National guidelines for child and youth behavioral health crisis care

The National Guidelines for Child and Youth Behavioral Health Crisis Care offers best practices, implementation strategies, and practical guidance for the design and development of services that meet the needs of children, youth, and their families experiencing a behavioral health crisis. Additional technical guidance is provided in a companion report produced by SAMHSA in conjunction with the […]

Nonwillingness to return to the emergency department and nonattendance of follow-up care arrangements following an initial suicide-related presentation

Background: For people experiencing a suicidal crisis the emergency department (ED) is often the only option to find help. Aims: The aims of this study were (a) to identify predictors of patients’ nonwillingness to return to the ED for help with a future suicidal crisis, and (b) whether nonwillingness to return was associated with follow-up appointment nonattendance. Method: This study […]

Assessing crisis chat visitors’ capacity to regulate thoughts related to suicide: A brief scale

Background:Regulation of suicidal thoughts may be defined as a person’s beliefs about their capacity to control affective and cognitive processes related to suicide. The inability to regulate suicidal thoughts is related to persistent suicidal thoughts, intentions, attempts, and suicide. Aims: The purpose of this study was to validate a scale that counselors could use to assess chat visitors’ […]

A shelter in the storm: Acceptability and feasibility of a brief clinical intervention for suicidal crisis

Background: People attending the emergency department (ED) for suicidal crisis are at significantly higher risk of taking their own lives in the week following discharge. Aims: We aimed to evaluate the acceptability and feasibility of implementing a brief clinical aftercare intervention provided through Allied Health Brief Therapies (AHBTs) Clinics. Method: Consecutive referrals (n = 149) to the clinics following assessment in […]

The development of an online training tool for crisis supporters on late life suicide: Improving knowledge while promoting empowerment

Telephone crisis services have an increasing role in suicide prevention yet existing interventions have not empowered crisis supporters with adequate education targeting the needs of older people in crisis. An existing educational intervention was adapted for crisis supporters through collaboration between a crisis support service, clinician researchers, and an eLearning technology company. Empowering crisis supporters, […]

Perceptions of public messaging to facilitate help seeking during crisis among U.S. veterans at risk for suicide

Objective The primary objectives of this study were to (1) examine how veterans at risk for suicide understand and interpret suicide prevention messages, and (2) identify message features that support (or hinder) help seeking behaviors. Method Individual virtual interviews (N = 40) were conducted from August 2018 to April 2019 with a nationwide sample of veterans who […]

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) […]

Suicide risk assessment fears, attitudes and behaviours of lifeline crisis supporters

Lifeline Australia operates crisis support services through Lifeline Crisis Supporters. An integral part of their role is to conduct online suicide risk assessments with help-seekers. However, there is limited literature regarding suicide risk assessment practices for this population. This study aimed to examine how suicide prevention training, vicarious trauma and fears impacted suicide risk assessment […]

An analysis of young clients’ communications about their suicidality on a text message helpline: “I’m scared of what I might do to myself”

Background: Youth suicide is a major international concern and prevention is a priority. In most cases suicidal behavior would be preceded by a period of suicidal ideation. Although feeling suicidal is recognized as a risk factor for suicide, there is little research which captures young people’s own experience of suicidality in a moment of crisis. Aims: This […]

Real-time suicide surveillance supporting policy and practice

Suicide mortality rates are a strong indicator of population mental-health and can be used to determine the efficacy of prevention measures. Monitoring suicide mortality rates in real-time provides an evidence-base to inform targeted interventions in a timely manner and accelerate suicide prevention responses. This paper outlines the importance of real-time suicide surveillance in the context […]

Suicide crises among women and mothers during and around the time of pregnancy: Prevalence and timing of initial contact with first responders and health services

Objectives: Suicide is a leading cause of maternal mortality. Suicidality during and around the time of pregnancy can have detrimental impacts on a child’s development and outcomes. This paper examines prevalence, demographic characteristics, and timing of initial contact with first responders and health services for a cohort of women who experienced suicidality during and around […]

A systematic review of user expectations and outcomes of crisis support services

Background: Crisis support services play an important role in providing free, immediate access to support people in the community experiencing a personal crisis. Recently, services have expanded from telephone to digital modalities including online chat and text message services. This raises the question of what outcomes are being achieved for increasingly diverse service users across different […]

Evaluation of outcomes for help seekers accessing a pilot SMS-based crisis intervention service in Australia

Background: In July 2018, Lifeline Australia launched Australia’s first short message service (SMS) crisis support service. Lifeline Text aims to reduce psychological distress and increase coping and social connectedness among help seekers, particularly those who prefer text-based communication. Aims: We aimed to independently evaluate the pilot SMS service over a 240-day period. Method: The service evaluation used operational data, pre […]

Characteristics and perceptions of sexual and gender minority youth who utilized a national sexual and gender minority-focused crisis service

Background: Sexual and gender minority youth (SGMY) have heightened risk of suicidality; yet, we know little about their experiences when utilizing crisis services. Aims: The purpose of this study was to understand the characteristics and experiences of SGMY when in contact with SGMY-specific suicide crisis services. Method: Data were from 592 SGMY who contacted the most widely utilized national US […]

Suicide exposure in crisis workers

Background: Crisis workers provide services to individuals who are in acute distress. There is no research examining personal and occupational exposure to suicide in these workers. Aims: We aimed to examine the prevalence of personal, occupational, and colleague suicide exposure among crisis workers, the mental health outcomes associated with suicide exposures, and perceived professional preparedness for client suicide. Method: Crisis […]

Implementation of a pilot SMS-based crisis support service in Australia: Staff experiences of supporting help-seekers via text

Background: Australia’s first short message service (SMS) crisis support service was launched by Lifeline Australia in July 2018. The pilot program was independently evaluated over a 240-day period. Aims: We aimed to examine the experiences of key staff employed in the Lifeline Text pilot and identify the skills and types of support required to deliver a high-quality SMS-based […]

Procedures for risk management and a review of crisis referrals from the MindSpot Clinic, a national service for the remote assessment and treatment of anxiety and depression

Background: The MindSpot Clinic (MindSpot) provides remote screening assessments and therapist-guided treatment for anxiety and depression to adult Australians. Most patients are self-referred. The purpose of this study was to report on the procedures followed to maintain the safety of patients and to examine the circumstances of urgent referrals to local services made by this remote […]

Implementation of a trauma-informed suicide prevention intervention for youth presenting to the emergency department in crisis

Given the increasing number of children presenting to the emergency department (ED) in psychiatric crisis, our tertiary children’s hospital ED adopted SAFETY-Acute/Family Intervention for Suicide Prevention (SAFETY-A), an evidence-based practice for suicide prevention. Because of the relationship between trauma and suicide among youth, this study piloted the feasibility of combining SAFETY-A and a standardized approach […]

Distant supervision for mental health management in social media: Suicide risk classification system development study

Background: Web-based social media provides common people with a platform to express their emotions conveniently and anonymously. There have been nearly 2 million messages in a particular Chinese social media data source, and several thousands more are generated each day. Therefore, it has become impossible to analyze these messages manually. However, these messages have been […]

Mental health service use before and after a suicidal crisis among children and adolescents in a United States national Medicaid sample

Introduction: Mental health follow-up after an emergency department (ED) visit for suicide ideation/attempt is a critical component of suicide prevention for young people. Methods: We analyzed 2009 to 2012 Medicaid Analytic EXtract for 62,139 treat-and-release ED visits and 30,312 ED-to-hospital admissions for suicide ideation/attempt among patients ages 6 to 17 years. We used mixed-effects logistic regression models […]

Typology and impact of YouTube videos posted in response to a student suicide crisis: Social media metrics and content analyses

Background: Videos relating to suicide are available on YouTube, but their characteristics and impacts have seldom been examined. Objective: This study aimed to examine YouTube videos posted in response to a sudden spate of student suicides in Hong Kong during the 2015-2016 school year and evaluate the impacts of those videos. Methods: Keyword search was […]

Negative life events and suicide in the National Violent Death Reporting System

Negative life events may be a major precipitating factor for suicide and may differ across sociodemographic groups. We used data from the National Violent Death Reporting System (NVDRS) to explore whether age, gender, current mental illness, and disclosure around suicide predicted adult decedents’ precipitants for suicide. Method: An NVDRS data set was used that included […]

Considerations for implementing a three-digit suicide prevention number in Canada: Policy brief

The purpose of this policy brief is to outline considerations for implementing a three-digit suicide prevention number in Canada. It reviews several relevant international contexts; specifically, the implementation of a three-digit suicide prevention and mental health crisis hotline (988) in the United States (U.S.) and the recently approved 113 number in the Netherlands. In addition, […]