What Is a Crisis? Perspectives of Crisis Support Help-Seekers.

Background: Understanding what types of crises help-seekers view as relevant for contacting crisis support services is needed to inform crisis service provision and training. Aims: This study aimed to explore help-seeker perceptions of what comprises a crisis, describing the main themes and examining how these relate to reasons for contact reported in previous research. This study further aimed to compare perceptions of what comprises a crisis between suicide-related and nonsuicide-related help-seekers. Method: As part of a larger online survey, Lifeline help-seekers (n = 375) responded to an open-ended question about their perceptions of personal crisis. Results: Thematic analysis identified 15 crisis themes. The most endorsed by all participants were family and relationship issues, mental health issues, and assault/trauma. Suicide-related help-seekers were more likely to identify suicidality as a crisis, whereas nonsuicide-related help-seekers were more likely to identify general life stress as a crisis. Limitations: The self-selected convenience sample limits generalizability. Conclusion: Help-seekers perceive crisis as a complex concept comprising many themes, with some similarities and differences between suicide-related and nonsuicide-related help-seekers. The findings may inform crisis helplines in promoting and tailoring their services to better meet user needs.

Consumer Perspectives on the Use of Artificial Intelligence Technology and Automation in Crisis Support Services: Mixed Methods Study.

BACKGROUND: Emerging technologies, such as artificial intelligence (AI), have the potential to enhance service responsiveness and quality, improve reach to underserved groups, and help address the lack of workforce capacity in health and mental health care. However, little research has been conducted on the acceptability of AI, particularly in mental health and crisis support, and how this may inform the development of responsible and responsive innovation in the area. OBJECTIVE: This study aims to explore the level of support for the use of technology and automation, such as AI, in Lifeline's crisis support services in Australia; the likelihood of service use if technology and automation were implemented; the impact of demographic characteristics on the level of support and likelihood of service use; and reasons for not using Lifeline's crisis support services if technology and automation were implemented in the future. METHODS: A mixed methods study involving a computer-assisted telephone interview and a web-based survey was undertaken from 2019 to 2020 to explore expectations and anticipated outcomes of Lifeline's crisis support services in a nationally representative community sample (n=1300) and a Lifeline help-seeker sample (n=553). Participants were aged between 18 and 93 years. Quantitative descriptive analysis, binary logistic regression models, and qualitative thematic analysis were conducted to address the research objectives. RESULTS: One-third of the community and help-seeker participants did not support the collection of information about service users through technology and automation (ie, via AI), and approximately half of the participants reported that they would be less likely to use the service if automation was introduced. Significant demographic differences were observed between the community and help-seeker samples. Of the demographics, only older age predicted being less likely to endorse technology and automation to tailor Lifeline's crisis support service and use such services (odds ratio 1.48-1.66, 99% CI 1.03-2.38; P<.001 to P=.005). The most common reason for reluctance, reported by both samples, was that respondents wanted to speak to a real person, assuming that human counselors would be replaced by automated robots or machine services. CONCLUSIONS: Although Lifeline plans to always have a real person providing crisis support, help-seekers automatically fear this will not be the case if new technology and automation such as AI are introduced. Consequently, incorporating innovative use of technology to improve help-seeker outcomes in such services will require careful messaging and assurance that the human connection will continue.

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 via telephone, online chat, or text message crisis services were recruited via social media and a link provided after Lifeline service use, who completed an online survey about their awareness, expectations and outcomes of Lifeline's services. The responses from help-seekers who self-reported suicide-related and non-suicide-related reasons for contact were compared. Participants were highly aware of Lifeline's services, particularly the phone service. The main expectations of all help-seekers were to feel heard and listened to, feel less upset and feel understood. There were 59.5% of the sample that reported suicidality as a reason for contact. Suicide-related contacts endorsed more reasons for contact than non-suicide-related contacts. Expectations of suicide-related help-seekers were greater, but they were less likely to report that their expectations were met. The high expectations and complexity of suicide-related contacts reveal the challenges in meeting the needs of this high-priority group, particularly within the context of the multiple demands on crisis support services.

Community expectations and anticipated outcomes for crisis support services-Lifeline Australia.

Crisis lines provide a critical first line of mental wellbeing support for community members in distress. Given the increasing referral to such services, there is a need to understand what the expectations of the community are around the role of such services in our public health responses. A computer assisted telephone interview was undertaken between 28th October and 30th November 2019. The aim was to explore expectations and anticipated outcomes of Lifeline Australia's crisis support services from a nationally representative community sample (N = 1,300). Analysis was undertaken to determine if demographic variables (age, gender, indigenous status, country of birth, culturally and linguistically diverse (CALD) status, sexual orientation, household composition, region and State/territory) and past service use affected community expectations. Results showed that a majority of respondents expected Lifeline to listen and provide support, recommend other services, and provide information. Help-seekers were expected to feel heard and listened to, receive safety advice or support to stay safe, and feel more hopeful. Lifeline was expected to prioritise people feeling suicidal, in immediate personal crisis, and experiencing domestic violence. Findings reveal that community members hold expectations for Lifeline Australia to serve as a suicide prevention and general crisis support service, which are congruent with the service's aims. There was little variation in community expectations of crisis support services based on demographic factors and past service use. The results show that the community has extensive and diverse expectations for this national crisis service to meet both short and longer-term needs for all vulnerable members of the community-entailing a very substantial public health service responsibility.

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 modalities. Aims: This systematic review aimed to determine the expectations and outcomes of users of crisis support services across three modalities (telephone, online chat, and text message/SMS). Method: Online databases (CINAHL, MEDLINE, PsycARTICLES, PsycINFO, Psychological and Behavioural Sciences Collection) and gray literature were searched for studies measuring expectations and outcomes of crisis support services. Results: A total of 31 studies were included in the review, the majority of which were telephone-based. Similar expectations were found for telephone and online chat modalities, as well as consistently positive outcomes, measured by changes in emotional state, satisfaction, and referral plans. Limitations/Conclusion: There is a paucity of consistent outcome measures across and within modalities and limited research about users of text message/SMS services.