics using data from a national crisis helpline. Data were extracted for 215,066 calls to Taiwan’s national suicide prevention hotline (January 2018–May 2020). We used negative binomial regression to investigate changes in the weekly number of calls during the early period of […]

Measuring associations of the department of Veterans Affairs’ suicide prevention campaign on the use of crisis support services

Campaigns have become popular in public health approaches to suicide prevention; however, limited empirical investigation of their impact on behavior has been conducted. To address this gap, utilization patterns of crisis support services associated with the Department of Veterans Affairs’ Veterans Crisis Line (VCL) suicide prevention campaign were examined. Daily call data for the National […]

Mental wellbeing and resilience in suicide prevention crisis line volunteers

Crisis line volunteers are critical to nationwide suicide prevention efforts as they provide free support services to those experiencing emotional distress or suicidality. Most crisis lines rely on volunteers for call-taking, however, the experiences of these volunteers and the impact of call-taking on their mental wellbeing remains understudied. The current study aimed to explore mental […]

Reasons to love life: Effects of a suicide-awareness campaign on the utilization of a telephone emergency line in Austria

Background: A suicide awareness campaign was initiated in the Austrian federal state of Styria to increase help-seeking behavior in the population. Billboards were shown throughout Styria depicting joyful everyday-life situations with a focus on social and family connectedness, and promoting the Telephone Emergency Service, a crisis hotline. Aims: The present study investigated the impact of this campaign […]

Systematic review of research and interventions with frequent callers to suicide prevention helplines and crisis centers

Background: Helplines worldwide have frequent callers who may occupy a large proportion of call volume. Therapeutic gain from frequent calling has been questioned. We conducted this review to identify the characteristics of frequent callers and to compile recommendations about how best to help them. Method: Using preferred reporting items for systematic reviews and meta-analyses (PRISMA) standards, we searched […]

New COVID-19 challenges and response strategies adopted by a national suicide prevention hotline: A qualitative study

Crisis helplines provide important support for vulnerable individuals during the COVID-19 pandemic, which may also impact the helplines. We explored the challenges that the pandemic brought to Taiwan’s national suicide prevention hotline and the hotline’s responses. We interviewed 14 hotline workers and conducted data analysis using the framework method. The pandemic posed two new challenges […]

National guidelines for child and youth behavioral health crisis care

The National Suicide Prevention Lifeline transitioned to the 988 Suicide and Crisis Lifeline in July 2022. This free, confidential system provides 24/7/365 behavioral health crisis response through text, chat, and voice calls.  Congress increased its appropriation for the crisis center service to address rising rates of behavioral health crises across America. This transition represents an […]

Adolescents’ engagement with crisis hotline risk-management services: A report from the Emergency Department Screen for Teen Suicide Risk (ED-STARS) study

Objective This study examines the feasibility of a risk-management protocol for adolescent research participants at risk for suicide that relies on engagement with telephone crisis counselors. The study also examines whether engagement is moderated by adolescent demographics and clinical characteristics. Method Participants were 234 adolescents (83% female; 63% White) ages 12–18 (M = 15.3 years) drawn from the […]

Safety planning on crisis lines: Feasibility, acceptability, and perceived helpfulness of a brief intervention to mitigate future suicide risk

Background The role of crisis hotlines traditionally was limited to de-escalation and service linkage. However, hotlines are increasingly recruited to provide outreach and follow-up to suicidal individuals. Hotlines have the opportunity to not just defuse current crises but also provide brief interventions to mitigate future risk. The Safety Planning Intervention (SPI) is a brief intervention […]

Calls to helplines in Australia following media reports of Robin Williams’ suicide

Objective In the United States, there was an increase in calls to helplines following media reporting of Robin Williams’ suicide. We aimed to determine whether this was the case in Australia. Method The helpline services Lifeline and Beyond Blue provided us with weekly data on calls received for 2013–2015. We conducted interrupted time series regression […]

Veterans’ satisfaction and perspectives on helpfulness of the Veterans Crisis Line

Objective Crisis hotlines are an important part of a public health approach to suicide prevention. The Veterans Crisis Line (VCL) provides hotline services to Veterans. There is a paucity of research concerning the effectiveness of the VCL. The current work describes efforts to establish groundwork for VCL effectiveness research. Methods 155 VCL users who were […]

How the helping process unfolds for clients in suicidal crises: Linking helping-style trajectories with outcomes in online crisis chats

Objectives Crisis counselors’ active listening and collaborative problem-solving helping styles have been associated with outcomes for clients in suicidal crises. These associations have been based on static conceptualizations of helping (i.e., helping style for the entire session). Our aim was to further understand how the crisis counseling helping process unfolds (i.e., helping trajectory) and helping […]

Crisis text-line interventions: Evaluation of texters’ perceptions of effectiveness

Objective Crisis Text Line (CTL), the largest provider of text-based crisis intervention services in the U.S., has answered nearly 7 million conversations since its inception in 2013. The study’s objective was to assess texter’s perceptions of the effectiveness of CTL crisis interventions. Method Survey data completed by 85,877 texters linked to volunteer crisis counselor (CC) reports […]

Conducting research in crisis helpline settings: Common challenges and proposed solutions

In this editorial the editors argue that researchers in crisis helpline settings should consider evolving theoretical understandings of suicidality when selecting outcome measures, and that increased consistency across studies in outcome measurement is needed. Using an upcoming crisis helpline study as an example, the editors offer solutions to common challenges in randomized controlled trial (RCT) […]

Youth crisis hotlines: Merging best practice suicide prevention with a system of care (IN: Youth Suicide Prevention and Intervention, edited by J.P. Ackerman & L.M. Horowitz)

In the USA, crisis hotlines, such as the National Suicide Prevention Lifeline, have become a valued resource for individuals experiencing a suicidal crisis. Often staffed by trained counselors, crisis hotlines can provide immediate support and can help to identify a caller’s problem and potential solutions, ensure the caller’s safety, and connect them with appropriate resources. […]

Help-seeker expectations and outcomes of a crisis support service: Comparison of suicide-related and non-suicide- related contacts to lifeline Australia

Lifeline Australia aims to prevent suicide and support community members in personal crisis via the provision of free anonymous telephone, online chat and text message services. This study aimed to identify the expectations and outcomes of Lifeline help-seekers, including whether there are differences between suicide-related and non-suicide-related contacts. Help-seekers (N = 553) who had previously contacted Lifeline […]