Crisis Literature

Statistical Analysis
We employed multilevel modeling (i.e., mixed-effect regression analyses) to account
for the
hierarchical structure of our data (calls/callers nested within crisis centers). The
software
package, Supermix (2009), available from Scientific Software International was
used.
Supermix (2009) can fit models with both our dichotomous and continuous variables
with
nested data. The independent variables entered into each regression analysis were
training
status (with or without ASIST training) as a random effect, and the time period of
the
training session (July 2008, January 2009, or July 2009) as a fixed effect. All
statistical tests
were 2-sided. P values of less than .05 were considered to be statistically
significant. The
inter-rater reliability of the counselor behaviors and caller outcomes was assessed
using
intra-class correlation coefficients (for continuous scales) and kappa (for
dichotomous
items), employing SPSS, version 18 (PASW, 2009).

https://www.lifeline.org.au/Get-Help/Facts---Information/help-seeking

https://www.lifeline.org.au/ArticleDocuments/589/What%20is%20Helpseeking.pdf.aspx

An evaluation of crisis hotline outcomes. Part 2: Suicidal callers.

Gould MS1, Kalafat J, Harrismunfakh JL, Kleinman M.

Abstract

In this study we evaluated the effectiveness of telephone crisis services/hotlines, examining

proximal outcomes as measured by changes in callers' suicide state from the beginning to the end
of their calls to eight centers in the U.S. and again within 3 weeks of their calls. Between March
2003 and July 2004, 1,085 suicide callers were assessed during their calls and 380 (35.0%)
participated in the follow-up assessment. Several key findings emerged. Seriously suicidal
individuals reached out to telephone crisis services. Significant decreases in suicidality were
found during the course of the telephone session, with continuing decreases in hopelessness and
psychological pain in the following weeks. A caller's intent to die at the end of the call was the
most potent predictor of subsequent suicidality. The need to heighten outreach strategies and
improve referrals is highlighted.

National suicide prevention lifeline: enhancing mental health care for suicidal
individuals and other people in crisis.
Gould MS1, Munfakh JL, Kleinman M, Lake AM.
Abstract

Linking at-risk callers to ongoing mental health care is a key goal of crisis hotline interventions
that has not often been addressed in evaluations of hotlines' effectiveness. We conducted
telephone interviews with 376 suicidal and 278 nonsuicidal crisis callers to the National Suicide
Prevention Lifeline (Lifeline) to assess rates of mental health care utilization following Lifeline
calls and to assess attitudinal and structural barriers to service utilization. Postcall utilization
rates were approximately 50% for suicidal and crisis callers who received mental health care
referrals. Lack of health insurance and callers' perceptions about mental health problems
emerged as significant barriers to accessing continued help.
2012 The American Association of Suicidology.

http://aspe.hhs.gov/basic-report/aian-suicide-prevention-hotline