Social & Economic Factors Education Employment Income Family & Social Support Community Safety Search Policies & Programs

hints
Display All Policies & Programs

Crisis lines

Health Factors: Family & Social Support
Decision Makers: Local Government Healthcare Professionals & Advocates Nonprofit Leaders Public Health Professionals & Advocates
Evidence Rating: Some Evidence
Population Reach: 100% of WI's population
Impact on Disparities: No impact on disparities likely

Is this program or policy in use in your community? Tell us about it.

Description

Crisis lines provide free and confidential counseling via telephone-based conversation, web-based chat, or text message to individuals in crisis, often those with severe mental health concerns such as suicidal thoughts. Crisis line counselors provide emotional support to callers, assess suicide risk, and refer callers to resources including counseling, social services, and emergency services. Counselors can be professionals or volunteers (Gould 2012).

Expected Beneficial Outcomes

Improved mental health
Reduced suicide

Evidence of Effectiveness

There is some evidence that crisis lines reduce suicide risk and depressive symptoms among callers (Gould 2007, Ramchand 2017, Tyson 2016, Coveney 2012). Additional evidence is needed to confirm effects.

Assessments of crisis hotlines in the US and the UK indicate that callers experience reductions in suicidal thoughts, self-harm ideation, distress, and hopelessness at the end of their call (Gould 2007, Ramchand 2017, Tyson 2016, Coveney 2012). Volunteers and professionals both appear to effectively conduct suicidal risk assessment and show empathy to callers; however, counselors with more experience appear to provide greater benefit than counselors with less experience (Mishara 2016). Suicidal callers who speak to counselors with training in suicide intervention show greater reductions in suicide risk and depression over the course of a call than callers who speak to counselors without such training (Gould 2013).

A survey of the National Suicide Prevention Lifeline (NSPL) suggests that 50% of those who call a suicide hotline and are referred to mental health services access those services (Gould 2012). Researchers suggest counselor training, integration with health care systems, and creation of protocols for call monitoring and suicide risk screening are needed to increase crisis line effectiveness (RAND-Acosta 2017).  

An evaluation of the NSPL’s initiative that provides follow-up calls to high-risk callers and individuals discharged from inpatient or emergency department settings suggests that follow-up calls may reduce the risk of future suicide attempts (Gould 2017, NSPL 2014).

Implementation

United States

The National Suicide Prevention Lifeline (NSPL), funded by the Substance Abuse and Mental Health Services Administration (SAMHSA), provides telephone-based hotline and online crisis chat services to anyone in suicidal crisis or emotional distress in 164 local crisis centers in 49 states (NSPL). SAMHSA’s Disaster Distress Helpline (DDH) offers trauma crisis counseling and support for those who experience mass violence or natural disasters via call or text (DDH). Both NSPL and DDH have a Spanish line and provide an interpretation service for more than 150 languages. The Veterans Crisis Line and Crisis Text Line are two other examples of hotlines that serve individuals across the country (VCL, Crisis Text Line).

Examples of local initiatives include Nevada’s Crisis Call Center, which provides telephone-based hotline and text message crisis intervention services 24 hours a day, and California’s Suicide Prevention Initiative, which offers telephone-based hotlines as well as web and text-based chat services (Crisis Call Center, RAND-Acosta 2017). 

Wisconsin

Journey Mental Health Center provides 24/7 suicide prevention hotlines to Dane County residents (Journey). The Crisis Center of Family Service provides crisis hotlines to Brown, Sheboygan, and 13 Northern and Northeastern counties (CCFS).

Citations - Description

Gould 2012* - Gould MS, Munfakh JLH, Kleinman M, Lake AM. National suicide prevention lifeline: Enhancing mental health care for suicidal individuals and other people in crisis. Suicide and Life-Threatening Behavior. 2012;42(1): 22–35. Accessed on January 2, 2018

Citations - Evidence

Coveney 2012 - Coveney CM, Pollock K, Armstrong S, Moore J. Callers’ experiences of contacting a national suicide prevention helpline: Report of an online survey. Crisis. 2012;33(6):313-324. Accessed on January 2, 2018
Gould 2007* - Gould MS, Kalafat J, HarrisMunfakh J Lou, Kleinman M. An evaluation of crisis hotline outcomes. Part 2: Suicidal callers. Suicide and Life-Threatening Behavior. 2007;37(3):338-352. Accessed on January 2, 2018
Gould 2012* - Gould MS, Munfakh JLH, Kleinman M, Lake AM. National suicide prevention lifeline: Enhancing mental health care for suicidal individuals and other people in crisis. Suicide and Life-Threatening Behavior. 2012;42(1): 22–35. Accessed on January 2, 2018
Gould 2013 - Gould MS, Cross W, Pisani AR, Munfakh J Lou, Kleinman M. Impact of Applied Suicide Intervention Skills Training (ASIST) on National Suicide Prevention Lifeline counselor: Interventions and suicidal caller outcomes. Suicide and Life-Threatening Behavior. 2013;43(6). Accessed on January 2, 2018
Gould 2017* - Gould MS, Lake AM, Galfalvy H, et al. Follow-up with callers to the National Suicide Prevention Lifeline: Evaluation of callers’ perceptions of care. Suicide and Life-Threatening Behavior. 2017. Accessed on January 2, 2018
Mishara 2016 - Mishara BL, Daigle M, Bardon C, et al. Comparison of the effects of telephone suicide prevention help by volunteers and professional paid staff: Results from studies in the USA and Quebec, Canada. Suicide and Life-Threatening Behavior. 2016;46(5):577-587. Accessed on January 2, 2018
NSPL 2014 - National Suicide Prevention Lifeline (NSPL). Crisis Center Guidance: Follow-up with callers and those discharged from emergency department and inpatient settings. December 2014. Accessed on January 2, 2018
Ramchand 2017* - Ramchand R, Jaycox L, Ebener P, et al. Characteristics and proximal outcomes of calls made to suicide crisis hotlines in California: Variability across centers. Crisis. 2017;38(1):26-35. Accessed on January 2, 2018
RAND-Acosta 2017 - Acosta JD, Whitley MD, May LW, Dubowitz T, Williams M, Chandra A. Suicide prevention hotlines in California: Diversity in services, structure, and organization and the potential challenges ahead. RAND Health Quarterly. 2017;6(3). Accessed on January 2, 2018
Tyson 2016* - Tyson P, Law C, Reed S, et al. Preventing suicide and self-harm: Evaluating the efficacy of a helpline from a service user and helpline worker perspective. Crisis. 2016;37(5):353-360. Accessed on January 2, 2018

Citations - Implementation

CCFS - The Crisis Center of Family Services (CCFS). Crisis Center. Accessed on January 2, 2018
Crisis Call Center - Crisis Call Center. 24-hour crisis hotline. Accessed on January 3, 2018
Crisis Text Line - Crisis Text Line. Support for teens, 24/7. Accessed on January 3, 2018
DDH - Substance Abuse and Mental Health Services Administration (SAMHSA). Disaster Distress Helpline (DDH). Accessed on January 2, 2018
Journey - Journey Mental Health Center (Journey). 24/7 Suicide prevention hotline. Accessed on January 2, 2018
NSPL - National Suicide Prevention Lifeline (NSPL). Together, we can change lives. Accessed on January 2, 2018
RAND-Acosta 2017 - Acosta JD, Whitley MD, May LW, Dubowitz T, Williams M, Chandra A. Suicide prevention hotlines in California: Diversity in services, structure, and organization and the potential challenges ahead. RAND Health Quarterly. 2017;6(3). Accessed on January 2, 2018
VCL - Veterans Crisis Line (VCL). Confidential help for veterans and their families. Accessed on January 2, 2018

Page Last Updated

December 18, 2017

* Journal subscription may be required for access.