Crisis lines: Current status and recommendations for research and policy

Objective: The 988 telephone number was established by the National Suicide Hotline Designation Act of 2020 and implemented in July 2022 as a more accessible way to reach the National Suicide Prevention Lifeline. Current financial and training resources, however, are insufficient to ensure effective implementation. Methods: To better understand the state of the literature on […]

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 […]

Outcomes following suicidal crisis among hazardous and harmful alcohol users in the Crisis Resolution Team

Despite associations between alcohol use and suicidal acts, little research measures prognoses of alcohol-using patients treated by Crisis Resolution Teams (CRTs), an intensive community-based intervention. We estimated the association of alcohol use amongst patients accepted following suicidal acts or ideation in four London-based Crisis Resolution Teams, with death-by-any-cause or recontact with crisis care. We analysed […]

Integrating minority stress theory and the interpersonal theory of suicide among sexual minority youth who engage crisis services

Objective The present study sought to integrate minority stress theory (MST) and the interpersonal theory of suicide (ITS) to better understand high rates of suicide among sexual minority youth (SMY). To date, the ITS and MST have largely advanced independently from one another even though the research base for each theory contains gaps that the […]

Suicide mortality and related behavior following calls to the Veterans Crisis Line by Veterans Health Administration patients

Objectives To assess outcomes for Veterans Health Administration (VHA) patients following calls to the Veterans Crisis Line (VCL). Methods 158,927 VHA patients had an initial VCL call in 2010–2015 with documented identifiers. Multivariable proportional hazards regressions assessed risks of suicide and suicide-related behavior through 12 months. Covariates included age, sex, region, mental health encounters in the […]

A longitudinal examination of the interpersonal theory of suicide for predicting suicidal ideation among LGBTQ+ youth who utilize crisis services: The moderating effect of gender

Despite high rates of suicide among LGBTQ+ youth, the interpersonal theory of suicide (IPTS) has rarely been examined in this population. The current study utilized a longitudinal design to examine whether perceived burdensomeness and thwarted belongingness independently and simultaneously predicted higher levels of suicidal ideation over time in a sample of LGBTQ+ youth who utilized […]

National Suicide Prevention Lifeline crisis chat interventions: Evaluation of chatters’ perceptions of effectiveness

Objective As part of the National Suicide Prevention Lifeline’s crisis response system, the Lifeline Crisis Chat Network (LCC) answers chats from hundreds of thousands of at-risk individuals yearly. The study’s objective was to assess the effectiveness of these online crisis interventions. Method Data from 39,911 pre-chat surveys and 13,130 linked pre- and post-chat surveys completed by […]

Improving police responses to suicide-related emergencies: New evidence on the effectiveness of co-response police-mental health programs

Background Several police organizations have implemented training programs and co-response police-mental health programs to improve interventions among people in crisis. Some researchers have questioned the “one size fits all” approach of these programs and their ability to improve the management of specific psychosocial emergencies such as suicide-related behaviors. Objectives This study evaluates the effect of […]

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 […]

Lifeline Crisis Chat: Coding form development and findings on chatters’ risk status and counselor behaviors

Objective This study aimed to develop a reliable tool for the abstraction of data from crisis chat transcripts; to describe chatters’ suicide risk status and selected counselor behaviors; and to examine the relationship of chatters’ self-reported pre-chat suicidal thoughts to counselor behaviors and to chatters’ disclosures of suicide risk during the chat conversation. Methods Coders […]

Co-creating safe spaces: Study protocol for translational research on innovative alternatives to the emergency department for people experiencing emotional distress and/ or suicidal crisis

Introduction Safe spaces are an alternative to emergency departments, which are often unable to provide optimum care for people experiencing emotional distress and/or suicidal crisis. At present, there are several different safe space models being trialled in Australia. However, research examining the effectiveness of safe space models, especially in community settings, is rare. In this […]

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 […]