A categorization system of crisis center telephone use: Patterns of interaction

Abstract

Current investigations of telephone crisis intervention effectiveness have neglected the evaluation of broad patterns of interaction between the crisis center and the larger community. This study describes the development and implementation of a Caller Frequency Category System (CAFS) which is based upon the frequency and type of contacts between callers and the center. Data collected for 100 clients from a crisis intervention center suggest that the system can be applied reliably and does differentiate among clients by the type of interaction they have with the center. Two unexpected findings were that (a) longer‐term callers tended to be older men or teenage girls, and (b) the greatest proportion of total telephone use involved calls initiated by the center itself to people other than crisis clients. Revisions to the CAFS are proposed which will clarify the role which a crisis center serves in the community‐wide resolution of personal crises.

Systematic review of research into frequent callers to crisis helplines

“…Of the 19 empirical studies, three were intervention studies [19][20][21] (summarised in Table 1), five were surveys of crisis helpline callers 16,17,[22][23][24][25] (summarised in Table 2), and 11 were call record audits 13,18,[26][27][28][29][30][31][32][33][34][35] (summarised in Table 3). Studies varied in their data collection methods and definition of frequent callers.…”

“…Nine studies compared frequent callers with other callers. [22][23][24][27][28][29][30][31][32] The data reported for frequent callers varied from only reporting the number of calls made by frequent callers 13,33 to a more detailed presentation of caller demographics, suicide history and prior treatment for frequent callers. 23,26,27,30,32 The intervention studies all took place in North America; two in Canada 20,21 and one in the USA.…”

“…13,18,19,27,28,30,32,34,35 Frequent callers were described as time-wasters who took up a significant amount of time for crisis helplines, limiting the amount of time available for other callers. 13,17,18,29,33,34 They were seen to contact crisis helplines continuously with recurring problems, without appearing to make discernable positive changes over time. 18,27,28,35 In responding to frequent callers, crisis helpline workers were described as developing feelings of frustration and resentment 27 and experiencing an overall emotional drain.…”

“…More than half of the audit studies presented some comparison of frequent callers with other callers. [27][28][29][30][31][32] Of all the studies, nine defined frequent callers as callers who made more than one call to a crisis helpline. 13,[16][17][18]22,24,25,28,31,33,34 Other studies defined frequent callers as callers who made a specific number of calls over a period of time.…”

“…Their definition separated callers into six types of calling patterns based on the number of calls made, the time period over which the calls occurred and whether each call was related to the same problem or multiple problems. 29 There were four studies that did not provide a specific definition of frequent callers but referred to Ten of the studies reported on a representative sample of all callers to crisis helplines, 13,[22][23][24][25][28][29][30][31]33 see Table 4. Together these studies reported on over 520,000 calls to ten separate crisis helplines.…”