Exploring the use of telephone helpline pertaining to older adult suicide prevention: A Hong Kong experience

Chan, Ckk; Wong, Ho Kit; Yip, Paul S. F.

doi:10.1016/j.jad.2018.04.093

Cited by 29 publications

(35 citation statements)

References 26 publications

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“…Outcomes were assessed via sociodemographic data from the service's computerized system, as well as suicide mortality status from the Coroner's Court matched against crisis line users using the unique Hong Kong Identity Card. In this study, helpline users accounted for 14.4% of known suicides in Hong Kong during the 4 year follow-up period, and the suicide rate among helpline users was far higher than the general Hong Kong older adult population (Males: 86.3 vs. 32.6 per 100,000; Females: 42.8 vs. 16.7 per 100,000; both Incident Rate Ratio [IRR] = 2.6) (38). The majority (60%) of the helpline suicides occurred within 5 years of the service.…”

Section: Distal Evidence Of Effectivenessmentioning

confidence: 78%

“…Only two studies were RCTs [Gould et al (29) moderate risk of bias and Mishara et al (15) high risk of bias; Oxford quality ratings of 1]. Additionally, there were four cohort studies (11,14,31,38), and the remaining studies were a mix of observational and quasi-experimental design, most of which were cross-sectional or single group before-after designs (high risk of bias; Oxford quality ratings of 4).…”

Section: Methodsmentioning

confidence: 99%

“…The only study across the entire body of evidence rated as low risk of bias was by Chan et al (38) who conducted a retrospective cohort study analyzing death by suicide among elderly users and non-users of a telephone helpline between January 2012 and December 2015 (Oxford quality rating of 3). Outcomes were assessed via sociodemographic data from the service's computerized system, as well as suicide mortality status from the Coroner's Court matched against crisis line users using the unique Hong Kong Identity Card.…”

Section: Distal Evidence Of Effectivenessmentioning

confidence: 99%

“…Significant predictors of suicide among the helpline users included older age, male, living alone, and selfreported mental illness. Protective factors were also identified including skeletal system diseases and brain and nervous system diseases (38).…”

Section: Distal Evidence Of Effectivenessmentioning

confidence: 99%

“…Many studies evaluating distal effects after the crisis service suffered from substantial dropout, thereby increasing the risk of bias interpreting findings. However, some distal studies utilizing administrative data were able to retain complete follow-up data [e.g., suicide mortality data (38); medical records (31)], but they did not benefit from participant self-report to contextualize findings. Cautious interpretation of Chan et al findings is warranted.…”

Section: Summary Of Main Findingsmentioning

confidence: 99%

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The Effectiveness of Crisis Line Services: A Systematic Review

Hoffberg

Stearns‐Yoder

Brenner

2020

Front. Public Health

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Background: Crisis lines are a standard component of a public health approach to suicide prevention. Clinical aims include reducing individuals' crisis states, psychological distress, and risk of suicide. Efforts may also include enhancing access and facilitating connections to behavioral health care. This review examines models of crisis line services for demonstrated effectiveness.Methods: Literature searches of Medline, EMBASE, PsycINFO, Web of Science, CINAHL, Cochrane Library, and Google Scholar were conducted from January 1, 1990, to May 7, 2018. Experts were contacted, and references were mined for additional studies. Eligible studies provided health-or utilization-related effectiveness outcome(s). Results were graded according to the Oxford Centre for Evidence-Based Medicine and evaluated for risk of bias using the Effective Public Health Practice Project quality assessment tool for quantitative studies.Results: Thirty-three studies yielded effectiveness outcomes. In most cases findings regarding crisis calls vs. other modalities were presented. Evaluation approaches included user-and helper-reported data, silent monitoring, and analyses of administrative records. About half of studies reported immediate proximal outcomes (during the crisis service), and the remaining reported distal outcomes (up to four years post-contact). Most studies were rated at Oxford level four evidence and 80% were assessed at high risk of bias.Conclusions: High quality evidence demonstrating crisis line effectiveness is lacking. Moreover, most approaches to demonstrating impact only measured proximal outcomes. Research should focus on innovative strategies to assess proximal and distal outcomes, with a specific focus on behavioral health treatment engagement and future selfdirected violence.

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Section: Distal Evidence Of Effectivenessmentioning

confidence: 78%

Section: Methodsmentioning

confidence: 99%

Section: Distal Evidence Of Effectivenessmentioning

confidence: 99%

Section: Distal Evidence Of Effectivenessmentioning

confidence: 99%

Section: Summary Of Main Findingsmentioning

confidence: 99%

See 3 more Smart Citations

The Effectiveness of Crisis Line Services: A Systematic Review

Hoffberg

Stearns‐Yoder

Brenner

2020

Front. Public Health

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Preliminary Research Priorities for Factors Influencing Individual Outcomes for Users of the US National Suicide Prevention Lifeline

et al. 2022

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ImportanceSince July 2022, calling or texting 988 in the US connects callers to the National Suicide Prevention Lifeline following a law passed by Congress to simplify access to the mental health crisis line in the US. Compared with other areas of suicide research, knowledge regarding how and to what extent crisis lines prevent suicide crises and suicide deaths remains in its infancy. The state of this research is briefly reviewed and critical directions for future research on factors that may influence effectiveness are suggested.ObservationsThe new 988 line stands to improve access to critical lifesaving measures in the moments of a suicidal crisis. However, urgent questions remain regarding how to improve effectiveness of crisis lines. Available evidence suggests that crisis lines are often effective at reducing immediate distress and reducing suicide risk, but substantial gaps remain in understanding how crisis lines work.Conclusions and RelevanceFuture research is recommended with suicide prevention crisis lines, such as 988, to identify and test factors influencing effectiveness, including conversation, consumer, dyadic, and structural-level characteristics. Existing research, while minimal, suggests that prescription of 988 to prevent suicide death is clinically warranted, but much more work is needed to optimize care.

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The geography of suicide in older adults in Hong Kong: An ecological study

Guo

Chau

Chang

et al. 2019

Int J Geriat Psychiatry

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Objectives:The geography of suicide has been widely explored among the general population. However, little is known of the geographic variations in suicides among the older adults and their spatial correlates. This study aims to explore the spatial variations in the elderly suicide rates and their correlates in Hong Kong.Methods: Bayesian hierarchical models have been used to estimate smoothed standardized mortality ratios (2006)(2007)(2008)(2009)(2010)(2011)(2012)(2013)(2014)(2015) on suicide in people aged 65 years or older in each geographic unit in Hong Kong. Their associations with the Social Vulnerability Index and the accessibility of eight types of services (ie, recreational services, rehabilitation services, food services, daily necessity services, community services, and transportation services) were further analyzed. Results:The results suggested that compared with the simple "inner-city high suicide rate and suburban low" pattern in the Western studies and the "central low suicide rate and peripheral high" pattern in the Asian studies, the spatial variations of elderly suicides in Hong Kong exhibit a much more complicated pattern. In Hong Kong, higher elderly suicide clusters were found in both the lower-density areas located in the New Territories and in some inner-city areas. The spatial variations of suicide in the older adults cannot be explained by the Social Vulnerability Index.Instead, service provision such as recreational services, daily necessity resources, and community centers played a more significant role in affecting suicides in the older adults.Conclusions: Strengthening public services, providing more public spaces and activities, and making good use of the community resources might be key and efficient strategies in elderly suicide prevention in Hong Kong.

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Exploring the use of telephone helpline pertaining to older adult suicide prevention: A Hong Kong experience

Cited by 29 publications

References 26 publications

The Effectiveness of Crisis Line Services: A Systematic Review

The Effectiveness of Crisis Line Services: A Systematic Review

Preliminary Research Priorities for Factors Influencing Individual Outcomes for Users of the US National Suicide Prevention Lifeline

The geography of suicide in older adults in Hong Kong: An ecological study

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