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1.
J Med Internet Res ; 26: e42049, 2024 May 15.
Article En | MEDLINE | ID: mdl-38748472

BACKGROUND: Building therapeutic relationships and social presence are challenging in digital services and maybe even more difficult in written services. Despite these difficulties, in-person care may not be feasible or accessible in all situations. OBJECTIVE: This study aims to categorize crisis counselors' efforts to build rapport in written conversations by using deidentified conversation transcripts from the text and chat arms of the National Child Abuse Hotline. Using these categories, we identify the common characteristics of successful conversations. We defined success as conversations where help-seekers reported the hotline was a good way to seek help and that they were a lot more hopeful, a lot more informed, a lot more prepared to address the situation, and experiencing less stress, as reported by help-seekers. METHODS: The sample consisted of transcripts from 314 purposely selected conversations from of the 1153 text and chat conversations during July 2020. Hotline users answered a preconversation survey (ie, demographics) and a postconversation survey (ie, their perceptions of the conversation). We used qualitative content analysis to process the conversations. RESULTS: Active listening skills, including asking questions, paraphrasing, reflecting feelings, and interpreting situations, were commonly used by counselors. Validation, unconditional positive regard, and evaluation-based language, such as praise and apologies, were also often used. Compared with less successful conversations, successful conversations tended to include fewer statements that attend to the emotional dynamics. There were qualitative differences in how the counselors applied these approaches. Generally, crisis counselors in positive conversations tended to be more specific and tailor their comments to the situation. CONCLUSIONS: Building therapeutic relationships and social presence are essential to digital interventions involving mental health professionals. Prior research demonstrates that they can be challenging to develop in written conversations. Our work demonstrates characteristics associated with successful conversations that could be adopted in other written help-seeking interventions.


Qualitative Research , Humans , Female , Male , Adult , Hotlines/statistics & numerical data , Crisis Intervention/methods , Writing , Communication , Middle Aged
2.
Harm Reduct J ; 21(1): 102, 2024 May 28.
Article En | MEDLINE | ID: mdl-38807227

The opioid epidemic remains one of the largest public health crises in North America to date. While there have been many diverse strategies developed to reduce the harms associated with substance use, these are primarily concentrated within a few large urban centers. As a result, there have been increased calls for equitable access to harm reduction services for those who cannot or choose not to access in-person harm reduction services. In December 2020, Canada's National Overdose Response Service (NORS) a telephone based overdose response hotline and virtual supervised consumption service, was established in collaboration with various agencies and people with lived and living experience of substance use (PWLLE) across Canada to expand access to harm reduction services using novel Opioid Response Technology. In this manuscript we explore the lessons learned from the establishment and continued operation of the service exploring topics related to the initial establishment of the service, securing a phone line, routing technology, EMS dispatch solutions, peer and volunteer recruitment, legal and ethical support, policy and procedure development, securing funding, and marketing. Furthermore, we detail how this service has grown and changed in response to the various needs of service users.


Drug Overdose , Harm Reduction , Humans , Canada , Drug Overdose/prevention & control , Hotlines , Telemedicine , Opioid-Related Disorders/prevention & control
3.
Front Public Health ; 12: 1337362, 2024.
Article En | MEDLINE | ID: mdl-38694977

Suicide has emerged as an urgent threat in recent years as COVID-19 impaired the health and economic wellbeing of millions of Americans. According to the Centers for Disease Control and Prevention, the impact of COVID-19 and the ongoing opioid epidemic has "taken a mental, emotional, physical, and economic toll on individuals, families, and communities," increasing the need for innovative solutions to prevent suicide on a national scale. The National Suicide Hotline Designation Act of 2020 established 988 as the universal telephone number for suicide prevention and represents a key federal intervention to address this crisis. However, research on 9-8-8's effectiveness is limited, given the Act's recent enactment and implementation at the federal and state levels. This policy analysis investigates how and to what extent the mental health crisis system in Georgia has improved since the implementation of the 2020 Act as well as the implications of state law on population-level mental health outcomes. Georgia is used as a nationally representative case study for two reasons: (1) Georgia had a robust statewide suicide hotline prior to 2020, providing solid infrastructure on which federal expansion of a suicide hotline number could be built, and (2) the conflicting characteristics of Georgia's mental health system represent several different pockets of the U.S., allowing this analysis to apply to a broad range of states and locales. The paper draws on takeaways from Georgia to propose state and national policy recommendations for equitable interventions to prevent and respond to this form of violence.


COVID-19 , Hotlines , Suicide Prevention , Humans , COVID-19/prevention & control , COVID-19/epidemiology , Georgia , Suicide/statistics & numerical data , United States , Health Policy , Policy Making , Mental Health
4.
Int Breastfeed J ; 19(1): 36, 2024 May 22.
Article En | MEDLINE | ID: mdl-38778298

BACKGROUND: Remote forms of breastfeeding support, such as helplines and social media, offer a flexible and convenient form of support to offer help at critical points, e.g., when the risk of breastfeeding cessation is high. Currently, there is little known about who accesses different forms of remote breastfeeding support and what factors impact overall satisfaction. As part of an evaluation of the UK National Breastfeeding Helpline (NBH) (which offers breastfeeding support via a helpline and online media), we aimed to (a) understand who accesses different forms of NBH support, and (b) identify key factors associated with overall satisfaction for helpline and online media support. METHODS: All service users who contacted the NBH between November 2021 and March 2022 were invited to participate in the evaluation via an online survey. Survey questions explored the type and timing of support, reasons for the contact, attitudes towards the help and support received, impact of the support on breastfeeding experiences and demographic factors. Chi-squared and Mann-Whitney tests explored variations in who accessed the helpline or online media. Multiple linear regression models were fitted to explore the factors related to the service users' 'overall satisfaction'. The quantitive data were combined with qualitative comments into descriptive themes. RESULTS: Overall, online media users were significantly more likely to be younger, White, multiparous, less educated and have English as a first language compared to those who contact the helpline. Similar factors that significantly influenced overall satisfaction for both support models were the service being easy to access, receiving helpful information that met expectations, resolving breastfeeding issues, and feeling reassured and more confident. Significant factors for the helpline were callers feeling understood and more knowledgeable about breastfeeding following the call, being able to put into practice the information provided, feeling encouraged to continue breastfeeding, feeling that the volunteer gave the support that was needed, and seeking out additional support. CONCLUSIONS: Online and helpline forms of breastfeeding support suit different demographics and call purposes. While optimal breastfeeding support needs to be accessible, flexible and instrumental, helpline users need real-time relational support to deal with more complex challenges.


Breast Feeding , Social Support , Humans , Breast Feeding/psychology , Female , Adult , United Kingdom , Surveys and Questionnaires , Social Media , Young Adult , Hotlines , Patient Satisfaction , Mothers/psychology , Male
5.
Palliat Med ; 38(6): 625-643, 2024 Jun.
Article En | MEDLINE | ID: mdl-38708864

BACKGROUND: People with palliative care needs and their carers often rely on out-of-hours services to remain at home. Policymakers have recommended implementing telephone advice lines to ensure 24/7 access to support. However, the impact of these services on patient and carer outcomes, as well as the health care system, remains poorly understood. AIM: To evaluate the clinical- and cost-effectiveness of out-of-hours palliative care telephone advice lines, and to identify service characteristics associated with effectiveness. DESIGN: Rapid systematic review (PROSPERO ID: CRD42023400370) with narrative synthesis. DATA SOURCES: Three databases (Medline, EMBASE and CINAHL) were searched in February 2023 for studies of any design reporting on telephone advice lines with at least partial out-of-hours availability. Study quality was assessed using the Mixed Methods Appraisal Tool, and quantitative and qualitative data were synthesised narratively. RESULTS: Twenty-one studies, published 2000-2022, were included. Most studies were observational, none were experimental. While some evidence suggested that telephone advice lines offer guidance and reassurance, supporting care at home and potentially reducing avoidable emergency care use in the last months of life, variability in reporting and poor methodological quality across studies limit our understanding of patient/carer and health care system outcomes. CONCLUSION: Despite their increasing use, evidence for the clinical- and cost-effectiveness of palliative care telephone advice lines remains limited, primarily due to the lack of robust comparative studies. There is a need for more rigorous evaluations incorporating experimental or quasi-experimental methods and longer follow-up, and standardised reporting of telephone advice line models and outcomes, to guide policy and practice.


After-Hours Care , Palliative Care , Telephone , Humans , Cost-Benefit Analysis , Hotlines
6.
Palliat Med ; 38(5): 555-571, 2024 May.
Article En | MEDLINE | ID: mdl-38600058

BACKGROUND: Telephone advice lines have been recommended internationally to support around-the-clock care for people living at home with advanced illness. While they undoubtedly support care, there is little evidence about what elements are needed for success. A national picture is needed to understand, improve and standardise service delivery/care. AIM: To explore telephone advice lines for people living at home with advanced illness across the four UK nations, and to construct a practical framework to improve services. DESIGN: A cross-national evaluation of telephone advice lines using structured qualitative interviews. A patient and public involvement workshop was conducted to refine the framework. SETTING/PARTICIPANTS: Professionals with responsibilities for how palliative care services are delivered and/or funded at a local or regional level, were purposively sampled. RESULTS: Seventy-one interviews were conducted, covering 60 geographical areas. Five themes were identified. Availability: Ten advice line models were described. Variation led to confusion about who to call and when. Accessibility, awareness and promotion: It was assumed that patients/carers know who to call out-of-hours, but often they did not. Practicalities: Call handlers skills/expertise varied, which influenced how calls were managed. Possible responses ranged from signposting to organising home visits. Integration/continuity of care: Integration between care providers was limited by electronic medical records access/information sharing. Service structure/commissioning: Sustained funding was often an issue for charitably funded organisations. CONCLUSIONS: Our novel evidence-based practical framework could be transformative for service design/delivery, as it presents key considerations relating to the various elements of advice lines that may impact on the patient/carer experience.


Caregivers , Palliative Care , Qualitative Research , Humans , Caregivers/psychology , United Kingdom , Adult , Home Care Services , Female , Hotlines , Male , Telephone
7.
Clin Med Res ; 22(1): 6-12, 2024 Mar.
Article En | MEDLINE | ID: mdl-38609141

Objective: To determine if host genetics may be a risk factor for severe blastomycosis.Design: A cohort of patients who had contracted blastomycosis underwent targeted SNP (single nucleotide polymorphism) genotyping. The genetics of these patients were compared to a set of age and gender-matched controls and between patients with severe versus mild to moderate blastomycosis.Setting: The Marshfield Clinic Health System in central and northern WisconsinParticipants: Patients with a diagnosis of blastomycosis prior to 2017 were contacted for enrollment in this study. A phone hotline was also set up to allow interested participants from outside the Marshfield Clinic Health System to request enrollment.Methods: SNP frequency was assessed for significant differences between the patient cohort and controls and between patients with severe versus mild to moderate blastomycosis. We also tested the effect of Blastomyces species identified in clinical isolates on disease symptoms and severity.Results: No significant differences were found in SNP frequency between cases and controls or between those with severe or mild to moderate blastomycosis. We did detect significant differences in symptom frequency and disease severity by Blastomyces species.Conclusions: Our study did not identify any genetic risk factors for blastomycosis. Instead, the species of Blastomyces causing the infection had a significant effect on disease severity.


Blastomycosis , Humans , Blastomycosis/diagnosis , Blastomycosis/genetics , Blastomyces/genetics , Genotype , Ambulatory Care Facilities , Hotlines
8.
Int J Public Health ; 69: 1606941, 2024.
Article En | MEDLINE | ID: mdl-38651035

Objectives: We tested an adapted version of an effective U.S.-based peer-texting intervention to promote Quitline use and smoking cessation among rural participants in Vietnam. Methods: We conducted a two-arm randomized trial with participants recruited at four rural community centers. The intervention included peer messages sent for six months that promoted Quitline use and smoking cessation. Additionally, biweekly two-way text messages assessed participants' interest in Quitline referral and current smoking status. Comparison participants received only the bi-weekly text message assessment of their current smoking status. At six months, we assessed Quitline use and smoking cessation. Smoking cessation was assessed using the 7-day point prevalence question and verified with a carbon monoxide breath monitor (<=6 ppm). Results: Among 750 participants, the intervention had higher Quitline verified use (18%, 95% CI 0.14, 0.22) than comparison (1%, 95% CI .2, 2, p < 0.0001). Carbon-monoxide-verified smoking cessation did not differ between the two groups. However, intervention (28.3%, 95% CI) and comparison (28.1%, 95% CI) participants had substantial rates of carbon monoxide cessation at 6 months (both 28%). Conclusion: Our study highlighted the promise of texting interventions to extend tobacco control efforts in Vietnam.


Rural Population , Smoking Cessation , Text Messaging , Humans , Smoking Cessation/methods , Vietnam , Male , Female , Adult , Middle Aged , Peer Group , Health Promotion/methods , Hotlines
9.
J Psychiatr Res ; 174: 114-120, 2024 Jun.
Article En | MEDLINE | ID: mdl-38626561

Crisis line responders initiate emergency dispatches by activating 911 or other local emergency services when individuals are determined to be at imminent risk for undesired outcomes. This study examined the association of characteristics, psychiatric diagnoses, and somatic symptoms with emergency dispatches in a national sample. Veterans Crisis Line data were used to identify contacts (i.e., calls, texts, chats, emails) that were linked with medical records and had a medical encounter in the year prior to contact. Hierarchical logistic regression clustered by responders was used to identify the association among demographics, psychiatric diagnoses, and somatic disorders, and emergency dispatches. Analyses examined 247,340 contacts from 2017 to 2020, with 27,005 (10.9%) emergency dispatches. Odds of an emergency dispatch increased with each diagnosis (three diagnoses Adjusted Odds Ratio [AOR] (95% CI) = 1.88 [1.81,1.95]). Odds were highest among individuals with substance use disorders (SUD) (alcohol AOR (95% CI) = 1.85 [1.80,1.91]; drugs AOR (95% CI) = 1.63 [1.58, 1.68]), which may be a result of intoxication or overdose during contact, requiring further research. Having more psychiatric and somatic conditions was associated with greater odds of an emergency dispatch, indicating that comorbidity contributed to the need for acute care.


Mental Disorders , Humans , Male , Female , Middle Aged , Adult , Mental Disorders/epidemiology , Mental Disorders/diagnosis , United States/epidemiology , Substance-Related Disorders/epidemiology , Substance-Related Disorders/diagnosis , Aged , Young Adult , Veterans/statistics & numerical data , Somatoform Disorders/epidemiology , Somatoform Disorders/diagnosis , Hotlines/statistics & numerical data , Crisis Intervention/statistics & numerical data
10.
BMC Public Health ; 24(1): 1191, 2024 Apr 28.
Article En | MEDLINE | ID: mdl-38679706

BACKGROUND: During the Covid-19 pandemic, a number of hotlines/helplines/call centers was implemented to provide remote services and support public health. The objective of this study was to investigate the characteristics, challenges and lessons learned of implementing Covid-19 hotlines/helplines/call centers during the pandemic. METHODS: PubMed, Web of Science, Scopus, the Cochrane Library, IEEE Xplore, and ProQuest databases as well as Google Scholar were searched between 1st January 2020 and 31st December 2023 to retrieve relevant articles published in English. The quality and risk of bias of the studies were assessed using the Appraisal tool for Cross-Sectional Studies (AXIS), the Mixed Methods Appraisal Tool (MMAT), and Critical Appraisal Skills Programme (CASP) Checklist. RESULTS: In total, 43 out of 1440 articles were included in this study. About half of the hotlines/helplines/call centers were launched in March 2020 (n = 19). Providing psychological support (n = 23), reliable information about Covid-19 (n = 10), healthcare advices about Covid-19 (n = 8), and triage (n = 7) were the most common purposes of implementing these services. The most common challenges included a lack of physical examination, unavailability of hotlines/helplines/call centers at the point of need, and delay in updating Covid-19 information. The most common lessons learned were employing qualified staff, providing proper training, and getting feedback from the callers and operators. CONCLUSION: According to the results, most of the Covid-19 hotlines/helplines/call centers were launched in the early months of the pandemic, and about half of them were active seven days a week. Most of the operators were mental health providers and clinicians. The findings show the importance of continuous psychological support during crises, particularly when adequate information about the situation is not available. The challenges experienced by the callers and operators as well as the lessons learned by the service providers also need to be considered for future crises to increase the effectiveness of similar services.


COVID-19 , Call Centers , Hotlines , Humans , COVID-19/epidemiology , Hotlines/statistics & numerical data , Call Centers/organization & administration , Pandemics , SARS-CoV-2
11.
Br J Nurs ; 33(5): S12-S15, 2024 Mar 07.
Article En | MEDLINE | ID: mdl-38446506

BACKGROUND: The present study aimed to evaluate oncology patients' experiences with a hotline service in a tertiary cancer centre, identifying areas for local improvement and to inform the work of the hotline. METHODS: A link to an online platform to complete a survey was sent through bulk messaging to 3028 mobile numbers. The survey answers and results were saved and consolidated in the online platform. FINDINGS: The survey received 368 responses: 49% of participants had their calls answered within 10 minutes, while 18% (n=66) waited 30 minutes or more. Eighty-two per cent were satisfied with the length of time they waited to speak with a nurse and 71% reported that their overall experience was very good. Ninety-seven per cent of participants felt listened to and were offered support and 91% felt that their reason for calling was adequately addressed. CONCLUSION: The present study offers persuasive evidence indicating that oncology patients are largely satisfied with the hotline service; nonetheless, it is recognised that a more robust evaluation is needed. Regardless, the need for certain improvements has been identified to offer the potential to enhance patients' experience.


Hotlines , Neoplasms , Humans , Neoplasms/therapy , Medical Oncology , Emotions , Patients
12.
Psychogeriatrics ; 24(3): 617-626, 2024 May.
Article En | MEDLINE | ID: mdl-38433324

BACKGROUND: Young-onset dementia (YOD) community care requires personalised approaches. Yet, the specific details of YOD consultations are unclear. This study explored how initial consultations correlate with client profiles. METHODS: Data from regional YOD helplines were used to analyze the main characteristics of people living with YOD or who had concerns about the possibility of YOD (n = 132). Among several categorical variables, the following were used for analysis: age group, sex, type of living arrangement, employment status, presence of dementia, and content of the consultation. To identify groups of items that frequently occur together, strongly connected rules were identified using association rule analysis with the a priori algorithm. To focus on the characteristics of clients, rules related to client characteristics were extracted based on the type of consultation. RESULTS: A total of 51 rules were identified for the consultations. These rules fell into two categories: (1) consultations for medical matters, which mainly involved employed individuals with undiagnosed dementia, and (2) other consultations on daily life or work, which mainly involved individuals diagnosed with dementia and were characterised by the influence of sex. These rules indicate the importance of medical involvement in confirming the diagnosis and specific individualised care following diagnosis for people living with YOD. CONCLUSION: Clients with or without a dementia diagnosis were consulted differently in the YOD helplines. Before receiving a diagnosis, medical matters were the main theme of consultations, whereas after receiving a diagnosis, adjustments to daily life or work were the main themes. The results of this study suggest that the needs of people living with YOD and the services they require may vary depending on their backgrounds.


Age of Onset , Dementia , Humans , Male , Female , Dementia/diagnosis , Middle Aged , Aged , Hotlines/statistics & numerical data , Referral and Consultation/statistics & numerical data , Adult , Japan
14.
Spat Spatiotemporal Epidemiol ; 48: 100636, 2024 Feb.
Article En | MEDLINE | ID: mdl-38355257

In this study, we developed a negative binomial regression model for one-week ahead spatio-temporal predictions of the number of COVID-19 hospitalizations in Uppsala County, Sweden. Our model utilized weekly aggregated data on testing, vaccination, and calls to the national healthcare hotline. Variable importance analysis revealed that calls to the national healthcare hotline were the most important contributor to prediction performance when predicting COVID-19 hospitalizations. Our results support the importance of early testing, systematic registration of test results, and the value of healthcare hotline data in predicting hospitalizations. The proposed models may be applied to studies modeling hospitalizations of other viral respiratory infections in space and time assuming count data are overdispersed. Our suggested variable importance analysis enables the calculation of the effects on the predictive performance of each covariate. This can inform decisions about which types of data should be prioritized, thereby facilitating the allocation of healthcare resources.


COVID-19 , Humans , COVID-19/epidemiology , COVID-19/prevention & control , Hotlines , Vaccination Coverage , Hospitalization , Delivery of Health Care
15.
Harm Reduct J ; 21(1): 31, 2024 Feb 05.
Article En | MEDLINE | ID: mdl-38317194

BACKGROUND: In response to the exacerbated rates of morbidity and mortality associated with the overlapping overdose and COVID-19 epidemics, novel strategies have been developed, implemented, operationalized and scaled to reduce the harms resulting from this crisis. Since the emergence of mobile overdose response services (MORS), two strategies have aimed to help reduce the mortality associated with acute overdose including staffed hotline-based services and unstaffed timer-based services. In this article, we aim to gather the perspectives of various key interest groups on these technologies to determine which might best support service users. METHODS: Forty-seven participants from various interested groups including people who use substances who have and have not used MORS, healthcare workers, family members, harm reduction employees and MORS operators participated in semi-structured interviews. Transcripts were coded and analyzed using a thematic analysis approach. RESULTS: Four major themes emerged regarding participant perspectives on the differences between services, namely differences in connection, perceived safety, privacy and accessibility, alongside features that are recommended for MORS in the future. CONCLUSIONS: Overall, participants noted that individuals who use substances vary in their desire for connection during a substance use session offered by hotline and timer-based service modalities. Participants perceived hotline-based approaches to be more reliable and thus potentially safer than their timer-based counterparts but noted that access to technology is a limitation of both approaches.


Drug Overdose , Epidemics , Mobile Applications , Humans , Hotlines , Drug Overdose/epidemiology , Qualitative Research , Harm Reduction
16.
J Child Sex Abus ; 33(2): 183-203, 2024 Feb.
Article En | MEDLINE | ID: mdl-38358248

Sexual assault crisis hotlines provide crucial support for survivors. Though some hotline users engage in inappropriate conduct (e.g. prank or obscene calls), few studies explore these interactions. To address the lack of literature exploring inappropriate hotline interactions, we conducted a secondary data analysis of chat transcripts (n = 233) shared with the research team as part of the formative evaluation of a university-based sexual assault program's web-based crisis hotline. From those transcripts, we analyzed potentially inappropriate interactions (n = 38), most of which (n = 28) hotline responders flagged as inappropriate in post-chat log forms. We used codebook thematic analysis to explore how hotline responders identified and navigated these interactions. Our analysis generated three themes describing the processes through which responders seemed to identify potentially inappropriate chats - detecting implausibly graphic and abusive content, identifying patterns of presumably inauthentic chat topics, and interpreting ambiguous content. Hotline responders seemed to navigate ambiguous and less egregious boundary violations by gently redirecting conversations, and addressed clearer violations by setting firm, direct boundaries. Chatters responded to boundary setting by desisting and disconnecting or attempting to reengage responders. Findings highlight ambiguities and challenges web-based sexual assault hotline responders face and suggest a need for additional responder support, training, and debriefing options.


Child Abuse, Sexual , Rape , Humans , Child , Hotlines , Survivors , Communication , Internet
17.
J Affect Disord ; 351: 372-380, 2024 Apr 15.
Article En | MEDLINE | ID: mdl-38302063

BACKGROUND: The COVID-19 pandemic brought along many known risk factors for suicide. It is important to map out contributing and protective factors for suicide risk and examine possible changes in these associations during pandemics such as COVID-19. The current study aimed to examine how information on risk and protective factors obtained through a suicide prevention helpline is linked to the assessed suicide risk and the possible impact of the COVID-19 pandemic. METHODS: Data on 9474 calls registered by operators of the suicide prevention helpline of Flanders (i.e., part of Belgium) were analysed using network analysis. Using network analyses allowed for a data-driven examination of direct and indirect pathways through which risk and protective factors are associated to perceived suicide risk. The network before and during COVID-19 were compared to examine the possible impact of the pandemic. RESULTS: Our findings suggest that different vulnerability and protective factors contribute to perceived suicide risk. Experiencing a break-up, abuse, previous attempt(s), experienced difficulties with the healthcare system and availability of resources were directly and uniquely associated with perceived suicide risk before and during COVID-19. LIMITATIONS: Main limitations of this study are the possible bias of operator assessment accuracy, absence of several important psychological risk factors and the use of cross-sectional data. CONCLUSIONS: The current study provides insight in the effect of COVID-19 on suicidality and its risk and protective factors amongst suicide prevention helpline users, a population with high risk of suicide. Implications for suicide prevention helplines are discussed.


COVID-19 , Suicide , Humans , Suicide Prevention , Hotlines , Cross-Sectional Studies , Pandemics , COVID-19/prevention & control , Suicide/psychology
18.
Suicide Life Threat Behav ; 54(3): 416-424, 2024 Jun.
Article En | MEDLINE | ID: mdl-38345174

BACKGROUND: This study addresses the suicide risk predicting challenge by exploring the predictive ability of machine learning (ML) models integrated with theory-driven psychological risk factors in real-time crisis hotline chats. More importantly, we aimed to understand the specific theory-driven factors contributing to the ML prediction of suicide risk. METHOD: The dataset consisted of 17,654 crisis hotline chat sessions classified dichotomously as suicidal or not. We created a suicide risk factors-based lexicon (SRF), which encompasses language representations of key risk factors derived from the main suicide theories. The ML model (Suicide Risk-Bert; SR-BERT) was trained using natural language processing techniques incorporating the SRF lexicon. RESULTS: The results showed that SR-BERT outperformed the other models. Logistic regression analysis identified several theory-driven risk factors significantly associated with suicide risk, the prominent ones were hopelessness, history of suicide, self-harm, and thwarted belongingness. LIMITATIONS: The lexicon is limited in its ability to fully encompass all theoretical concepts related to suicide risk, nor to all the language expressions of each concept. The classification of chats was determined by trained but non-professionals in metal health. CONCLUSION: This study highlights the potential of how ML models combined with theory-driven knowledge can improve suicide risk prediction. Our study underscores the importance of hopelessness and thwarted belongingness in suicide risk and thus their role in suicide prevention and intervention.


Hotlines , Machine Learning , Suicide , Humans , Risk Factors , Female , Male , Suicide/psychology , Adult , Risk Assessment , Suicide Prevention , Natural Language Processing , Middle Aged
19.
Suicide Life Threat Behav ; 54(2): 361-369, 2024 Apr.
Article En | MEDLINE | ID: mdl-38265194

INTRODUCTION: Research has established that suicide-related media can impact suicide rates both positively and negatively, supporting efforts to engage the media in the service of suicide prevention. The goal of the current study is to evaluate the impact of a suicide prevention media campaign implemented April 7-14, 2019 in Oregon. METHODS: Several indices of help-seeking behavior and suicide risk were employed: suicide-related Google Health API searches, National Suicide Prevention Lifeline (Lifeline) (currently known as the 988 Suicide and Crisis Lifeline) call volume, and state suicide mortality data from April 7, 2016-May 6, 2019. Eight states with similar 2016-2018 average suicide rates were compared with Oregon. Bayesian structural time-series modeling in R was used to test intervention effects. RESULTS: During the 30 days following the start of the campaign, there was a significant increase in Lifeline calls from Oregon area codes (2488 observed vs. 2283 expected calls, p = 0.03). There were no significant changes in suicide mortality or suicide-related Google searches in Oregon. CONCLUSIONS: The campaign appeared to increase help-seeking behavior in the form of Lifeline calls, without any indication of an iatrogenic suicide contagion effect. However, the campaign's potential to reduce suicide mortality was unmet.


Suicide Prevention , Suicide , Humans , Hotlines , Oregon , Bayes Theorem , Time Factors
20.
Womens Health Issues ; 34(2): 180-185, 2024.
Article En | MEDLINE | ID: mdl-38199835

OBJECTIVE: Women represent 15% of veteran callers to the Veterans Crisis Line (VCL); there has been little research identifying the experiences and needs of women veterans who use the VCL. The objective of this study was to identify women veterans' experiences with and recommendations for strengthening VCL services for women. METHOD: We conducted qualitative interviews with 26 women veterans across the United States who had contacted the VCL in the preceding year. Interviews were conducted by telephone in 2022 and were audio recorded and transcribed. A team-based content analysis approach was used to identify participants' concerns around contacting the VCL and recommendations for strengthening the service. RESULTS: Interviews revealed women veterans' concerns with regard to contacting the VCL related to responder gender, appropriateness of VCL services for veterans not at imminent risk for suicide, and potential consequences of contacting the VCL. Key recommendations included letting veterans select the gender of the responder who takes their call, providing more information to potential callers about what to expect from VCL calls, and raising awareness about and maintaining options for caller anonymity. CONCLUSIONS: This study uniquely focused on women veterans' experiences and perspectives, in their own voices. Findings point to trauma-informed approaches supporting women veteran callers to the VCL and may also hold implications for other similar crisis hotline services.


Suicide , Veterans , Humans , Female , United States , United States Department of Veterans Affairs , Hotlines , Emotions
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