Analysis of veterans crisis line data: Temporal factors associated with the initiation of emergency dispatches

Purpose: To identify temporal patterns of emergency dispatches as initiated by Veteran Crisis Line (VCL) responders and among moderate- and high-risk contacts.

Methods: Incidence rate ratios (IRRs) were used to examine the incidence of emergency dispatches among all 1,437,543 VCL contacts across 2019-2020.

Results: Emergency dispatches were initiated in 57,077 (4.0%) contacts. IRRs were elevated during Labor Day, IRR (95% CI) = 1.33 (1.15-1.54), and Independence Day, IRR (95% CI) = 1.22 (1.05-1.43), weekends, Saturdays, IRR (95% CI) = 1.04 (1.01-1.08), Sunday (reference), and 6 pm to 11:59 pm, IRR (95% CI) = 1.06 (1.04-1.09). IRRs for moderate- and high-risk contacts were higher on Memorial Day, IRR (95% CI) = 1.16 (1.00-1.33), Sunday (reference), and 6 pm to 11:59 pm (reference).

Conclusions: The initiation of emergency dispatches fluctuates over time and were highest during Labor Day and Independence Day, weekends, and evenings. Moderate- and high-risk contact also fluctuate over time and were highest on Memorial Day, Sundays, and midnight to 5:59 am. VCL policy makers can use knowledge of temporal fluctuations to allocate public health resources for increased efficiency and greatest impact; however, additional research on temporal stability and generalizability is needed.